“Clinicians often deliver tangible reinforcers using an accumulated reinforcement arrangement or token economy to decrease problem behavior and increase desirable, appropriate behavior,” describes Abul-Khadhim, Obaid and Kramash (2018, p. 12).” The remarkable rise in the cases of children diagnosed with attention deficit hyperactivity disorder (ADHD) in the previous years has caused significant consequences on the educational framework globally (Aleid, 2019). As a matter of consideration, in the United States, the extra budget has been directed to public schools for the sake of students with ADHD amounting to above $3.2 billion in 2015 (Whitney et al., 2018). As a result, besides turning out to be a public health concern, ADHD has grown to be a significant educational concern. Moreover, following several years of research, there is sufficient evidence that ADHD has a chronic effect. It reveals itself in early childhood and persists to a troubling level in the entire childhood and adolescence and until the students become adults (Hickey et al., 2018; Matson et al., 2016). The indications of ADHD lead to changes in school and family performance and relationships with their fellow students, and they bring along a poor extended psychiatric, social and educational changes.
Considering the high occurrence of ADHD, its extended effects, and its chronicity, the pursuit of effective interventions to deal with it has been a perpetual concern for the previous few decades. Amid the extensive variety of interventions utilized are traditional treatment, restrictive or supplemental foods, biofeedback, allergy cares, cognitive-motor training or play intervention (Abul-Kadhim et al., 2018). Only three kinds of treatments, however, have attained much support in the empirical research including the central nervous system stimulants, behavior alteration, and a blend of the two.
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Even though there is a need to explore the application of Token reinforcement in schools further, it has proved to be effective in the treatment of students with ADHD.
Special Education Needs of Students with ADHD
A school is an environment where learners need to possess skills in the planning, regulation, coordination, and assessment of the procedures needs in adhering to some practices, in proper interactions with adults and colleagues, and active involvement in the teaching and/ or learning process. Thus, the school entails a proper setting for encouraging self-control. Unfortunately, however, schools have proved to be challenging to the learners that have not attained enough self-regulatory development to react to the demands it puts forward (Matson et al., 2016). Research has confirmed evidence on the adverse educational results on learners with ADHD (Abul-Kadhim et al., 2018; Webb, 2017). On the global arena, about 70 percent of children with ADHD show some kind of learning challenges, and they are 3 to 8 time more exposed than the other normal classmates to receive special education, be eliminated or suspended, or repeat a grade (Pfiffner et al., 2018). Moreover, even though the diagnosis of ADHD may not entail its own distinct category of special education, 75 percent of students utilizing special education services for behavioral challenges, and about 80 percent of those in interventions for learning disabilities fulfill the criteria for ADHD (Hickey et al., 2018).
The academic and behavioral challenges of students with ADHD are as a result of self-regulation challenges, a framework that typically entails three aspects: an attentional aspect, an inhibitory aspect, and a strategic and organizational aspect (Patel, 2017). The attentional aspect has to do with the input or energetic component of the cognitive process. According to Webb (2017), the inhibitory aspect entails the components that regulate impulsive or improper reactions. Lastly, the strategic and organizational aspects entail the higher order organizational procedures that guide the cognitive component, including the preparation and planning, and working memory (Pfiffner et al., 2018).
Students with ADHD experience failure in learning tasks that need sufficient degrees of attention, inhibition, and active engagement. Alzahrani (2018) determined that there are evident indications in the classrooms linked to failure in attentional energy like the number of errors that learners with ADHD make on a simple item when they do more complex ones, the rise in errors at the end of doing activities or the challenges in completing assigned tasks. Considering these circumstances, the students are not motivated toward achievement or success. Patel (2017) emphasized that learners with ADHD focus less time to study and may not be diligent to attain educational objectives as their normal colleagues.
Description of Token Reinforcement in Schools
Given the degree of the academic and social challenges of learners with ADHD, and the significance that the school has as the foundational basis of their development, it becomes apparent to define and plan for intervention that would respond to their special education needs. Token Reinforcement can be effective in schools to treat ADHD in their students. Token reinforcement is an internal, in-class positive reinforcement activity for creating and ensuring proper classroom performance and conduct (Aleid, 2019). A token reinforcement intervention may be required when other positive programs, like selectively utilizing teacher attention or a home-founded reinforcement program, are limited to encourage the learner with ADHD to behave and act properly. With this scenario, a tangible reward activity, regulated by the teacher, may be a necessity (Whitney et al., 2018). Recognizable rewards can be suitably regulated through a token reinforcement program.
Token systems have been successfully implemented as behavior-management and the motivational tool is an educational and rehabilitation center since the 1800s (Abul-Kadhim et al., 2018). Token reinforcement program entails the giving of tangible tokens (for instance, poker chips, stickers, smiley faces, and among others) or rewards after proper behavior. The rewards or points can be aggregated in the entire day and exchanged for specified tokens at a particular time. A predetermined objective is made for the number of points that are needed to get a reward (Webb, 2017). The instructor or classroom aid is necessary for spreading the tokens and offering the reward.
In the implementation of token behavior, the teacher first chooses behaviors to target for change. He should select two to four of the most pronounced problem behaviors that he is targeting to change. The behaviors must be described explicitly. The elements of well-defined behavior should be systematic. First, the behavior must be clear to the child and all the people relating to her (DuPaul et al., 2018). Therefore, the behavior should first be clear, specific and observable. If the behavior can be noted and two varied individuals observing it can agree when it happens, then it becomes a good definition of behavior. If the behaviors are vaguely determined, it becomes challenging for the teachers to assess them and students to recognize when they have performed them (Pfiffner et al., 2018).
Secondly, a token reinforcement program is framed to be constructive and motivational, concentrating on enhancing the desired behaviors, in this case for students with ADHD. Behaviors intended for change should be elaborated in that what the child is expected to do is clear, instead of focusing on what he should stop doing (Patel, 2017). Thirdly, the focus is on classroom products instead of behavior or the process of conduct. The token program concentrating on disruptive behavior or academic tendencies like focusing on a task, sitting calm, or staying seated, could help in addressing such behavior. Nonetheless, they do essentially amount to heightened work productivity. The token program should be one that targets the products of academics for it to lead to heightened productivity in academics and at the same time enhance the behavior (Matson et al., 2016). It should be noted that the behavior of some students with ADHD can be somewhat disruptive to the classwork and others and could need to be the target of change (Pfiffner et al., 2018). As a recommendation, targeting behaviors that entail classroom behaviors should be performed only following a time of rewarding academic success.
The second step in the implementation of a token reinforcement program on a child with ADHD is developing a framework to monitor the tokens or points. For younger students between the ages of 4 to 7 years, tokens like poker chips, stamps or stickers can be utilized (Hickey et al., 2016). The tokens are offered for the child to put them on a container at his desk. For older students, points, numbers or checkmarks are placed on a card and put near their desks or journal (Pfiffner et al., 2018). The teacher should also be careful to use powerful rewards for the token reinforcement program to be successful. The reward should be motivating, especially when the students find it desirable and worth striving for. This could be established by involving the student in suggesting the number of possible rewards.
The next step would be to establish the appropriate goals or number of tokens a student has to attain to get a reward. The goal should be reasonably and one that can be attained. For instance, if a student was finishing 40 percent of his assigned work before the intervention program, then a proper goal could be 50 percent (Pfiffner et al., 2018). The program should be explained to the student at a neutral moment. The behaviors expected to be changed and how to effectively do those behaviors should be clear. The goal of earning the rewards must be shared with the child as well as explaining what point the rewards will be given. The teachers should consistently give feedback, especially for every happening of the desired behavior or at particular intervals. At a predetermined time, the teacher evaluates the success of the child in attaining the goals and offer rewards to the student (Aleid, 2019; Matson et al., 2016). When the child's behavior improves to the expected level for a specific time, the program can be changed in many ways. The number of tokens needed for a reward can also be adjusted accordingly.
Strengths and Weaknesses of Token Reinforcement in Schools
Cognitive-behavioral therapy (CBT) is one of the most effective non-medication interventions to have been used to address ADHD. The token reinforcement program is also centered on changing behavior and it has been successful over the past. A recent study assessed the token reinforcement program efficacy for ADHD management of 70 teenagers (Webb, 2017). Positive impacts of the program were evident for dosage, the parental score of adherence to pharmacotherapy, teenagers’ self-reported personal modification (like self-esteem), parent, and teacher-reported rates for signs of inattention, consistent school attendance, deteriorating school-year promotion, family and educational functionality, teacher-reported relationship with colleagues, academic success and self-esteem (Pfiffner et al., 2018).
The utilization of a token reinforcement program can be instrumental in enhancing classroom climate or environment. The teacher will no longer be using much of their time redirecting students because of bad or undesired behaviors. The enforcement of the program entails the use of positive language as one motivates students to show good behaviors (Aleid, 2019; Matson et al., 2016). The teacher ensures that he includes simple statements of commendation like "Thank you, congrats, keep up, etc.," instead of just concentrating on poor behaviors and possibly embarrassing the learner. Words such as, "Alphonso, I have told you four times to put that pen away" could be embarrassing. This can improve the student's morale and he will enjoy the interventional program on him.
The token reinforcement program is also one of the most common treatments for managing and assessing dysfunctional behavior. Student’s parents and other caregivers have a daily or weekly record of targeted behaviors initially prepared together with the student. For students with ADHD, some studies have recommended these daily or weekly sheets (which encompass predetermined behaviors on cards). This approach utilizes consequences approach awards of tokens for targeted behaviors (positive contingency support) and may influence significant challenges to the displaying of improper behaviors like withdrawal of a formerly gained token (Pfiffner et al., 2018). Patel (2017) reiterated effective approaches for behavioral interventional programs appropriate in the school environment utilizing the token reinforcement framework as a strategy. He determined that the strategy could result in enhanced behavior for students to finish their tasks. He also established clinically significant enhancements in task-related attention and productivity and precision of work done in class, particularly when merged with the cost response framework. This kind of tool has been proving efficacious as far as addressing ADHD related symptoms are concerned.
Token reinforcement program in schools for students with ADHD can also enhance their academic performance since the students recognize what is expected of them. A token economy system is very effective as it motivates the students to behave in a proper manner (DuPaul et al., 2018). It is the proper behavior that will cause the students to record good performance because he will be able to exercise diligence in schoolwork (Pfiffner et al., 2018). The reinforcement program entails students being rewarded for attaining their tokens (what was expected of them), their peers are also able to be motivated to act responsibly. Students that adhere to rules and procedures prescribed by the token reinforcement program become positive peer models as they can show others good behaviors (Webb, 2017). Children easily influence one another to actions and by demonstrating the expected behaviors they can impact positively on their peers.
Other strengths are associated with the aspect of giving points for the students portraying the desired behaviors. Aleid reported that the token reinforcement program “assigns points for expected behaviors within the program environment” and the approach is extensively utilized in programs intended to help in dysfunctional behaviors of several disorders such as ADHD (2019, p. 8). Most studies particularly relating token reinforcement approach effects have utilized counts of behaviors produced as outcome measures, then relating mean frequencies at baseline data as well as post-intervention (Pfiffner et al., 2018). Many studies abound where the researchers have affirmed the place of token reinforcement programs in reducing students’ improper behavior (internalizing or externalizing) like lack of attention, aggression, breaking rules, or organization and planning concerns (Matson et al., 2016; Patel, 2017). Therefore, the technique has proved to achieve a reduction in inappropriate behaviors associated with ADHD than any other interventional program.
One of the greatest challenges of the token reinforcement system is the requirement to make the reward system as positive as possible. The caregiver or teacher can be tempted to snatch the students token if they misbehave or opt to use negative orientation on them. The teacher should consistently reassure the student with ADHD that he can always do well next time. He should have hope to earn his tokens next time (Pfiffner et al., 2018). Another weakness is that the token system is not accommodative to other students. If the token reinforcement program was being implemented to more students, every one of them may have varied behavioral goals and there should be products on the reward menu that pleases each one of them. The teacher should ensure that he uses healthy competition to encourage all the students so that none feel left out. Reward systems that are not understood or too complex make students lose interest faster (Matson et al., 2016). As such, the teacher is obligated to make the reward framework simple and focused on one to three behaviors at a time.
A token reinforcement program is the most powerful behavioral intervention for changing the behavior of students with ADHD. In fact, the changes in the classroom behaviors of the students can be likened to those received by stimulant medications. Token reinforcement programs permit the utilization of powerful incentives or rewards than any normal ones in the classroom. Token reinforcement programs provide more immediate rewards than home-founded programs or other interventions (DuPaul et al., 2018; Webb, 2017). It has also been determined that token programs are intensive in-class programs that are necessary for many students. This is indicative that the intervention is so time-consuming and not easy to manage since the teachers also have other responsibilities. Whereas the token reinforcement program appears simple, the implementation can be involving. Teachers may also need to undergo some extra training or consult with a trained individual to be able to successfully implement the program (Pfiffner et al., 2018). In one study, a teacher was able to successfully carry out a wide token reinforcement program with 18 hyperactive students after consulting a behavioral specialist who guided him on how to initiate the program (Aleid, 2019).
Outcomes and Generalizability of the Studies
Regarding generalizability, studies that have particularly utilized the token reinforcement programs for ADHD patients have recorded substantially enhanced behavior on relating pre-and post-treatment data. This fact verifies the findings above on the efficaciousness of a token reinforcement program to address improper behaviors associated with students with ADHD. Many studies have been specific to the behaviors that were improved through the adoption of a token economy (Pfiffner et al., 2018; Matson et al., 2016; Patel, 2017). As concerns behavioral modification, it is significant to methodically assess the functional challenges of students with ADHD and just gauge the reduced average frequency of their behaviors that they display. This kind of consideration may be instrumental in coming up with decisions regarding treatment if any medication has to be done alongside the program (dosage, contraindications) or even for families that may need their children to undergo behavioral treatment only.
Techniques that concentrate on enhancing positive behaviors have been considered higher and more embraced than those that concentrated on reducing negative conduct. Patel (2017) assessed acceptability for five varied parenting approaches: response cost, a timeout for spankings, timeout only, spanking only, and token program. The outcomes showed that parents preferred token programs on their children and it had a high rating on the Parent's Consumer Satisfaction Questionnaire. Webb (2017) determined treatment acceptability of the token reinforcement program using the intervention rating profile - 15 and a 6-point Likert scale. The outcomes before the program was implemented revealed that the teachers had rated the token program as a favorable classroom management approach (Hickey et al., 2018). Following the implementation of the program in the classroom, the ratings rose and teachers rated it as an increasingly acceptable program for the students.
Conclusions on the Effectiveness of the Token Reinforcement
Token reinforcement is effective in students with ADHD as evidenced by the results of this study. The program is instrumental in reducing the rate of disruptive behaviors among students. A token economy program when used appropriately, shares several characteristics of other behavior modification interventions. The program is effective as it bridges the gap between the target response and backup reinforcer and the behavior of the student can be reinforced at any moment. The program also improves the academic performance of students. It is also true that a good performance of the students can be maintained for a long period until the backup reinforcer is given. Token reinforcement program also has a less chance to be influenced by satisfaction and can offer a visual reminder of the progress or otherwise as far as the student's commitment to the target behavior is concerned. Therefore, the students can keep on track and be motivated to continue in the program to get the benefits.
The token reinforcement program is effective in terms of the tangible reinforcers that are used. Tokens are portable and there is no maximum number. The number of tokens can depict the level of reinforcement, and they can be used for long and consistently. Devices can be utilized to spontaneously produce tokens depending on the behavior of the students, with the chance of customizing the physical characteristics of the token. Token economies are essential when reinforcement of teacher offering commendation and attention is not as effective. Token economies will also be very effective when there are several reinforcers contrasted with depending on just one reinforcement. Availing a diverse number of backup reinforcers to select from may work well for the program since the students will not likely be satisfied and their opportunities to have at least one item that acts as a reinforcer is heightened. These aspects offer much flexibility of the token reinforcement program to be implemented on the students and be guaranteed with great results of changed targeted behaviors.
References
Abul-Kadhim, W. J., Obaid, R. H., & Krmash, H. A. (2018). The Effectiveness of the Token Reinforcement in Reducing the Aggressive Behaviour among Pupils with Learning Difficulties. Indian Journal of Public Health Research & Development , 9 (12), 1210-1215. https://scholarlycommons.pacific.edu/cgi/viewcontent.cgi?article=3982&context=uop_etds
Aleid, W. A. (2019). Reducing The Rate of Behavioral Problems for Students with ASD & ADHD using the Techniques of FBA. International Journal for Research in Education , 43 (2), 209-232. https://scholarworks.uaeu.ac.ae/ijre/vol43/iss2/9/
Alzahrani, S. (2018). Using a reinforcement system as an intervention plan to reduce unwanted behavior of student with ADHD: deep learning study in a single subject research design. Journal of Advanced Pharmacy Education &Research| Apr-Jun , 8 (2). https://japer.in/storage/models/article/muLTniGd9iK4gUWFjNAi7DLw0lCAlbqZQwbcaBDr09bxFSM07k6SRY9eaENo/using-a-reinforcement-system-as-an-intervention-plan-to-reduce-unwanted-behavior-of-student-with-a.pdf
DuPaul, G. J., Kern, L., Belk, G., Custer, B., Hatfield, A., Daffner, M., & Peek, D. (2018). Promoting parent engagement in behavioral intervention for young children with ADHD: Iterative treatment development. Topics in Early Childhood Special Education , 38 (1), 42-53. https://journals.sagepub.com/doi/abs/10.1177/0271121417746220
Hickey, V., Flesch, L., Lane, A., Pai, A. L., Huber, J., Badia, P., & Dandoy, C. E. (2018). Token economy to improve adherence to activities of daily living. Pediatric blood & cancer , 65 (11), e27387. https://onlinelibrary.wiley.com/doi/abs/10.1002/pbc.27387
Matson, J. L., Estabillo, J. A., & Matheis, M. (2016). Token Economy. https://www.researchgate.net/profile/Maya_Matheis/publication/311611740_Token_Economy/links/5ad11e800f7e9b2859323c2d/Token-Economy.pdf
Patel, R. R. (2017). The effect of token reinforcement on moderate-to-vigorous physical activity exhibited by young children. https://scholarlycommons.pacific.edu/uop_etds/2983/
Pfiffner, L. J., Rooney, M. E., Jiang, Y., Haack, L. M., Beaulieu, A., & McBurnett, K. (2018). Sustained Effects of Collaborative School-Home Intervention for ADHD Symptoms and Impairment. Grantee Submission . https://eric.ed.gov/?id=ED588762
Webb, T. W. (2017). Effects of a Token Economy on a Student with Autism Exhibiting Disruptive Behavior in a General Education Classroom. https://scholarworks.bellarmine.edu/ugrad_theses/11/
Whitney, T., Cooper, J. T., & Lingo, A. S. (2018). Using a Token Economy Combined with a Mystery Motivator for a Student with Autism Exhibiting Challenging Behavior. Kentucky Teacher Education Journal: The Journal of the Teacher Education Division of the Kentucky Council for Exceptional Children , 5 (2), 1. https://digitalcommons.murraystate.edu/ktej/vol5/iss2/1/
