It is no secret that a good therapist should have some strategies in his or her toolbox to address undesirable behaviors. Parents often come to occupational therapy to address behaviors because these behaviors are interfering with the child reaching the level of independence that their peers might be meeting.
Since behavior is a form of a communication, it is important to address behavior as such. Communicating effectively is a vital piece to reaching independence and confidence.
Positive Reinforcement to Encourage Desirable Behavior
Positive reinforcement is the intentional encouragement of positive, desired behaviors through a reward system. Rewards can be anything from eye contact, attention, escape, praise, and a token system. This is, in my opinion, the most crucial part of altering any behavior.
Sometimes without meaning to, behaviors are rewarded through something as simple as eye contact!
When attempting to alter a behavioral pattern, it is vital to avoid accidentally rewarding undesirable behaviors by avoiding eye contact during redirection, or allowing the child to escape a task which he/she has been instructed to complete.
The simplest, most powerful form of positive reinforcement for desired behavior is praise! Every child loves to be praised. And by praise, I mean more than “good job!”
Children are smart. Be specific in your praise. Think about the compliments that mean something to you, are they generalized or personalized?
“I love the way you used both hands to finish picking up your toys!”
“Good job holding the pencil with your strong hand!”
“Thank you for raising your hand, [insert name]”
Make it count. Children will notice.
Forward Chaining
In forward chaining, the parent or therapist teaches the child how to complete the first step of the task before moving on to the rest. The child is prompted to complete the first step and all subsequent steps are completed by the therapist/ parent. Once the child can complete the first step without any prompting, the next step is taught.
Backward Chaining
As you might assume, backward chaining is the opposite of forward chaining. In backward chaining, the parent or therapist is responsible for completing the steps until the very last step of the task. Once the last step is conquered without any required prompting, the next-to-last step is taught. This method gives the child an immediate reward and reinforcement built into it, giving the child a sense of accomplishment once the task (last step) is completed.
Errorless Learning
This method is exactly as it sounds and the idea is that you as a parent or therapist prevent the child from making errors while teaching a new task. This is very effective for children who become easily overwhelmed with the “trial and error” method and end up throwing tantrums or exhibiting aggression because of the frustration associated with learning a new task.
To make this work, be clear what your expectations are with verbal instructions and modeling the task.
Also, be ready and vigilant to prevent the mistakes they are likely to make. This takes a little bit of anticipation and preparedness on the parents’/ therapist’s end. Some parts of the task may require more assistance than others, but only give as much as help as they need.
Lastly… REINFORCEMENT IS KEY! Remember, all children associate eye contact as a reward, so make eye contact and give meaningful feedback based on how much they completed on their own. Reinforce with praise throughout each of the steps completed.
Should errors occur (and they will), withhold the reinforcement you are using and repeat your instruction and modeling of the task. Refrain from using negative feedback such as:
“No, that’s not how I showed you.”
“Stop!”
“You did it wrong.”
“Let me do it for you.”
All of these phrases and similar ones underscore the feelings of incompetence and failure. Instead of giving false praise or negative feedback, use neutral wordage such as:
“Let’s start here.” (while helping the child begin a step over)
“Watch what I do, and then you try.”
“This is how you tie your shoes” (followed by a modeled demonstration)
Regardless of which approach you decide to use, always remember that misplaced positive reinforcement can unintentionally reinforce and reward undesired behaviors. Praise and positive reinforcement should be intentionally saved for when a child completes a step or an entire task on their own — dependent on what skill level they are at.
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