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Practice Toilet SitsUsing rewards can be a great way to increase your child’s participation in toileting and continence. Many parents aren’t sure what to reward, or how. This video explains how to choose a good reward, how to give it, and what skills to reward. For more information on what to reward, check out our video about “Inchstones”.
A Complete Transcript is Below
Hi, my name is Ka Likig. I am the Director and Occupational Therapy Consultant for the Vermont Continents Project.
In this video, Beyond the Sticker Chart, we’re going to talk about when to use rewards, choosing a good reward, and how to give that reward.
Let’s make sure we are all using the same definition of the word reward:
Any activity that we do throughout our lives has a consequence or a result. If the consequence is something that we like, or life is better with that thing than without it, then we can say it’s rewarding. And when an action is followed by a reward, most of the time we are more likely to repeat that action.
I’m going to describe the two major types of rewards: intrinsic and extrinsic.
I’ll explain them in more detail in a moment, but for now, briefly:
Extrinsic rewards—shown with the hand giving a gold star in the picture—are a reward that comes from outside of you, the person doing the activity. Something someone does for you or gives to you are extrinsic rewards.
Intrinsic rewards are rewarding feelings or thoughts coming from inside—like feeling proud, happy, or confident, or more comfortable in your body, like the child with the smiling face thought bubble over their head.
This is probably a good time to mention that you’ve probably heard that you’re not supposed to use rewards for toilet training.
And there are lots of good reasons that people say that.
A child who is new to toilet training will often have their own internal, intrinsic motivation and curiosity. And using the toilet is rewarding by itself—intrinsically—because it fulfills that curiosity.
In other words, using the toilet is rewarding because it’s new, it’s interesting, and it can be a challenge to solve. And this motivation might naturally decrease over time—but by then, your child is likely continent—whereas some sort of extrinsic reward you’ll have to fade out over time.
So if this describes your child, focus on the part of this presentation about intrinsic rewards.
But if you’re watching this program, you might already know that not every learner is motivated by continence and toileting.
This is especially true for older toilet learners who may have months or even years of frustrating, difficult experiences relating to toileting. And the reward can be a jolt of new motivation.
And if your child has a disability that affects their learning of new ideas or expectations, a reward can also be a teaching tool that helps to bring their attention to the specific skill that you really want to focus on.
So if either of these describes your child, consider using both intrinsic and extrinsic rewards.
Let’s start by learning more about intrinsic rewards, which are sort of like a type of natural consequence.
For example, when I brush my teeth, I like that feeling that my mouth has afterward. I also feel good that I’m taking care of my body. So brushing my teeth is intrinsically rewarding.
And that feeling might make me more likely to brush my teeth when I need to. I probably don’t need an extra reward to make brushing my teeth feel worthwhile.
As I mentioned, the mastery of continence can be intrinsically rewarding.
It’s pretty cool to discover that your body can control certain functions. Feeling like a big kid, or doing something similar to others they want to connect to, or the feeling of underwear rather than a pull-up, smelling clean, or having dry pants—motivate some kids too.
Intrinsic rewards are always the thing we’re going to be focusing on and looking for.
What aspects of the toileting process can you emphasize to your child to hook their interest and motivate them?
You can build this up by saying things like, “Wow! I bet you feel like such a big girl. You went poop on the potty all by yourself!”
But most of the time when we use the word rewards, we’re probably talking about extrinsic rewards—things we intentionally give or make happen as a result of our child doing something we want them to do.
Extrinsic rewards are what we’re going to be talking about for the rest of this video.
Here’s my example:
I don’t really like washing dishes. I may make a deal with myself that I’ll have a treat or watch a TV show I really like after I finish washing the dishes.
And I’ve taken an activity that isn’t very rewarding on its own and I’ve applied an extrinsic reward to it.
We can separate those extrinsic rewards into three big categories: social, activity, and object.
They’re not 100% separate from each other, so don’t worry if you think of a reward and maybe it seems like it’s more than one of these.
- Social rewards are the ways that we communicate with our child because of them doing something that we want them to do.
It can be as simple as saying “Great work!” or giving a high five. - Activity rewards are sort of one step up from there.
It’s a more extensive social reward that maybe involves props or pieces—like a dance party or blowing bubbles, an outing, or playing a card game. - Object rewards are something that you actually give.
And of course, it can be as small as a single candy, or the sky’s the limit on the other end.
Generally, you always want to start with those social or activity rewards. They’re really wonderful for connecting with your child, and they’re easy to tweak or fade over time.
There are three steps to giving a reward:
- Choose your inchstone
- Choose your reward
- Choose your reinforcement schedule
I’m going to explain all of those.
You might remember inchstones—those small goals along the way to your milestones.
We have a whole other video on them, so I’ll only offer a couple of brief reminders that are particularly important when you think about inchstones and rewards.
One is that you need to pick something your child does that you can see and measure.
So “not having a tantrum” is not something that your child does.
But “coming to the bathroom with one reminder” is something your child does. You can see it, and you can measure it. It was one reminder, right?
You want to focus on achievable goals—things that are attainable now or soon.
Your child’s success—and feeling of success—is a huge part of the intention here. So choose something that feels important to you and feels doable for your child.
Your goal is for them to be successful—and get that reward—lots and lots of times.
You also want to offer some choices of which inchstones your child is going to be focused on and being rewarded for.
You can give them a closed list of options based on the inchstones you know might be coming next.
And you also want to make sure that they know what the step is that they’re being rewarded for.
Also, an important reminder: dry pants is not an appropriate goal, especially at the beginning of the process.
If your child has struggles with toileting, they are likely working through some level of constipation. And we always want to encourage children to get everything out—not keep it in.
Dryness comes after control.
There are five principles of what makes something a good reward:
- Easy to give – so you can offer it at a moment’s notice.
- Immediate – so your child connects the reward to what they just did.
- Inexpensive or free – because if you’re giving it every time, it adds up.
- High preference – your child should really want it.
- Unavailable elsewhere – so it’s special and motivating.
Another thing that’s really important for parents to understand is that a reward is never something the child already has and then we take it away if they’re unsuccessful.
That would be a punishment, which is not the same as a reward.
We always want it to be something that we are giving in response to the child doing the thing that is the goal.
Last, we want to think about our reinforcement schedule—which is just a fancy way of saying how often we give the reward.
- When teaching a new skill, start with a continual reinforcement schedule—a reward every single time.
This builds the most opportunities for your child to learn and succeed. - When the skill becomes more consistent, move to an intermittent reinforcement schedule—maybe every third time they sit on the toilet, or every fifth time they participate in wiping.
- Token reward systems, like sticker charts, are also intermittent.
For example, after 10 stars for pooping in the toilet, they might go to McDonald’s.
Or you could cut apart a picture of a toy they want and give a piece each time until they earn the whole thing.
This lets you give a bigger reward, planned in advance.
- Then you move to variable reinforcement—meaning you give it unpredictably.
Maybe after the third success, then not again until the sixth.
This is the best way to taper out a reward system, and it helps maintain the behavior over time—because your child still feels the excitement of maybe getting the reward next time.
As we say in many of our videos, remember that your child’s success is your goal.
Rewards are a wonderful way to lift your child up, to show your pride in them.
And as I mentioned earlier—they’re not an opportunity for punishment or taking something away.
If your child misses the target or doesn’t achieve their goal, respond with a positive, “Better luck next time!” attitude.
That helps show your child that you want to give them that reward—that you want them to be successful.
You’ve got this.
Thank you for your time.
The information contained in these videos is for informational purposes only. It is not a substitute for professional health or medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider.
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