Using reward/punishment to 'untangle' diagnoses from learned behavior?

[whatamess]

Hello,
In the past I have posted about my 12 year old difficult child whose been labeled Pervasive Developmental Disorder (PDD)-not otherwise specified, ADHD, Anxiety disorder, ODD(lol) and sensory processing disorder (SPD) (crasher). He's intense. He's affected our entire family in different, but powerful ways.

Right now I am focused on my 5 year old. He will turn six in Fall and enter Kindergarten. I have requested the school district evaluate him. He has had difficulty in preschool with tantrumming, refusal to participate, staying on the outskirts of the group, hypersensitive, needs routine, doesn't like to be praised in front of others. The preschool teacher made lots of accommodations for him and he managed. This summer I sent him to a kindergarten readiness program at the school he will attend in fall for kindergarten. It was four weeks long, just mornings. The first day went ok, but by the end of the 4 week session he was refusing to enter the classroom of his own accord and then screaming and kicking as I physically helped him into the room. His teachers said he "more often than not' refused to participate in activities like singing, dancing, calendar and table work. He lost minutes almost every day for refusing to work. They told me he tried to crawl out of the room.

At home he tantrums over sensory things like socks and other clothing not being right. He is a very picky eater. He collects things. He is picked on or insulted by difficult child constantly since age 2. difficult child cannot stand him to be around and will yell at him to leave any room he's in. difficult child will tell him his shows are for babies, that he's too little to do things, that he'll never finish whatever computer or video game he attempts. difficult child pokes and teases him, really pushes his buttons. 5 year old does the same to difficult child-they are emotionally the same age (difficult child might even be younger). 5 year old has witnessed so many tantrums and horrible behavior.

I have consulted a therapist to help with the evaluation process for school. I have told her I think he has anxiety- (part from living with the stressor of being part of difficult child's world and there's a part that I feel is possible a genetic tendency). And that he's has sensory issues (hypersensitive). I do not think he is on the spectrum because his social issues revolve around anxiety, not around difficulty understanding how to interact.

The therapist is suggesting we untangle the possible diagnosis's from learned behavior/naughty behavior by implementing a reward/punishment chart. I have abolished these types of systems in my home because of how they utterly failed my difficult child in school and other settings. I do not support rewards for expected behavior and feel that if there is negative behavior that we have to figure out how that relates to a possible disability. The therapist said that is how she conducts therapy and that if I didn't agree that we should consider not pursuing this in therapy with her. I felt this was pretty inflexible. I also don't really want to experiment with my child's feelings and end up punishing him if his behaviors are related to anxiety and sensory processing disorder (SPD). Do you know what I mean? I feel a plan needs to be in place for the start of the school year, so I am trying to be proactive. Does anyone know if school's will give an OHI designation based on anxiety issues?

 

[Andy]

I think it interesting that a reward/punishment chart would be used to untangle diagnosis's. I feel you are on the right track in looking at anxiety as one of the issues. (I don't know enough about sensory issues to comment on that one) To have an older sibling harrassing you your entire life telling you that you are useless would lead anyone to not even try. Why should he do well in school? His brother has already pounded in the fact that he is a looser. He doesn't want positive attention but I bet he also just doesn't want any attention because somehow his brother will tell him that it is not important. When you feel like a looser, any attention is hard to take.

Do you have access to a psychiatrist? A psychiatrist would be able to start the diagnose process through various tests and gathering medical info as well as info from his teachers and you. You also may want to get a neuropshych evaluation to pinpoint diagnosis that psychologists and psychiatrist are not able to diagnose. (You state your 12 yr old difficult child has been "labeled". By who and how? Is that another possible option for you to go back to that professional with your 5 year old? Is your 12 yr old on any medications? Are they helping?) We were fortunate that our difficult child's psychologist was in a partnership with a psychiatrist. They work as a team. The psychiatrist helped get the diagnosis and prescribes the medication and the psychologist works with difficult child on tools to use to get through life - how to recognize and handle his anxiety.

A child's life goes by so quickly. I hate it when I hear doctors dragging their feet and hesitating to do tests that can get quick answers. Sometimes these testings take months to get into.

Did the therapist actually use the word "punishment"? That should be thrown out of the equation no matter what you decide to do. To punish is always wrong in my opinion. Disciplining is different, it is a positive teaching of consequences - focus on teaching the child what he/she did wrong instead of punishing. Each child is different when it comes to these charts. They do work for some, however, as a mom, you know best if they will work for your child or not. If for some reason you do decide to try one, keep the "punishment" side of it to a very minimal. Choose only a few major things you are working on. With my difficult child who was much older, having his hand on the car door handle before the car was placed in park was one of our few causes to loose points because it was a serious major issue we were trying to get him to stop. Focus on the positive. Getting a reward for making it through the morning without having brother frustrate him into a temper or refusal to do something is much better than loosing points because he got mad at his brother. Use it as a positive way to show him that he is capable of doing whatever his brother is telling him he can't.

I do understand you not wanting to give extra reward for things that are expected. However, your 5 year old is really struggling to do what is expected and some encouragement may be needed to let him know he made the right decision. You don't know yet why he is not doing what is expected. Your mommy instinct is pushing you to look for answers.

I was so sad when my difficult child came home at age 6 and refused to watch Bob the Builder any more simply because a classmate told him it was a baby show. That classmate took some joy out of difficult child's life. Those "baby shows" still have lots of good lessons to learn and are good clean quality non-violent shows for our kids to watch.

 

[Allan-Matlem]

Andy ,

The therapist sees behavior as something learned or manipulative , working for him , so if you want him to behave differently , you have to make him want to behave differently. I prefer the understanding ' Children do well if they can ' and we nned to support them to acquire missing skills

Allan

 

[whatamess]

Hi Andy and Allan,
I appreciate both your posts.

Andy, our family has really kind of accepted 'defeat' in that difficult child's behaviors are so pervasive we can't resolve them all, so we avoid triggering when we can and remove ourselves from his presence when we can't. I know this is difficult for me and am realizing the toll it takes on the other kids. I was hoping this therapist was one who would help by talking through coping strategies with my 5 year old. I really think that if he were given additional support in stopping and stepping back from engaging with difficult child that he could do it successfully more often.

Allan, thank you for posting the link to your site. My thoughts about motivation are a mix of thoughts from Alfie Kohn and Ross Greene, so just reading the first part of your page reminded me that this IS how I want to proceed with helping my youngest-giving him the benefit of the doubt and knowing that he doesn't want to have trouble-he just needs help (and not by way of a candy or other treat).

I actually delved into this a bit further with my 5 year old last night. He was so insightful, it made me regret even thinking for a second about a 'chart' to manipulate him. When I asked him about going to Kindergarten in the fall, he said he doesn't like school. I said, "Other kids like going to school, why don't you?". He said, "I'm different from the other kids". When I asked him what was different about him, he said, "My brain is different. People's brains all work differently". How does your brain work? "I walk slowly into school". And as the conversation continueed he talked about needing time to get used to being at school and when it gets close to the time to go home, he's can do what the other kids are doing. How insightful is that?!! I was super-impressed by his self-analysis and I am determined to respect his 'brain difference' and support his need to warm-up to school and the activities within. I wonder if he is articulating what most kids on the spectrum feel, that the transitions of the school day are too overwhelming and if they don't slow it down for him, he will choose not to participate.

 

[LittleDudesMom]

Whata, I agree with most of what you are saying in theory, but in practice there are some points we separate a little on.

While my difficult child didn't have the stressor of an older sibling who constantly beat him down and took parent time from him, he did have many of the issues you are having with him in school. I can tell you that my difficult child, like your 5 yo, had a very mature insight into his "issues". It definitely helped in the long run. In the short run, there were things we did, both at home and school, that rewarded good behavior and effort. While punishments followed the natural consequence flow, rewards for efforts put forth were things like picking out of the treasure chest in the assistant principal's office, feeding the fish in the classroom, choosing a board game to play with mom, an extra library book brought home from school. They were little things, but things that were intended to teach my young difficult child that very often there are options to behaviors and went a long way to help him thing better of himself.

I understand that all our difficult children are different. I also understand that many of our children can't help or even understand the challenges they live with. But I also believe that very often our children can pattern into reacting a particular way because of either habit or eventual outcome (i.e., coming home from early or getting out of frustrating situation). Not always, and not every child. But I do know that positive reinforcement and gentle and consistent expectations and consequences can very often make a difference. They become part of the pattern of helping a child understand how to deal with challenging situations for life.

As far as the sensory issues, they could be attributable to anxiety or they could indicate a whole different disorder. In some way, perhaps dealing with the mired of issues with your challenging older son has made you wary of alternative discipline techniques. Dealing with our challenging children is not easy. It is stressful for the entire family. Youngest appears to have really been hammered by your oldest. That in itself has left a big mark on him.

As far as the therapist, you have to feel that his doctor is on the same page as you. If this therapist is not willing to listen to your perspective, it's time to shop for another. I also feel that youngest would benefit from a psychiatrist evaluation. You are on the right track by asking the school to start their testing process. One of the biggest factors in success in the future is early intervention!

I agree with you that youngest has a great insight into himself. It's a great place to start!

Sharon

 

[whatamess]

Hi Sharon,
I am very wary of how school's implement the reward/consequence systems~ in our experience, it gets abused and consequences are doled out at inappropriate times. At his summer program he was losing minutes of recess/free time every day and it really made him not want to engage/participate even more. One day they even carried over the lost minutes to the next day's free time~believe me it was extremely difficult to get him to school that day ~ can you imagine being 5 and knowing the day is already going to start with a consequence?! If I try to pursue a neuropsychologist evaluation or psychiatrist evaluation, it will take months to get in. I need action now~lol!

 

[LittleDudesMom]

Starting the school evaluation is a good thing because an IEP may be in order. One of the first things I did was make sure that recess was never taken away! That was written into his IEP. Alternative methods included unfinished classwork being sent home for homework. But your boy is only 5. Hopefully you can get some answers as to what he's dealing with soon so that he can start the school year in a positive way.

Sharon

 

[Andy]

Allan, I do understand the use of these charts as a tool to help direct the person in making better choices. I just didn't know that they were used as a "test" to determine what diagnosis to give.

Whatamess, That was a wonderful conversation you had with your 5 year old. Keep talking to him. He sounds like a great kid. I really like how he said that he walks into the school and that he reconizes his need for more time in transition than the other kids. My difficult child was an "observer". We would go to cub scout, Sunday School, Vaction Bible School, where ever and he never wanted to join in. I never pushed it and when an adult would try to encourage him, I would say, "Give him time, he just wants to watch for now". And one day, he came out of his shell though years after all the other kids did and he is doing great! You wouldn't suspect this confident kid was ever so extremely "shy" as some would put it. I knew it wasn't shyness but more wanting/needing to learn and be sure he understood before doing.

Do what you need to get an IEP in place. I don't know the steps because the teachers my difficult child had worked with me. They would do whatever I asked of them to help difficult child get through the two difficult years he had. Not all school systems are as willing to work with parents on the level our private school was. Once he entered the public school system, even getting my difficult child to have permission carry a waterbottle around in Middle School was a "fight" needing a doctor's order. Elementary school teachers are more accomodating and willing to work with each individual kid. However, with budget cuts and growing classrooms, that is a challenge for even the best teacher.

I also agree wholeheartly that taking recess away should never be considered. This is so important for a kid's health, physical, emotional, and as well as social. Recesses are set for a reason - to give the kids a chance to stretch, run, play, a break. EVERY kid needs this break to play. It would be an open "punishment" that other kids will very soon pick up on and though the younger kids 5 - 7 are more tolerable and understanding that this is a way of life, as the kids get older, they will use it to tease him opening an entire new set of problems.

Starting each day as positive as possible goes a long way. Inform the school that any discipling actions must be met the day of the situation. It is too long for a 5 year old to sit and think about the consequences if they go into the next day. It may take some creative thinking on how to accomplish this if the action is at the very end of the day but I am sure you can come up with something.

I would suggest you continue to pursue the neuropysch exam and whatever other tests you want. Get a date set. You can always cancel if the time gets closer and you don't feel you need it.

You are doing a great job in recognizing what is happening, trying to figure out why, and looking for answers.

 

[Allan-Matlem]

Hi,
Andy - It was another poster who talked about charts. I agree as Stuart Ablon from http://thinkkids.org says that rewards etc' can make a kid look good ' but it does not teach skills and as Alfie Kohn it does not make kids commited to the values you are teaching just motivated to get rewards. In fact there is research showing that rewards actualy cause more anxiety amd cause inappropriate behavior. Most consequences which are imposed are neither logical ( maybe to the teacher ) or natural. A natural consequence is like wasting time and missing the bus so you need to wait for the next bus. You will take the next bus and go on your journey , nobody is consequencing you.

There is a place for rewards when it is ' self determined ' . Alfie Kohn's work is based a lot on Deci and Ryan. We need to choose goals and more important enjoy the process of getting there . We may find that the extrinsic motivation of the goal is not enough so we may decide to find something else , like buying a candy for a week's practicing at the piano. Our goal is to become proficient , we enjoy playing , we decide we need some extra motivation. The point is the kid is the author of this , it is not some one trying to manipulate him. Even when the doggie biscuit offered by the teacher is attractive , the effect is only short and causes kids to loose interest in what they are doing and choose easy tasks.

The ' different brain ' little guy. - Our greatest tool with kids is conversation , we listening using dialog questions to direct conversation , perspective taking , putting concerns on the table , looking for various alternate solutions , possible obstacles etc . In order to find a solution we need the input from the child , drilling down to get a clear undertanding of his concerns. The good news is the ' brain is like a muscle ' , the more we exercise it , the more we are involved in ' thinking ' , we change the brain. It is important using Carol Dweck's term to show kids that we get places having a ' growth mindset , rather than a fixed mindset. Often our concerns can be viewed as goals and expectations. What goals do our kid have , do they share our expectations of themselves. What's getting in their way , what is their unmet concern or missing skill. Besides working through the checklists of missing skills and unsolved problems - see the CPS sites for the paper work , start to prioritize problems and start working on the them collaborating rather than doing to your child. It is not a technique but a process and takes many CPS moments to acquire skills and trust the process.
That is why I recommend chatting about general stuff , taking perspectives , noticing concerns and suggesting solutions.

I recommend evaluations and labels just to get the accomodations and resources for your child. We have to show schools that children do well if they can and that a only a trusting relationship between teacher an kid can facilitate progress. The book ' lost at school ' and the links are good resources

I hope this helps

Allan

 

[ML]

Wow, Allan, that's exactly what we're realizing with manster. If the motivation doesn't come from within him, it doesn't truly change behaviors. I wil definitely check out your blog.

 

[Andy]

Exactly Allan! That is why many parents of difficult child's are finding they don't work for them. The focus too quickly turns to the reward and many kids try to get that reward changed to something bigger so it does start creating more anxiety both in arguments with parents and with the kid trying to manipulate a way to get everything for nothing. Also, when a reward is not met, many difficult child's just look at it as another place they failed in.

You are also right on with conversation being a very important tool. Our kids have more skills in that area than we give them credit for sometimes. Who would have guessed that a 5 year old would be able to explain why school was hard in the terms that whatamess's son did? Talking to them does open up many new view points. They do see things differently than we think they do sometimes. Once we can hear and understand where they really are coming from, we have taken the most important step in trying to lead them to making the right decisions.

 

[DaisyFace]

Allan--

Exactly right! I HATE behavior charts for that very reason. It does NOT motivate an oppositional child--but instead becomes a new source of aggravation to both children and parents as kids try to find a way to "beat" the chart and parents struggle to get the child to stick with the chart. Everybody loses.

A easy child does not need a behavior chart to do well, so why would it be the solution for a difficult child ?

 

[BusynMember]

I'll pass along only what I know. I do have a son with Aspergers. AFTER working out some issues the Pervasive Developmental Disorder (PDD) caused, and ONLY after that, he is motivated highly by rewards. But he wasn't before the Pervasive Developmental Disorder (PDD) was addressed and it did not make him NOT have Pervasive Developmental Disorder (PDD). You can't. That isn't a learned behavior. It's a difference in the brain's wiring.
Secndly, my sister is an aide in a big school district (one said to be very good) in Illinois and she works with kids who are on the spectrum. The teacher/Special Education team insists on reward/punishment systems for all the children. She reports to me that this is ineffective for every single child in her class, however they don't tell that to the parents because the more kids they have, the more funding they get. I think with Pervasive Developmental Disorder (PDD) kids, you need a doctor (orpsychologist) who is very knowledgeable about Pervasive Developmental Disorder (PDD), and will help both you and him deal with the diagnosis, what it means, and how to handle it for the best possible outcome.
Good luck whatever you decide to do!