Archive for category Behavioral Therapy

Behavior Therapy – Only Ask Three Times –when your child won’t listen and obey

Here’s a tip: After you have asked three times for your child to do something, stop being verbal and resort to gestures.

It’s one of those little annoyances that kids will do to manipulate us parents and caregivers for attention. Let’s face it, they all love the sound of mommy’s voice and the more they hear it, the more satisfied they are!

Sit down!
Come around the bed!
Give to mommy!
Wipe your chin!
Lay still!
Don’t move!

The list is endless, but you needn’t go hoarse repeating yourself. If you don’t know sign language that’s okay. Invent a gesture for each command. Using the command will switch gears in their brains where they go from auditory to visual and it may be enough to get the response you are looking for.

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Biting Humor

I just have to report something funny! Our daughter, almost 3 years old, now brings her teeth to a body part of mine and lets me know, by letting her teeth and lips touch my skin, that she’s “about” to bite me. Then, with great speed, she pulls back, looks me straight in the eye with an intellectual look, taps her temple and says, “I remember, I remember!” –she still gets a rise out of me, only this time she knows she is making me smile!
-Annie

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Biting – Reinforcing Good Behaviors

Nothing replaces a good therapist working with you, and I hope that you will find my blog posts inspiring but keep in mind that I am only reporting on what I am learning and experiencing as I make my way along this journey of behavioral changes.

This post is going to be short and sweet. It’s about looking for opportunities to reinforce the good stuff and pre-empting the bad behaviors by redirecting them into positive experiences.

My toddler is clever. She can smell a rat and already she knows we are trying to change her behavior. She is full of resistance and making more fuss than ever before. We have had to take smaller steps than before and we are looking at the littlest things to reinforce. Here’s our list:

- affection
- peaceful behaviors
- nice touching, nice use of hands
- kindly asking for attention
- good waiting (patience)
- following directions, especially on the first request!

Repeat particular phrases over and over that reinforce the good behavior:
- I like when you’re calm. It helps me help you.
- I want to know what you need. Good asking/telling daddy.
- When you are ready to tell me, I will listen. (reinforces: calm gets you what you want)
- I like when you play nice with me.
- That’s good waiting! Mommy likes it when you wait nicely for her.
- When you are calm, mommy can help you.

Stay tuned as our journey continues…

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Biting – Trades for Preferred Tasks

You need to teach your child “When I do what I’m asked, I get what I want.”  -Kerri Orr, Behavioral Therapist

Memorize this message because you will be teaching it to your child over and over again. In order to teach this, you must begin with simple trades that your child is capable of doing. For example, my little gal doesn’t obey commands like “bring me your sippy cup” or “bring me a book and I will read it”. She does obey commands like “give me a high five” and “give mommy a kiss”. It’s a simple practice that I am weaving into my daily life that is teaching her that in order to get what she wants, she must give me something first as a trade.

Bargaining examples for a young toddler:
1.) My daughter looks at me in front of a chair and says “up” one of her first words and most often used. I tell her, “First give Mommy a kiss and then I will put you up!” Once I get the kiss (trade unit) I do what she wants (assistance).  
2.) When she asked for cheese, I said, “First give Daddy a high-five and then I will give you some cheese.”
3.) “I know you want to play. Can you give me your brush first? Then we will play.”

Bargaining examples for an older toddler:
1.) First bring me your shoes and then we will go for a walk.
2.) First you need to eat then we will play.
3.) I know you want to go to the park/playground. Thank you for telling me. We will go in ten minutes (set timer). First you need to play here for ten minutes and then mom will take you to the park/playground.

Always keep your end of the bargain immediately after your child has kept their end to maintain consistency and trust.

Another problem: Tissue in the mouth (aka, unacceptable item in mouth)
What child hasn’t chewed paper towel, toilet paper, facial tissues and random paper? My little gal takes after me in this respect as I used to make spit balls as a toddler and place them in little piles. My problem is that my daughter will chew the paper like chewing gum…and won’t spit it out into my hand when I ask her to. This non-compliant behavior could represent a safety issue somewhere else. It has to be handled correctly.

WARNING: If you introduce food as something ‘appropriate for the mouth’ to TRADE for the paper in the mouth you are establishing in the child’s mind the following: “If I have something bad in my mouth, mom will trade me some food for it. Therefore, all I have to do to get food is put something bad in my mouth.”

Here’s a script for a correct trade
Mom: “Would you like some apple (something appropriate in the mouth)? First I need you to take that out of your mouth and give it to me, then you can have the apple.”

Stay tuned for more!

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Biting – “First, Then” Approach with Positive Reinforcement

Most people aren’t happy when someone, without any warning, does a “180″ on them –meaning they change the subject, get up and walk away, leave them suddenly for something different and so on. Imagine a little child playing happily and then suddenly their playmate jumps up and gets the phone, makes a move to cook dinner, etc.  In my limited experience with children with learning delays, they need time to process their communications that are incoming and outgoing. I try to count to ten before expecting an answer, for example, and I keep my mouth shut as best I can while my daughter is processing her answers before speaking. It’s not easy, and I do my best.

Setting Expectations…and Reminders
I didn’t realize that everytime I jump up and change directions I am confusing my daughter who is 2 years and 8 months at this writing. I can’t always offer some buffering but I am learning that it is important to set her expectations so she doesn’t get mad when I change directions. Here’s what I am doing now:

- ”First we’ll read this book and then Mommy will take you for a walk/bath/etc.”
—–”Remember: Mommy is going to take you for a walk now that we are done with reading a book.”
- Set a timer for 2 minutes: “First we will play for two minutes and then Mommy has to go cook.”
—–”Remember: When the timer goes off, Mommy is going to go to the kitchen to cook and Daddy is going to play with you.”

Show them what they can do…
If your child is old enough, show them pictures of activities that they might choose from to do when you are done or that someone else can do with them while you are busy with whatever it is that is going to disconnect you from your child.

Puzzle pieces as a reward…
Cut an activity picutre card into three or four pieces and put them into your pocket. As your child does what you ask of them, reward them with a piece of the puzzle. When they collect all pieces and the picture of the activity is formed, you must drop everything and do that activity to reinforce their success at practicing acceptable and good behavior.

Implement consistency…
Using my problem as an example, when dinner time approaches, I can tell my daughter, “Head’s up! Mom has to cook in 2 minutes” –set the timer and train her to listen for the dinger/alarm so that she learns the sound and that means a change of program.

Reinforce Appropriate Behavior…15 to 20 times a day!
- Thank you for telling me how you are feeling.
- Mommy knows how you feel/what you want now.
- Thank you for asking nicely.
- Good asking. High five!
- Oh, someone’s mad: tell me why.

Praising good behaviors…dozens of times a day!
Make sure that your praise is appropriate for their age and that you are not giving a sticker, for example, to a toddler who will put it in their mouth and try to chew and swallow it. I know because I tried it and it backfired! One thing is for sure, you want your enthusiasm to reign supreme in giving praise right now. It’s essential that you do not give any bad behaviors a raised voice; but good deeds must be praised well enough for your child to notice the difference between regular talking and scolding (low tone/voice) and excited, joyful praise that says, “Gee, I must have really done something very exciting and good!”

Be sure to reinforce good behavior in the beginning 1 for 1. Later on, reward at a rate of 1 for 2 and then 1 for 3. In other words, the first several times they do what you want, praise, praise, praise. Then let your praise come every other time they do what you want. Later on, let it be every third time.

Mix and match any of these rewards:
- Verbal praise: Good talking! Good telling mom how you feel!
- Activity praise: go play, read, walk outside, bath or pool time
- Token praise: give a piece of food like a cracker, sticker, puzzle piece to an activity

Reverse Reaction…
If you are like me, and you have been yelping in pain everytime you’ve been bitten, and you gave a dramatic display of displeasure worthy of an Oscar, it is now time to reverse your reactions otherwise you will be played for a fool. Biting now gets a low toned, low volume reaction, “No biting! You just earned a time out! Two minutes!” and a dramatic drop into the crib on her diapered butt. No more dramatics for biting; it all must be saved for rewarding and reinforcing good behavior.

Stay tuned…more to come!

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