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Caregivers' Skills Program


In the last section we learned that punishment is not only detrimental to the IA or HM child but may actually contribute to the development of IA or HM behaviours. Therefore, more effective forms of discipline that quickly produce permanent changes are needed if we're going to keep the IA or HM child off Ritalin. Children dislike and avoid zero stimulation - the absence of reinforcement or punishment. This knowledge had psychologists develop discipline techniques based on zero stimulation that are not only highly effective but lack the detrimental effects of traditional forms of punishment.

The three methods we will be describing are:

Ignoring will be discussed in this section. Time Out, which has been specifically redesigned for the IA or HM child, will be discussed in the next section. Reinforcement Removal will be discussed in the section after that; it is a stronger discipline technique.

We'll begin this section by defining what discipline means and what criteria are necessary for it to be effective. Some forms of discipline can be unintended traps that can work against our goals of helping the IA or HM child and ultimately keeping him off Ritalin. Therefore, you'll learn what these traps are and how to avoid them.


Before beginning the discussion of discipline, we want to emphasize the sequence to use in dealing with IA or HM children.

First, actively reinforce all forms of positive behaviour. If IA or HM patterns continue, try reasoning with your child. At a quiet time discuss your concerns about specific target behaviours.

For example, 

You could say, "Tommy, whenever I tell you to do something are you aware that you ignore me, or you get mad and talk back to me? Sometimes you even lose your temper. I'd like you to learn to talk to me in a nice way. I promise I'll try to carefully listen to what you have to say but I can't promise I'll always agree with you."

When reason fails we begin activating the discipline techniques.

Ignoring - the mildest form of discipline - is only useful for the mildest forms of misbehaviours and is covered in this section.

Time Out is the most frequently used and successful method and is used if reasoning fails or if the behaviours are too strong for ignoring. Time Out in the Caregivers' Skills Program has been specifically designed for IA and HM children, so read the section with considerable care.

Finally, Reinforcement Removal (in psychology this is formally called response cost) is used for behaviours that are highly resistant to treatment, for example, lying and more severe misbehaviours such as aggression.


Before discussing specific methods of discipline it is important to review the criteria that are necessary if discipline is really going to work.


Discipline should be applied immediately following misbehaviour. Recall that this rule also applies to reinforcement. Ideally, the child should be disciplined while the misbehaviour is occurring, so an association is made between misbehaviour and consequences. If discipline is delayed, its administration may occur when the child is behaving acceptably. Consequently, the child may learn to associate discipline with proper behaviour, which can be very confusing.

We must be able to correct misbehaviour that occurs outside the home, so you will learn how to discipline at Grandma's house or at the supermarket without embarrassing your child.

Let's look at an example:

Two sons and their father were visiting their grandmother. Their aunt was also present with her four children. One son got a bit rough with one of his younger cousins. Not wishing to embarrass him but also wanting to deal with his misconduct the father quietly told the son to come over to him. He whispered in his ear, "I want you to go sit on Grandma's bed for time out." The son did so for ten minutes and when he came out he whispered to his father what he had done wrong. The father asked him how he should be playing, which the son correctly answered, and then resumed his play. He learned that even at Grandma's he must remember how to behave.

The rule is to meet the requirement for immediacy as best we can.


Discipline must be consistent. It cannot be sporadic or haphazard if parents hope to see improvement in their children's behaviour and attitudes. This rule also applied to reinforcement. Parental inconsistency is one of the most frequent problems in dealing with children. In addition, be aware that IA and HM children require even more consistency than most children. Being inconsistent confuses them, so they have trouble knowing what is right or wrong. This means they can't think correctly - the trademark of IA and HM children.

Let's look at another example:

Mark was an extreme IA-HM child. His mother had a history of being very inconsistent with him. She let numerous behaviours slip past her and then would scream at him for something minor, like giggling at the dinner table. She and her husband went through training, but Mark's mother continued to be inconsistent, resulting in minimal improvements. This suggested therapy for the mother. Once she completed therapy she was able to be very consistent, which finally resulted in remarkable changes in Mark.

To get results with the IA or HM child, you will have to work hard if you wish to be consistent. Of course you'd prefer to drop your child at the therapist's office for an hour each week and enjoy wonderful results. Sorry. It just doesn't work that way.

No Nervousness, No Humiliation

Discipline should not produce tension or anxiety within the child. Physical punishment, which does that, is ruled out. A spanking, a paddling, or a smack across the face can be degrading and humiliating. This is exactly what an IA or HM child who already has low self-esteem does not need. Similarly, yelling can be detrimental. Frequent yelling can impair the parent-child relationship. It can also make your child very nervous. If you yell often, watch out when your child becomes an adolescent. He has learned from you how to yell, and your teenager will yell back. Also, please remember that frequent yelling teaches a child to tune out, which is exactly what we don't want the IA or HM child to learn.

No Unintended Reinforcement

The best methods of discipline require as little person-to-person interaction as possible. As we review discipline techniques you'll learn that only one sentence is permitted to initiate the discipline, which is usually "Go to time out!" Any additional interaction inadvertently reinforces the behaviour you're working on. You must minimize the risk of socially reinforcing the very behaviour you're trying to eliminate.


No matter what method of discipline is employed and no matter how effective the research says it is, no long-lasting gains will occur unless parents reinforce the child for good behaviours. This includes deliberate praise for specific improvement and unconditional expressions of love and caring when the child is behaving well.

Even though many parents work full-time, they must make the time for talking to and for having fun with their children. All children must have individual attention; otherwise, any program is doomed to failure. Without abundant reinforcement we will not achieve the end result we hope for: a well-behaved and well-motivated child. Such a youngster comes only from a loving home.


As we said above, the most aversive environment for children is one in which there is no stimulation. Zero stimulation means that contact with material or social reinforcers is almost completely eliminated and all aversive and punishing contact is removed. Zero stimulation means that the environment around the child is as boring as possible. Because punishment does not work, psychologists have developed three effective methods of discipline that employ zero stimulation (boredom). These methods get the best results without the drawbacks or side effects we just discussed. (Isn't it interesting that boredom can get better results than punishment?)

The three methods we will look at that approximate zero stimulation are Ignoring, Time Out, and Reinforcement Removal (RR):


Ignoring, which means removing social reinforcement, is useful only for very mild target behaviours - those you can tolerate without losing control. If you lose control you will run into several traps that can make matters worse, so keep in mind that ignoring is only useful for extremely mild misbehaviours. Mild is a very subjective term and means behaviour you can usually ignore. If you can't ignore it or if it annoys you, it isn't mild.

The Traps in Ignoring

A pattern can unfold the level of behaviour before and after ignoring begins. These traps also apply whenever social or material reinforcement is removed, either in time out or RR. At each step, if you do the wrong thing, there are traps that can actually worsen behaviour. The learning of behaviour and misbehaviour occurs over many years. Many target behaviours are learned slowly in the beginning, followed by an acceleration of learning and finally a tapering off of the learning process. This is called the learning curve.

The Worsening of Behaviour

Target behaviour worsens immediately following the beginning of ignoring?

For example, 

If Mary uses crying in a manipulative way when you try to ignore her, she'll start crying louder. Let's say she demands a piece of candy while you are shopping in the grocery store. You answer, 'No, sweetheart. No candy before dinner." Mary then begins to cry. You turn away from her to ignore her crying. You know what comes next: she then cries loud enough for the whole store full of people to hear her. Is it tempting to give in just to avoid the embarrassment? If you do, Mary may stop crying at that point but guess what she'll learn to do the next time she goes shopping with Mother: cry louder.

Two other examples of target behaviours include banging on the dining-room table and nagging. When any of these behaviours become intense, most parents lose patience and yell at, or perhaps spank, the child. Then, as you now know, the parent is inadvertently reinforcing the undesired behaviour. The child learns that by behaving more intensely, she wins attention. What did Mary learn?

To avoid this trap, the parent must use the 100 percent rule, which means that once ignoring is begun, it must be implemented 100 percent of the time or matters will be made worse. Mary's mother should not give in. She should let Mary cry, even though it's embarrassing, until Mary gets tired and eventually stops. Otherwise, Mary will learn to cry louder and louder during every shopping trip in order to get candy.

If Johnny nags you to buy a small toy from the toy machine, which is always placed at the entrance of grocery stores, and you try to ignore him, he'll nag more incessantly. Give in and you've taught him to nag more relentlessly to get his way. If Billy bangs on the dinner table and you ignore it for a while, resulting in his banging harder, the odds are that eventually you'll resort to yelling at him to stop. You have then taught him how to win at getting attention at the dinner table: bang louder. Understanding this may help you see that ignoring can only be used for much milder forms of behaviour. Can you completely ignore any of these three behaviours? If you can't, there are stronger ways to discipline.

Emergence of New Behaviours

If the parent is able to ignore the target behaviour 100 percent of the time, the child will then try several new target behaviours that may not have been in the child's initial repertoire of misbehaviours. For example, Billy may deliberately knock over a glass of water or hit his brother, or claim to be sick. Mary may have a temper tantrum. Johnny may kick you. Thus, a second trap can now occur. The parent, again losing patience, may yell or spank. The result will be to reinforce new problem behaviours. This will only wind up increasing the total number of target behaviours.

The solution to this dilemma is to adhere to the 100 percent rule of ignoring for the milder misbehaviours or to use stronger discipline techniques for the more severe behaviours, which you will shortly learn how to do.

The Return of Behaviour

If the parent is able to control his frustration, the initial target behaviour will finally begin to go away. Do not sigh with relief yet! The problem is not quite solved. The behaviour may remain extinguished for a few days or even a few weeks. However, it can suddenly re-emerge, probably less intensely. If the parent believes the problem has been solved, he'll probably get angry, scream, and spank - once again inadvertently reinforcing the target behaviour, which will return to its original level. To make matters worse, now the behaviour will be resistant to extinction, meaning that you have taught the child to wait in order to get her way. Eventually the day will come when Mary once again cries in the store, Johnny will try nagging again, and Billy will try banging on the dinner table. If their parents give in, each child will have learned that, with persistence, their parent will break down. A good lesson from this last trap is that "inconsistency breeds persistency."

This process will most likely occur several times. To avoid the reinforcement trap, you must follow the 100 percent rule, Ignore completely, and the behaviour will finally extinguish completely.

As you can see, ignoring is very inefficient and slow. It requires in finite patience and works only against attention-seeking misbehaviour.

If a behaviour is not attention seeking, such as playing a video game, which is a self-stimulating game and not conducted to get attention, then ignoring is useless. If you cannot be patient when dealing with a particular target behaviour, then do not use ignoring.

Avoid Competing Reinforcement

For ignoring to work, reinforcement from other sources must be removed. For example, if you are ignoring Erica's behaviour while her brother and sister are laughing uncontrollably at her or while your spouse is trying to talk sense into Erica, ignoring will not work.

Reinforce Correct Behaviour

In order for ignoring to work, it is essential that you actively and deliberately reinforce the child's correct responses. The combination of ignoring the incorrect target behaviour while reinforcing the correct behaviour is called differential reinforcement. Give your children the attention they need in a positive way when they are behaving well and ignore them when they misbehave.

Mary's mother, when beginning shopping, should lean over, hug and kiss Mary and say, "You're being such a good girl. You didn't ask for candy and you're not crying. After dinner tonight you can have an extra piece of cake." When passing the toy machine Johnny's dad should say, "Son, you didn't nag for a toy. You remembered our talk about how expensive those toys can be. I'm proud of you."

"Billy, you are sitting so quietly tonight at the dinner table. You are so considerate. That makes me feel so good."


Each of these traps can occur with all forms of discipline. Therefore, you'll be learning much more powerful methods that, when applied correctly, can avoid each trap. Even though ignoring is only useful for the mildest misbehaviours, reviewing what can go wrong is a useful way to introduce the traps that occur with any form of discipline.

IA children will engage in some of the milder forms of misbehaviours because they generally are well behaved. But the HM child is another matter, and it is best not to use ignoring for any of their misbehaviours. Use the more potent methods to get them firmly under control.

In the next section we'll discuss time out as a technique designed to deal with IA and HM children, If followed correctly rapid changes will occur in your child and you can sigh with relief because you won't need Ritalin.















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)