Behaviourally-based Treatments 333A note on rewards
Every child is different. Help parents decide what is motivating, and
always check with the child or adolescent and ask for their suggestions.
Rewards may be intangible, such as time with parents, etc. Tangible
rewards do not have to be expensive; they can be sitting in a parent’s
place at dinner, wearing special clothes, extra TV etc. There are many
other alternatives to money and presents.
They need to be given as soon as possible after the behaviour has
occurred (not a bike for Christmas).
Check what unintended rewards a child or adolescent is getting for
undesired behaviour (for example, peer approval). Be aware of when
desired behaviour is occurring and monitor if it is being rewarded (is the
child actually being ignored when she is playing quietly?).
Check that rewards are being consistently applied.
Switch rewards every few days. Many parents will say ‘I tried that, it
worked for a few days then didn’t work.’ But how many adults would
find the same chocolates just as exciting after getting them for ten days
in a row?
When stuck for a reward, consider the Premack principle, which is to
use as a reward what a person chooses to spend most of their free time
doing. This could be playing on the computer, lying in bed, or whatever
is acceptable. For an autistic child, it could include twirling their hands
in front of their eyes.
With older children and adolescents (and parents!), cultivate self-
rewarding. Like rewards given by others, these may be intangible (for
example, praising oneself for good behaviour), or tangible (for example,
a treat).
Implementation
To learn a new behaviour, a individual must knowwhatto do,howto do it
andwhento do it. If parents are to change their child’s behaviour, they, too,
must be equally clear. For the change to occur will require competence, or
being able to do it, andperformancerepeatedly, which requires the will to
do it.
The intervention will only rarely consist of the mechanical imple-
mentation of standardised techniques for altering the frequency of be-
haviours. Rather, most contemporary behavioural therapy draws upon
these behavioural principles but adapts them into a wider context. General
measures employed include:
Planning ahead,for example, reducing school pressures on a phobic girl,
avoiding taking a hyperactive boy to the supermarket, taking fight-
prone siblings outto the park rather than keeping them indoors.
Negotiating with the child or adolescent. Many parents make what seem
to them to be reasonable demands, only to find them disobeyed,
which leads to a major confrontation. Getting parents to negotiate basic
situations (for example, bedtime routines, or what the family does on