I have a student who sucks him thumb in class when he gets upset in class.  Unfortunately, he has had a very rough year.  This fall children’s services was called into house for neglect and possible physical abuse.  We started working on the thumb sucking behavior in September, before the allegations of neglect and abuse.  The student and I spoke about the behavior and decided on a sign to make him aware of the thumb sucking.  He told me if I put my thumb to my mouth and then pulled my thumb away in a circle like motion, he would stop sucking his thumb.  This method worked for a short time, but eventually the student ignored my sign and I stopped giving the sign.

 Differential reinforcement procedures seemed like a method that would work with this student.  Rewarding an alternative behavior would probably create better buy in from the student.  Obviously if the behavior I want to change is sucking a thumb, then the opposite behavior would to not suck the thumb.  We sat down and brainstormed what rewards might be worth not sucking his thumb.  After our brain storming session we decided, every time he keeps his thumb out of his mouth he would get a sticker (usually a star).  At the end of the day he could trade the stars in for a prize.  The more stars the he receives, the better the prize.  The grand prize for him was 20 minutes of free time to draw in the writing center.  Some of the other prizes included toys from the laundry basket, extra snack, and holding the teacher’s hand in the hallway.  If he sucked his thumb, he would get a strike.  Three strikes equal no snack that day.  We also decided I would use our thumb sucking sign in the beginning to remind him.

 When we started, the DRI process was working fairly well.  Initially, I used our sign to remind him.  The first few days he got three strikes and no snack, but he also earned some stars.  He did not earn enough stars to receive a prize, but he earned more stars everyday so he was encouraged by his progress.  After approximately a week or week and a half, the student earned enough stars to receive a prize.  He was extremely excited and proud of himself.  He was also beginning to receive fewer strikes and have snack again on some days.  This process was setup so the student could receive three strikes and earn enough stars to receive a prize/reward in the same day.

 Unfortunately, we have had a major set back.  Right now the stress in his life supercedes any positive reinforcement system.  Even his strong desire for free drawing time does not sway him from thumb sucking.  The student comes in everyday on the verge of tears.  The thumb sucking provides a comfort that he is not ready to give up.  I am not sure if I should change the system we have in place or wait until his life settles back down and begin again.
 
 DRI is the right process to eliminate the student’s thumb sucking behavior.  DRI was working and both the student and I were invested in the process.  I was very consistent with the rewards, so the student was very clear about the process.  I also had the cluster (prep) teachers involved, so the student could earn stars or strikes even if I was not in the room.  I am continuing to use DRI even though progress is currently slow and dependent on the home situation.  Hopefully, when his home life is settled, we will be able to finish the process with positive results.

Amy Gerard is a graduate student in the Department of Special Education at Hunter College.

Thanks Amy!
posted on 1/25/05