How to Improve Routines in Kids and Teens
Happy Sunday everyone. Today's Sunday Skill article is a long one. It touches on an important topic: how to teach and encourage children to complete daily tasks without the arguments, resistance, or dozens of reminders.
After you have a solid foundation of using differential attention (aka strategic labeled praises and planned ignoring) paired with daily Special Time with your child, it is time to develop and implement incentive systems to improve daily tasks, routines, and difficult behaviors. Remember, if you jump straight to these systems, they are likely to fail, as we have not lowered the intensity of the behavioral challenges with the initial foundational and relationship-building skills.
Reward systems are critical to improving motivation in children with ADHD or related behavior concerns because they reinforce behaviors, tasks, or chores that are hard for them, and over time it becomes easier. For example, if it's hard for your child to remember to brush their teeth (and they do not enjoy doing it), then it will be hard to get them to change their behavior and brush their teeth on their own without some type of positive reinforcement. You've probably tried discussions and reminders for a while, but it has not created a positive, consistent habit in them yet.
Some parenting influencers or even professionals discuss how reward charts or incentive systems aren't helpful or can even be harmful to children and teens. If I'm being honest, I really don't understand where they are coming from, and think that message is actually harmful. I understand that parents want their children to have intrinsic motivation to complete daily tasks. I hear this frequently in my private practice. But the reality is that they don't right now. You've tried, probably for a long time, and it hasn't worked. Wishing, discussing, repeating yourself for months or longer, while getting frustrated, certainly isn't going to build intrinsic motivation.
What can work? Building intrinsic motivation by using extrinsic motivation for a period of time. When a difficult or non-preferred task is paired with something rewarding or fun, over time, through conditioning, that task becomes more enjoyable and intrinsic motivation is developed. This is how habits are built, and children have a lot of habits they need to be good at to grow up to be functioning adults. When done properly, children learn how to follow routines.
While labeled praises can sometimes be enough positive reinforcement to improve many behaviors, there are some behaviors or tasks that require more, depending on the child. That's where reward or incentive systems come in. Note that you do not need to buy your child things to make this work, especially not repeatedly. This is not sustainable, and it is not necessary. You simply need to build a system where your child unlocks privileges that are motivating for them, and often this can be the things they are already doing at home. For example, when they brush their teeth, only then do they "unlock" their electronic time or playing outside. Your child earns their reward for completing the behavior, or they choose not to and don't earn the reward.
This process ensures the behaviors become habits, which is really the goal with these systems. We are not going to have to set things up for your child forever. It is merely to create a positive association between the completion of the task and their subsequent reward, and over time, the reward is not needed as the habit is formed. There are certain tasks in life that are important skills or critical to their health (such as brushing teeth).
This process sounds simple, but it can actually be slightly more complicated than it sounds, especially if your child struggles with anger, aggression, or significant distractions. There are a lot of things to consider and think through when implementing a system, and they unfortunately can fail for a lot of reasons. This explains why almost all families that I work with tell me that their experience with reward charts has been negative, that they don't work. In those who have shared they worked, they often describe them as only effective for a period of time, losing their luster after a few weeks.
Steps for Getting Started
1. Behavior Goals. Almost any behaviors can be targeted with a reward chart. It's critical to start simple in the beginning. The goal for the first 1–2 weeks is to teach your child that they now have certain expectations for their behavior. Your child may not be used to having to work hard to "unlock" fun activities. We need to teach them that this is the new routine. We want the initial behavioral goals to be straightforward and very achievable. We want them to win! We are not targeting the most difficult behavior for your child. This will come in a few weeks. List out behaviors you think you want to target, and pick 2–4 easy goals. Do not start at 10 goals. We are not there yet, and this is the #1 reason these charts fall apart. Age of your child also matters. If they are 4–5 years old, I would lean toward starting with 1–2 goals. If they are 7 or 8, starting with 3 or 4 can be possible. Importantly, it also depends on the severity of your child's behaviors. If your child's behavior is severe, or you as the parent are very overwhelmed, it is better to start much easier with fewer goals. This is because if you start out easy and the child wins, you have lots of room for praising and positive reinforcement, and all you have to do is make it harder the next week. Slow and gradual is best. If you make it too hard, you now have to backtrack and remove goals, which may teach the kid, "When I don't listen or do the goals, I have fewer expectations in the future." That's not the lesson we want to teach them. Or worse, you may give up on this process.
2. Objective, Observable, Quantifiable, and One at a Time. Each goal needs to be observable, objective, quantifiable, and focused on one behavior at a time. In other words, we need to be sure that you, as the parent, can assess: was your child successful, or were they not successful, with each specific goal? If you can't determine this, you won't be able to determine if they unlock the reward that day. For example, "speaks respectfully" may not be the best goal to start with, because there is an unlimited number of opportunities for them to engage in the behavior. What happens if they are respectful 80% of the time in a given day but disrespectful 20% of the time? Do they earn their reward? A better goal would be "is respectful at least 2x per day." Do we want them to be respectful more often? Maybe! But we're starting simple and achievable. Similarly, we do not want to phrase one goal as "brush teeth and get dressed." What if they do one but not the other? You're not going to know what you should do: reward or withhold reward? We need consistency on your part to make it easy for you. To be clear, those are great goals, but separate them out so that they are two different goals: "1) brush teeth" and "2) get dressed." I would start off with daily tasks as the goals, not more complex, somewhat subjective goals such as "be respectful." That's something you can work toward once the child has been successful for a bit.
3. Pick a motivating reward for the child. The key to the success of this process is to select a highly motivating reward. What do they like to do or choose to do in their free time? What do they already earn for free? What are you willing to give them daily but that you're also willing to withhold if and when they do not meet their daily goals? You can either implement one reward (e.g., 30 minutes of iPad time) or create a daily reward menu where they get to select one activity from the menu on days that they are successful at meeting their goals. You can involve your child in coming up with reward ideas. This can be fun for many kids! Keep in mind the reward is daily. Spacing out rewards after multiple days of success is extremely hard for children with significant behavioral concerns. The daily reinforcement is what makes progress.
4. Be prepared for a little or a lot of pushback. If your child realizes that they don't get access to their fun things without completing daily tasks, they may push back. This is normal and predictable, so do not fret. Remember the foundational strategies, including planned ignoring when they complain, and praising when they complete the goals. The key is that you say what you mean and mean what you say. Follow-through is critical for this to work. The goal of the first foundational strategies was to reduce the intensity of the behaviors and meltdowns so that when you implement the reward chart, the child is not melting down as intensely. If you find their meltdowns are severe and last more than a week of attempting to implement the reward chart, this could be a sign that you may have started onto the reward charts too soon and need to go back to the foundational strategies. If unsure, consult a professional. Most of the time, if you're consistent and follow the chart, the child will adapt and begin to comply. Do not stop the chart because the child says they aren't going to do it or they don't care. This is a huge mistake. It is rare that the child actually does not care, particularly if they have the potential to earn an exciting daily reward. If you continue the chart for the first week and they say they do not care and fail to try to meet the goals, then your reward may not be enticing enough, or the goals are too hard. Refusing for a few days is common, and usually, if things are set up correctly, the child learns that you're serious and will adjust to meet expectations. Again, consulting a professional with experience in behavioral therapy and reinforcement will be important. Every family and child is different.
5. Implement the chart. The key to this system is that if they complete their behavior goals as you have outlined them, the child must get access to the reward. If you do not allow them to have their reward when they meet their goals, the chart falls apart. They will not trust what you say, and that is the problem. There is a level of trust you are building with your child through this reward system. I like to think of it as a "contract." Do not make the mistake of saying, "Well, we ran out of time." If the day is such that the only way to give them their reward is for them to be 10 minutes late to bed, in almost all circumstances I would recommend giving them the reward and allowing them to be 10 minutes late to bed (e.g., "Because you worked so hard and did such a good job completing X, Y, and Z, you still earn your reward even though we're a little late on bedtime"). The need for these systems is not forever, and we can revise the system so that you have more time, but for now, when you're in the moment in this situation, you must follow through on what you told them. Similarly, if the child fails to complete their goals as they are outlined, do not give them access to the reward, no matter what. This sabotages all effort moving forward, and the system will not work. Stay calm and state, "You didn't meet your goals today, so you don't get access to your game, but I know you can do it tomorrow!" You're calm and encouraging. This is hard for kids, and that is okay. Do not show major signs of anger or irritation. You're not mad they didn't meet their goal. This is not helpful. You're optimistic about tomorrow and encouraging. Remember brief planned ignoring if a meltdown starts, and labeled praises after they calm down.
6. Track success and revise the system. We must track how the child is doing so that you know how to revise the reward chart. If the child is only successfully earning their reward 2 out of 7 days, then we are absolutely not ready to make the chart harder by adding additional goals, as they have not shown the ability to complete the current goals. However, if the child is successful 6 or 7 out of 7 days, we are ready to move on to make the chart harder. We can do this in a few ways.
First, we can make a goal harder by adjusting how we phrase the current goal. In other words, if we have a goal that stated "puts clothing in hamper with 2 or fewer parent reminders," and they are successful throughout the week, we can change the goal to make it harder by reducing the number of reminders allowed to 1 reminder. Another way we can make the system harder is by adding an additional behavioral goal. Usually, I recommend only adding one or at max two additional goals at a time. Remember, these are all habits. It's hard to change habits, even for adults, so please do not overwhelm your child just because there are dozens of behaviors you would like them to improve. Too many goals are a common reason these charts so often crash and burn. Slow but steady will win the race. Please be patient.
Depending on the child and how things are going at home and with the chart, revising the system every 1–3 weeks can be appropriate. Over time, if you find that the child completes the tasks extremely easily or even without needing the reward, then you can remove the behaviors from the reward chart. This does not mean they aren't required to complete those behaviors or tasks; they just are expected to do it without the reward. Once a behavior is removed, you can add the next behavior goal you want to the chart and complete the process again.
These systems are tailored heavily to the family and can become more complicated, but these are the foundational guidelines that families should follow when helping their child build habits.