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Caregivers' Skills Program


In this section you will learn to understand reinforcement as the means for improving desirable behaviours. We will review the differences between social and material types of reinforcers and the principles for applying them.


Parents typically want to focus at first on discipline, but this does not get good results. It is better to begin with how to reinforce - reward - children's correct behaviour. There is then a dramatic increase in success.

The true secret to success lies in the positive interactions between parent and child. Reinforcement is the key ingredient for working successfully with a child. Once a child's behaviour improves, discipline becomes less necessary. Using reinforcing techniques with IA and HM children is critical in helping them overcome their typical low self-esteem. Once youngsters' behaviour patterns become positive, they are treated positively, which helps them feel better about themselves.

Reinforcement involves procedures that either maintain or increase behaviours. Conversely, any maintained or increasing behaviour is most likely getting reinforced. Often we inadvertently reinforce the bad behaviours we wish to eliminate, which we will later learn to avoid doing. This section focuses on how to control reinforcements so that your child will learn new and desired responses.


We can divide reinforcers into two broad categories - Social and Material. Material reinforcement may be divided into two categories - activities and objects.

Social reinforcers include personal interactions between you and your child:

  • paying attention,
  • spending time with the child,
  • looking at the child, talking to the child,
  • praising,
  • touching,
  • listening, and
  • just plain showing a response.

Material reinforcers include activities your youngster enjoys:

  • watching television,
  • having free play,
  • going outside,
  • riding a bike,
  • playing games,
  • enjoying special privileges,
  • attending a special event, and
  • having prized objects such as toys, favourite foods, money.

Reasons to Prefer Social Reinforcement

Here is a major difference in the CSP. It strongly endorses the use of social reinforcement over material reinforcement for the following reasons:

1.    Social reinforcement during early childhood is important in developing a close relationship between parent and child. Positive bonding cannot occur unless the parent actively reinforces the child's appropriate behaviours. The focus of this program extends beyond controlling behaviours to building strong, loving relationships. Developing this bond lessens the risk of any serious acting out during the teenage years. Some adolescent rebellion will most likely occur, but the severity of it can be curtailed by building a loving relationship. By building a close relationship, you'll make it easier to teach values to your IA or HM child. Instilling new values is a key element of the CSP. A program based solely on material reinforcement may control behaviours but does little to build relationships.

2.    Material reinforcers generally produce the quickest improvements in behaviour, but these improvements often fade rapidly. We have all observed an improvement in our children's behaviour just before the winter holidays, when they hope to earn the toys, dolls, and games advertised on television. By New Year's Eve, the children have tired of the presents and reverted to their pre-holiday pattern. The incentive is gone. When the child tires of the reinforcer, it loses its potency for controlling behaviours. This is called the satiation effect. With social reinforcement there is usually no satiation effect to worry about.

3.    Material reinforcers promote a payment expectancy - unless the child earns a material reward, he will not behave. Several authors dispute this pattern or rationalize that adults are paid for labour and therefore why shouldn't children be paid? Ask this: How much are adults paid for work at home? We work willingly, lovingly, and voluntarily at home to fulfil our responsibilities to our family. We behave correctly as a sign of courtesy and respect for other family members and not because we get paid. We should expect to develop these same values in our children. They should develop a strong, natural sense of caring and responsibility toward home and family. Teaching these values to our children is more important than simply controlling their behaviours. With social reinforcement, payment expectancy does not become an issue.

4.    Social reinforcement is extremely important for children because it helps them develop a more positive self-image - more self-esteem. Many parents instinctively, consciously, and consistently praise and socially reinforce their children; unfortunately, many others are unaware of how often they yell at, criticize, punish, or ignore their children. Youngsters develop their primary attitudes about themselves from how their parents treat them and what their parents say to them. The child who is treated negatively during the early developmental years will not develop a positive self-image. Once early attitudes are locked in - probably by the age of ten - they are extremely difficult to eradicate. We should consistently praise our offspring; most of the time they work hard to do the positive things we desire from them. IA and HM children often have a history of harsh treatment from parents, teachers, and peers. They need social reinforcement more than most children. They need to hear positive things to enhance a more positive self-image. The IA or HM child seems to invite negative reactions. Positive and consistent social reinforcement prevents this kind of problem.

5.    Token economy programs, which are based on material reinforcement, are inappropriate ways to raise children. Having charts on the wall and giving stars and check marks undermines the normal parent-child social interactions. If a child is to develop appropriate social skills and a sense of appropriate family interactions, then the family should be a model of normalcy. Lists, charts, and poker chips do not establish a model for normal family behaviours and interactions. Because children are learning patterns of human conduct within the family, it is essential to establish a foundation upon which they can draw as adults when establishing their own families. Adults can be confused about their roles, conduct, and values if their reference point from early life was not normal. Token programs are not normal for the home.


Several basic principles underlie changing our children's behaviours effectively:

1.    Immediate social and material reinforcement is more effective in changing behaviours than delayed reinforcement. You must reinforce the correct behaviour as soon as it occurs if the child is to learn the association between new social skills and behaviours with positive responses from others. Immediacy is critical during the learning stage of new behaviours. If reinforcement is delayed, children may be confused about what we expect and the behaviour that is occurring at the time of the reinforcement, instead of the behaviour we are trying to teach them, will increase. For example, Johnny is told to pick up his toys. He does so quickly, but an hour later when we praise him for his earlier compliance, he is banging on the table. He will now continue to bang on the table. Reinforcement is incredibly powerful, but if used incorrectly it can work against you.

2.    If reinforcement is to be effective, the parent must reinforce correct responses consistently. This is extremely important during the learning or acquisition of new appropriate behaviours. In other words, during the learning of new behaviours try to reinforce each correct response.

Here are a few examples:

You say, "Johnny, please pick up your toys and get ready for dinner." Johnny immediately begins to put his toys away. Reinforce by saying, "Johnny, I'm really proud of you for listening to me and doing as you are told so quickly. I'm very proud of you."

Notice that in CSP language you are reinforcing compliance to your command. Or you say, "No Johnny, you may not have candy before we eat."

Johnny says "OK" and quietly walks away. If Johnny has a history of temper tantrums, don't let this moment slip by. Say, "Johnny, wait a minute. I want to give you a hug and a kiss. When Dad said no you didn't blow up and you accepted what I said in such a nice way. I love you, son."

Or if you hear Johnny and his sister Mary settle a dispute without fighting, go in the room and say, "Johnny, Mary, I was listening to you two settle your difference in a nice way. Johnny, you asked Mary to play with her keyboard and when she said no you gently told her you'll be careful with it. I'm so proud of you for asking so nicely and without threatening your sister. And Mary, you said no at first, but you listened to what your brother had to say and even changed your mind so he could practice on your keyboard. You didn't whine or cry but instead you handled it like a big girl. I'm so proud of you. I'm so proud of the both of you. I love you."

Training new behavioural patterns requires a lot of work at first, but as these new patterns lock in, our work becomes easier. You will see results much more quickly than you may expect, and the hard-work part does not last very long.

Caregivers must also be consistent in their policies with one another. Both Mum and Dad and every other caregiver must reinforce consistently when an appropriate behaviour is being learned. Whoever is with the child at the moment of a correct response must reinforce that response.

Adults who cannot be consistent risk making minimal gains in their work with their children. They should consider therapy to learn to be more consistent. Sorry, but the approach in this program means that you have to work hard to get the desired changes you want in your offspring.

Consistency requires that you reinforce behaviours when the child is in different situations - restaurants, church, stores and so forth. Another good thing about social reinforcement is that you can praise a child anywhere and at any time.

3.    Contingency means that consequences exist for target behaviours. Reinforcement is given as a consequence of the child's responding correctly; discipline is provided as a consequence of the child's not responding correctly. This cause-and-effect formula is the basic foundation for working with IA and HM children. The more problematic the child, the more strictly we must apply the rules.

Some authorities (mainly humanistic and Rogerian psychologists) believe that conditional reinforcement is detrimental to a child's psychological development and that children should not have to perform to earn praise. They claim that reinforcement should be unconditional.

Yes, children have a natural exploration drive, as these writers proclaim. With conditional reinforcement, however, that drive is more focused and harnessed. Contingent reinforcement is essential for learning new behaviours because it aids and enhances children's natural creative drive rather than blocking it. In other words, it motivates them, which is the key to success with the IA or HM child.

Both conditional reinforcement (praise for performance) and unconditional reinforcement (telling the child "I love you") should be practiced abundantly. Children who are abundantly reinforced will be more comfortable and secure about themselves and thus will be less likely to spend their lives searching for approval.


Here is a little secret: all reinforcement is conditional and contingent. Whether reinforcement is intended to be conditional or unconditional, any interaction with a child reinforces whatever behaviour is going on at that time. It is not a matter of what is said; it is a matter of timing. If you make contact with the child, you are reinforcing that child at that moment.

Here's an example:

MUM: Johnny, please pick up your toys.

JOHNNY: You don't love me!

MUM: I love you. It's your behaviour I don't like.

On the surface this seems to be a healthy interaction with a child. The reality is this: Mother is inadvertently reinforcing the poor-me statement (You don't love me). By interacting with her child, she is reinforcing the behaviour that precedes the interaction. The child makes an association between the verbalization and her attention. If this continues, the parent is likely to see an increase in poor-me verbalizations, while non-compliance remains at the same level. Timing is the key.

In our approach, as you'll learn in the section on discipline, if Johnny frequently uses poor-me statements to manipulate, then consequences should be firmly and immediately implemented. This is not to introduce the idea of Time Out here, because in the CSP it has been redesigned to deal with the IA or HM child, and it is best to carefully read the section. 


In this instance Johnny engaged in two target behaviours in rapid succession: he was noncompliant and made a poor-me statement. Therefore, the sequence of rigorous parent-child interaction necessitates not reinforcing these behaviours and instead disciplining them immediately as follows:

MUM: Johnny, please pick up your toys.

JOHNNY: You don't love me!

MUM: (in a firm voice) Go to time out!

After time out, this is what should happen:

MUM: Johnny, you may come out of time out. (Johnny walks up to her.) Why did you go to time out?

JOHNNY: Because I didn't pick up my toys.

MUM: And what else?

JOHNNY: Because I said you don't love me.

MUM: What are you supposed to do?

JOHNNY: Pick up my toys.

MUM: Good. Now go do it. (Johnny turns toward the room his toys are in.) Thank you for listening, Johnny. (Her statement immediately reinforces correct compliance.)

We are interacting contingently with our children all the time. Unfortunately, much of this interaction is negative. At home and at school, when children are quiet and being well behaved, we ignore them. When they do or say something inappropriate, we give them our attention - the negative kind.

If you wish to make unconditional reinforcing statements to your child, make them while your child is behaving well. When my children are sitting quietly playing, reading, or watching TV, I often hug them and say, "I love you." By not giving them attention when they misbehave, you can deliberately avoid inadvertently reinforcing unwanted or undesired behaviour.

Caregivers - mainly parents and teachers - are judicious about contingent punishment but are lacking in contingent reinforcement. Again, the secret of success is not the punishment; it is the reinforcement.


When socially reinforcing a behaviour, use descriptive statements such as these:

"I like the way you're sitting at the dinner table. You're being quiet and asking for things in a nice way."

When Johnny brings you his homework after completion say,

"You did a beautiful job on your homework. Your writing is nice and neat, just the way Mummy showed you."

"Johnny, I'm glad that you picked up your toys when Mummy asked you, without making a fuss. I'm very proud of you."

These statements should serve as positive reminders of what the child is doing correctly and exactly what behaviour is needed to earn the caregiver's approval. Positive descriptive statements should be used by all caregivers, including parents, teachers, and grandparents.

Parents use descriptive statements all the time, but usually in a negative way, such as:

"Why didn't you pick up your toys like I asked you?"

"Why don't you ever listen to Mummy ?"

"Stop making those sounds at the dinner table. I want you to sit quietly and keep your mouth shut."

"Your paper is sloppy. Look at that letter L. How many times do I have to show you how to do it right?"

In other words we wait for children to misbehave and then we interact with them negatively by yelling and describing what they did wrong. Negative statements are the predominant way parents and teachers treat children, and sadly it is the predominant way we treat IA and HM children. This pattern proves counterproductive for children who should be developing a positive self-image.

Have you noticed that misbehaviour often gets gradually worse until we explode? For example, Johnny may kick the table leg and we try to ignore him. Then he hits his sister - then we explode. To prevent escalation of misbehaviours, learn vigilance. Use positive description statements before the child does anything wrong. An example is, "Johnny, you're sitting so quietly tonight at the table. I'm proud of you." Do this before he starts banging on the table. Reinforce the child as early in the sequence as possible.

One thing to avoid when reinforcing socially is talking to your children in an exaggerated, childish manner. While saccharine or falsely sweet statements do get the attention of the very young child, they also model inappropriate social behaviour. The child will probably imitate this verbal pattern and then other children may respond with ridicule and ostracism, which, in turn, can be very painful and scarring. Speak to young children in a clear, warm, and caring way. Be natural.

Use of Social Reinforcement to Shape Complex Skills

Shaping is a reinforcing technique that helps motivate children to learn new skills and motivation is the key to success with the IA or HM child. Shaping breaks a complex behaviour or skill down into a number of small steps, making learning easier. Gains in each of the steps earn a descriptive praise.

Here's an example of shaping:

We want five-year-old Danny to make his bed each morning. First, we observe what he can do without help (this is base level), then we praise (reinforce) him for his effort, no matter how far from perfect his initial attempt may be. Second, we show Danny how to do the next step, such as pulling the cover evenly over the bed. The child then practices this until he gets it right. When Danny has mastered steps 1 and 2, we praise him.

We reserve reinforcement until Danny masters the most recent step. Step 3 may be tucking the bedspread under the pillow. Step 4 may be smoothing the bedspread over the pillows.


We do not have to teach the child all the steps in one day. Yes, shaping does require effort on your part, but once your child learns how to make the bed, you'll never have to do it for him again. Isn't that wonderful?

Shaping complex behaviour and self-help skills has several important benefits: Children learn to share the family responsibilities, which helps them feel important. They learn to do tasks independently, without prompting, coaxing, and relying on you for help almost all of the time. These are crucial elements of the CSP.

Use of Shaping to Combat Dependency

Remember the target behaviour of dependency? Well, skill building reduces task, cognitive, and emotional dependency. Furthermore, youngsters learn to take pride in themselves by successfully accomplishing increasingly complex skills and this fosters a positive self-image.

The use of shaping may hold important implications for adult life. Many skills are never taught by parents or teachers because of the time and trouble it would take to do so. Teach your children as many skills as possible so they can develop self-confidence and independence. Add increasingly complex skills as they get older: how to cook, how to wash clothes, how to fix a light switch, how to repair a car and so on.

Yes, being patient is sometimes difficult when children make mistakes. Yes, often doing the task by ourselves is faster and easier than preparing our youngsters to assume the responsibility. Building skills and self-confidence and improving independent functioning are far more important goals than efficiency.

Use of Shaping in the Classroom

If you are a teacher, are you using shaping as a classroom technique for learning new skills? Are you using shaping with your own children as well as with your students? Do you as a teacher judiciously and consistently use social reinforcement in shaping complex concepts? Do you praise students for what they do correctly and well? Do you reinforce each student equally throughout the academic day? In other words, is shaping skills an everyday event for you? If so, you are most likely an excellent teacher.

All teachers need to do is walk around the classroom while the children are on task and touch their shoulder, praise them, and smile at them for their efforts and for their skill improvements. Doesn't this create a more positive environment for all children? Praising the IA or HM child for effort is an important motivating tool. When stopping to help students, the teacher can also prompt them on the next step while praising them for having improved a skill by one or more steps. This requires only a few seconds with each child.

Remember that trouble in school is the main reason IA and HM children are referred for therapy. Also recall that these children are not motivated to perform well in school. Bluntly stated, they hate school. A positive teacher using shaping techniques is crucial in getting these children to like school, that is, to motivate them to want to do well. If a child becomes positively motivated to perform well in school, the IA or HM patterns will disappear.


It is rarely necessary to use material programs with children below the age of twelve because correctly applying social reinforcement produces such excellent results. Sometimes, however, material reinforcers are useful for controlling behaviours that do not occur in the parent's presence. Most frequently this means school performance - one of the most important concerns of parents with an IA or HM child.

Because 20 percent of IA and HM cases may require additional intervention because of no improvement in school, material reinforcers become useful. Later in the program you'll be learning how to help this 20 percent. Therefore, this is a good point at which to outline some easy-to-understand guidelines for a material program that we'll use in that section

The principles of immediacy, consistency, and contingency that apply to social reinforcement apply to material programs as well.

Here are additional principles reserved specifically for objects and activities:

1.    Identify what your child finds reinforcing. Do not assume that you know what is reinforcing to a child. Just because you like ice cream does not mean your child does. Through observation, determine what objects and activities your youngster prefers.

All children - even the seriously disturbed - have a wide variety of reinforcing objects and activities. There is always something. With the list from your observations you can begin the program and be successful.

2.    To avoid lapses due to satiation, update and monitor on a continuous and ongoing basis. Material reinforcers eventually lose effectiveness because of overuse or overexposure (the satiation mentioned earlier). What may be reinforcing early in the program may later no longer attract the child and should be replaced with something more effective.

Some parents combat satiation by removing a particular reinforcer for a while in the hope of maintaining its effectiveness. As you probably already know, when you deprive a child of an object or activity, the youngster finds it desirable. For example, if you do not allow your child to use her bicycle, it probably won't bother her for a few days. Eventually she will most likely begin requesting it more and more. At that point, having use of her bicycle will be useful for controlling a behaviour because it will have regained importance to your child.

The law in many places requires that some reinforcers may not be withheld. Food is an example. As a guideline, never remove or deprive children of a reinforcer that is life-sustaining, such as food, water, shelter, or clothing. These are called primary reinforcers. All other reinforcers - a bicycle, a football, a favourite doll - are called secondary reinforcers and can be useful in controlling undesirable behaviours.

3.    If a child fails to get one reinforcer, he is not allowed to substitute something else in its place. A program works better and faster when this principle is in effect.

This case will clarify the principle:

Because seven-year-old Michael dawdled every morning, he missed the bus and his mother had to drive him to school. In IA and HM children dawdling is very common. This made his mother late for work. Waking him up earlier did not remedy the situation. Yelling, pleading, and threatening did not help either. IA or HM children are excellent at getting your dander up

Michael loved to ride his bicycle, so we gave him the contingency that if he was ready for school on time, exactly at 7:45 A.M., he could ride his bike after school from 3:30 to 5:00. If he failed to be on time in the morning, he would not be allowed to ride his bike or do anything else-no substitutions-on that day during those ninety minutes. This meant that from 3:30 to 5:00 Michael was deprived of contact with friends, phone calls, and most especially, homework, which meant he had to do it all later in the evening and miss his favourite TV show. Some readers may think this is a bit harsh or strict. But, the techniques in the CSP are designed for the IA or HM child. This means that we want to change inappropriate behaviours to appropriate behaviours in the briefest possible time.

If we want Michael to change fast and avoid any pressure to put him on Ritalin, these rigorous techniques are sometimes called for. However, in this program each day is a fresh start. This means that Michael can make choices: be ready and on time the next day and be allowed to ride his bike, be late again and not ride his bike, or get his homework done early.

If Michael can substitute other reinforcers during this time period, we neutralize the stringency or rigor of the CSP. If Michael can't ride his bike but can play with his video games, the consequences to him are meaningless.

The removal of homework is also important because if he completes his homework in this time period, he's free later to pursue fun activities. Allowing IA and HM children to do their homework when an activity has been lost indeed neutralizes the effectiveness of the CSP.

The IA or HM child is out of control; strong, firm intervention is called for. Stringency is what makes the CSP work. The faster a child changes, the faster he receives an abundance of positive material and social reinforcements. The faster he improves, the sooner peers and adults like him, which means the faster his world becomes more positive. You would prefer this stringency to the use of drugs or corporal punishment or to allowing these children to continue suffering the pain of ostracism and repeated failures.

Michael's mother did not permit him to swap activities, which would have neutralized the program's effectiveness. The first week this was put into effect, Michael was on time each day and he has been ever since. This was accomplished without resorting to Ritalin.

4.    Do not offer to buy the child something special if he improves a behaviour. Getting a new bicycle for good grades teaches youngsters about bribery and extortion. Instead, we require them to earn the reinforcers that are already part of their environment or part of their daily routine.

Examples of natural reinforcers are:

  • watching one hour of television at night,
  • talking to friends on the telephone,
  • playing football with friends,
  • going outside for free play after school for an hour or two, and
  • eating a favourite dessert after dinner.

Each of these can be useful when we have to deal with some very important behaviours. In fact, these reinforcers should be used if a school program becomes necessary. In that program we use a daily report card; the day's grades determine the use of these reinforcers, with no substitutions. Each day is a new day with a new report card. Therefore, the IA or HM child can make a decision to perform well and behave correctly that day or lose the reinforcers.

5.    Social reinforcement must also be given abundantly whenever the child's performance is correct. Even when using material reinforcers, we must still reinforce socially. Material programs will fail quickly unless correct behaviour is also rewarded with praise, a hug, a kiss, and so on.

Remember this as a cardinal rule for all behavioural methods: The real success is in the social reinforcement.


Maybe you're eager to learn about discipline, and we'll get there. Consistent social reinforcement, however, is the key to success. Without it, no form of discipline will work. In fact, nothing will work.

When actively reinforcing behaviours you'll begin to see incorrect target behaviours subside and new appropriate behaviours begin to emerge. Without knowing how to correctly discipline, the changes won't be substantial, because it is the combination of reinforcement with appropriate discipline that is essential to getting the complete change we're striving for. However, most of the families begin socially reinforcing right after this section and see changes right away, which means no Ritalin for their child is becoming a reality.















Acknowledgement: The content of this program is based on Ritalin Is Not The Answer: A Drug-Free, Practical Program for Children Diagnosed with ADD or ADHD by David B. Stein, PhD (Jossey-Bass, 1999 paperback)