Sticker Shock: When Behavior Therapy Falls Apart

Though too often packed with errands and cleaning, weekends are the light at the end of the tunnel when I get to see my family and not think about work (as much anyways).

This past weekend, the snow was a blessing in disguise. I don’t like snow. I grew up with it, and we've finally reached a mutual understanding: I won't shovel it (unless under duress) if it doesn't infringe too much on me.

Last weekend, it infringed. It forced me to slow down. And I'll admit that it contributed to one of the best weekends I’ve had in a while. While my husband cleared the driveway, I pulled the girls on sleds in the same circle over and over and over. The temps weren't frigid (around here, above 20 degrees is do-able), and I enjoyed myself. When we came in the house, Hadley said, "That was fun." The simplicity of it all really resonated with me.

What's not simple? School sticker charts for behavior therapy. Who knew they could be so complicated? Or that I'd be hiding from them most weekends? Here’s how stickers charts have progressed, or I should say digressed, since mid-October when Hadley was diagnosed:

November: The chart is finally in place nearly three weeks after the concept is introduced at school. Hadley's day is broken in to "periods" with immediate feedback given by placing stickers and giving encouraging words at the end of each. She has 8 periods with 3 desired behaviors for a total of 24 stars.

Hadley’s given the opportunity to help pick her daily reward. These are things she cannot access unless she earns 50 percent of her stickers.

December: We've changed the format at least 4 times. Immediate feedback is not being given and I'm concerned the chart has become a tool to point out negative behavior. Dates are missing, so I don't know whether a reward is warranted. The psychologist suggests that Hadley place the stickers on the chart to make it more meaningful to her. I purchase a special Tinkerbell folder and Tinkerbell stickers, hoping they will appeal to Hadley and remind her teacher to send the sticker chart home.

January: Hadley is barely getting any stickers. Three days in a row, she has zero of 24 stickers. I’m getting increasingly frustrated. I don’t know if she’s given up, is rebelling against the stickers, or both. She does not seem to be motivated by rewards.

We brainstorm motivations with the school principal. She was getting iPad time at school, but it was rewarded inconsistently, which became a major de-motivator to her. Moving a reward from 10:30am to 2:00pm may not be a big deal to most kids, but to an ADHD child, it is no good.

February: We’ve seen a slight increase again in stickers, but no where near the 50 percent. She's brought home 3 yellow notes in the last 3 weeks and I feel we're moving from bad to worse. Somewhere, I suspect, she's receiving attention -- reinforcement -- for her negative behavior. The teacher does not feel the charts are working or worthwhile. She wants to try something new.

Like me, Hadley's psychologist disagrees. The charts have potential as a behavior-therapy tool, if implemented consistently. We decide to continue with the sticker chart, but try some new approaches: Sticker Chart Take 6.

Hadley tells me that her teacher does not reward stickers after every period, but rather just twice a day. It turns out Hadley was taking so incredibly long to pick out each sticker that it was eating away at classwork time. Now we're back to the original strategy with feedback and stickers given (and chosen by her teacher) more regularly.

In addition, I'm now including a note in Hadley's bag each day indicating the day's chosen reward. If she can remind Hadley of her reward throughout the day, we're hoping it will sustain her motivation.

I’m also looking to "up the rewards" without breaking the bank. Yesterday's reward was "Hadley's Beauty Salon," where she painted my nails, her sister's nails, and did my make-up. Today she was one sticker short, but neither snow nor sleet will keep us from our appointed goal!