Pairing yourself with a child with a neurological condition

pairing-bellaSleep Practitioner Bethan Roberts gives advice on pairing yourself with a child to help deal with problem behaviour.

Pairing is the process of creating an enjoyable and reinforcing relationship between the child/young person and a given situation/person. Pairing is a very important place to start when trying to create behavioural change, by pairing yourself (as a parent/carer/professional etc) with positive reinforcement, so that you become the reinforcer rather than just the giver of reinforcement, can help achieve behavioural change and enable children feel safer in unknown/unpreferred situations.

Social situations

Every child and young person has the right to be a valued part of their society. The level of involvement is very individual however.  Many adults that children and young people come into contact with have an expectation that children will seek social reinforcement naturally. However many do not and therefore need to learn and experience that these situations can be reinforcing. If we think about school as an example, is there a lesson or activity they’re struggling with? Try to establish what the specific problem is, for example is the sheer length of the assembly and expectation for ‘appropriate behaviour’ too much to be achieved right now? Is there a compromise to be made? Could the time spent in assembly be limited to 5 minutes and increased as tolerance is developed. This would ensure that the young person has access to high value reinforcement in exchange for the desired behaviour for example a magazine in exchange for remaining in assembly and not screaming.

pairing-poppyDay to day activities

Doctor appointments, supermarket shopping, day trips, play dates, going to the bank, dentist – the list is endless and somewhat overlooked sometimes by those who’ve never experienced a meltdown due to unforeseen cues at supermarket checkouts, or the smell of the dentists surgery. But when is this activity necessary? It’s quite common for children and young people to dislike attending appointments with the above professionals, but unfortunately somewhat necessary, and therefore something that could benefit from being worked on. Practice when success is not vital. Would your doctor/dentist be willing to see your child weekly (short term) for 5 mins to work on pairing with reinforcement? Could you call into the supermarket when you don’t need to buy anything, spend two minutes walking up an aisle and then out?

Deciding where to start when tackling these issues can be tricky. There are things that we could begin to deal with today and some that are best left to a later date. Below are a few points to consider:

  • What kind of benefit will they/the family get from this i.e. going on holiday vs supermarket shopping?
  • Is it essential that they are able do this right now i.e. attend a doctor appointment vs attending the school disco?
  • Be mindful of any additional demands that may be inadvertently placed on the child i.e. being quiet, sitting still
  • Try and have a bag of tricks with you. If they are sensitive to noise, could headphones or ear defenders be useful. Keep some high level reinforcement handy that you will only produce when demand levels are very high, these can be produced in exchange for desirable behaviour (perhaps teamed with verbal praise to reinforce what they’re doing)
  • Understanding why the undesirable behaviours happen can help to change them

Work with other agencies such as school, doctors surgery, youth groups, supermarket staff, etc to ensure success there too. It has been my experience that often (not always) people that you come into contact during these times can be important in achieving success. Very often, by sharing with them a little information about your child and what you’re are trying to achieve can help foster an environment of understanding and positivity. Don’t forget, safety is always the most important thing to consider. Never be afraid of admitting things aren’t going to plan. You can always abandon the plan and start again another day!