Positive Reinforcement

We have probably all heard of positive reinforcement or positive support and how this technique helps establish and improve well-mannered habits and reinforce essential life skills in children with autism or a diagnosis under the Autism Spectrum Disorder (ASD) umbrella. A child is instructed to string blocks onto a string in a certain order and for every block that is correctly strung, they get a token, a sticker or a high-five. The child is shown how to brush their teeth properly and for every time they are able to complete the task correctly on their own, they get to play a game they enjoy, or they get to sleep with their favourite stuffed animal. These are some basic examples of positive reinforcement. The types of positive reinforcement that “work” for each child are as widely varied as the symptoms of ASD. In other words, what works for one child may not work for another child. Some children are happy to get stickers on a reward card while others are happy to receive a hug or an excited exclamation of “Good job!”. There are so many different types of rewards that children might enjoy that teachers/caregivers/parents/therapists may have a notebook page or an index card that contains notes regarding each child’s preferences. The information on the card may include rewards that have been phased out, ideas for phasing current rewards out, praises that the child has a positive reaction to, ideas for future rewards and praises and what rewards they get for what behaviours/activities, etc. This method of keeping track of a child’s preferences makes sharing knowledge and current rewards unified across the board so that the child will know what to expect regardless of the environment/person they are working in/with. This is extremely helpful given the fact that most children with ASD have an adverse reaction to changes.

The eventual goal of any positive reinforcement regimen is to have praise become the only reward. “Praise is important to develop into a type of reinforcement because praise is a naturally occurring reinforcer” (1). This is because in adulthood, general verbal appreciation is a typical result of good work. Examples of this would be a boss telling you to “Keep up the good work” after you complete an especially difficult assignment. Physical rewards are less likely in adulthood, unless it is on the job in the form of a raise or a promotion that includes something physical such as a preferred parking spot or a new office, or a prize in a game-type setting. So how do we go from “reward”-based reinforcement of good behaviour to that of praise”-based? It will take an indeterminant amount of time, as it varies with each unique case, but it is as simple as using the praise and rewards systems together and slowly but surely easing out the reward part and shifting into just using praise.

The biggest benefit to positive reinforcement for children with ASD is the fact that it is continuous and something they can depend on. Given that one of the characteristics of autism is having a fixation on one single activity and the inability to change course without extreme agitation, it is helpful that they know what to expect if they perform a task properly. They can rest on the fact that they will be rewarded one way for a chore done well or another way for performing appropriately in a certain situation. Giving positive reinforcement for changing tasks gives them incentive to behave appropriately during the transition. It opens them up to the realization that changing a task can be a positive experience, rather than an upsetting one.

When parents, teachers and therapists understand this concept, they can begin to help the child learn life skills and tasks that are essential to living that the child once found distressing. Tasks such as brushing teeth and hair, bathing, eating certain foods, carrying out the activities of getting dressed, pouring a bowl of cereal and milk or toasting bread, once things that were impossible or nerve-wracking, soon become joyful pursuits because the child gets positive reinforcement which encourages them to do them again. “The aim is to increase the chances the child will respond with the changed behaviour. Positive reinforcement is given immediately after the desired behaviour has occurred so that it will shape the child’s future behaviour” (2).

The timing of reinforcement is also important when building up the behaviours and skills you are trying to teach. “One tip is called the 50% rule for time between reinforcers… Think about how much time there is in between a behaviour. When you take an 18-month-old that you are trying to teach how to sit in a chair, they might sit in a chair for 10 seconds… divide that time in half… so every 5 seconds, I have to give them a reinforcer… This increased the duration that she was in her chair” (3) Take this timing into account when considering when to use reinforcements and as the skill builds, the time for reinforcement will gradually increase. It may only be seconds at a time, one day at a time. Say you are teaching a young child to brush their teeth. They only brush for about 10 seconds, so at 5 seconds, you encourage them with a “woohoo, you are doing a good job”, and then at 10 seconds, you encourage them the same way again. You do this again and again, day after day, until the skill is built into a full 2 minutes, (generally considered an appropriate time frame to brush teeth (4). Once the skill of being able to brush the teeth the full two minutes is attained with the timing of positive encouragement being withheld until the task is completed, then you can work on being able to brush the teeth properly, working with the same method of positive encouragement*.

When determining the type of positive reinforcements and/or ways to positively encourage desired behaviours and skills, it is crucial to take into consideration rewards that can be built up to or “levelled up” as the time and desired skills improve. “It is also important that the reinforcer is not something the child already has free access to. …do not give as much as the child would want given free access, as this would leave them nothing to work towards. … A visual system can work well with autistic children, where they can see their progress as well e.g. ticks on a behaviour chart” (5). Some caregivers use a points system, some use sticker charts, and still others use tokens. The point of any reinforcement is that the child must enjoy it. If the child appreciates the reward, they will happily strive to earn it as they are acquiring the anticipated skill and/or learning the desired behaviour. If the child doesn’t like the reward offered, they will not have the incentive to behave appropriately or complete the task given. Therefore, finding rewards that the child desires is extremely important. Steady positive reinforcement is essential to gradually building important life skills and appropriate behaviours. When applied correctly and continuously, lasting skills and good behaviour can be acquired. Positive reinforcements can be applied in nearly endless ways. You can use it to help with social skills, transitioning between tasks, learning to get dressed and other forms of self-care, eating a variety of foods, and many other tasks and skills.

When children learn that they can depend on certain behaviours earning desired results, they seek out other outlets to earn further desired results. Continuous affirmation can gradually build upon itself and help the child to learn many new skill sets and seek approval for completed tasks. In time, the child may begin to initiate tasks on their own to earn a desired result. This is a very monumental shift from the general behaviour of children with disabilities as they usually do not have the desire to initiate tasks on their own. Believed to be caused by their “insistence on sameness, inflexible adherence to routines, or ritualized patterns… (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route…)”. Therefore, if this ability to start a task on their own is witnessed, it should be rewarded in a manner that is very meaningful to the child which will help to reinforce the importance of the act of initiating the task themselves. Positive reinforcement can, conceivably, strengthen life skills needed to be independent; however, in some cases, full independence may not be possible depending on the severity of the disability. It may also be possible to transition a child into a regular classroom setting, if given enough encouragement of the appropriate skills needed to progress between different tasks without irritation or, at least, a less negative response. It may also help a child to begin communicating more openly and build their social skills. Each child is unique and the skills that can be attained through Positive Reinforcement are unique to each case, but one thing is certain, positive reinforcement is capable of opening pathways to learning skills that would otherwise not be attainable to children with ASD or other disabilities.

1 http://theautismhelper.com/teaching-tip-positive-reinforcement/

2 http://www.autism-help.org/behavior-positive-reinforcement-autism.htm

3 https://www.occupationaltherapy.com/ask-the-experts/what-positive-reinforcement-ideas-to-2354

4 http://www.colgate.com/en-us/oral-health/basics/brushing-and-flossing/how-long-should-you-brush-your-teeth-for-0113 *Note that the type of positive encouragement that is used for the desired result is unique to each person and you may need to use a variety of types of reinforcers or “stack” the reinforcements, as in more desirable rewards for longer periods of time.

5 http://www.autism-help.org/behavior-positive-reinforcement-autism.htm

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