Reinforcement for Children with ASD
How to Use Rewards with Children with ASD
-
Because of the difficulties people with ASD have with communication and social interactions, typical ways of using reinforcement may not work well. For example, a child with ASD may not go along with a procedure for some of the social reasons another child might comply (for example, be embarrassed if they did not do it or do it because everyone else is doing it). Also, since many people with ASD have strong feelings about what they like and do not like, typical rewards that are used for children without ASD may not be as motivating.
-
It is important to use specific rewards when asking your child with ASD to participate in blood draws, and before the visit to practice strategies, such as relaxation (link to relaxation section), that will help. Doing this will help your child with ASD connect these activities with other enjoyable things. This may make the process less stressful for your child and will let your child know that his or her hard work will be rewarded.
-
Certain ways of using rewards have been researched enough to be considered an established treatment for children with ASD. For more information about evidence-based treatments, go to the National Standards Project at www.nationalautismcenter.org.
Tips for Using Rewards Effectively
-
Make them Immediate.
Give reinforcement as soon as you can. If this is not possible (for example, the reward is going to a playground and you have to drive there), provide some type of visual (link to visual supports section) way to let your child know that the reward has been earned and is coming soon (for example, a picture of the activity or a token).
-
Keep them Varied and Novel.
Choose a reward that your child does not always have available and is different enough to be motivating during something like a blood draw. For example, do not use toys that your child is allowed to play freely with at home as a reward. The reward you choose also should not have been available immediately before the procedure. For example, candy or an edible treat would not be the best choice if your child had just eaten a large meal.
-
Have Several Options.
If your child is undergoing several medical procedures, have a few different rewards so that your child remains motivated throughout the entire visit. It is important to remember that something that is reinforcing for certain situations with your child may not be reinforcing for every situation. For example, your child may clean up his or her toys in order to receive something that is mildly reinforcing at home, such as going outside. This may not be reinforcing enough for your child to comply with something like a blood draw, though. This may be because he or she sees a blood draw as much more difficult or unpleasant than cleaning up his or her toys.
-
Be Clear.
When giving your child the reward, make eye contact and speak enthusiastically. Be clear about what the reward is and exactly what your child did to earn it (for example, sat still, walked in without help).
-
Always Follow Through.
It is very important to provide the reward promised to your child when the task is completed. If you are offering something and you are not sure if it can realistically be provided, do not offer it. Offering these will make the use of rewards less effective because your child may stop believing that they will be given.
What if challenging behaviors occur?
-
Continue to focus on the task and praise the parts of the procedure your child is completing. Instead of shifting attention to the challenging behavior, provide brief statements or a visual that tell your child what you would like for them to do (for example, hold your arm out).
-
If you think challenging behaviors may occur, introduce your child to the strategies on this website before the visit and practice them during daily activities he or she enjoys.
-
If challenging behaviors become more difficult to manage, it may be appropriate to consider behavioral consultation with a professional to address these behaviors directly.
