Skills Training

Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.

Children with ADHD, and their caregivers, must each learn a new set of skills. Caregivers need help developing the skills to best manage their child's behavior and promote normal development. Children often need help learning better social skills so that they can more easily form friendships and otherwise communicate well with others.

Skills for caregivers: Behavior Management Training

reward dice This skills training focuses on techniques that change the surroundings of a child to improve behavior. Here we describe what caregivers will typically learn during this sort of training.

Caregivers learn they have the ability to increase desirable behaviors and lessen the unpleasant ones. To increase a behavior, we reward it, or reinforce it. To decrease an unpleasant behavior, we ignore it or punish it. It may seem counterintuitive to suggest ignoring a behavior can diminish it. However, if a behavior is not rewarded with attention it will diminish. Punishment refers to anything in the environment (child's surroundings) that causes a decrease in a behavior. We do not mean spanking or otherwise hurting a child! These behavioral management techniques can be used at home or in school settings.

Increasing desirable behaviors: Caregivers learn about a token reward system. In this approach, each correct behavior is immediately rewarded by something small. It also provides a larger, longer-term reward that encourage sustaining positive actions. For instance, a child might be rewarded with a sticker each time he raises his hand before speaking. When he collects 10 stickers on his chart, he gets to bring home the classroom hamster for the weekend. Some other child might prefer a leather jacket. The key is to find something that is rewarding for that particular child.

Decreasing undesirable behaviors: Caregivers learn how to correctly use "timeouts" to punish (diminish) undesirable behaviors. Timeouts involve removing the child from an enjoyable environment to sit quietly alone while they reflect on their behavior. As with rewards, in order for something to have a punishing effect, the child would need to experience their removal from the original environment as unpleasant or undesirable.

Caregivers will learn the importance of a loving, positive, instructive approach. This helps ensure children do not feel as though everyone is just waiting for them to do something wrong. Designing and applying such a plan is rather complex. It is helpful to get professional guidance.

In behavioral management training, professionals work closely with families. They teach and help families apply some basic principles of behavior modification. These include:

Provide clear rules and behavioral expectations.
Develop written contracts for specific behavioral change.
Establish routines and schedules.
Allow natural consequences to occur and provide opportunities for correction.
Reward desired behaviors immediately or as quickly as possible.
Do not reward inappropriate behavior by paying attention to it.
Make instructions clear and explicit.
Make age-appropriate goals that change over time.
Provide supportive environments that promote success (e.g., minimize distractions during homework).
Use behavioral shaping techniques to gradually train a desired behavior. Behavioral shaping means rewarding small incremental positive changes as a new behavior is learned.

Rewards are more helpful than punishment. Research has shown that children with ADHD do not benefit from punishment in the same manner as other children. Therefore, an effort should be made to utilize a method that emphasizes rewards for positive behavior.

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Individual and Cognitive Behavioral Psychotherapy for the Child with ADHD

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