Children's Books about Poop and Potties
Enemas as Incentives to Cooperate

Reward Charts Need to Be Visible: Q&A with Dr. Tom

In previous posts I have emphasized the need for sticker charts and sometimes (inexpensive) rewards to help motivate children to actively participate in their treatment.  The following Q&A speaks to the need for charts and rewards to be public and to reward the the behaviors required to achieve a treatment goal as well as the goal itself.
 
Mother: "Thank you so much for your sound advice.  I am using the reward chart as you suggested and marking it on my own & keeping it in a drawer with his poop record & he earned a big reward yesterday.  He is feeling good about himself but we had a big struggle to get him to SIT on the potty after breakfast.  He wanted to stand only which is one of our biggest struggles."
 
Dr Tom: I recommend that you bring the incentive chart out of the drawer so he can see it. Recall that he gets stars, stickers, etc for doing those things which will increase the likelihood of having quality BMs as well as for having them. Therefore, his chart should start with going to the bathroom cooperatively (allow a little resistance at first) followed by sitting and pushing (at least twice per instructions in my book). Having a BM is the last thing on the list. He gets small prizes (eg an M&M) for each of the first 4 steps and a larger prize for the BM (eg 4 M&Ms or whatever you are giving him now).