Table 1.
Taxonomy of techniques and components of behavioral parent and teacher training programs for children with ADHD (Hornstra et al. 2019)
| Number | Name | Definition |
|---|---|---|
| 1. Shaping knowledge | ||
| 1.a | Psycho-education parent | The formal review of information with the caretaker(s) about the development of the child’s problem and its relation to a proposed intervention. This often involves an emphasis on the caretaker’s role in either or both |
| 1.b | Psycho-education teacher | The formal (usually didactic) review of information, directed toward the child’s teacher(s), or school |
| 2. Observation and monitoring | ||
| 2.a | Monitoring | Establish a method for the person to monitor and record their own behavior(s) or the behavior(s) of the child |
| 2.b | Behavioral/functional analysis | Explain, teach or train parents/teacher how to identify and test hypotheses about the behavior, its causes and consequences, by collecting and interpreting data |
| 3. Antecedents | ||
| 3.a | Disciplinary communication | Setting limits and rules and/or giving clear and developmentally appropriate directions, stating behavioral expectations and consequences |
| 3.b | Anticipate and plan for misbehavior | Thinking ahead about problem situations and prepare a plan of behavior management for the child before entering the potential problem situation |
| 3.c | Restructuring the environment | Change, or advise to change the physical or social environment in order to facilitate performance of the wanted behavior, create barriers to the unwanted behavior (other than prompts/ cues, rewards or punishments) or avoid exposure to specific social, contextual/physical cues for the behavior, including changing daily or weekly routines |
| 3.d | Prompt/cues | Introduce or define environmental or social stimulus with the purpose of prompting or cueing the behavior. The prompt or cue would normally occur at the time or place of performance. Includes also the removal of prompts or cues (fading) |
| 3.e | Distraction | Advise or arrange to use an alternative focus for attention to avoid triggers for unwanted behavior |
| 3.f | Behavior substitution | Prompt substitution of the unwanted behavior with a wanted or neutral behavior |
| 3.g | Habit formation | Prompt rehearsal and repetition of the behavior in the same context |
| 4. Consequences/contingency management | ||
| Positive consequences | ||
| 4.a | Social reward | The training of parents or others involved in the social ecology of the child in the administration of social rewards to promote desired behaviors. This can involve praise, encouragement, affection, or physical proximity |
| 4.b | Material reward (behavior) | Arrange for the delivery of money, vouchers or other valued objects if and only if there has been effort and/or progress in performing the behavior (includes ‘Positive reinforcement’) |
| 4.c | Activity reward | Arrange for the delivery of a preferred activity if and only if there has been effort and/or progress in performing the behavior |
| 4.d | Reward (not specified) | Arrange delivery of a reward if and only if there has been effort and/or progress in performing the behavior (not specified as social/material/activity) |
| 4.e | Remove aversive stimulus/ punishment | Advise or arrange for the removal of an aversive stimulus or an unpleasant consequence to facilitate behavior change (includes Escape learning, negative reinforcement) |
| 4.f | Reward approximation | Arrange for reward following any approximation to the target behavior gradually rewarding only performance closer to the want behavior (includes Shaping) |
| 4.g | Situation-specific reward | Arrange reward following the behavior in one situation but not in another (includes Discrimination training) |
| 4.h | Reward alternative/incompatible behavior | Arrange reward for responding in a manner that is incompatible with a previous response to that situation (includes Counter-conditioning) or for performance of an alternative to the unwanted behavior (includes differential reinforcement) |
| 4.i | Reduce reward frequency/stretching the ratio’s | Arrange reward to be made contingent on increasing duration or frequency of the behavior (includes Thinning) gradually weaning the density of reinforcement during acquisition from very high levels (100%) to very spare levels of reward (e.g., 20%) |
| 4.j | Consistent responding | Teach parents the importance of consistent responses to child behavior |
| 5. Consequences/ contingency management | ||
| Negative consequences | ||
| 5.a | Planned ignoring | Parents or teachers are instructed to ignore frequently occurring, mildly annoying behaviors that serve the function of attention seeking |
| 5.b | Natural and logical consequences | Training for parents or teachers in (a) allowing youth to experience the negative consequences of poor decisions or unwanted behaviors (e.g., getting cold for not wearing a hat), or (b) delivering consequences in a manner that is of appropriate level and type for the behavior performed by the child |
| 5.c | Punishment | Arrange for an aversive consequence contingent on the performance of the unwanted behavior other than natural and logical consequences, response cost or (over)correction |
| 5.d | Response cost | Remove or discontinue reinforcement following performance of an undesirable or disruptive behavior |
| 5.e | (Over)correction | Parents or teacher are instructed to designate the unwanted behavior or repeat the wanted behavior in an exaggerated way following an unwanted behavior |
| 6. Combined techniques | ||
| 6.a | Daily Report Card [DRC] | The use of a list of behaviors by the teacher that have been deemed appropriate targets for intervention (e.g., interrupting, non-compliance, academic productivity, academic engagement). Associated with each item is a means of rating the target behavior across one or more observation intervals (e.g., time of day or class period). DRC forms are sent home with the child each day, and parents review daily and weekly progress and provide home-based privileges (e.g., use of bicycle, computer time) contingent on meeting goals |
| 6.b | Tangible rewards/token economy | The training of parents or others involved in the social ecology of the child in the administration of tangible rewards to promote desired behaviors. This can involve a point or token system |
| 6.c | Time-out | The training of or the direct use of a technique involving removing the youth from all reinforcement for a specified period of time following the performance of an identified, unwanted behavior |
| 6.d | Premack principle | A more-preferred activity can be used to reinforce a less-preferred activity |
| 7. Generalization and maintenance | ||
| 7.a | Rehearsal, role-playing, practice or visualize (parent/teacher) | In-session opportunities for parents to practice skills through rehearsal and role-playing situations: role-playing with the parent trainer |
| 7.b | Homework | A set of tasks assigned by the therapist to do at home |
| 7.c | Modeling | Provide an observable sample of the performance of the behavior, directly in person or indirectly (e.g., via film, pictures, for the person to aspire or to imitate), includes modeling |
| 7.d | Generalization of target behavior (parent/teacher) | Advise to perform the wanted behavior, which is already performed in a particular situation, in another situation |
| 7.e | Maintenance/relapse prevention | Exercises and training designed to consolidate skills already developed and to anticipate future challenges that might arise after termination or reduction of services |
| 7.f | Problem solving (parent/teacher)/Conjoint behavioral consultation | Techniques, discussions, or activities designed to bring about solutions to targeted problems, usually with the intention of imparting a skill for how to approach and solve future problems in a similar manner, using following steps: Identifying the Problem, Defining the Problem, Forming a Strategy, Organizing Information, Allocating Resources, Monitoring Progress, Evaluating the Results |
| 8. Relationship building communication skills | ||
| 8.a | Emotional communication | Using relationship-building communication skills (e.g., active listening); helping children identify and appropriately express emotions |
| 8.b | Positive interactions with the child | Using skills that promote positive parent–child interactions (e.g., demonstrating enthusiasm, following child’s interests, offering appropriate recreational options); providing positive attention |
| 8.c | Responsiveness, sensitivity, nurturing | Responding sensitively to child’s emotional and psychological needs (e.g., soothing); providing developmentally appropriate physical contact and affection |