Helping Kids Undergo Medical Procedures

Adults have enough trouble with painful medical procedures.  Think about what kids face . . .  How can we help them cope? 

An article in the March issue of the Monitor on Psychology, a magazine from the American Psychological Association, summarizes several approaches, including one based directly on the science of consequences.  (See link here; the article is called "Vulnerable Patients.") 

Psychologist Keith Slifer (Kennedy Krieger Institute and Johns Hopkins University) helps children with sleep apnea, who may have to wear an uncomfortable breathing mask at night.  By gradually introducing the mask--watching others use it, for example--and rewarding the children for making progress, the youngsters have less trouble adjusting to wearing it. 

What reinforcers are used in this sort of work?  Praise is pretty universal, but beyond that, not surprisingly, they vary.  While stickers work for many kids, they don't work for all.  One youngster hated getting wired up for an electroencephalogram (EEG).  Slifer's team ended up using the chance to toss a ball as a very effective reward.

One successful innovation also used elsewhere is "break cards."  Children undergoing a procedure can give these to the nurse when they need a break--getting immediate reinforcement by escaping the discomfort, plus the benefits of control.  (Not a bad idea for adults either.)  Do the kids ask for too many breaks?  No, says Slifer, they're generally reasonable--a real win-win situation.

The rewards for the psychologists?  Seeing their patients cope better, with less pain and frustration.  Successfully thinking up more ways to ease the process.  And, not least, the fun of coming up with creative rewards for their patients. 

Heading to the Twin Cities area

And I'll be there in Minnesota throughout the last week of May, doing book events practically every day!  I'll start out with an invited address at the Association for Behavior Analysis conference (and two book signing sessions).  As I mention in the book, "behavior analysis" is the name for the scientific/practice field that specializes in the science of consequences as its core area, so I eagerly anticipate this event each year.  Then I'm speaking at Common Good Books (Garrison Keillor's bookstore) on May 29 at 7 PM.  On the 30th, I'll be at Carleton College in Northfield for a noon talk, and on the 31st at 6:30 PM, at the Twin Cities Obedience Training Club (positive reinforcement basis).  Whew.  See the Events page on the book's website for details--and see you there!

On not getting the reference: When popular culture fragments

People may disagree about the consequences, but not about the basic fact:  In the United States, as elsewhere in the developed world, popular culture ain't what it used to be.  So many entertainment, educational, and other cultural choices are now available that the mass media are reaching far less massive masses, and common ground can be hard to find. While that makes it easier to enjoy your favorite niches, it's become harder for people to connect.

Herman Melville

I think of this every time someone exclaims about a character in a new TV show I never heard of.  (I don't have cable.)  The other day, someone showed me a New Yorker cartoon of Captain Ahab and a red whale.  Allusions to well-known classics like Melville's Moby Dick may still be safe for most New Yorker readers, but certainly not everyone.

What's especially interesting for me is, naturally, the connection to reward value.  Hearing an unknown reference can make tracking it down reinforcing--sometimes so much so that I head for my computer and do it right away.  Talk about creating motivation.  It's almost like a mystery to be solved. 

What makes it sufficiently reinforcing that this happens?  Lots of factors, of course.  If the reference is made by someone I chat with regularly.  If it's positive and comes up more than once or twice.  If it's relevant to what I do, or something else I find rewarding.  Even if I hear total strangers discussing it, if it sounds sufficiently humorous or important or popular.  You can generate your own list, an interesting exercise in understanding your own motivations.  If I'm crunched for time--recall that we always have choices between different consequences--then I might forget it, or make a note of it for the weekend.

Sometimes the effects are considerably delayed.  I'm not sure what finally did it, but after resisting for years, I finally read the whole Harry Potter series and saw the movies. Now I know what everyone was talking about!

Dance of the Balloons

Balloons created and clutched by little dance flies, that is . . . as described in my book.  Over time, different species in this family of insects developed variations on the basic dance that forms their courtship ritual--"as close to behavior fossils as we're going to get."

Dance flies with "balloon."  © Ken R. Schneider

I've never seen this spectacle, but now my brother has!  He was even able to get this photo.  You can't really see it, but attached to the balloon is an even tinier edible insect for the female to nosh on during mating.

Holes in the jeans

Find holes in most items of clothing and throw them out or fix them up.  Holes in jeans, it's a style!

Faddish fashion rewards can and do regularly overrule common sense.  When I taught college in Minnesota, I well remember my surprise at seeing students wearing jeans with holes in the frigid midwinter.  Brrr.  The celebrity who got this one started has a lot to answer for!  The style has been passé for years, which is some reassurance.

But then, no one said that rewards have to make sense.  And no one said marketers couldn't try to make weird things desirable.  They can and they do. 

And we do too.  On a more everyday basis, consider the effort we go to to get others interested in what we like--that is, to change its consequence value for them.  (If they come to like it, that's rewarding for us.)  It might be something unusual, or it might just be a new movie.  Know people well and you know exactly what approach has the best chance of working.  After all, you've seen what works for them in the past.

You might even be able to convince them to put holes in their jeans.

Heading for DC area

I'll be monitoring the progress of spring in an upcoming three-state book tour to Virginia, Maryland, and West Virginia.  No more snow, please . . .

The Virginia Festival of the Book is where I start, with a talk on Friday, March 22nd--right near the famous Rotunda!  I've never been to Charlottesville before, and I'm looking forward to it.  I'm in a panel with fellow nonfiction author Toby Lester, speaking about his new book Da Vinci's Ghost--which provides the history of da Vinci's famous anatomical "man in a circle" drawing. It's fascinating, and we were able to find connections between our books.  I also enjoyed Lester's first book, The Fourth Part of the World, which delves into the history of European maps of the world, leading up to how the Americas got their name.

Here's the rest of the talks:  St. Mary's College of Maryland on Monday, March 25th, University of Maryland-College Park on March 27th, West Virginia University on April 1st, and Baltimore's downtown Enoch Pratt public library on April 2nd.  For details about times and locations, please check out the Events page on my website:  here.  I hope to see some of you on the trip!

Second printing

A quick note--I just found out that The Science of Consequences has gone into a second printing!  Thanks, everyone, for your interest in the book.