Saturday, March 17, 2018

The Kazdin Method for Parenting the Defiant Child

Point chart:
A common problem with larger rewards requiring many points is that their delivery isn’t immediate. When developing behavior, especially early in the program, the emphasis should be on small rewards that can be earned daily. Having your child save up all his points for one big, much-desired reward will lead to an ineffective program...

Here is how to get the best of both worlds. In addition to the usual little rewards that your child can buy with two, four, or six points, and in addition to the more expensive rewards costing ten or twelve points, you can also choose a more delayed, larger back-up reward that requires a lot more points to achieve...

For this, we need a second chart that keeps track of all the points your child has earned, whether he spent them or not—like an end-of-the-year wage earnings statement... 
Just transfer the Total Points for the Week number from his chart to the special rocket-ship chart, even if he spent those points on smaller prizes. (51-52)

Fading:
Once you’ve got the program under way, make an effort not to nag. If Sarah isn’t doing what you ask, remind her once, then let her know that she won’t get the point this time, and we’ll try again next time. If she’s showing signs of progress in doing what she’s asked without being reminded, you can also add a wrinkle as you go: if she can get out of bed and come down to breakfast on time without being asked or reminded to, she gets an extra point. What we’re trying to do here is fade your participation, so that Sarah gets in the habit of being responsible for herself in the morning. Such fading is crucial to the success of the program. Remember that the program is intended to be temporary, a dynamic process that you taper off until the behavior is a habit and you don’t need the structure of prompts and rewards around it. (81)

Fading:
There are ways to reduce the program—called “fading”—so that, by the time you abandon it, discontinuing the program does not make much difference anyway. By then, the behavior no longer depends on the A’s, B’s, and C’s that developed it. Fading has been well studied; there’s a solid research base that tells us what works.

1. Make the reinforcers more intermittent or more delayed (or both). When you’re developing the behavior, it’s important to reinforce all or almost all instances of the behavior that you see. As the behavior develops, give the reinforcer for larger chunks of the behavior, so that there’s less direct connection between performing the behavior and getting the reward. For instance, instead of awarding points each day for twenty minutes of homework, do it every other day. The child gets the same number of points, but she has to perform up to the standard for two days in a row to get any points at all for those two days. If she gets five points per day for those twenty minutes, she can get ten points on Tuesday if she did the required amount of homework on both Monday and Tuesday. (Remember to praise her on Monday, even though you don’t award points on that evening.) But if she slacked off on Monday or Tuesday, then she gets no points for either day.

Then, after a week or so of this, you can go to just giving twenty or twenty-five points at the end of the week if most nights—let’s say four out of five school nights—meet the homework criterion. Don’t insist on perfection, but you can build in bonus for perfection. For instance, she gets twenty points for four good nights of homework in a week, and a fifth earns her a five-point bonus, for a total of twenty-five. But if she does only three nights of homework, which falls below the minimum standard of four good nights per week, she gets no points at all for the week.

The delayed program probably would not work as an initial way of changing the behavior. It would be too sporadic; the connection between behavior and consequence would be too tenuous. But as a way of maintaining behavior, it’s great. Soon, after maybe a couple of weeks of awarding points just at the end of the week, the program can probably be dropped entirely.

2. Use a leveled system. Another way to fade the program and maintain behavior is to introduce levels into the program and to have the child progress through these levels. The final level is no program, when the behavior can be maintained without any special attention to it.

The first level is the regular program we have been describing in previous chapters. After behavior stabilizes, the child progresses through additional levels, with incentives to move on to higher ones. The minimum number of levels is two; when we do employ a leveled program, we usually go for two or three levels. As the child progresses to the next level, the consequences for behavior are more delayed and intermittent, exert less immediate control over behavior, and are not connected to specific acts during the day. The child’s incentive to move from one level to the next is that he can get access to new rewards and more freedom—more choice, more independence.

We used a simple two-level version of a leveled program for a six-year-old boy named Jake who was prone to tantrums. At level one, Jake earned points each day if he handled No, you can’t do that or It’s time to go to bed calmly, without crying and arguing. He could earn two points for a reasonably peaceful bedtime. If he had no tantrum when his parents said no during the course of the day, he received two points for each instance of that, too. Because he was in the habit of asking for special foods, privileges, expeditions, and shows on TV almost every day, requests to which his parents frequently said no, he had lots of opportunity to practice responding calmly to not getting his way. There was a point chart on the refrigerator, and at the end of each day, if he had enough points, he could buy all sorts of rewards, including a pick from a grab bag, a special healthy miniature candy bar, and so on. Early in the program, we had practice simulations during the day to accomplish the reinforced practice and get the behavior going. After a week, we reduced the simulations to only two practices a week. The tantrums were lessening in intensity, and most of the time he had no tantrum at all.

We added a second level. We kept the first level just as it was, but, in addition, we told him that any time he had two perfect days in a row with no tantrums, he would earn himself off the program. That was level two. On the day after two perfect days in a row, he would not earn points, but he could choose any of the rewards (without paying with points) and could stay up fifteen minutes later (a new reward, available only at this level). If the next day continued with no tantrum, the level-two conditions would continue for another day—because the second and third perfect days in a row would, of course, meet the criterion for two perfect days in a row, and so on for another day and another and another, as long as he kept up the no-tantrum string. Any day he had a tantrum, we went back to level one. We called level two the “big-boy level,” which gave it an air of challenge for him—a setting-up event to increase the likelihood of the behaviors. Jake was at level one for the first four or five days, went to level two, stayed there for a couple of days, had a tantrum and went back to level one, earned his way back to level two with two perfect days in a row, and from that time on remained pretty constantly at level two.
Soon there was no need for the program, but of course his parents could always return to it as necessary. (188-190) 
 

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