Behavior reduction tips during diaper changes, from your Behavior BFF!

By Leanne Page, M.Ed., BCBA

bSci21 Contributing Writer, and your “Behavior BFF”

From a mom:

I have a two-year-old daughter who has lately decided to despise getting her diaper changed. It’s so bad that when she has a dirty diaper she screams and flails before we even get near the changing table. Getting her cleaned up is akin to wrestling an angry jungle cat. Please help. She’s not ready for potty training and we can’t live like this.

Let’s start with a little conversation. I’ll do both parts.

Me: What is it you want her to do, exactly?

You: Lay still and let me change her dirty diaper.

Me: Okay. Tell her that. And what is she going to get if she does lay still?

You: Umm..a clean diaper. That should feel a lot better.

Me: Yes and clearly that’s working as a good reinforcer, already, huh?

You: (embarrassed silence)

First, figure out what the desired behavior is. Be specific. Break it down and TELL your child. Explain and teach it to them when you’re not in the middle of a tantrum. Review the GOOD behaviors often. Then, provide a reinforcer for engaging in the desired target behavior. Make it good.

Positive reinforcement is a powerful tool that we can use to increase desired behaviors. When you have a problem situation like this one- don’t just jump straight to time out and taking away privileges. What does that teach your kid? It definitely isn’t teaching the appropriate behaviors.

What’s our Number 1 job as parents? To teach our children.  We have to find ways to teach them the appropriate behaviors and then reinforce those behaviors until they occur naturally on their own. 

Parents almost always want their children to behavior simply because it’s the right thing to do. Does that work? Sometimes, sure. Always? Heck no. We then need to teach them how to behave in those sticky situations. Is that enough? Sometimes, sure. Always? Heck no. We need to reward them for doing these good behaviors.

By definition, positive reinforcement is something that increases the behavior in the future. So, we give some sort of reward and then our children are more likely to do the appropriate behavior in the future. 

Practical ideas for this situation:

1) Use consistent language to teach the desired behavior and explain the reinforcer. “Lay still when your diaper is being changed. After you lay still, then you can watch Elmo.”

2) Give a reward every single time they do the desired behavior. Make it a good enough reinforcer so that your kiddo will remember it and behave to get it the next time this situation arises.

3) Give the reinforcer (aka reward) immediately. Especially if your kid is still in diapers, the whole delayed gratification thing is going to sail right over their heads. Technically speaking, positive reinforcement is what immediately follows a behavior. Just know that you need to reward immediately if you want your Little to respond appropriately next time!

4) Be consistent. Use the same language every time. “Lay still when your diaper is being changed. After you lay still, then you get _____.” Do this every time to decrease the tantrums.

5) Eventually fade out the reward. Wait until this is working consistently and you don’t have a screaming child to wrestle into a clean diaper. Once you’re feeling successful, give less of the reward, give a smaller reward, or give it every other time. Gradually fade out the reinforcement. Don’t just drop it all of the sudden, take your time.

Try it and let me know how it goes!

Don’t just take my word for it. There are decades of behavior analytic research backing up these practical ideas.  Here’s  just a tiny sample.

Cooper, J., Heron, T., & Heward, W. (2007). Basic Concepts. In Applied Behavior Analysis(2nd ed., pp 256-260. Columbus: Pearson.

Homme, L. E.; Debaca, P. C.; Devine, J. V.; Steinhorst, R.; Rickert, E. J. (1963) Use of the Premack principle in controlling the behavior of nursery school children. Journal of the Experimental Analysis of Behavior, Vol 6(4), 544.

Skinner, B. F. (1953). Science and human behavior.

Sulzer-Azaroff, B., & Mayer, G. R. (1991). Behavior analysis for lasting change. Holt, Rinehart & Winston.

Do you have questions for Behavior BFF? Leave a question here in the comments, email the writer, or check out any bSci21 social media outlets to leave your question or problem scenario!  

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Leanne Page, M.Ed, BCBA has worked with kids with disabilities and their parents in a variety of settings for over 10 years. She has taught special education classes from kindergarden-grade 12, from self-contained to inclusion. Leanne has also managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting. Since becoming a mom, Leanne has a new mission to share behavior analytic practices with a population she knows needs it- all moms of littles! Leanne does through her site and through her book ‘Parenting with Science: Behavior Analysis Saves Mom’s Sanity”.

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