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Great Info for Parents:

Changing Behavior

With assistance from Edward A. Bos, M.A.

Alex Smith, Psy.D.

Providence Gateway Family Medicine Clinic

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Informed Consent

MANDATORY REPORTS ARE STILL REQUIRED FOR:

IF YOU’D LIKE THERAPY:

THIS ISN’T THERAPY:

Even though there are trained mental health providers here, it’s important to keep this an educational setting

Contact your PCP to make an appointment with a behavioral health provider

Threats of imminent harm toward anyone, �or any abuse of a child or vulnerable adult

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Expectations

1. Questions are welcome

2. Try to stay on topic

3. Share the mic

4. Keep things kind, respectful, & open-minded

5. We will start and stop on time

6. Please put your devices on silent or vibrate

What other expectations do you have?

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Discipline

Conditioning Behavior

Corporal Punishment

General Strategies

Questions & Answers

Additional Resources

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(Steven He, 2021a)

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Negative reinforcement

Remove something the�dog doesn’t want

Feeling = Relief

Positive punishment

Add something the�dog doesn’t want

Feeling = Fear

Negative punishment

Remove something�the dog wants

Feeling = Frustration

Punishment

= behavior decreases

Negative

= Removing Something

Extinction

The behavior doesn’t have a connected consequence (“doesn’t work”) and therefore disappears

Reinforcement

= behavior increases

Positive reinforcement

Add something�the dog wants

Feeling = Joy

(Blomster, 2018)

Positive

= Adding Something

Let’s Start with

a Simpler Model

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Positive punishment

Add something the�dog doesn’t want

Feeling = Fear

Negative punishment

Remove something�the dog wants

Feeling = Frustration

Punishment

= behavior decreases

Negative

= Removing Something

Extinction

The behavior doesn’t have a connected consequence (“doesn’t work”) and therefore disappears

Reinforcement

= behavior increases

Negative reinforcement

Remove something the�dog doesn’t want

Feeling = Relief

Positive reinforcement

Add something�the dog wants

Feeling = Joy

(Blomster, 2018)

Positive

= Adding Something

Let’s Start with

a Simpler Model

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Negative reinforcement

Remove something the�dog doesn’t want

Feeling = Relief

Negative

= Removing Something

Reinforcement

= behavior increases

Positive reinforcement

Add something�the dog wants

Feeling = Joy

Let’s Start with

a Simpler Model

(Blomster, 2018)

Positive

= Adding Something

Positive punishment

Add something the�dog doesn’t want

Feeling = Fear

Negative punishment

Remove something�the dog wants

Feeling = Frustration

Punishment

= behavior decreases

Extinction

The behavior doesn’t have a connected consequence (“doesn’t work”) and therefore disappears

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Positive �Reinforcers

(Oquendo, n.d.; Webster-Stratton, 2019)

Crayons
Book
Chapstick
Surprise from the prize bag �(all inexpensive items)

Inexpensive�Items

Picking the family’s dessert
Picking a TV show
Inviting a friend to dinner
Sitting in Mom’s or Dad’s chair at a meal
Staying up 15 extra minutes

Special�Privileges

Going to a Portland Pickles game
Going to the park or library
Sleepover with grandparents
Trying a new food

Special Outside�Activities

10 extra minutes of playing together
Making cookies together
Doing a puzzle together
Taking a walk together

Special Time�with Parents

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When to Deliver Rewards

Start with a fixed-ratio schedule

Be very consistent
This helps motivate learning

Buy One

Get One

--- FREE ---

CUSTOMER LOYALTY

1

2

3

4

5

6

7

8

9

FREE

✔

(Frank Porter Graham Child Development Institute, n.d.)

JACKPOT 9000

B A R

7

Then use a variable-ratio schedule

Rewards are almost a surprise
This helps solidify what was learned

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Punishments

(iddea Photo, 2023; Webster-Stratton, 2019)

Selective Ignoring

Time-Outs

Negative Punishment

Stay up too late

→ tired the following day

→ late to class/detention

Don’t close your window

→ mosquitos in room

Natural Consequences

Ride bicycle into street �→ Lose bicycle privileges

Sneak extra screen time

→ Lose screen time tomorrow

Logical Consequences

Inconsistency
Reversed/Negative directions:

- “Stop doing ________”

+ “Please do ________”

Overusing negative punishments

Things to�Avoid

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Common Strategies:�

(Therapist Aid, 2016; Webster-Stratton, 2019)

The caregiver recognizes preferred behavior with a symbolic item

Sticker, Points, Coupon

The child can “spend” those on something they want

Works best if it’s simple, consistent, and has clear expectations

Description

Requires child’s buy-in
Can be challenging if it gets overly complicated, or if the requirements to earn the token have lots of conditions
Limitations must be communicated up-front

“You can buy new shoes” doesn’t mean vintage $500 Jordans

Cons

You can use it anytime

“I’ll give you 3 points if you help with dishes”

Provides instant feedback to the child

Easier with tokens than big rewards

Generally easy to do

Pros

�Behavior Chart/Token Economy

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Common Strategies: Time-Out

(James, 2020; Webster-Stratton, 2019)

It’s a cooling-off period after unwanted behavior and big emotions
Should happen in a family that also shows love and praise
Keep it short (example: 3 min for ages 3-7, or age +1)
Should be in a safe place
Should have clear reasoning and follow-through for compliance

Description

Improper use can cause more unwanted behavior

Can be hard to find a safe place with no distractions or other reinforcers

Can be hard for everyone to come back together with warmth and positivity after

Cons

Generally easy to understand

Generally easy to do

Can be combined with token economies or logical consequences for greater effectiveness

Pros

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Common Strategies: Selective Ignoring

(Lake Area Discover Center, n.d.; Urquiza et al., 2011; Webster-Stratton, 2019)

Useful to extinguish minor irritating behaviors
Tell the child that they’ll be ignored if they continue
You can verbalize appropriate behavior to yourself for the child to overhear

“It sure would be good if someone would share their toys”

Description

Not appropriate for anything destructive or aggressive

The extinction burst is a common challenge

Can be hard to manage parents’ non-verbals, like eye contact and facial expressions

Cons

Simple

Effective for many behaviors

Can be combined with praise to cultivate any preferred behaviors that are observed

Pros

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Corporal

Punishment

What are we teaching?

Exposure to violence hurts brain �development

Spanking/hitting can harm �parent-child attachment

Removes some internal motivation�to change

Hard to feel responsible when you’re�mad/resentful instead

Generally best avoided

(Steven He, 2021b; Webster-Stratton, 2019)

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General Strategies

(Wang, 2019; Webster-Stratton, 2019)

Foster Healthy Bodies

Food
Water
Sleep
Hygiene

Communicate

Play together
Listen & ask questions
Give options when possible

Foster Structure

Predictability (≠ boring)
Clear expectations
Consistent consequences

Parent Actions

Healthy Bodies

Learn & Test

Try things
Make mistakes
Ask questions

Communicate

Lead playing/games

Child Actions

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Q&A

(Digital Storm, n.d.)

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Additional Resource:��CDC Positive Parenting

The early years of a child’s life are very important for their health and development.

Parents, health professionals, educators, and others can work together as partners�to help children grow up to reach their full potential.

https://www.cdc.gov/child-development/

U.S. CENTERS FOR DISEASE�CONTROL AND PREVENTION

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Additional Resource:��Other Classes w/Providence

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Additional Resource:��Swindells Resource Center

https://www.providence.org/locations/or/childrens-health/swindells-resource-center

Swindells Behavior Support Playlist on YouTube

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References

Blomster, E. (2018, September 14). Operant learning vs clicker training vs ”traditional” training [Consequences.jpg image file]. Retrieving for All Occasions. https://www.retrievingforalloccasions.com/operant-learning-vs-clicker-training-vs-traditional-training/

Digital Storm. (n.d.) ANY-QUESTIONS-PNG-7.JPG [image file]. https://clipground.com/pics/get

Frank Porter Graham Child Development Institute. (n.d.). Step 1.7: Select a schedule of reinforcement. https://asdtoddler.fpg.unc.edu/reinforcement/implementation-steps/positive-reinforcement/step-1-planning-ebp/step-17-select-schedul.html

iddea photo. (2023, June 27). Girl in grey dress sitting in corner. https://www.pexels.com/photo/girl-in-gray-dress-sitting-in-corner-17386405/

James, C. (2020, February 6). Child-Development the Time-Out Controversy: Effective or Harmful. Indiana University School of Medicine Pediatric Blog. https://medicine.iu.edu/blogs/pediatrics/child-development-the-time-out-controversy-effective-or-harmful

Lake Area Discovery Center. (n.d.). Selective Attention: Shaping Your Child’s Behavior. https://ladcfamilies.org/wp-content/uploads/2022/11/LADC-Selective-Attention-Handout.pdf

Steven He. (2021, May 4). Asian Parent Punishments. https://youtu.be/TsSP-nHjZ0Q?feature=shared

Steven He. (2021, June 2). Asian Parent Punishments 2. https://youtu.be/Sq21nifsMsc?feature=shared

Therapist Aid. (2016, April 29). Parenting: using rewards and punishments. https://www.therapistaid.com/therapy-guide/parenting-rewards-punishments

Urquiza, A., Zebell, N., Timmer, S., McGrath, J., & Whitten, L. (2011). Selective attention. Course of Treatment Manual for PCIT-TC [Unpublished manuscript]. https://pcit.ucdavis.edu/wp-content/uploads/2012/08/29_selectiveattention.pdf

Wang, M. (2019, September 3). Child, Boy, Cute image. https://pixabay.com/photos/child-boy-cute-kid-young-4448370/

Webster-Stratton, C. (2019). The Incredible Years: Trouble Shooting Guide for Parents of Children Aged 3-8 Years (3rd Edition).