What If There Do Not Seem To Be Any Interventional Rewards That My Child Enjoys?

Dr. McGee answers the question: 'What If My Child Doesn't Enjoy Rewards?'

Oct. 23, 2008 -- Question: What if there do not seem to be any interventional rewards that my child enjoys, and is it possible to teach a child with autism to value social attention as a reward?

Answer: Often when we begin intervention with a young child with autism we're using various food treats, if you will, because often that's where we can find something a child will respond to. Of course we quickly want to shift to toys which are more normal sorts of rewards. And most toys are made so that they present various visual or auditory qualities. So if we have a child that is responsive to food treats or regular toys that have visual and auditory qualities, then we generally have no problem in terms of identifying rewards.

When we don't, we will tend to go in and do a very systematic assessment of various sensory modalities to see if there are stimuli that a child really prefers -- and they may be unusual -- such as olfactory stimuli, things that have funny odors or different odors. Or tactile stimuli, things that feel differently. Or vestibular, things that, you know, a child who likes to rock or jump up and down. And we will continue to explore until we find the reward that's most powerful in changing a child's behavior. And then we will apply that systematically while we're trying to expand the child's interest in other, more normal play events.

In terms of can you teach a child to value social attention, we definitely can. It occurs over a period of time in terms of pairing a tangible reward, such as a food treat or a play item that a child highly desires, with attention. And often the child's given a correct response, we'll praise them, and immediately deliver one of their preferred tangible rewards and in this way we're able to build up their ability to value social attention.