As a starting point, this training tool presents a number of situations, focusing on the child’s conduct, such as:

• • When playing alone or with other children
  • At mealtimes, when dressing, washing up or going to bed 
  • When asked to do chores or homework
  • With visitors in their own home, someone’s else’ home or in public places
  • With secondary caregivers 

Parents can rate their child if they have problems complying with instructions or rules, depending on whether the conduct is mild, moderate or severe. The final score can help parents monitor their child’s behavior and identify issues to focus on.

This training tool can lead to an enlightening pattern of behavior and interpersonal dynamics in the home. There are four factors that interact with one another to contribute to every child’s behavior:

The first two factors identify the strengths and challenges of parent and child—that is, their personality traits or characteristics—and identifies the interactions between them. 

The second two factors—environmental or life stressors (or supports) and consequences, the most important factor—help identify parental strategies to reward and/or punish child behavior to inform future work.

Parents can rate each family member on a high-low continuum, based on different characteristics, and gain better understanding of why their child behaves a certain way and where the behavior comes from—whether based on genes, environment or a combination of the two. 

The goals of this activity are to improve the parent-child relationship through behavioral play therapy, while reducing anxiety/attention-seeking behavior throughout the day. Parents can practice one-on-one time in order to:

Attend to positive child behaviors and ignore mildly negative ones 

Improve the quality and consistency of their attention

Promote a more secure, predictable attachment

One-on-one time can benefit all children, but especially those with symptoms of: 

• • Anxiety
  • Depression
  • Trauma
  • Attachment disorders
  • Selective mutism
  • Behavioral issues
  • Attention-deficit/hyperactivity disorder (ADHD)

It is recommended that parents spend five minutes of specialized one-on-one time with their child at least five days a week.

Parents should:

• • Use a high rate of positive reinforcement skills—PRIDE (praise, reflect, imitate, describe, enthusiasm)—including labeled praises, reflections and behavioral descriptions. 
  • Give accurate, honest and immediate praise. Children learn from their parents’ attention, description and praise.
  • Stick with it and keep trying, without worrying about mistakes.

Parents should not:

• • Participate if preoccupied, busy or upset, when the quality of attending to their child will be poor
  • Ask questions, give commands and criticisms or provide instructions
  • Involve other children

Once things are going well, parents can spend one-on-one time with other children to make it a part of the family routine. One-on-one time can be adapted for older children and adolescents by making it more interactive, less descriptive and more structured, such as non-competitive games, walks or bike rides.

Parental attention is a primary motivator for both good and bad behavior, especially in younger children. PMT teaches parents to use their attention as a powerful motivator through praise.

Clinicians can guide parents to:

Make praise or approval immediate, consistent and appropriate for every instruction or house rule a child or adolescent follows. This makes it more likely to see future improvements. 

Use specific phrases of appreciation—called “labeled praise”—as in: 

“Nice job picking up your toys,” or “I appreciate when you do your homework without reminders.” 

Parents should avoid praise that does not reflect on a specific action or behavior or does not seem relevant to something deserving.  

Be alert for and reinforce a child’s positive and appropriate behaviors. 

Offer enthusiastic and sincere praise, adding hugs and high-fives

Praise the “positive opposite” of a negative behavior, rather than giving attention to the negative, or praise less negative approximations of a behavior. For example: brushing teeth with less of a fuss

Attention-seeking children are less able to differentiate between positive or negative attention. Any attention reinforces negative behavior. Sometimes negative attention is even more reinforcing at first, because it is more predictable.

Hand-in-hand with praise is active ignoring, used for mild-to-moderate behaviors that may be annoying, attention-seeking, inappropriate or disruptive, but not rule-breaking or dangerous. Ignoring is a harder skill than parents might expect, but it can be highly effective in “turning on” attention to positive behaviors and “turning off” attention to negative behaviors. Ignoring is effective only in the context of a rewarding environment.

Clinicians can guide parents to:

• • Avoid getting drawn in by arguing, scolding or talking
  • Avoid eye contact or expressing emotions, verbally, in facial expressions or movements
  • Get absorbed in something else
  • Be prepared for the “extinction burst” (expected and temporary escalations of misbehavior), for example, tantrums in young children or angry, rude language in older children
  • Use “differential reinforcement” with two or more siblings

Compliance has a greater likelihood of occurring when instruction is given effectively and sparingly, when important and the parent can see the task to completion.  Children with ADHD and oppositional behavior receive more instructions than the average child and learn to tune them out. 

Effective instructions are specific, clear, delivered calmly and as statements (not questions) and limit distractions.

Ineffective instructions are vague, repeated, “chain” (too many steps), interrupted, given as the “royal we” or asked as questions.

Creating a rewards system for children can help children and adolescents to better understand themselves and, in turn, motivate positive behavior change.

Rewards should:

• • Increase positive reinforcement 
  • Increase parent attention to appropriate child behavior
  • Be convenient, immediate, organized and fair
  • Set the child up for success

Certain types of rewards work better with some children than others. Children with ADHD and oppositional behavior, for example, may be less motivated by non-tangible reinforcers than other children.

Clinicians can guide parents, with child input, to accomplish the following tasks:

Make a list of desirable behaviors to increase

Assign points to behaviors and rewards

Make a list of salient rewards on multiple levels, for example:

• • • Immediate: marbles, stickers, seeing a friend after homework
    • Daily: extra one-on-one time, extra screen time, allowance (older children/teens)
    • Weekly: going for ice cream or a movie 
    • Long-term: “big ticket items,” from toys to technology

It is difficult to target behaviors for improvement. Common pitfalls for award-setting may include:

• • Setting the bar too high or needing too many completed behaviors to receive the reward
  • Rewards are too delayed or to frustrating to achieve (all or nothing awards)
  • Points are taken away, demotivating the child

Establishing clear guidelines for expected behavior allows parents to set clear consequences. Children with ADHD or oppositional behavior may have greater difficulty “internalizing” rules. Clinicians can guide parents to:  

– Identify a few non-negotiable, non-tolerated behaviors, such as unsafe or physically aggressive behavior, while explaining immediate consequences for what is non-negotiable.

– Post “House Rules” and introduce at a family meeting 

– Prepare for success: Establish daily earning of high-level privileges (earning time on a new smart phone or laptop) as part of the positive-reinforcement plan and reduce ongoing conflict for frequently “taking things away.”

Learn more about the Parenthood Center at CFI…

CONNECT TO CARE