Reward System for a Child With ADHD: Building a Token Chart
Why does a reward chart work in the first week and then collapse? The token system at the base of behavioral parent training, step by step, with common mistakes.
Building a token system: the protocol6 steps
- Choose at most three behaviors. Make them concrete and observable: "brushed teeth," "put on shoes." General goals like "behave well" do not work.
- Make a reward menu together with the child. Small, medium and big rewards: extra play time, a meal of their choice, a special activity with a parent. A reward the child chooses motivates more.
- Give the token right after the behavior. A reward left to the end of the day loses its connection for a young child. Immediate feedback is the heart of the system.
- Keep winning frequent and the reward reachable. In the first weeks the child should be able to earn tokens several times a day. A reward that is too far away ends motivation.
- Do not take back a token that has been earned. When a mistake happens, no token is given at that moment but what was earned before is not taken back. Losing what was earned breaks trust in the system.
- Review weekly and change when needed. The child may get bored or the target may have become easy. Renew the reward menu, change the behavior, raise the difficulty slightly.
A colorful chart hangs on the fridge at home. It was prepared with excitement three weeks ago. Now the last day marked on it was two weeks ago.
Reward charts get set up a lot and collapse a lot. The reason is usually not that the idea is wrong but a few details in the setup. This article describes the token system, one of the basic tools of behavioral parent training, and the common mistakes.
Why a reward
In ADHD the motivating power of a delayed reward is weak. Distant goals like "if the grades are good we'll buy a bike in the summer holiday" struggle to steer the child toward today's task. The task is done but the reward comes too late.
The token system closes this gap: right after the behavior it gives a small, visible reward, and over time these small rewards are exchanged for a bigger one. The meta-analysis by Fabiano and colleagues and the review by Pelham and Fabiano report that behavioral approaches (reward, predictable consequences, parent training) are well supported for ADHD.
Setting it up
The details of the steps above:
Number of behaviors. Trying to fix everything at once collapses the system. Three behaviors is the limit that the child and the parent can keep track of. For example for the morning: getting out of bed, getting dressed, brushing teeth. For the morning arrangement the article on the morning routine for a child with ADHD helps.
Concreteness. Instead of "tidy your room," "the clothes on the floor are in the basket." The child needs to be able to see what to do and when it is finished.
Form of the token. According to the child's age: stickers, beads, a coin dropped in a jar, a star on a chart. Being visible and touchable makes a difference for young children.
Reward menu. Together with the child, in three tiers: small (immediate), medium (a few days), big (the weekend). It does not have to be material; half an hour more play, an activity with a parent, a meal of their choice.
Common mistakes
- Too many behaviors. The child does not know what to focus on.
- Delayed reward. An end-of-day tally of "how good were you today" stays abstract for young children.
- Taking tokens back. Taking back what was earned teaches the child that the system is unreliable and leads them to give up.
- Tying the reward to other things. Basic necessities (food, sleep, love) are not used as rewards.
- Irregularity. A system applied on some days and forgotten on others does not work. Start small but be consistent.
- Not renewing the system. The reward menu and the targets get boring over time; they need to be renewed every few weeks.
Praise and reward together
Next to every token, let there be a short and distinct praise: "You put your shoes on yourself, well done." Over time the need for the token decreases and the social praise remains. In parent training this is called "positive attention" and it makes up half of the system.
The current practice guide by Daley and colleagues emphasizes that parent training improves parent behavior and the child's behavior problems in children with ADHD, but that the effect on core ADHD symptoms is more limited. So a reward system does not solve everything; it makes a difference in the targeted behaviors and in the relationship.
Consequences
Mild and consistent consequences can be used together with rewards. For example a shorter screen time allowance when a direction is not followed. These need to be:
- known in advance
- connected to the behavior
- applied in a calm voice
- not long and heavy
Heavy punishments suppress in the short term but do not teach the behavior and damage the relationship. For the moment of anger there is the article on anger outbursts.
When to get support
If setting it up on your own feels hard, if the system keeps collapsing or if your relationship with the child is becoming tense, it makes sense to get support from a specialist who provides parent training. What these programs contain is in the article on parent training programs.
This article is for information purposes; the decision for your child belongs to the doctor who assesses them.
Frequently asked questions
- Does the token system really work?
- In behavioral intervention research, token and reward-based approaches are among the well-supported methods for behavior in children with ADHD. Its effect is marked when it is built correctly and fades quickly when it is built wrongly.
- Is rewarding a child a bribe?
- No. A bribe is given while bad behavior continues. A reward system reinforces good behavior that was set in advance. Over time social praise and natural rewards come to the fore.
- Why is the chart dropped after a week?
- When the novelty effect passes, interest falls. In a child with ADHD, reward systems get boring quickly; rewards and targets need to be renewed at set intervals.
- Should punishment never be used?
- Mild and consistent consequences (for example a shorter screen time allowance) can be used together with rewards. But heavy and harsh punishments are ineffective and damage the relationship.