Amy is a 10-year-old girl with Down syndrome. She also has traits of autism, but was not given that diagnosis. She is verbal and expresses herself, but can be hard to understand. She also has a short attention span and gets easily distracted. Her parents think that she knows what they are saying, but they have to make sure she is paying attention. They contacted me because they could not get Amy to listen to them and to do what they tell her. They repeated directions over and over, and ended up yelling at her. They often just gave up let Amy to do whatever she wanted. They were very worried about what would happen in the future as she got older.

Need to Follow Through

At our first meeting, I discussed with Amy’s parents that when they don’t follow though with their directions, Amy is learning that she does not have to listen to them. Their worry about her future was correct. Once she gets to be an adolescent and she hasn’t learned to follow directions and rules, this could become a much more serious issue.

We Talked About 4 Steps to Improve Her Cooperation

1.  Have a consistent routine and structure to her day as much as possible. (A Day In Our Shoes website offers free printable visual schedules.)
2.  Let Amy know the expectations ahead of time. Don’t expect her to drop whatever she is doing and do what they say right away.
3.  Let Amy make choices when possible.
4.  Use reinforcement/rewards to motivate Amy to change her behavior.

A Visual Schedule Made a Big Difference

When her parents used these strategies, Amy got to know her routine. Then it didn’t feel like her parents were “bossing her around”, which had triggered her to not listen. She knew when it was bath time, dinner, free time, etc. Her parents made a schedule with words and pictures to make sure she understood it. They reviewed the schedule throughout the day, and Amy really liked that. Later, she would look at the pictures on her own, and was ready for the next transition.

Using Rewards

Amy’s parents also gave her points for following the schedule that they put on a rewards chart. Amy loved plush toys, and she learned that when she earned 20 points, she could get a new plush toy. She was very excited when she earned points and counted how many more she needed to get her new toy.

The Importance of Giving Her Choices

Amy’s parents learned to give her choices instead of always directing her and telling her what to do. They would ask her to choose between 2 outfits when getting dressed in the morning, and to choose what she wanted for breakfast. Amy had a couple chores; feeding the dog, and emptying the trash. She could choose which chore she wanted to do that day, and they put pictures of Amy doing that chore on her schedule. Believe it or not, Amy started to willingly do her chores.

The Strategies Were Very Successful

Amy became more and more cooperative and was following directions. Her parents were able to fade the reward to getting one point at the end of the day for following her schedule and listening to her parents. Eventually, they were able to fade out the rewards altogether. Instead they praised and hugged her, which she loved.

If you would like help and support with your child’s behaviors, feel free to contact us for a free 15-minute introductory phone call.