The following information and resources have been provided courtesy of The Lurie Center for Autism, a program of Massachusetts General Hospital and Mass General for Children.

The Lurie Center for Autism is committed to advancing treatments for and knowledge about Autism Spectrum Disorder (ASD) and other developmental disorders, and translating these discoveries into exceptional clinical care. A program of Massachusetts General Hospital and Mass General for Children, The Lurie Center is a multidisciplinary treatment, research, training, and advocacy organization dedicated to supporting individuals and their families across the lifespan.

This resource is intended to provide information so that you can be better informed. It is not a substitute for medical advice and should not be used to treat any medical conditions.

This information is also available in Arabic, Chinese, Haitian Creole, Portuguese, Russian and Spanish. Click here to view these resources.

Attending

Attending is when you describe your child’s appropriate behavior. Sometimes it means imitating what your child is doing. It lets your child know that you are interested in the positive things that they do. Often our focus is on negative behavior. Attending can help you build a more positive relationship with your child. Attending is often very difficult for parents to learn because negative behaviors are often the source of much concern and worry. When you are attending, do not give instructions or ask questions. Simply describe what the child is doing.

Examples:

• "You're stacking the blocks high!"
• "You're blowing up the balloon!"
• "Wow, you're running fast!"
• "Now you're pushing the truck!"

Sometimes you can imitate what the child is doing. For example, if they are stacking blocks, you can also stack blocks nearby.

Often when kids do not comply with instructions, parents give many directions and ask lots of questions. Unfortunately, the more questions and directions children hear, the less likely they are to listen. It also means that parents give more directions and ask more and more questions, resulting in the child responding less and less. Attending helps break this cycle.

Rewards

Rewards help your child know when you approve of what they are doing.

Types of rewards:

• Verbal: praising your child’s behavior.
• Physical: giving physical contact (like a pat on the back).
• Activities: doing activities that your child chooses.
• Material or Non-social: desirable objects or special treats.

How to use rewards effectively:

• Label the behavior that you like.
• Use rewards immediately after the behavior you want to see.
• When starting this process, reward the behavior every time you see it.
• Only give rewards for behaviors that you want to happen more often.

Guidelines for Attending and Rewarding

Do:

• Describe the child's positive behavior.
• Imitate the child's play.
• Verbally praise and label positive behaviors.
• Reward yourself for your efforts!

Do not:

• Give instructions.
• Ask questions.
• Try to teach.

Ignoring

Ignoring is when you do not give your child attention. Ignoring has 3 parts:

• No physical contact – Do not touch your child.
• No verbal contact – Do not talk to your child.
• No eye contact.

If your child does something dangerous or destructive, do not ignore it. But there are many other behaviors that can be ignored. Examples: tantrums, whining, inappropriate crying, screaming, pouting, arguing, inappropriate demands for attention, etc.

In order for ignoring to work, you need to take away ALL attention from your child’s behavior. Act as if you cannot see or hear them. You might even need to leave the room. Once you start ignoring a behavior, you must keep ignoring it. Otherwise, your child will learn that they can get your attention if they have a tantrum or cry for long enough. This can make the behavior worse.

Ignoring is often the most difficult skill for parents to use. This is because of the extinction burst: inappropriate behavior may increase before decreasing. This makes it more and more difficult to keep ignoring. We know that it is frustrating and difficult, but it will make a difference if you stick to it!

How to ignore:

• Select a behavior that can be ignored.
• Remove all your attention when the behavior happens.
• Once you start ignoring, don't stop.
• Expect the behavior to occur more often before it occurs less often.
• Reward and attend to appropriate behavior.

Giving directions

Often, the directions that we give children are not clear and have multiple parts. This can be confusing for kids. Giving effective directions will make it more likely that children will follow them.

Things to do:

• Get your child's attention and make eye contact before giving a direction.
• Use a firm, but not loud or stern, voice.
• Give specific and simple directions.
• Use physical gestures when appropriate, such as pointing.
• Use "do" instead of "don't" directions.
• Reward compliance.
• Think before giving a direction.

Things to avoid:

• Directions with multiple steps
• Unclear directions, such as "be good". Be specific about what you want your child to do, such as "sit in your chair".
• Directions in the form of a question, such as "Can you pick up your toys?". This allows your child the ability to say no.
• Directions that start with "let's" if it is for the child to do alone. An example of this is "Let's clean up."
• Giving a reason for your directions. This can distract children. Keep things short and simple.