Anyone used the Nurtured Heart Approach?

[mellifera33]

I'm not sure that this is strictly a learning challenge thing, but here goes. My almost 5 y/o ds and I are stuck in a negative spiral. He gets fixated on something that he's not supposed to do or have, and it is nearly impossible to stop the sequence. He acts like he can't even hear me, and won't answer me if I ask him if he understands what I am saying. He also doesn't seem to "get" consequences. I can't tell if it is willful, or if he is getting "stuck." This is happening more and more often, and is affecting where I am willing to go with the kids. If I can't take the double stroller to keep him contained if he melts down, we're not going there. 

 

I learned about the Nurtured Heart Approach after watching Dr. Newmark's presentation about ADHD. I ordered the book "Transforming the Difficult Child" intending to use the strategies for my 7 y/o who has moderate/severe ADHD, but my 4 y/o has much more challenging behaviors than his brother! Has anyone used this program to break a negative pattern of interaction with a child?

[sbgrace]

Yes. The approach, and parenting in ways similar to that, are all that seems to work with my special needs son. That was especially true when he was younger, and is still mostly true now. I actually think it's a good way to parent any child. But I so get the negative cycle you wrote about! I found it sort of hard to implement long term. I am not sure why. But Glenn Latham parenting book I read feels similar and felt easier to manage somehow. Maybe it was me/timing.

 

But I'm a fan of the approach.

[PeterPan]

I either have this or read it or both.  It must not have made a radical difference in my life, oops.  You've had evals?  My ds like that first got labeled ADHD with social delay and then another switched it over to ASD with ADHD.  He's still a challenge, sigh.  Trying to think about what works.  I'm reading The Explosive Child right now, and it's the first thing I've read that actually fits him.  Sure get the other book, but I would definitely add EC to your list.  

 

And yes, we have a horrific time taking ds places sometimes.  Little self-regulation, extreme impulsivity, gets stuck, NOT going to stand there quietly like other kids.  Do you have a smartphone with apps?  If you don't, it's time to get one.  Seriously, just compromise every principle you have and get one and put idiotic apps on it like Goat Simulator or the hawk feeding app.  My ds will spend HOURS playing those.  If I need to get through a store, that's what he's going to be doing.  He also has a kindle and noise blocking earbuds.  We survived the convention last year, but we put noise blocking headphones on him with the earbuds underneath and gave him the apps the entire time.  He just sat there playing the whole day in the corner of a booth.  To go around with him in the stroller?  Horrific.  BAD memories of doing that, lol.  There was this year, I can laugh now, but he's melting down and I've got a stroller and bags and a cart and food trays and the aisles were tight and...  Mercifully someone rescued me!  

 

And I'll just say what you may already be thinking, that there are very few people who can babysit him.  A friend of mine offered recently, when my FIL died and we had a ton going on (and I was in a daze from several days of no sleep), and I said you don't get it. She handled it.  But I always structure those things very carefully.  

 

Anyways, don't assume it's you.  Like I know you know that, and it is sort of in the sense that techniques can help.  I'm just saying it's not your fault and that when you get evals it will probably start to sort out.  You might look into OT.  Find a pretext.  There were things I just thought I had to live with, and the OT from the ps came to do his eval and she's like NO WAY would they live with that.  They'd put him in OT and have some serious self-regulation goals.  They'd have picture schedules and sensory breaks and all sorts of things the IEP would specify (his now does!) to help.  Because I think sometimes we just go oh it's ADHD, I homeschool, I have to live with it.  But the OT can help and the problem-solving techniques can help and using techniques for kids who get stuck can help. I HATE when people change things on my kid without telling me.  His swim teachers will do that.  They'll just say oh x is gonna change, and then he has meltdowns.  I'm like REALLY you can't believe me when I said he has issues?  REALLY you can't talk with me first and let me explain it in a way that works?  But no, people keep telling me he looks so NORMAL, like of course all kids with SN have horns and green-glowing eyes or something???

 

The Explosive Child will help you get out of the consequences as discipline trap.  I'm all for disciplinary consequences when the issue is motivation.  But a lot of times, at least with my kid and the running away and in his world and hiding under the table and intractability, it's really more of a self-advocacy issue.  He's not able to self-advocate and say what he feels, so running and physical responses (hitting, punching, meltdowns) are his communication.  If it can be let go, let it go.  Like don't chase him anymore.  As long as the thing isn't dangerous, just don't do it.  I really have to stop myself, because it's this emotional control thing.  His emotion feeds on my emotion, so I have to stop.  Anything I say will come at me later, repeated by him.

 

We had a LOT of that running stuff at that age.  We have it less now.  (He'll be 7 soon.)  Maybe that will encourage you.  No, he doesn't understand cause/effect.  He also has sensory issues, so he doesn't FEEL it.  And I know he doesn't understand cause/effect in an age-appropriate way, because something as simple as if you put something wet on the floor what will happen to the floor *doesn't register*.  So it's not you.  We decided to discipline less, hug more, and get through it.  Like we ignored a LOT that we would have disciplined another child for.  And we hugged for a lot that with another dc you would have handled differently.  At 6 1/2 we began some simple, simple heart work like "I'm sorry I hit you," requiring eye contact during the talking (very hard!) and a hug afterward.  The hug will be all messed up too, either too hard or too soft, and that too is his physical communication.  But again, I let go a LOT.  I might have 3 components, but maybe only 1 is my goal and the other two are formative, kwim?  And sometimes he shouts that he's sorry, and then we go to "I'm sorry I yelled at you" with eye contact and a hug.  And sometimes this goes on a while.  But that for us was 6 1/2, not 4, kwim?  And 4, he was pretty much a hellion.  Like my dd thinks we're horrific parents.  Oh well.

[PeterPan]

Not any of what you asked, but I explicitly teach him and train him in the signs of affection I want him to show.  I want him to notice me when he comes home and give me a hug, so I've trained him in this.  I want him to be able to respond with affection, even if he doesn't initiate, so I will say I love you and blow him kisses every time he goes out to play.  I sort of over do it, but I decided that it would cover over some of the problem behavior, that we can get that problem behavior better with time, sigh, but the love, that's long-term, being able to respond with love to another human he lives with, that's long-term.  

 

The ONLY thing I get really, really, really edgy over and try to enforce is coming when I call you.  But I don't mean a retraction call when you're stuck in something or running away.  With him it's more an answer when I call you.  I REQUIRE an answer when I call you.  And that takes some training to get.  It's just a danger point with an unpredictable child.  It's something we practice.  Start young and practice during the day.  We actually used to have practices, just like you'd train a dog.  I would call him and then give him a reward for coming.  (Yes, I admit it, lol.)  That's what we did at age 4.  To him it was funny.  If I call him now and he's not stuck, just in sort of yellow or green zone and ok, he'll come but maybe take his own sweet time.  But what I always get and what I require is an ANSWER.  I decided the answer was my minimum for safety, since his actual butt up and walk to mom is slow.  An answer will work for me.

 

So I think it's ok to pick something like that and practice it.  Just make sure it's the simplest form and something in reach and that it's actually that vital to you.  In our house and with our yard it is, because I can't tell where you are otherwise.  We lost him, sigh, when he was little.  So that was something that was very important to me to train and require.  He's not necessarily going to come, but he'll verbally respond.  If he doesn't, I'll physically go find him and communicate to him that he forgot to respond, that it's very important that he reply, that I can't tell if he's safe, and that he needs to come get a hug.  Oh no, we haven't done that a bunch, lol.

[PeterPan]

Before you go places, do you discuss the expected behavior and what tools you have to help him and at what time/stage those tools will be delivered?  When he was little (like till 4-5), I could go to ONE store with him, and even that was horrific.  Now I can go to several stores if they're brief, directed trips, but we pre-talk about expected behavior.  "Expected" is the golden word for this.  It's not perjorative or implying he's bad.  It's just this is what people expect in this situation, this is what I expect of you. My ds responds well to this word.

 

So if I need to go to a couple stores, I might tell him in the first store we will only be 3 minutes and that we are saving the iphone for the 2nd store where we will be longer.  That way he knows the plan upfront and doesn't have to ask or whine.  And then carry a snack in your purse and say we're whipping that out for the 3rd store.  Or have one snack for each store. (If I'm doing this, I tell him so upfront, before we go in.)  Or have 2 snacks for a long store. I go to Subway at Walmart and buy him a whole stinking sandwich with a kid meal and toys to keep him busy.  But lots of pre-talking, telling him the plan, the supports, etc.  

 

I no longer expect good behavior.  I expect whatever behavior I provide supports to make happen.  

 

I think someday his behavior will be exclusively about volition, and there are times now when I stop him and I tell him that was SIN, because it's so glaringly obvious it was about volition.  But at that age his behavior was largely reactive (reacting to his body, to a situation) and relative to supports and structure.  Now, at almost 7, I'm just starting to see things a percentage of the time that to me are really volitional, that to me reflect some making a choice, a heart choice, not just this reactivity.  I'm saying the interactions you want or had with your others may come, just later.  

[kbutton]

I have not heard of this approach, but I remember what it was like when my son was like this. It's a big struggle. I didn't have a diagnosis at that point (it's 2e--spectrum, ADHD, and SPD). I think OhE's advice is good. Working on the relationship helps a lot. Little "silly" drills practicing what to expect is good.

 

I can't remember where you are in the diagnosis process. I strongly suggest finding out if you can get behavioral supports (from whatever kind of therapist will attempt it). If you can find a behaviorist in particular, that would be fantastic. With regard to showing more affection and modeling that behavior, I found that my son really, really responded to a bedtime phrase we started in the late toddler years, and it made a big difference in his behavior. I would say, "Goodnight. I love, and I'M GLAD YOU ARE MY BOY." It was huge for him. It changed his perception of things considerably. I was saying it, in part, to convince myself it was true--things were so difficult, and we had some bad experiences seeking help from "friends" and from professionals. Lo and behold, one night I heard the corollary right back..."I love, and I'm glad you're my mommy." It was quite some time before it happened, but it did. It still means a lot to say it every night.

 

I will also say that there are times we still have to forget about who is behaving badly and just have a snuggle/singing session in my lap. Rock, hold, sing softly (or whatever your son tolerates and likes). We do silly stuff that started very young, like putting my son's name into familiar jingles that we'd changed to make them about him. Little lovey things, but sometimes silly things. He loved it, and I find that he still loves it. It means a great deal to him.

[texasmama]

Have you tried to ask him what is happening during these times when he is fixated at a time when things are good, he is calm, and no fixation is going on?  It may provide some insight.  He may say that he doesn't hear you and is not aware of you.  You may need to ask a lot of different questions in order to get a meaningful answer.  Avoid the question "why" because there is never any answer with kids this age.  What are you thinking?  What are you feeling?  Can you hear me?  Is there something I can do to help you get your mind off of the thing?  What happens inside your head when you cannot get something you want?  Do you tell yourself anything?  Do you think you will never get to have or experience that thing?  You get the idea.  It may take several tries of approaching this topic in different ways to get anything useful at all.  You might never get anything useful.  But it shows that you want to understand, and sometimes kids will provide information that changes your approach.

 

I have a kid with ASD, and when he melted down as a little guy (lack of ability to emotionally regulate himself), it helped a lot if I just put my hand on his arm or shoulder.  It grounded him somehow.  Also, exercise and moving the body in any way a lot every day helps many kids to get their brains in a better place.

 

You've gotten great advice - those are just a couple of things that came to mind.

[Tokyomarie]

I found the Nurtured Heart Approach to be a valuable tool in my toolbox- along with other tools- for encouraging positive behavior without using harsh, punitive techniques. I've never been one to love punishment as a main tool for discipline, but I found myself getting frustrated with a particular child who wasn't compliant with typical calm approaches. Through NHA, I learned how to avoid energizing negative behavior, how to encourage the positive- and even how to create opportunities for the child to demonstrate positive behavior even when the child was determined to avoid showing positive behavior. And I learned to be clear about my boundaries without using emotion to enforce them.

 

I also like Ross Greene's work- OhE referred to The Explosive Child. For a team that writes from a specifically Christian view (should that be of interest), I like Scott Turansky & Joanne Miller of The National Center for Biblical Parenting. They favor a heart-based approach to parenting rather than a behavior modification approach.

 

Each of these authors has had an impact on my thinking about behavior. It's also helpful to think about physiological reasons for difficult behaviors, such as sensory processing disorder, allergies and sensitivities, and rhythms of life (schedules for sleep, nutrition, exercise, etc) to figure out how challenges in these areas might be contributing to your children's behavior.

[PeterPan]

I pulled my copy last night and went through it quickly.  It's really focused on ADHD and the reversing the negative dynamics, the way Marie is describing.  It's fine for that, but it really only applies to my dd.  As I read I kept having this wow, you really don't get it, as far as applying it to my ds.  I think someone who thinks they're *only* dealing with ADHD but has more going on could get a whole lot of guilt-tripping from it.  

 

Mellifera, if you don't have a copy and can't it through your library, buzz me and you can have mine. (just pm me)  I found the 123 Magic book to be a much more useful discussion of natural consequences for dd (ADHD only, no rigidity, fixations, meltdowns, getting stuck, etc.).  Also this is good for straight ADHD.  Superparenting for ADD: An Innovative Approach to Raising Your Distracted Child  I don't find a consequences dynamic (something NH endorses) useful AT ALL with ds (ADHD with social delays, ASD, take your pick) and in fact I think someone could go down a really wrong track if they guilt-tripped themselves into thinking they would provide positive support and reasonable consequences (aka good parenting) and everything would just go away, that it's their fault their dc does things, etc. "Consequences" backfire with ds because he has no sense of cause/effect and thus no way to control it or learn from it or predict what the outcome of his choices will be. I know that's not what the book SAYS (feel guilty, it's happening because you're just not praising enough and not giving enough consequences), but I'm just saying what I FELT and kept screaming as I read it.  It's not MY FAULT ds gets stuck or has meltdowns.  It's not MY FAULT he doesn't understand things.  

 

There are some things that need more techniques beyond good parenting.  The market for the book is ADHD with a negative dynamic, not so much meltdowns and fixations.  I would be looking for more techniques like the Greene book.  

 

Marie, I was just skimming a Geisler/Turansky book and workbook last night that I picked up at the convention.  I didn't know Turansky had other useful things.  Are there any that are *specific* to ASD, rigidity, and extra challenging situations or is it mostly in the ADHD realm?  I've only read one book so far from a "christian" perspective on ASD, and it was SO skewed and incomplete it was frustrating.  Of course, you know me, latching onto one thing.  As soon as that author endorsed hitting the ASD child on the face when spanking didn't connect, we were done.   ;)  So I'd be very interested if there are some that explore the more challenging situations from a biblical or heart-oriented perspective.  

 

Ha, I just went back and reread Mellifera's op, hehe.  She already has it ordered.  Enjoy, read it, pull many things for your arsenal.  Then go get Greene.  The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, Chronically Inflexible...  Btw, part of the reason I struggled with dd over the years was I didn't realize how low her processing speed was.  I didn't even realize such a thing could happen.  So sometimes you have to pair techniques with accurate information about your dc, kwim?  

[Lecka]

I have had a good experience with straight-up autism-specific approaches with my son with autism.  Other things have not totally worked for him.  

 

It is not necessarily what I would do with my other two kids.  Not that it would be bad for them -- but it would not be the best choice.  

 

The thing about autism-specific ----- they can be a big hassle in some ways, and especially starting out.  It is a big system to learn and try to implement (or was for me), there is a big learning curve at the beginning. 

 

When I have tried many other things, had them not work, and feel like it is time to go to autism place...... and then I see that it is effective....... well, I am highly motivated to deal with it.  

 

I have seen other people who thought they should start it, but then it seemed like they got into it and it was more than they needed, and so it was more trouble than it was worth for them.  

 

At the beginning my son did not understand the concept of negative attention, he could not tell that attention could be positive attention (yay!) or negative attention (stop!  no!).  He was getting an enthusiastic reaction either way, he thought.  He liked to get an enthusiastic response with a lot of excitement.  

 

We started with this, with ignoring some things, or re-directing with no comment and no facial expression.  Alternately, when he was doing well, we would be super-super enthusiastic and have a lot of facial expression.  He liked that and didn't understand it was not good to get that by pushing a lamp off the end table.  We had to teach him that by how we responded to his actions.  

 

That was one thing that really helped, but it is very, very odd to do.  Like -- your kid pushes a lamp off the end table (previously a guarantee of a huge reaction from me, iykwim) and you ignore it or quietly re-direct -- how does that seem like an effective response?  But this was effective where so many other things were not.  

 

Another thing is that if he is stuck, sometimes being stuck can mean he is not able to "hear" and process information.  For some kids, while they can't "hear," they can "see."  So it is a possibility that visual strategies would be helpful.  This is where you have a laminated card you carry around, that you take out as a reminder to look at, when certain things start to happen.  It is not something I have really done, but I have heard it is really good, and I have done it in some small informal ways and found it helpful.  

 

I think it makes so much sense to start with a reputable program that it sounds like Nurtured Heart Approach is.  But I have not tried it.  I have got a lot of information for the more autism stuff if you ever are interested, though.  

 

For autism -- you would start (probably) by keeping a log of his difficult behavior.  What happened, what happened before, and what happened after.  Then you look at the list and try to see if you can identify a function of the behavior (which include attention, escape, and access).  If one of these functions seems to fit, you try to respond appropriately (attention -- ignore, teach a better way to gain attention; escape, don't allow it, teach better ways to cope and express needs;  access, don't give it, teach acceptable ways to ask for things and work up a frustration tolerance).  Then there are so many related strategies.  There are so many skill gaps or deficits that could be a root problem, and those can be identified, and supported and taught.  There are many ways to change the environment to increase success by making things easier on the child, and slowly increase the difficulty level.  A schedule and a timer can help kids know how long things will last and what to expect.  Etc. Etc. Etc.  

 

A good relationship is necessary and underlies all of this, too.  It is just ---- there is more to it than that.  I have found all the things like "The 5 Love Languages for Parents" to help with that.  But it is a foundation.  It is not a book about teaching children with autism.  

 

 

[kbutton]

For autism -- you would start (probably) by keeping a log of his difficult behavior.  What happened, what happened before, and what happened after.  Then you look at the list and try to see if you can identify a function of the behavior (which include attention, escape, and access).  If one of these functions seems to fit, you try to respond appropriately (attention -- ignore, teach a better way to gain attention; escape, don't allow it, teach better ways to cope and express needs;  access, don't give it, teach acceptable ways to ask for things and work up a frustration tolerance).  Then there are so many related strategies.  There are so many skill gaps or deficits that could be a root problem, and those can be identified, and supported and taught.  There are many ways to change the environment to increase success by making things easier on the child, and slowly increase the difficulty level.  A schedule and a timer can help kids know how long things will last and what to expect.  Etc. Etc. Etc.  

A good relationship is necessary and underlies all of this, too.  It is just ---- there is more to it than that. 

 

:iagree:

 

As for consequences/cause and effect with spectrum kids, it's not a one-size-fits-all answer. My son does understand cause and effect and consequences, but he doesn't get it quite like a typical kid would. It's hard to know where a child is in this process and what capacity they could ultimately reach in this process. You have to kind of figure this out by trial and error--some situations make a difference in their ability to understand this as well. I would also make sure you are having the consequences and cause/effect discussion outside of "the moment," whatever that moment might be--trying to delay gratification, trying to get him to stop a behavior, etc. I also think that a child on the spectrum who is capable of understanding some of these things needs exponentially more data about life, people, how other's think, how the world works, etc. than a typical child in order to reach the same milestones. (This would be difficulty with generalizing, I think.) And again, it doesn't look the same. I wish I could quantify it better, but I usually need something specific to jog my memory in order to offer a good comparison or put words to it. My son's severity on the autism spectrum is very low, but it's there. Even his tutors have a hard time quantifying and pinning down how it works with him (and how to keep moving him forward when he doesn't fit the autism books totally either), and they have the professional jargon down pat.

 

I guess I'm saying that until you know what is going on with your son, you should hold your expectations in check and keep this kind of information in mind for informational purposes (either a way for you to describe this to others, or as a description of what is in the realm of possible for your son in the future), not as a trajectory you can count on, until you know more from evaluations and his own growth over time. But definitely explore these ideas and resources and see what you can make work in the meantime. That's what we all do. 

[PeterPan]

Kbutton, your ds is 12-ish now, right?  What was he like at 4-6?  Did he have the same sense of consequences and cause/effect, or did that come with time and maybe nurturing on your part?

[kbutton]

Kbutton, your ds is 12-ish now, right?  What was he like at 4-6?  Did he have the same sense of consequences and cause/effect, or did that come with time and maybe nurturing on your part?

 

He's 11. It came over time and probably with discussion. I hesitate to say nurturing, because I learned through the school of hard knocks what to do or not do (and a lot of dead ends where I never figured things out). I was also pretty desperate to have harmony, but have at least some of that be on my own terms, so I worked very hard to make my terms work when I could find a way. My son is quite logical, so I looked for some kind of logic in what he did and tried to work with it, even if if "logical" meant that it followed a pattern rather than being logical by neurotypical standards. In some ways, your DS is where my son was in preschool (based on our meets face-to-face and some descriptions you've given), but I think that's at least partly because of the apraxia. But I think these comparisons are difficult, especially since there are other factors (like the apraxia and LDs), and the sensory is likely a bigger deal for you (or at least manifests differently). I imagine the apraxia itself was taxing for your son, and then the therapy was also taxing. I can't imagine trying to work on a lot of personal/social/behavioral growth at the same time that hard stuff was unfolding. We didn't have that with my son. My neighbor has a theory that most kids have leaps in development in just one area at a time, not usually multiple areas, and I think she is right about that. Some kids don't surge and stop as much, and their growth is more even, but some kids really grow in spurts, physically, mentally, cognitively, etc. My son was really developing in the cause/effect and consequences area in preschool. Another big surge came in probably 3rd grade (and that was also about the time that other pieces weren't surging forward, such as social stuff, and we got a diagnosis at the end of 3rd grade, age 9). And while my son could not put his finger on what was bothering him, if I could, he'd readily chime in with huge relief that I'd figured it out, and he would be able to articulate and help me fine-tune my approach by describing his thinking. 

 

We read books (Berenstain Bears, etc.) and watched TV that was social story focused, though I didn't have a clue at the time what a social story was. Thomas the Tank Engine, Caillou, Curious George, etc. I swear those kinds of shows taught him how to be a kid and to make sense of the world. If you can find shows that do that but are age-appropriate, it might help a lot. Although my son still likes Curious George, and would probably watch Thomas out of nostalgia. I would have introduced Mr. Rogers if I'd realized he would like it--I didn't care for it at all as a child, but he was really drawn to it later on. By then, I think he was in school, and it wasn't on at the right time.

 

HTH

[PeterPan]

Kbutton, that is a fascinating theory about the work for one glitching up the others, hmm.  It's why we stopped ST for a while, because we really felt reading was a virtue too.  He's at least age-appropriate now, even though he isn't IQ-appropriate.  There are definitely these correlations in the research (physical development and social, etc. etc.), where improving the one improves the other.  And of course when you get behind in things (speech, reading, etc.), you don't get the level of interaction that nurtures that higher level development.  His gymnastics coach even said something recently about him being bright, as if to say he had previously assumed ds was just DUMB and that that was why he acted young, acted a certain way, etc.  He's a super nice man.  I'm just saying that has always been the challenge with us, to nurture the inside and not just look at the outside, to know what he was ready for, etc.  I've got this We Choose Virtues stuff I want to begin with him.  It's super explicit, and I'm hoping it will give us, as you say, words for more things.

 

Mellifera, I hope you don't mind me mentioning this, but I noticed you said in another thread that your ds had had some speech issues.  The similarities with our boys caught my attention.  :)

[nature girl]

Sorry to butt in with a question, but reading the reviews for Nurtured Heart it seems like it might be helpful for my (primarily ADHD) girl. At the moment we use a pompom jar as our reward and consequence, when the jar is full she gets a fun field trip. Now if I see a negative behavior, just saying the word "pompom" will often get her to stop, to prevent me taking a pompom away. From the little I read it sounds like this is similar, praising profusely for positive behavior and unemotionally stating the consequence for negative...Are there other major components I'm missing? Is it worth picking up the book if our technique is working (at least to some extent) now?  

 

I should say that the pompoms work in keeping the negative behaviors from progressing too far, but they don't prevent them from starting. She's not at the point where she can think, "I'd better not do this or xyz will happen." Can the technique help more with the impulsivity we're facing?

[Lecka]

http://www.amazon.com/Everyday-Parenting-Toolkit-Step---Step/dp/0544227824/ref=sr_1_2?ie=UTF8&qid=1439210370&sr=8-2&keywords=alan+kazdin

 

This is the book for that style that I have read, because it is in our library.  I have read both books by this author.

 

It has a lot of ideas along the lines of the pom-poms.  

 

It is similar to a lot of things for autism, but it is not sufficient for autism.  There is too much specific to autism that is not found in this book.  But still, it has a lot of good ideas for the pom pom thing.

 

Here is some information, though.

 

For a lot of kids, you might want to separate your "positive" -- getting a pompom, from your "negative" -- losing a pompom.  If losing a pompom works, then I don't have a problem with it at all.  In general there is a risk of kids deciding they don't care about earning pompoms if they might lose them ----- some kids are like this.  If your daughter isn't, she isn't.  But if you were to see a sign of this, then you could respond by no longer removing pompoms, and having something else you did instead of removing pompoms.  

 

Here is another idea with pompoms that might help (if she is capable -- and I think it is hard to know, what kids are capable of, and what we wish they were capable of, and what they are capable but we don't give them a chance).  

 

You set a target behavior.  If there is something specific, that she has a pattern of doing.  If there is a short list of desired behavior you want at a certain place.....

 

You tell her:  "we are going to x place, and here is the behavior we need."  

 

Then if she does good for 2 minutes, give her a pompom, and say "I like how you are doing x,y,z, just like we talked about."  Then after 5 minutes, do it again.  Then after 3 minutes.  You want to start out doing it a lot, and at random times.  Whatever "a lot" is for her (based on how long she can usually go without doing something impulsive -- this is why you have the record, so you can see how long she has between impulsive behaviors in various places -- you want to make sure to give a "good job" pompom before the amount of time when she usually would do something impulsive).

 

If you are very impressed, give her more than one pompom.  If she is amazing and you can't believe it, give her a handful.

 

For this, you are using pompoms to reinforce the absence of an undesirable behavior, at a time it has not occurred (or is not occurring).  But you talk about the desired behavior, not the undesired behavior.  In his book he calls it "a positive opposite."  

 

This is how we got my son to be able to go in stores without grabbing at things or refusing to walk or hitting me. I took tiny candy in the first place (like Nerds, or something that can be broken into little pieces like a cookie), and he got little treats throughout.  Then once he had a good habit, we quit doing it, it was no longer needed.  While we were doing it, a huge success was a trip to Hobby Lobby when he did not grab for anything, and the check-out clerk complimented me on my kids' behavior.  I also was able to take him and my daughter to pick a live Christmas tree, and he stayed with me.  After he did so well with those two, we could cut way back on it.  

 

At the time, he was not at a point where he could do something so difficult for a token (a pom pom will be called a token, but he usually has stars, stickers, smiley faces drawn into circles, fingers -- like "5 fingers" and he holds his fingers out one at a time, pennies, etc.).  So instead of a token, or a secondary reinforcer (saying good job, high five, a hug, obvious pleasure in your child's behavior), he still needed a primary reinforcer at that time (food, candy, flavored water, chocolate milk).    

 

But if pom poms are working, that is great, there is no need to go down to a lower level.  But if there is something where she has shown it is very, very difficult for her, you can consider going back to a lower level for a certain thing.  

 

But here is the other big weakness of this book that is needed and found in autism books, but apparently really not necessary for many children.  Why is the child having the behavior?  Is she overwhelmed?  Can't express her needs?  Doesn't know how to recognize her needs?  Very confused about what is going on?  Anxious?  Is there a skill gap?  Etc, etc, etc.  

 

This book does not go into that much detail.  

 

It is just about "here are some great strategies for using tokens."  And, I think it does have some great strategies.  

 

I think it is worth a check-out from the library, just to see if there are any ideas or tweaks that might be helpful.  

 

It also does not replace reading the Ross Green book about The Explosive Child.  I have heard of too many people having good results with it, even though it is a slightly different kind of approach.  But I can think of it like the "target behaviors" that you choose are the "Basket Number Whatever" behaviors from the Ross Green book.  I have not really done much with the Ross Green book, mainly b/c I went to all-autism books.  I have a good impression, though.  

[PeterPan]

Lecka, thanks for explaining all that.  I have the Kazdin book in my library pile (unless I already returned it?), and I was trying to figure out why I had gotten it, lol.  Sometimes these books take more time to read than to comprehend and I just don't get it done.  Summaries are awesome.  :)   

[Lecka]

There are probably 5 other strategies/ideas this good in the book.  They are towards the middle if you want to skip and just read that chapter, maybe you can tell from the chapter title, lol.  

 

My son's therapist likes cute things, too, btw, and we have not done this, but she has had kids who like pizza.  She makes them a chart that is a pizza tray, and then the tokens are pizza slices.  They have a target behavior (this is for one desired behavior that they would like kids to do either independently, or cooperatively, depending on the goal), and for each time the child does the target behavior, they get a pizza slice.  When they get all the slices, they get to go out for pizza.  

 

I think she has done it more for, like, an older child who completes homework or a chore, so it is possibly to get one slice a day, and then get pizza after about a week.  

 

With this kind, you can have multiple reinforcement schedules going at the same time, it is not all just one thing.  This can be good if there is a time of day that is going well, and then a time of day that is going poorly, so you can keep positive reinforcement for those good times, it is not all lost to the bad time.  

 

This way there can also be a mix of short-term little treats, and long-term big treats.  

 

My son is very far from being able to get a token towards a more long-term goal.  Right now, a long term for him is about an hour.  He is not ready for multi-day things.  

 

But to teach multi-day goals, you can start by having a mix of short-term and long-term goals, and have the long-term goal be better than the short-term goal.  The child can start to see "oh, I will get the long-term goal, it just takes time."  It is teaching in a way.  

 

He talks about this some in this book, he has some cute ideas, too, iirc.    

 

[kbutton]

Loving Lecka's clarifications and ideas about rewards and such. I will try to chime in later with a question about high IQ kids who like to game the system or feel bad when they've learned something and no longer need a reward for it, lol. Can't quite formulate it yet. (Sigh, it's always something, right?) We'd use rewards more if we didn't feel we had some difficulties with those as well. 

[mellifera33]

Wow! We were camping over the weekend and I didn't have internet access, but I am glad to see so much discussion today. :) 

 

And multiquote isn't working. I has a sad. 

 

I have read most of the Nurtured Heart book, and will be starting to use the approach gradually, for all of the kids, and I might even use a secret credit system for myself. You know, to reinforce good habits. lol 

 

My 4 y/o, who I wrote about in my first post, has no diagnoses. I will be making an appointment for him, though, to see what a professional thinks. We have been going through the eval process with my 7 y/o, and I found that a lot of the behaviors that the psych asked us about did not pertain to the 7 y/o, but did to the 4 y/o. Our insurance changed this month, and office visits will no longer be subject to the deductible, so I will have to find an in-network psych for him. Or since he'll be five this month, maybe we'll start with the school district. The school psych will be doing some testing with my 7 y/o, and we'll see how that goes. 

 

I've spent the last year or so thinking that the 4 y/o didn't warrant a diagnosis, but needed a better discipline system--his negative behaviors are pretty sporadic. Of course, I thought my 7 y/o didn't have LD because his academic problems changed day by day, not knowing that the inconsistency was a sign of an LD. Doh! 

 

I remember reading The Explosive Child years ago, before I had children, when I worked at a bookstore. At the time I kind of pooh-poohed the approach, thinking, "My children will never act like that!" lol. My mom likes to remind me that when I was a kid, my pediatrician told her that I was the worst behavior problem he had ever seen. 

 

Grumpy toddler calling. :)

 

 

 

 

 

 

[PeterPan]

My mom was even worse.  She would get so frustrated with me she'd say nasty things about how she hoped I had a child JUST LIKE ME someday, like it would be a CURSE or something.  So when my child acts like I probably did, I hug him more and think about how much I like him anyway.  :)  I wish she could have, but I think she was more pressed, without the support of a husband at home (Dad was in the Navy), etc.  

[nature girl]

Lecka, thank you SO much for your ideas! I think they could work really well for dd, I'm excited to try. (We need to hit the grocery store tomorrow, which I dread since there's usually bolting, climbing, and games to see how precariously she can possibly stack yogurt containers or paper towel rolls...) I'll be carrying a pocket full of pompoms tomorrow! I do think that could work, and start to engrain better habits.

 

I keep expecting her to start just shrugging when I take out a pompom, but it still does mean a lot to her. I think it might be the disapproval in general that gets to her, and this is a physical sign of it. She's SO proud when she does well too, so I think giving her that approval for periods of good behavior, rather than just at the end, could be really effective. 

 

I just put the book on hold at the library as well, looking forward to reading it (along with the 10 books I have out on ADHD, social skills and EF. My reading list has become a lot less fun recently.  :sad:) 

[Lecka]

Some other ideas are to keep it a shorter trip, have it be at a good time of day (not tired, not hungry for sure, maybe after a walk or some other activity that is not too active).

 

If she would like it, give her some very important grown-up responsibility to help with the list or with coupons or something.  Pretend you can't see something and then be appreciative when she can point it out.  If there is anything she can hold or carry, that is good.

 

Go over the plan before you get out of the car.  

[nature girl]

Welp, we headed to the grocery store this afternoon, her with a shopping list so she could be my helper, me with a pocketful of pompoms and complete naiveté...

 

Maybe she was better, in the sense that each time she acted up when I told her she was losing pompoms, she did come back/get down/climb out of the ice chest she'd closed herself inside before I could stop her. But yeah, we ended the trip at negative 5 pompoms. (sigh) Without this technique she could easily have been at negative 10+ though, so...progress? (another sigh)

 

I was so sad for her though, when I explained what we were doing she was so excited at the prospect of being a big helper and getting so far ahead, and each time she lost a pompom she made this devastated crying sound. It completely cemented for me the realization that she really can't help herself at this point, it's just so hard for her, a 2 year old in a 6 year old's body. I wish she was small enough to wear again, or to sit in the cart without inevitably knocking it over when she tries to stand and jump. 

[texasmama]

Welp, we headed to the grocery store this afternoon, her with a shopping list so she could be my helper, me with a pocketful of pompoms and complete naiveté...

 

Maybe she was better, in the sense that each time she acted up when I told her she was losing pompoms, she did come back/get down/climb out of the ice chest she'd closed herself inside before I could stop her. But yeah, we ended the trip at negative 5 pompoms. (sigh) Without this technique she could easily have been at negative 10+ though, so...progress? (another sigh)

 

I was so sad for her though, when I explained what we were doing she was so excited at the prospect of being a big helper and getting so far ahead, and each time she lost a pompom she made this devastated crying sound. It completely cemented for me the realization that she really can't help herself at this point, it's just so hard for her, a 2 year old in a 6 year old's body. I wish she was small enough to wear again, or to sit in the cart without inevitably knocking it over when she tries to stand and jump. 

It is at this point when I gently suggest parents to think about medication.  When kids cannot comply with a simple behavior mod program for a desired reward, it becomes clear that their behaviors are very much not within their control.  It really is very sad when a kid wants to comply but cannot.

[Lecka]

I agree.

 

Also, you don't have to take away pompoms.  You can let pompoms be something she gets, not something she loses.  

 

There is a risk of it being counterproductive.  

 

You can have something else you do, you don't have to take them away.  

 

I think, personally, when you have something good going with the pompoms, keep it positive, don't take them away.  Just let it be for when she is doing well.  

 

Unless you are working with somebody reputable who thinks it is a good idea ------ it is often not recommended.  

 

It sounds like it is too sad for her, and in addition, it sounds not effective, if she wanted to do well but couldn't.

 

You want effective.  

 

If the pompoms are effective for some things, don't make use them for something where they are ineffective.  It weakens them and it is not setting her up for success.

 

If you are reading a book that recommends taking them away ------ I can just say, I have never seen it recommended for autism for young children ime (which is limited).  I have seen it not be recommended.  

 

I know it is a thing people do -- but I don't think of it as a best practice.

 

I think there are some situations where it is a recommended practice, but I would not stay with taking away pompoms.  

 

I have a kind-of strong feeling on this, I just think it is not effective a lot of times, even though I know people do it.  I don't really know why they think it makes sense when it is not effective, and then (often) they soon after say "token systems don't work, my kid won't participate."  And I think -- well, maybe you should not have taken the tokens away.  But that is just a thing with me.  

 

Edit:  Basically -- you just don't earn a pompom.  You can say "too bad, you would have earned a pompom, but here is your next chance."  (And agreeing with Texasmama -- if she is capable.)  She doesn't get a pompom, but she doesn't lose one either.  

 

This is, basically, kind-of what you would do instead of taking away a pompom.  I think it is supposed to be okay to do, as far as I know, this is my understanding.  

[texasmama]

As Lecka said, positive only behavior mod approaches are probably my favorite.  Also, look up the behavioral term "shaping".  That is what you are alluding to when you say you want to feel positively about the progress made.  "Shaping" is rewarding approximations toward the goal.

[Lecka]

Deleted

[Guest]

Methods like this did not work for my kids either. Sorry! It's why I don't do parenting books. With my kids I have always tried to remove their attention from a bad behavior to something that I know would interest and engage them. That age group is too young and immature to tip the balance scale towards a future reward vs. instant gratification. We give them the tools to be successful, not set them up for failure. That's my school of thought anyway :)

[PeterPan]

Hold it, were you doing the pompom removal because of NHA?  What an awful experience! I'm sure the book has something good to say, but a negative consequences approach is not going to work for a child who cannot think through cause/effect and self-regulate.  The Kazdin book is MUCH more sane for extra-challenging kids.  The Everyday Parenting Toolkit: The Kazdin Method for Easy, Step-by-Step, Lasting Change for You and Your Child

 

Maybe apologize and tell her you inadvertently taught her more about math (and negative numbers, what a bright girl!) than how to obey and that you'll find better methodologies, that she pleases you and you know she WANTS to do well in the stores and that you're going to figure out some ways to make it possible.  Don't leave her hanging.

 

Meanwhile, do you have an iphone or kindle fire tablet to run apps?  Have you tried reserving some special screen time *just* for in the store and taking a bunch of food treats or whatever motivates her?  Didn't you say she likes little Toobs and little characters?  You could get one new Toob of characters, put 5 in a baggie, and tell her every 10 minutes she sits nicely she earns another one.  My ds, I'd use food, but little toys might work nicely for a girl.  Might cost you $5, but at least you'd survive the shopping trip unharmed.  Or if she has never had playmobil, get one of those surprise figure baggies that are $3.50 at ToysRUs.  The first half of the store she plays apps quietly, and if she does that then the 2nd half she gets the new figure.  And since it has to be assembled, it will keep her busy.

[LaughingCat]

Yeah, my DD did far worse than a sad little sound if taking away was included.

[Lecka]

Well, methods like this are extremely helpful with one of my kids.  Extremely, extremely helpful.  But I was told not to take away things. 

 

I have asked about this, b/c I hear about people who take things away..... I was told for my son's level, they would not take away.  I have asked a couple of people, and both of them told me "middle school age and above."  One seemed like she had a sub-group of kids where she thought it could be pretty effective and useful.  The other told me for one targeted behavior only.  

 

It is all autism-specific, but these are pretty legitimate people that I asked.  

 

If you got this from the book, it makes me think the book is old, or the author is not a BCBA (basically the specialist in this kind of thing).  

 

Edit:  I looked at the book again on Amazon, and it seems like it would be good to me!  

 

But there are some nit-picky little things that I think do matter, with just how token systems are used.  

 

It is something that has been very important for my son and continues to be very important, so I am pretty interested.  

 

But then books about it can be bogged down in little nitpicky details.  

 

I do think this Nurtured Heart Approach does look good.  Maybe add some of the nitpicky details to it, possibly.  

 

Like -- sometimes you read an autism book, and the whole book is just about finding reinforcers for your child, figuring out a target behavior, figuring out what rate and type of reinforcement to use (fixed/interval, delayed/immediate, primary, secondary), etc.  And it is so nit-picky!!!!!!!  It does not quite have the heart focus!!!!!!!!!  But it is what I need for it to work for my son.

 

I seriously doubt you need such a nit-picky thing, but I think I agree with OhElizabeth -- check out the Kazdin book, and just add it to the Nurtured Heart.  B/c it will not have so much heart-nurturing.  But it can tell you how to have a good shot at a quality token system.  

 

But both are important!  

 

 

[texasmama]

During my years of practicing therapy with kids/teens, I set up countless behavior mod problems because a major reason that kids are brought to therapy is that they are "acting bad".  I almost always made the behavior mod programs rewards-based only, with no consequences except removal to a room if a safety violation had occurred (hitting someone else, for example).  Parents often balked at "rewarding their kids for things they should be doing anyway", but I asked them how long they would go to their job if they did not receive a paycheck.  Changing behaviors for kids is WORK, and it is really okay for them to be paid for it.  What invariably happens is that in time the new, more positive behavior is cemented and the need for reinforcers drops off.  The kid forgets to ask.  The parents forget to give it.  All is well.  Parents fear that if they reward it now, they will be rewarding it forever but it just doesn't play out like that.  I've done many a behavior mod program with my kids.  My kids will now put themselves on a program. :lol:  I have one kid on a program right now.  It is positive rewards only.  No consequences.  My kids like these programs.  They work for everyone because they are a positive way to learn more functional ways of acting and interacting.  I never intended to become a behaviorist as a therapist, but I became one (at least in part) because it was a helpful tool.  Not the only tool, by any means, but a helpful one.

[Lecka]

Yeah.  I want to clarify -- the people I asked, I was like "do you EVER do it?" And one told me "one time" and that it was with a teenager, and that her supervisor was very involved with the case, really trying to figure it out.  And the taking away was only for one target behavior.  Like -- it was a big deal, not the normal thing they do at all.  

 

The other one said she did it sometimes, but only for middle-school and above.  

 

It is not that they are saying "do it" or recommending it.

 

They just didn't say "no, never, ever."  

 

For the one who said "sometimes, for middle-school and above," I privately think, it had better seem pretty compelling if they ever want it for my son, or else we will say no.  Maybe she is out-of-date or there is another option where it is not needed for the times she thinks it is okay.  But at the same time -- she said it, and I think she is legitimate in general.  I think she is good and I listen to what she has to say.  But she could be wrong on this, too!

 

So really -- I do agree with Texasmama.  

 

I am also going to edit a previous post, b/c it is just very hard to explain and get into. 

[Guest]

Oh I'm all for reward systems and I have used my own modified version of ABA with my youngest. I also was not referring to the book, which I know nothing about. I was referring to the specific pom-pom activity. How discouraging that must have been for Anna's Mom and how much that must have hurt an already fragile little girl's self confidence! It is why it is so important to filter experiences we read about!

[mellifera33]

Just to clarify, Nurtured Heart Approach does not encourage taking away credits. If a child misbehaves, and refuses to do a "reset" their credits are unavailable to spend on privileges, but as soon as a reset happens the credits are in play again. 

[Lecka]

Oh, thanks.  I think there was major thread drift here, I just realized.  

 

But thanks for the clarification.  I appreciate it.  

[nature girl]

Thank you all for your perspective. I'd pretty much reached the same conclusions after seeing what happened today, and realizing how much it really is out of her control. I think in the moment I was feeling sad and frustrated and disappointed, wondering if things were ever going to get better, and threatening pompoms was just desperation. (I didn't actually take the pompoms out, just went into the bathroom when we got home and had a good cry.)

 

The whole plus and minus pompom thing wasn't associated with Nurtured Heart, we started it years ago, a friend had used it very successfully with her young (neurotypical) son, and it did work quite well for us in some ways when nothing else had...I hate time outs, sending away/ignoring a child when they're upset always felt so wrong to me, and direct consequences, like taking a toy away, didn't seem to have any effect on her. Threatening removal of a pompom stopped many bad behaviors (harassing our cat, grabbing for food I was cutting, etc.) in their tracks, so we kept up with it. But I'm finally (maybe just after today) realizing it doesn't actually *teach* her anything, make her internalize the good behavior so that she'll do it of her own accord without the threat of losing anything, which of course is the point.

 

I do reward her for pretty much everything, even things like trying to use the bathroom before we go out. To some extent it's been helpful, but it hasn't done anything for the negative behaviors. (I do the "You would have gotten a pompom" or a treat or whatever suggested above all the time, but that also hasn't had much effect. The only thing that seems to work for her is threatening negative consequences...Actually, just before I came online tonight I had to threaten not to do her lullaby/bedtime back rub if she didn't brush her teeth. Again, desperation, but those teeth got brushed.)

 

I actually have the Kazdin book sitting next to me on the sofa right now...Good bedtime reading. Just glancing through the first or second chapter, I see him talking about framing everything in terms of behavior you WANT to see, rather than behavior you don't want. I guess that will be my first step, since I probably do usually phrase things in terms of what I don't want her to do. Ack, this is difficult...I'll read through the book in the next couple of days and hopefully find more that feels like it might work for us. That mix of impulsivity and stubbornness is such a hard combo to break through, though.

[Guest]

Just to clarify, Nurtured Heart Approach does not encourage taking away credits. If a child misbehaves, and refuses to do a "reset" their credits are unavailable to spend on privileges, but as soon as a reset happens the credits are in play again.

OK, here's what I don't get! Isn't this just another way of taking away something?

 

Here's my issue with this, if a child has been told that this is the good behavior and you will get this for your good behavior, even if you are going to escalate it as a future step once the child has progressed to that level (taking away something) for bad behavior, that just happens once for the specific action. You take away something, the child cries, he moves on. Next time he will be more careful. At least that has been my experience with my boys and I have effectively taken away things for bad behavior. They know the consequence up front though!

 

In the case with the pompoms you are using a symbol for a reward (that might or might not be completely real to them, after all they cannot see it) and are taking away a symbol (or access to it if you prefer). You are taking it away OVER, and OVER, and OVER. The child the first time is upset. The second time devastated. By the third time he begins to think, I am bad anyway so why bother. At that point he or she has given up. Not sure if you see my point here!

 

We want them to be successful. We want positive reinforcers at this age and stage. That's what I mean! We are also talking about kids with labels on this board and their actions may be lead from a number of different reasons, impulsivity, sensory seeking, whatever the reasons may be.

 

I have not read this entire thread and I have not taken a look at the book. Just sharing some of my thoughts.

[Guest]

Anna's Mom :grouphug: The pompom method was shared with me as well, back when I first started looking at ADHD as a possibility for my oldest. I didn't bother with that one. Prior to that the same friend had shared 1,2,3 Magic. I knew it would not work and was not thrilled with the idea but tried it out of respect for my friend. We had very different parenting approaches and I didn't want to sound like I was always rejecting her advise. I stopped in about a week. It did not agree with my parenting mentality. To follow something these days it really has to make sense to me!

[Guest]

Kbutton, your ds is 12-ish now, right? What was he like at 4-6? Did he have the same sense of consequences and cause/effect, or did that come with time and maybe nurturing on your part?

My 6 year old gets consequences and cause and effect, but that is something that will differ from child to child I feel. Symbols used as rewards I would not use with him though. The rewards and consequences have to be clear and immediately following the good or bad behavior. He doesn't meltdown at this stage with consequences. He cries and will say "mommy I'm sad!" to which I reply "I know you are sad but we said you shouldn't do that or the computer will go off" (for example). I then divert his attention to something else. If I take the computer away it applies to all electronics ;) He is too smart for that LOL and has tried to switch over to something else, which would defeat the purpose. All computer profiles are password protected and he is the only one that doesn't get to know the passwords. He has tried to switch over to his brother's computer once and chuckled when I caught him. He also tries to memorize passwords. Oyi!

[PeterPan]

Anna's Mom, since you're reading Kazdin tonight, your next step is to get Greene's The Explosive Child.  It would help you define the problems you're trying to work on.  Kazdin is the tools and Greene helps you define the problems.

 

Also, Kbutton said this to me and I pass it on to you.  You've gotten so used to her, you don't realize how much harder than normal you're having to work.  :(  Like you're saying you know, but wow.  

[Lecka]

I don't know exactly what the re-set is.

 

The way it works for my son:  He cannot get positive reinforcement while he is engaged in a behavior we do not want to positively reinforce.  

 

If he is in the process of getting tokens (like -- he is up to 7 and he needs 10), then he is promised something when he gets to 10.  After the unwanted behavior is not being practiced, he can start earning tokens again.

 

If he has just gotten to 10, and in the second between him getting number 10, and delivering the reinforcer, he has an unwanted behavior...... well, for the most part, the principle that "you cannot be positively reinforced while in the middle of an unwanted behavior" still is the higher principle (there are exceptions and stuff, but in general).  

 

But what would happen then is, problem-solving, because this is not a good situation to have.  It just is not.  So most of the time, for my son, the problem-solving looks like this:  We expected a certain amount before giving him the reinforcement, but either the amount we expected was too high, or the level of difficulty was too high, or it might have been boring, or it might have been something he has reviewed too many times, or maybe he needs to have a snack at this time of day, maybe it has been too much sedentary time and we need to schedule an outdoors break prior to this point, etc. etc. etc.  

 

In reality this is like:  problem-solving time.  

 

But in the moment where you are going "oops, oops, oops, oops," he mostly can't get the positive reinforcement while in the middle of an inappropriate behavior.  It is just -- that is probably not totally his fault, that is probably a structural problem in some way.  But it is like -- you are already having the behavior.  The bad thing is already happening.  I know, unfortunately, that I just cannot reinforce an unwanted behavior ---- it truly confuses my son, it truly shows me to be inconsistent.  I know you could say that it would be inconsistent to wait on the positive reinforcement until he is behaving again.  That makes sense in theory to me.  But in practice with him, I believe it is more confusing and inconsistent if I am inconsistent with an unwanted behavior.  It sends him a message that he tries to interpret the best he can and so why wouldn't he try the behavior again, to see what happens, to see how he will react, when he does not know how I will react now, b/c I was inconsistent.  That is really how I look at it.  

 

So -- that is not specific to how the re-set is done, I imagine it is a bit different.  

 

But I am sharing this principle anyway.  

 

It is also something where -- I know this is how it is for my son, I know it is more confusing to have some behaviors be okay sometimes and not okay sometimes, than to have a delay before getting a reinforcement he has earned.  That is really how I feel with him, at this point in time.

 

With another child with a different personality, or an older child, I think this might not be the right answer.  I think it could be hurtful to a child.  

 

But I am sharing how that works with my child.

 

Another thing, is that with my son, a behavior is anything at all.  It is not just behavior like "is this child behaving" like it is used in general.  Any observable action is a behavior for my son.

 

Most of the time he has tokens now, it is like, he is working on therapy, and in 30 minutes he will have 3 breaks, and he will get about 5 tokens every 10 minutes, and then get a break.  The tokens are just helping him to feel good (since he may not pick up on other forms of positive reinforcement as well as with a token -- he may not pick up on all the social reinforcers as clearly.... he picks up on them, but there are reasons to also have token).  They are also giving him a *visual* of how much time he has left before a break.  It is a time measurement, but it only measures time that he is acting appropriately -- if he is stalling, he doesn't get a token then.  But as an adult -- we can still make it work out that he gets a break when he needs it, b/c we are not a slave to a clock or to the token system.  

 

It is also extremely helpful for his math understanding, and I do not think he would be anywhere near as far along in math as he is if he did not use tokens.  For context -- he is really, really good with numbers up to 5 in every way, and he is decent and improving with numbers up to 10.  If he is working for 10 tokens, and there are blank token spaces shown (an empty circle, an empty velcro tab) that will be filled in ------ he is just sitting  there going "I have 6 circles filled in, and I have 4 left," and then "I have 7 circles filled in, and I have 3 left."  It is so good for his math.  There are also many motivating opportunities for him to have 5 circles filled in, and then tell him, "you did so good, fill in 3 circles."  Then he is doing some really good math there, and it doesn't even seem like math.  

 

I totally understand this is not needed for many kids, like, oh, my other two kids.  But it is so helpful with him.  So, so helpful.  

 

But what is probably different about it:  a behavior could be hitting somebody, or it could be answering a question.  These are both equally a behavior, b/c they are both an observable behavior.  A wanted behavior could be to answer a question.  An unwanted behavior could be to stare into space, or play with his shirt, and not answer the question.  That is just the way that it works.  

 

Then there are also gradations of behaviors, it is not just "yes or no."  If he is doing something incorrectly, but it is slightly better than he has done it before, then that is something that is good.  He is a little closer.  He is not all the way there, but he is closer.  We cannot count on just going from 0, he is not doing it at all, to 100, he is doing it perfect.  If he goes from 0 to 10, then that is a big step, it can't be ignored just because it wasn't the full step to 100.  Tokens can be helpful that way, because you can give a token for a "good try."  It is a lot more clear (imo) to give a token for a "good try" and have it communicate: I am really happy you tried, but it is not the right answer.  

 

When there are situations, which we have, when even with every best effort and intention and errorless teaching etc. etc., sometimes when there is a brand-new skill to learn, the reality is, he is at zero, and he is not going to make very fast progress.  He just may not.  

 

In that situation, which we have, it is not nice to hear and hear "good try, but here is the right answer" or whatever.  Even when there are easier questions mixed in that he can get the answer to.  That is a good strategy, but it doesn't make up for him, getting wrong answers -- he doesn't like to get wrong answers.  He doesn't like now knowing an answer, really.  That is what he really doesn't like.  (B/c I do try to do errorless teaching, but sometimes he might still not like to be asked a new question -- this is actually something that has been a struggle but has improved a lot.)

 

But if he *tolerates* not knowing an answer, and he tries, and he gets a wrong answer:   then it really DOES help him to get a "good try" token.  Because he did try!  We want to reinforce the trying, and the tolerating of not knowing the answer but trying instead of lashing out or withdrawing.  This is a MAJOR life skill, and a MAJOR problem if he cannot handle not knowing an answer, but oops, he has to learn new material sometimes, and oops, he often catches on slowly (or slower than he would like!).  

 

So this is something that is also really, really helpful about tokens for us, because he does respond to a token by feeling like "I did good because I tried."  And that is just not an easy response to get, or an easy message to convey.  B/c my son has some language delays, I can't necessarily *talk* to him about this, but I can *show* him, because he can understand being shown.  

 

I think a big part of it is just that tokens provide a visual, concrete thing for him, and he has a language delay, so sometimes language may be fleeting for him or he may not completely understand.  With those two things, a lot of the other messages that we can send (that I send to my other 2 kids and they pick up on) are just not necessarily going to be received by him.  With the other two, I have the tools of:  verbal explanation, them picking up on my body language, them picking up on my tone of voice, them picking up faster on things (often) and so being less frustrated, them being able to easily verbally express to me things that they would like and me easily being able to say "sure, just finish up such-and-such first."  My daughter also is able to make transitions extremely easily.  

 

[PeterPan]

Lecka, are you saying they have different kinds of tokens?  Like good try tokens and good behavior in class tokens and good independent work tokens?  Or you're saying they use the same token currency for many things throughout the day?  One I'm overthinking and two I was trying to figure out the "good try" concept to losing at games.  Horrific problem in our house and something that would be worth the effort to do some positive rewards with.  I've done replacement behaviors (shake, congratulate), but it's still a mess.  

[texasmama]

Lecka, are you saying they have different kinds of tokens?  Like good try tokens and good behavior in class tokens and good independent work tokens?  Or you're saying they use the same token currency for many things throughout the day?  One I'm overthinking and two I was trying to figure out the "good try" concept to losing at games.  Horrific problem in our house and something that would be worth the effort to do some positive rewards with.  I've done replacement behaviors (shake, congratulate), but it's still a mess.  

Are you working on just this behavior at one time?  I would suggest that, hitting it hard with all the positives and role playing and practice and desensitization and skills learning (self-talk about losing, running positive self-talk from you, deep breathing, taking a break when needed for physical activity, allowing quitting mid-game if done without a blow up, incrementally inching toward the goal, etc).

 

(Not Lecka, but those are my free of charge thoughts.  Also, if this is a really tough behavior to change, start with something easier.)

 

You probably know all of that, but again, there is no charge.  :D

[texasmama]

Anna's mom, I think you are awesome.  Some kids are just really, really hard.

[Guest]

Lecka, just to clarify, I believe it's great when a behavior modification works for someone's child or they make it work. I hope my comments were not misunderstood! The thing is, it does not mean that the same approach will work for every child, or even every parent's principles. It's why I feel that extreme cases are best left to professionals, which is what you have done with your son as I understand it. Also, in our cases we have spectrum kids and that can be a whole different ballgame in itself.

[texasmama]

What I love about behavior mod is that it is so flexible, depending on the needs of the child (and the parent).  And any approach with behavior mod usually takes some tweaking.

[texasmama]

Also, in my entire career, I only worked with two kids for whom behavior mod plans were fairly ineffective, and both of them had moderately severe FASD.  I did not work primarily with the ASD population, though I did have some kids on my caseload, particularly at the latter part of my therapy career,  (I am on therapist sabbatical due to homeschooling.)

[Guest]

Texasmama, I get what you are saying, but you are a psychologist as I recall. Correct? The kids you dealt with you observed yourself. When one parent shares with another parent the approach recommended to them, with possible tweaks for that specific child, then the other parent takes it, possibly adds their own tweaks because they are trying to make it work for their kid, then they share it with someone else... Oyi! It's why I don't advise others to do as I do. I am not a psychologist and I can at times be a cynic when reading about the different schools of thought on psychology. I am an older mom though, I read a lot, scrutinize and process them in my head, and then make my decisions. I don't expect others to do things as I do but definitely respect the right we have as parents to choose what we feel is right for our own kids. What makes sense or works for me in my mind will not necessarily be the same for another.