I. Background information of the recipient
1 Basic information: the payee is Lai Lai, an only child, born on June 2, 20021day. When she came for help, she was 3 years old and 8 months old and was in a small kindergarten class. Main advantages: smart, lively and generous, strong athletic ability, good at climbing, flexible and bold in action, adventurous, strong in language expression, rich in vocabulary and strong in self-awareness. Main disadvantages: love to lose temper, love to throw things around, often make a hullabaloo about, too free. I don't listen to the command, I don't concentrate, I tend to shift, I dress and eat slowly, and I don't want to do what I can.
2 family status: father, graduated from university, is now an airline aircraft maintenance engineer; Mother, former employee of a foreign company, is now a graduate student. At present, there are five people in her family who live with their parents and grandparents.
Birth history and health status: full-term delivery, birth weight of 2.85kg, body length of 50cm, no abnormality during pregnancy and delivery. At present, the weight 16kg and height 106cm are within the normal range. No major diseases and no family history of genetic diseases since birth. Great sports, fine movements, and well-developed language skills have never left their parents since birth.
4 Previous parenting style: From birth to four and a half months, the mother is the main caregiver. After the mother takes maternity leave, she will be taken care of by her grandmother and nanny during the day and her parents at night during the period of four and a half months, 1 year from four months to two years and eight months. During eight months-one year and three months, I was taken care of by my grandmother and nanny during the day. Parental care at night; Two years and eight months in kindergarten. Mainly taken care of by my mother, my grandparents moved in when they were three years old and three months old. Parents' main parenting style is to let go as much as possible, except for dangerous things that may cause harm to others or affect their health, and things that she wants to try. Let her do it as much as possible, and only help her when she can't do it in time. Therefore, she has flexible limbs and quick movements. When she was two years old and three months old, she was proficient in using spoons and chopsticks to eat. Grandparents' parenting style is arranged rather than arranged, and they are afraid that their children will eat less, so they will start feeding as soon as they don't do it.
5 Reasons for seeking help: My mother thinks that eating is the most basic physiological need, and developing good eating habits is the basis for cultivating other self-care abilities, hoping to take this as an opportunity to shape good behavior habits. Exercise self-care ability and promote family harmony.
Status of dietary behavior: basically, breakfast should be fed. Having lunch in kindergarten at noon, the teacher said that most of the time you can finish a meal by yourself, and occasionally you have to feed it, which is a procrastination phenomenon. At dinner, grandma feeds while her parents are away. When parents are at home, about one-third of the time they can take the initiative to eat the prescribed amount, one-third of the time they eat under intimidation and inducement, and one-third of the time they can't eat well. And often ask for feeding, or just serve after a few bites, and often eat while playing. To this end, the atmosphere at home is often very tense because of her eating.
Second, observation and evaluation before intervention.
Short-term goal: you can finish the specified amount of dinner alone in half an hour.
The ultimate goal: you can eat the prescribed amount independently within the prescribed time without any means, and keep it for a long time, and it is suitable for any situation.
Informal evaluation procedure: (1) Determine the evaluation method: On a weekly basis, the mother will record the eating situation of dinner every day, and only the recipients will eat the prescribed amount independently, and the time will be controlled within half an hour. Based on the observation records of the four weeks before the implementation of the plan. (2) Identify the behavior that needs to be corrected: Independent dining refers to the whole dining process. All the feeding actions are done by myself: half an hour refers to the time from sitting at the table to eating and leaving the table after eating; Prescribed weight means that parents (or grandparents) depend on the situation (body) of the day. Snack intake, etc. Arrange the amount of food, including staple food, side dishes, soup, etc. (3) Consistent observation and evaluation procedures: No matter who records at home, it must be evaluated in strict accordance with the defined behavior standards, and it can only be recorded as standard behavior if it is completely consistent. (4) Record: Record the behaviors observed before and after the implementation of the intervention plan according to the following table, and record "?" If you don't meet the behavior standards, record an "×" once and get a "?" Every week. Times (5) Evaluation results: The patients can skillfully and correctly use tableware such as spoons, chopsticks and forks, have no difficulty in swallowing and chewing, have no gastrointestinal discomfort, can stay at the table for more than half an hour, have a fixed dining position at home, and are fully capable of eating independently. But at home, I generally don't want to eat by myself. I often ask for food. My grandmother always meets my demands unconditionally and even offers to feed them (one reason is that children are not like this, and the other reason is that I eat too little). Mom usually refuses to eat by herself at home. Cry after being rejected, then run around the table, and then talk about conditions (such as asking to eat on mom's lap, telling stories while eating, and so on). ) The methods adopted by mothers include verbal praise (constant encouragement throughout the meal), material temptation and other strategies (such as deliberately leaving, competition, turning off the lights and eating, etc. ). These methods were once effective. I can eat independently in about three weeks, and my grandparents will return to their original state after they come. Children like novel snacks and bright and beautiful hair accessories, and like verbal praise and encouragement.
Three. Intervention planning and evaluation
The observation records before the implementation of the intervention program show that the average compliance behavior is 2.5 times/week, and it is expected to reach 7 times/week after the intervention and keep it for a long time.
Judging from the above evaluation results, the inconsistency of family rearing patterns is an important reason why good dining behavior cannot be established and sustained, so we must first solve this problem. First of all, parents should work together with grandparents to clarify the importance of cultivating good habits and the consequences of inconsistent upbringing, and urge their children to give up feeding behavior and be consistent with their parents. After grandparents expressed their approval. Make an implementation plan: Because the child always likes new and different stimuli, and his mother often uses material rewards to make him eat as required, if he still uses the rewards every time he has expected behavior, he needs to change the stimuli frequently, which will easily lead to boredom or material dependence, so he decided to adopt the token system-the child recently likes to imitate the teacher's tick on the paper when he calls the roll, and thinks that his name is ticked below, which shows that he is doing well, so he decided to use this as the basic reinforcement mode. Because there is only one dinner every day, even if the eating behavior meets the standard, only one tick can be obtained, which is not easy to cause a strong sense of accomplishment on the record sheet, so I decided to adopt a flexible form, that is, as long as she has other good behaviors, she can also record a tick, such as brushing her teeth, washing her face, dressing, pouring water for her parents, helping her grandparents, sharing with others, packing her things and so on. Negotiate with your child and ask her to choose something she particularly likes, and then she can get it after 50 ticks. Make a big record sheet, write down the date and name, stick it at a conspicuous height that the child can get at home, and often let her count the ticks by herself.
Evaluate the intervention plan according to the recorded data and the actual observed behavior. If the satisfaction behavior declines, analyze whether the strengthening choice is unreasonable or other influencing factors are not taken into account, and make timely adjustments.
Fourthly, the analysis of intervention results.
From the statistical chart of observation records before and after the intervention (see figure 1), it can be seen that after the implementation of the intervention program, the target behavior increased from two or three times a week to five or six times, and decreased in the fifth and seventh weeks, because the children had a cold and fever and poor appetite in these two weeks. My mother was distressed and took the initiative to feed it several times. The rest are not up to standard because the meal time is more than half an hour. Eating behavior no longer occurs. From the ninth week, the eating behavior was completely up to standard and maintained for a long time, and eating out many times also performed well. Observation records show that the intervention scheme is effective.
From the actual observation, after the implementation of the intervention plan, children actively tried to change their behavior and spontaneously came up with some new good behaviors (cleaning tables, tidying up dishes and chopsticks, etc.). ) in order to get more hooks. It took twelve days to save fifty hooks for the first time and ten days for the second time. In the process of implementation, parents also timely guide their children from material rewards to the acquisition of a sense of accomplishment. Every day when she is asked to count the hooks by herself, her mother praises her and makes her pay more attention to the number of hooks. In addition, parents often intentionally mention her achievements in front of teachers, relatives and acquaintances. Let her get a positive emotional experience. By the ninth week of the implementation of the plan, the short-term goal was achieved, that is, eating alone every night. From the tenth week, the behavior of ticking began to fade away, and only after good behavior appeared did parents give verbal praise in time. At present, children can eat three meals a day alone, and they can eat quietly on other occasions. At the same time, they have developed many other good behaviors. Like brushing your teeth and washing your face every morning and evening. Take the initiative to serve your family, and so on. Kindergarten teachers also reflect that children are gradually becoming sensible and capable.
On the basis of detailed evaluation, this case chose a suitable reinforcement mode, which enabled the case to be implemented smoothly as planned, and not only developed the target behavior, but also developed other good behaviors. It has achieved the effect of bringing the area from point to area. It should be noted that in the implementation of the plan, the emphasis of reinforcement should be shifted in time according to the behavior performance, and finally the external material reinforcement will be transformed into active and spontaneous behavior. For example, the case was attracted by material rewards at first, then the focus shifted to the number of hooks, and finally only words were used to praise it. In addition, in the implementation plan, we should always pay attention to some details, such as not eating for two hours before dinner, changing the food pattern frequently, and having dinner with the whole family to create an atmosphere, and so on. Only in this way can we achieve real results.