Behavioral Plans: Worth It Or Not?

“I’ve tried everything. Nothing works. Sticker charts don’t work. Besides, I don’t think I should have to bribe my child. I don’t want to reward him for something that he should be doing already.”

I have never met anyone who actually has “tried everything;” however, I respect that for parents of children with challenging behaviors, it sure does feel that way! My job as a child and adolescent psychiatrist is first to listen to parents describe their experiences, ask questions to turn over every stone, then try to find out what’s been missed. Or perhaps there is an old behavior program that needs to be revisited and “tweaked” to make necessary improvements.

Repeated, failed attempts to change problem behaviors can shake a parent’s confidence in the effectiveness of behavioral plans altogether. Keep in mind that if you don’t buy in to a behavior plan, your child won’t either. In an ideal world, a parent would not be rewarding their child for brushing their teeth, feeding the dog, or emptying the dishwasher. But if these things aren’t getting done, you will have to start somewhere.

Probably what you are doing now is not working well, so why not try a different approach? I encourage you to reconsider the potential power of a well-constructed, consistently-delivered behavior plan in your home. It is a “win-win” situation. Once the desired behaviors become more automatic and innately gratifying for your child, you won’t have to reward “every little thing.” Remember that adults are driven by motivators, too. Why do we get up every morning and go to work?

Here are some tips for a successful behavior plan:

Stay developmentally up-to-date. A sticker chart might stop working because it is no longer developmentally appropriate for your child. In fact, I would not expect any behavior program to work forever. Why? Because children grow and change, thank goodness! So make sure your plan to address difficult behaviors grows along with your child.

It is crucial to have “buy-in” from your child. Have a conversation about what she would like to earn. Think about two or three acceptable rewards to offer first, rather than leaving choices open-ended. The idea is to give your child opportunities to make choices that are developmentally appropriate.

Keep expectations realistic and simple. A common mistake parents and schools make is to have expectations so high that the child can never meet them. It’s OK to start by setting the bar low, even if it feels ridiculous to you. Let your child have a taste of success so she will want more. Instead of rewarding your child after a long and difficult week of completing all homework, for example, you might have to pare it down and reward for just one evening of completed homework.

Remember that behavior has a function: In general, children engage in behaviors in order to:

obtain something tangible (such as an iPad); obtain something intangible (attention or physical sensation); or avoid or escape something (such as chores or homework). If we understand why a child is engaging in a particular behavior, we are in a better position to change the environment, look out for triggers, or control the outcomes in order to shape the behavior.

Stay consistent. One of the most frequent problems I see when analyzing the history of home behavior plans is that they are applied inconsistently. I have compassion for these situations; families can be busy, scattered, and overwhelmed, so the path of least resistance is to “let go” rather than follow through with the plan.  But think for a moment about how we learn…whether it’s multiplication tables, a gymnastic routine, a new game. We learn through repetition! The same goes for shaping behaviors.

Don’t give up on an incentive plan. It can be a constant challenge to find what works as a motivator. Trinkets and small toys from the dollar store, or an occasional new video game can be helpful to reward positive behaviors, but after a while the cost of things adds up. Consider having your child earn: Tokens to add up over time to cash in for a larger item; Time for preferred activities (TV, electronics); Preferred adult or peer time (playdate or lunch with an adult role model); Family fun time (games, movies, trip to the park) and praise…which is always FREE! And feels awesome.

Know when to ask for help. If your family is struggling with behaviors that threaten anyone’s safety, you will want to seek professional help right away. Discuss the options with your pediatrician. You might need to locate a qualified mental health provider, obtain in-home applied behavioral analysis, or recruit your local family preservation services. For emergency situations requiring rapid response, you will want to call 911 or your local mobile crisis team, or proceed to your local emergency room for emergency psychiatric evaluation.

Dr. Ayanna Cooke-Chen is a board-certified adult, child and adolescent psychiatrist. She works in private practice in Hunt Valley.

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