Behavior Modification Therapy (BMT) is a method of doing therapy that involves systematic rewarding of specific behavior in order to increase the behavior and reduce undesirable behaviors. Of all the therapies designed to address the core symptoms of ADHD, BMT has been proven to be the most effective.
You can read more about Behavior Modification in my blog post: Treating ADHD without medicine.
“What we know today is that BEHAVIORAL techniques work the best.
Traditional therapy goes nowhere in regulating the primary symptoms of ADHD.”
– Ned Hallowell, psychiatrist, Chadd Conference
Today, we’ll explore mistakes that parents or teachers may make when setting up a Behavior Modification Therapy (BMT) program and my suggestions about what to do to get better results.
COMMON MISTAKES:
- Adults don’t always “test the water” to know if rewards will work.
- They attempt BMT with children who are defiant by nature.
- Once the child starts making progress, they stop being vigilant.
- Rewards are provided inconsistently or too late.
- Some adults do not prepare enough simple rewards that the child likes.
- Motivated adults try to tackle all the kid’s issues at once.
- When they see progress, adults’ expectations can rise too quickly.
FOR BETTER RESULTS:
1. TEST THE WATER: Make sure the child is receptive to rewards.
Children are NOT all the same. In order for a reward system to be effective and powerful with young children, they have to be the kind of child that is “re-enforceable” – a child who enjoys being rewarded. Some children don’t care about rewards – they are oppositional and defiant and just want to have the power to control their social environment according to their point of view. Be sure who you’re dealing with before diving head-first into BMT. Test the waters and be sure the child you’re working with will respond to rewards.
2. KNOW YOUR KID: Do not attempt BMT with children who are defiant.
Defiant children do not respond well to systems that impose structure. For oppositional kids, Power is the operative word. They’ll generally see a reward system as a means of taking power away from them; and then do their best to sabotage it. BMT with oppositional children only makes their behavior worse. Defiant children respond better to flexibility and to situations where they have a role in designing their environment.
3. GIVE THEM A CARROT: But have a whole farm on speed dial.
When positive results accrue from BMT, many people assume “mission accomplished” and stop the bus. Guess what happens? The adults go back to what they were doing before – handing out a constant series of threats (or doing nothing at all). And the child? Low and behold: all those undesirable behavior patterns return and everyone feels discouraged. Behavior Modification is like skin care for kids who will ALWAYS be battling blemishes, acne and pimples. You can’t stop using it. The best way to use Behavior Modification? DON’T STOP. DO IT FOREVER (or until the kid grows up and moves out of the house).
4. SWIFT AND STEADY: Provide rewards every day and quickly.
Positive reward systems provide structure in an ADHD child’s life. They deliver consistent feedback about what kind of behavior is considered appropriate. Remember that an ADHD child’s “social radar” is only about 6 inches in front of them. This metaphor describes their difficulty with anticipating anything in the future, which leads to a general disregard for rules and consequences.
Since they do not internalize structure very well, positive rewards must be consistent and timely. They need to be administered quickly, so the child can make the connection between the reward and the behavior that led to the reward.
5. KEEP IT SIMPLE: Prepare a range of very simple rewards to use every day.
A token system can work very well depending on the age of the child. Some people think that they have to give the most luxurious reward to make the child comply with behavior expectations. Actually, most kids want to spend time with their parents; not with expensive gifts. Kids don’t want a $500,000 Maserati sports car; they just want to know you approve of their behavior. Think small and inexpensive.
6. NARROW YOUR FOCUS: Work on no more than three behaviors at once.
ADHD children can exhibit many inappropriate behaviors. Consequentially, they are constantly being corrected by adults. Constant criticism can cause depressed mood and low self esteem. I recommend working on 3 or fewer of the child’s behaviors at any time; ADHD kids will lose focus if you do more.
Share what you’re working on with the other adults in the child’s life. When both the teacher and parent are stressing identical behaviors, it makes it easier for the child to process and monitor themselves.
7. LOWER THE BAR: Set reachable goals to keep a child engaged and inspired.
Setting expectations too high is setting your child up to be unsuccessful. For children to be motivated to participate in the BMT process, they have to feel an immediate sense of success. When you set the bar too high, they’ll quickly surmise that it’s just impossible to please you, so why try?
Instead: start low and raise those expectations very gently as your child becomes more successful in monitoring his or her behavior. The goal is not to produce a perfect child, but rather a child who is aware of themselves and makes a reasonable and continued effort to regulate their behavior.
Contact me and we can talk in more detail about how Behavior Modification can work for your child.
Markus
