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Caregivers' Skills Program


Congratulations! Your home life is much easier, more peaceful and loving now. So are you ready to take on your youngster's school performance? Then let's begin!

We're devoting a separate section to improving school performance because it is one of the most frequent problems with IA and HM children. Children who act out to an extreme and who fail to behave at home do so at school, and vice versa. The good news is that in approximately 80 to 90 percent of cases, once the behaviours at home are brought under control, school performance improves automatically. Please do not use the methods in this section until your child's target behaviours are under control at home. Until that time, set this section aside and practice the reinforcement described in the earlier sections.

Your child may have already begun to settle down in the classroom. The quality and quantity of loving attention in a reinforcing home will help motivate children to perform better in outside settings. But if your child continues to do poorly in school once target behaviours are under control at home, you will find this section especially helpful because it addresses this issue.


Let's begin with this ground rule: The key to improved school performance is your child's motivation. Highly motivated children come from families that consistently pay attention to their children's schoolwork and consistently reinforce their hard efforts. All of us are what we believe. If children are carefully nurtured early in life to love their education, to read and treasure books, and to work hard, they probably will develop the motivation to perform well in school. Behavioural programs and pills like Ritalin will not be necessary in the first place.

We must structure our time each day to gently and lovingly instil positive values and beliefs. This motivation evolves from love, caring, nurturance, and attention in the home. Highly motivated youngsters will learn. Even with the finest teachers and the best equipment, unmotivated children will not learn.

With the CSP, once behaviour at home has settled down, you can work on nurturing the values that underlie and motivate good school performance. If your child is in the 20 percent for whom school performance does not improve, the following program can be implemented.


Almost every child with poor school performance these days gets diagnosed as ADD or ADHD. Consequently, we must consider four things:

1.    Has the child been tested for learning disabilities? Learning disabilities markedly impair academic performance. Have your child tested.

2.    Is anyone terrorizing the child? Is he the victim of a school bully? Similarly, is the child's teacher overly negative, intimidating, or punitive?

3.    What is the child's readiness quotient RQ, other times called IQ (intelligence quotient)? If a child's readiness is below grade level, the academic curriculum may be too difficult; a slow learner may not be able to compete with peers. The inability to keep up may underlie a pattern of being IA or HM. Under these circumstances the child may need to be placed in a self-paced class or in a class with fewer students where she can get individual attention. These classes often do not use traditional grading methods. Instead, the child is assessed by whether or not she is making consistent progress.

A child with a high RQ may be bored and insufficiently stimulated, and this too can underlie inattentiveness and misbehaviour.

4.    Have your child's vision and hearing examined by a doctor. Sometimes a subtle problem may have gone undetected.

If educational tests, RQ (IQ) tests, LD tests, and hearing and vision are all in normal range, we can conclude that no problems are present and that the child is bright enough to perform well. More direct intervention can begin. If you've successfully carried out the CSP at home and your child is well behaved, your child is a bit more stubborn than most and needs some additional work to get more improvement in the classroom.

The following daily report card program is, therefore, added to the CSP to help with this problem.


In many school report cards are given every six or even twelve weeks. This time span is of little help in shaping academic performance, which requires frequent, immediate, and consistent reinforcement for good performance. You and your child need to know each day how the child is doing in school. A daily sheet or report card gives sufficient feedback, allows your child to have a fresh start every morning, and helps him or her understand what areas need to improve. This report card is used to coordinate your and your child's teacher's efforts to help your child perform better.

The first thing to do is to meet with your child's teacher. Discuss with her how this report card can help both your child and her. Filling out the report card every day may be interpreted by the teacher as an intrusion in an already busy schedule. Explain that this report card will help make her life much easier, since your child has been disruptive. Point out that you suspect this consumes a considerable portion of her time in dealing with him and probably contributes to both disturbing the entire class and upsetting her nerves. When she realizes that the report card will help you carry out meaningful consequences at home, which will get your child to settle down and make life in the classroom considerably more peaceful,  probably she'll readily help. Most teachers want very much to help a child who is having difficulty and are thrilled when a parent wants to do something about it. Rarely will a teacher refuse to help, once the benefits are made clear.

Sometimes a teacher may say she cannot do this for 25 children. In fact, the method is only needed for one or two IA and HM children. It is certainly worth the teacher's brief time and effort to help these children and get them under control. However, if the teacher does refuse to help, speak with the principal. The principal will usually direct the teacher to assist a child who has been failing for a very long time. It might be useful to offer to have the teacher read this program online. This is the easiest way to clarify what our goals are.

Often, IA and HM children are not aware that their performance is poor. Many students believe they are doing well because they performed well on the last two or three quizzes and seem to forget the failing grades of a couple of weeks before. This is extremely common. Begin by giving your youngster the responsibility to record all test grades. Have your child post the scores in a convenient location as a constant visual reminder of his standing at any given time.

The daily report card can enhance communication between you and the teacher, who, if she has agreed, can complete the daily assessment in only a few minutes. Your son or daughter returns the form to you each day. This report card is essential because you control the daily consequences at home.

In the report card, listed subjects in the order they are scheduled for the day. All aspects of the child's performance are then evaluated for each subject:

1.    Class Performance - which is the teacher's estimate of how well the child is paying attention in class and how well he is participating in class discussion. The grade is a collective estimate made by the teacher on behaviours such as the child carefully doing his work and staying on task, listening carefully, looking at the board or the teacher, and participating in class discussions and answering questions. The behaviours in this category include all the behaviours listed in the DSM-IV for attention problems. The following grades represent the teacher's estimate:

E = Excellent

S = Satisfactory

N = Needs Improvement

U = Unsatisfactory

Giving a single grade makes communication much easier for the teacher. Listing every detail is too time consuming and impractical, and may even lose the teacher's cooperation.

2.    Conduct -  which includes inappropriate behaviours such as talking to another student during work time, walking around without permission, excessive fidgeting, calling out in class, pushing in line, and so forth. In the DSM-IV these are listed as impulse control problems. Conduct is assessed collectively each day for all problem behaviours by the teacher.

3.    Test and Quiz Grades 

4.    Homework Grades - sometimes teachers grade this A, B, C, D, and F, and sometimes a numerical score is given. Be sure to know the letter equivalents for the numerical scores because they differ from school to school.

At the end of the school term, the daily report cards should closely match the regular report-card grades. If you find an inconsistency between the report card and the daily reports, then the teacher may not be using the daily sheet correctly.

Meet with the teacher every two weeks, if you can, to review your child's progress until all the problems dramatically improve.

Improvement means that your child is passing everything, that is, class performance is at S or better, conduct is at S or better, test and homework grades are at C or better. If your child passes everything, there should be positive consequences at home; if even one grade is failed, discipline should ensue at home, such as loss of free play.

Set Required Levels of Performance

In class participation, the teacher observes your child in class and estimates how well he is doing his work. Is he staying on task, participating in class discussion, raising his hand properly, and answering questions? This estimate is made during each subject throughout the day.

For conduct, the teacher reports her observations about how well your child is behaving. Is he talking to other children around him, calling out answers without raising his hand, getting out of his seat, pushing other children when in line, and walking around the room without permission? Again, this estimate is made for each subject throughout the day.

Criterion level refers to the minimum passing grade. An N or a U in either Class Participation or Conduct is considered a failure, that is, below criterion level. The minimum passing level is an S. One N (or U) in any subject means negative consequences at home, such as not being allowed free play.

For example:

Matthew was a severe IA-HM child. In class he often stared out the window. He completed his work in a sloppy fashion, often not answering all the questions; he wouldn't answer the teacher's questions. As for conduct, he fidgeted in his seat, got out of his seat and walked around the room, and constantly talked to other children around him. His parents had successfully completed the CSP at home, but his schoolwork didn't improve. The daily report card program was begun. During the first week he did extremely poorly, necessitating his loss of free play from 3.30 to 5.00 p.m. each day. By the second week his grades were improving. Matthew passed everything except for one grade in math, where he received an N for Conduct - one grade below criterion. That day he still lost free play. However, on Thursday he passed everything and was allowed his free play time. He's passed everything since.

Tests, Quizzes, and Homework

If an IA and HM child tests within the average range or higher during initial assessment, we can expect grades on the daily sheet to be roughly in the C or B range. Thus the criterion level is C. If he tests high, then we can expect B's or A's; therefore the criterion is set at B.

If the child scores at or above criterion level, the child earns reinforcers at home. If the child performs below grade level academically or behaviourally, even if only one grade, one conduct mark, one test grade, or if one homework grade is below criterion level, then he experiences negative consequences at home.

"Only one?" you may ask.


There have been numerous cases of children drastically failing in conduct, class work, and homework, and within one week after beginning the report card, their performances improved to passing. Setting such strict standards forces the child to immediately perform at his best. It also communicates simply and clearly what we expect of the child, thus eliminating confusion or misunderstandings.

"Can the IA and HM child really do this?"

Yes! Yes! Yes!

David Stein has been through this program hundreds of times with hundreds of cases, and the answer is yes. They are not diseased. They are normal children who can do this.

Another example:

Robert was an IA child. His conduct was always considered excellent. He was soft-spoken and rarely misbehaved. However, his class participation was consistently poor because he rarely paid attention, constantly looked around the room instead of looking at his work, and performed his work in a sloppy fashion. His homework and test grades were almost always N's or U's. His RQ was 122 (quite high), he had no learning disabilities, and his hearing and vision were normal.

In the first week of the daily report card program, his class performance improved to passing and his tests and homework grades improved. However, on Monday of the second week he received a D in reading and a D in social studies. He also failed tests in math and social studies. He lost free play that day from 3.00 to 5.00 p.m. On Tuesday he passed everything except for one homework grade in math. Again he lost free play. On Wednesday he passed everything and was permitted free play. In the following three weeks, on two days he received one failing grade in different subjects. On those days he lost free play. In the weeks that followed he passed everything and, henceforth, was allowed free play every day.


Recall that reinforcers are objects (toys, candy) and activities (free play, TV time).

Michael loved watching cartoons after school each day. He had successfully improved in all home behaviours on the CSP, and his school performance had dramatically improved except for his homework, which was usually incomplete and done sloppily. For one week he continued to fail in homework for most of his subjects, which meant no cartoons and no substitutes, that is, he was not allowed to do anything else. By the second week he understood what was expected, and he began doing his homework neatly and carefully, thus passing each day in all subjects. He began watching his daily cartoons.

A negative consequence may be the loss of free play after school from 3.30 to 5.00 p.m. And no substitutions! No television, no reading, no telephone calls, no homework, no games, no visitors-nothing for two hours. Remember the "no substitutions" rule for discipline.

Unlike grounding for six weeks, each day is a new beginning. Youngsters can decide to perform well the next day or get the consequences again. Remember the daily rule. If children resist improving after a few weeks, we can add removing the hour allowed for watching television - also with no substitutions. If necessary, we can get even tougher, but frankly (and fortunately) this rarely happens.

With children with high RQ scores, set the expectations for Test and Homework at all B's and A's. Children who have the ability can indeed improve performance to that level, again in only one week.

Will scored an RQ of 144, which is enormously high. He was consistently getting D's and F's in all his subjects for tests and homework. Because of his RQ, criterion level was set at B. His parents felt this was somewhat strict but reluctantly agreed to try it. Will was told he couldn't ride his bicycle after school each day if he made below a B on either homework or tests. The mere mentioning of this was sufficient. On Monday he made two A's and the rest of his grades were B's. Will really liked all the praise and compliments he was getting from his teachers and parents. He seemed surprised that he could do so well. His self-esteem improved. By the second week he began making almost straight A's. He's been an honour student ever since.

Some parents want to be more lenient and allow three C's for homework and tests rather than all B's and A's. As a result that the child will get exactly three C's every day and usually not in the same subjects. Yes, children can discriminate that well.

If you wish, you can increase your expectations gradually each week to shape school performance gently and slowly. For example, you may set the second week's level at two C's, the third week at one C, and the fourth week at no C's. It is preferable, however, to set stricter requirements at the start, as with Will.


Do not sit with children when they are doing homework. Let the consequences of the report card do the work. Do not reinforce children's helplessness. You may serve as a resource to answer questions, but do not sit with them and coach them. This is another major difference in the CSP. Trust that your child is normal and can do the work. Once you actually see these changes you will be a firm believer.

The two greatest lies are, "Mummy, the teacher never gives us any homework," and "Teacher, I lost it on the bus."

Homework is often a major issue, and parents with an IA and HM child generally force their youngster to do homework. They say, "If I don't sit with him, he won't do it." Remember that sitting with the child and prompting, coaxing, and cueing reinforces forgetfulness, task dependency, and "not thinking." Act only as a resource. When he finishes the work, check for neatness and accuracy. Point out what needs correction and then let your child struggle with it at his desk. The daily consequences for failing Homework on the report card will quickly get your child to improve as it did for Will.

Please remember: don't start the school program until your child's behaviours are extremely well controlled at home and you have allowed an additional few weeks to determine if the improvements transfer to improvement at school, in which case this school program is not needed.

The Blessed Snowball Effect

Once your child reaches grade-level performance, intrinsic (natural) reinforcement takes over, and the child enjoys discovering that he can perform at a higher level. This feels wonderful! Teachers tend to smile and treat the child better when improvement appears. Parents also tend to be more positive and reinforcing. These natural reinforcers help the child feel content and proud. They realize how good it feels to be "up there" academically.

A single grade below your expectation (criterion level) in any area-class performance, conduct, tests, or homework means loss of privileges that day. The daily report card determines what your child may or may not do after school that day. The child must remember the cause and effect of her actions in school without being reminded. Carry out the consequences calmly and efficiently.

You must stop yelling, screaming, pleading, and hitting to force your child to behave or do schoolwork. If you continue that pattern of punishment, your child will probably never improve. These methods do not work. Let this program work for you.

Most parents who use this approach will find that their child's grades and conduct improve and the child's nervousness subsides. With improvement in school comes an increase in intrinsic reinforcers, and parents frequently say that the child begins to appear much happier and much more at peace.


Review the program with the child before using it, then ask him to explain the program to you. Clarify any confusions or misconceptions. Repeat this only once. If he still seems confused, simply go ahead and start the program. With the process in operation he will begin to understand in a very short time.

Let's look at an example:

Adam was a nine-year-old in the fourth grade. His teacher, Mrs Johnson, requested that the parents seek professional help because Adam was failing almost all his subjects. The teacher believed he was bright and could do much better. His yearly national test scores indicated that his academic skills were considerably better than his grades reflected.

Mrs Johnson suggested that his parents discuss the use of Ritalin with their family doctor. Adam was placed on Ritalin but no improvements occurred. The school counsellor in a conference with his parents referred them for this program.

An initial assessment indicated that Adam's reading and math capabilities were a couple of years more advanced than his fourth-grade placement. His full-scale RO was 123; testing indicated that he had no learning disabilities; the results of eye and ear examinations were normal. He was clearly capable of doing much better schoolwork. Under the doctor's supervision, the Ritalin was gradually stopped.

Adam was not a severe behavioural problem in school, but Mrs Johnson observed that he would not stay on task and often seemed bored. He talked to other children, interfered with their work and played with his pens and pencils as if they were rocket ships. Adam was never rude; in fact he was considered a nice boy. The school psychologist diagnosed Adam as ADD.

His parents indicated to me that Adam was a bit of a problem at home. His misbehaviours included being noncompliant, oppositional, and having one or two temper tantrums a week. He voiced poor-me statements and negative verbalizations several times a day and whined and cried, especially when he was supposed to be doing his homework. His mother sat with him each evening while he did his homework. If she was not with him, he would not do it. No other target behaviours were reported.

Adam's mother, a housewife, greeted him at home after school. He was allowed to play from 3.30 to 5.30 p.m. each day. After dinner Adam hastily worked on his homework, which was typically sloppy and often incomplete, then he watched television or read. Fortunately, Adam liked to read. Isn't it amazing how his so-called ADD disappeared when he was doing things he liked?

The family began parent training and after four sessions began the CSP. All target behaviours at home improved and Adam seemed more content, but the improvement did not extend to his schoolwork.

Adam's parents then took a daily report card to his teacher. Mrs Johnson was eager to cooperate and Adam brought home reports each day. Adam understood that he would lose free play each day if his daily report cards showed any grade level below what was expected of him. This continued for one week. His home behaviours remained stabilized, but school performance improved only slightly. After the third week, not being allowed to watch television was added as a restriction. During the loss of free play and TV time, he was allowed only to walk around the house - no toys, no play, no homework, no reading, no cuddling with a family member (no substitutions). His class grades and homework then improved dramatically. Within three weeks he was achieving the required level of performance almost every day. His mother no longer sat with him when he did his homework; instead, she only served as a resource.

Within six weeks after his parents started the daily report card program, Adam was doing extremely well both in school and at home. He was more astonished than anyone else that he could perform so well in school. Mrs Johnson went out of her way to reinforce his improvements. Adam was a much happier child. In a little more than three months this case was complete. Most cases are successful within two months.


To stabilize the gains you have made, it is essential that you work in a positive way to make reading and education important values to your child. Too many parents think their child should do well in school without reading and education being important family values. It doesn't work that way.

In families where these values are successfully instilled, the children do not become IA or HM. For children who are IA or HM, if you followed the CSP and the daily report card program, some of the behaviours and cognitive problems are probably under control. But it may not be enough. Your child may be well behaved and doing well in school, with natural reinforcers helping to change your child's attitudes. Teachers are smiling and praising more, you are reinforcing actively, your child is getting along well with other children- but there's still more to do. We have to further strengthen the values of education and reading.


Earlier we discussed ways to make education and learning important, but perhaps it bears some repeating. Take your child on short educational trips. Visit museums, college campuses, and historical places. Make learning about nature important and fun. Take trips to scenic places. Go camping and teach your child camping skills. Go hiking. Get up early to watch the sun rise. Buy a telescope and scan the heavens. Instead of toys, buy microscopes, chemistry sets, or ant colonies and experiment with them with your child. Have your child help plant flowers and shrubs. Visit planetariums. Show an enthusiastic interest in your children's schoolwork. Talk with them every day about their day in school. Show your pleasure when they get a good grade.

Demonstrate your love for music.  Kids often don't like classical music until they attend a live concert and then there is a positive attitude change. Take your child to plays. Go as a family and you'll have fun, too.


It is vitally important to help your child become a reader. Readers perform better than non-readers in school and on national tests. Reading is so very important throughout life.

To get children to become readers it is important to help them learn to love reading. To do this we have to make reading a fun activity, so here are ten helpful hints to make that happen:

1.    Read to your children and choose subjects of interest to them. When you read to them, select materials that are at or above their current reading level (not grade level). Reading level is determined mostly by twice-yearly reading-skills tests; you should know these scores. Ask your child's teacher to explain the scores to you if you feel confused. Poor readers usually are below grade level in reading skills. Libraries and bookstores generally group books according to reading grade level.

When you read to them from more challenging books, you can expose them to more advanced vocabulary that will help with word-recognition skills and make it easier for them to decipher new words. Developmentally, children have excellent auditory learning skills that help with language learning. Be careful, though, to go no more than three grades above their current reading level. If younger children want the same book read to them each night, coax them to listen to something new, but if they don't want to, let it go. Better to keep the reading fun.

2.    When they read on their own, select material that is equal to or lower than their current reading level. Reading is much more fun when a child doesn't trip over every other word. Let them get into enjoying the content of the material. If they enjoy it, they'll do it. If they develop the reading habit, their reading skills will automatically improve.

3.    Allow children to read in bed for thirty minutes at bedtime. Many children, especially HM children, do not want to go to sleep at bedtime. They'll love being given this extra time to stay up. If they ask to do anything else-draw or play with a toy, for example-your answer should be a flat no. Only reading is allowed. Younger pre-readers can begin this nightly habit by looking at pictures. Remember, let children choose bedtime reading materials from their current and lower reading levels. Reading before bed or for pleasure should be easy and fun, not the chore that reading can be at school.

4.    Take trips to the library at least every other week. Make these trips special. Visiting the library should become an activity that children anticipate with excitement. Teach them that the library should be a place they love. Let them choose books on subjects they like. Gently encourage them to explore new topics, but don't insist. Again, select reading material at relatively easy levels.

5.    Subscribe to children's magazines and newsletters. Children are thrilled when the mail arrives bringing subscriptions in their name. Many magazines include fun exercises for children to do alone or with you.

6.    Allow comic books - they are perfectly fine. Don't be persuaded by the myth that they hurt reading ability. If children enjoy them, comics can contribute to making reading a joy. Do, however, choose carefully. Some comics are risqué and violent. Look for those that are fun to read and appropriate to the child's age.

7.    During quiet periods with your children, ask them about their reading. But do not push such conversations or pressure your child. If he seems excited and talks about the reading material, then listen and share the excitement.

8.    If you can afford to, buy books children can read and enjoy. Build a library for them. Teach them to treat books with tenderness and love. Teach them that books are sacred treasures.

9.    Take time to read for your own enjoyment and set an example that will foster a love for the written word. Shut off the television in the evening and sit and read as a family. During my household's nightly reading time, I have one son's head on my lap and the other boy snuggled on my shoulder. I love this, and I feel they do, too.

10.    Leave magazines around the house. Choose them wisely so they are suitable for children.

Our goal is to see your child buried in a book sometime during each day and night of their lives. If at night you peek into your child's bedroom after he is supposed to be asleep and you see him reading with a flashlight under the cover, quietly back out and smile. You've succeeded.


Now that your child's school and home environments are improved, let's review how we can help improve self-esteem. The CSP and the daily report card program change children's surroundings from negative to positive: teachers like them more, other kids like them more, their grades are better, and all this helps. But in the next section let's review how to be certain your child is feeling even better about herself. 

Remember what the IA or HM child has been through in life-the disdain, the criticism, the punishment, and Ritalin. A new, positive self-image is so important. On to the next section.















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)