I use a simple game to assess for a client’s ability to follow instructions, their desire to please, and the parents’ ability to follow instructions from me. (Also, the child’s ability to make consistent eye contact, their motivation by rewards, their defiance against authority…)

The steps are as follows:

1. I Say, “Look at me.”
2. I Say, “Do X.” Stated simply that way, void of “please, will you, for me, etc”.
3. Client say one of the following things to acknowledge me: “Yes, Okay, Yes Ma’am”

I pick a “marker” for progress. Usually I use literal markers and a mug. Every time the Cl completes the task (task=eye contact + task + verbal affirmation) I place a marker in the cup. We set a goal of, say, 10 markers and then I give the Cl a reward. Sometimes the reward is a prize, sometimes it is activity of their choice.

When I have concluded that the Client does, indeed, want to please and/or is motivated by a prize, I bring the parent into the session. Together, Client and I teach the parent the skill of following instructions. I invite the parent to alternate giving an instruction to the Client. This tool is very helpful in identifying road blocks of communication between Client and parent. I often find that the parent is sending difficult to understand symbols. It is a great place to start!

I use this consistently in my work with children. It establishes an expectation of behavior of mine for them and of them for me. (Good things happen for Good Listeners!)

Behavior Modification- Skill of Following Instructions

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