Using Sticker Charts to Stop Children Scratching Eczema
A lot of eczema kids scratch without being aware of it. In these cases, sticker charts are a great way to stop children scratching eczema by helping them to become aware of when they are scratching. It also gives you a chance to reward your child for the major, but largely hidden, achievement of stopping themselves from scratching.
Saying ‘well done’ to your child is by far the most effective way of encouraging behaviours. By using a sticker chart you can both recognize and celebrate their success. The concept of sticker charts is straight forward: identify a behaviour that needs encouragement and hand out lavish praise and a sticker every time your child does that thing. When they have collected a given number stickers they get even more praise and a reward. The real power of sticker charts is the tangible recognition of ‘good behaviour’ as it happens. For kids, the sticker should be a physical reminder of recognition and praise received. The building up of stickers on their chart is a visual measure of their achievements and gives you a chance to make a big fuss about how well they have done. Sticker charts are as much for you as they are for your child because they remind you to praise good behaviour as it happens. Download our free printable sticker chart (and stickers).
Using sticker systems to reward NOT doing things
Coming up with a sticker system to teach a child to do something is relatively straight forward: you decide what you want your little one to do and hand out praise and stickers whenever they do it. Coming up with a sticker system to get a child into the habit of not doing something (like scratching at eczema or thumb-sucking) isn’t quite so clear cut.
One approach is to come up with an alternative, acceptable thing to do instead and hand out stickers for doing that new thing. An example could be finding a fiddly toy to play with while they are watching TV or tapping an itch rather than scratching it. Our post on helping teach kids to cope with itchy eczema has more ideas. This is often a good place to start as you can teach your little one coping strategies rather than just asking them to stop doing something without telling them how.
Another approach is to identify specific time periods to focus on not doing the thing you are trying to stop, such as going to sleep, bath-time, watching TV or car journeys; or you could focus on one particularly itchy patch and award stickers for not scratching that area.
As with all sticker systems, to keep you little one engaged you’ll need to start with small, clearly achievable goals – maybe just 15 seconds tapping an itch rather than scratching is challenging enough to start with. It’s worth noting that younger children need more frequent rewards to hold their attention. Whatever system you come up with, make sure that your child understands it and you can evolve it slowly.
Golden Rules for successful sticker charts
- Give praise, praise and even more praise
- Stick to one issue and be realistic
- Involve your child right from the start, they must want to tackle the issue and understand how the sticker chart is going to work
- Help your little one as much as you can (without actually doing the work yourself)
- Be sure to give stickers immediately
- Remember to review the chart frequently and celebrate the building successes
- Evolve the goals to establish the new behaviours and then gradually phase out the sticker chart
- Don’t take stickers away – lack of reward will be more than enough
This, not very helpfully, depends on the child in question. A good guideline is that reward charts should work for children aged between 3 and 8. The lower limit is down to children just not being able to control their behaviour effectively until they are about 3; the upper limit is more child dependant, with older kids losing interest in this type of micro-reward system.
The more important things to consider are whether the child is capable of not scratching, whether they understand why they shouldn’t scratch and whether they have the capacity to control their behaviour yet. If the child isn’t ready, then a sticker chart won’t work.
How to make sticker charts work for you: the 4 ‘P’s
Planning: Make sure you are clear about what you want to achieve. Discuss it with your partner and anyone else involved in your child’s care to make sure that you can all be consistent. Ensure you have thought through how you want your sticker system to work and what rewards you want to use (more on this later). You also need to involve your child, without their understanding and buy-in, a sticker chart just isn’t going to work. Kids get bored quickly so don’t use sticker charts for everything. It’s also a good idea to leave gaps between using them for different things. About a month should do it.
Praise: This is the bit that makes sticker charts work. From your child’s point of view, the stickers themselves should be an incidental benefit and a way of measuring the amount of the praise they have had. Every time they achieve a goal make a really big thing of how well they have done before you give them the sticker. Big hugs, high fives, tummy tickles, sloppy kisses, silly dances, whatever works for you. Then repeat the production when they have stuck the sticker in place – although maybe with slightly less gusto! If you start running out of ways to say well done – check out our list of 50 ways to say ‘Good work’ at the end.
Being Positive: When you are trying to break a habit or teach a new behaviour you will need to help you child along the way by providing distractions and coping mechanisms (e.g. tapping itches, using a cold compress or finding a toy to fiddle with). It’s also easier for everyone to focus on the ‘good’ stuff if you use positive rather than negative words: instead of saying ‘Stop scratching’ try ‘That itch is bothering your – what shall we do to take you mind off it?’ You could also come up with a silly ‘secret signal’ to remind them not to scratch. When goals aren’t achieved, give a conciliatory hug and ask them how you can help next time – you might be surprised at the answer.
Patience: We all know that learning a new behaviour is hard, but it will be worth the effort. As a rule of thumb, it takes at least 21 days to break a habit.
Stickers, rewards and their pitfalls
Stickers lose their value quickly so unless they are a way of earning other rewards or prizes, your child is likely to lose interest. It usually works best to have frequent, small rewards for collecting around 4 or 5 stickers. This is especially true when you are starting out with a sticker chart as it helps children get used to the idea that making the effort to do something is worthwhile. It is also true with younger children who have little concept of time.
The prizes you choose are up to you but should depend in part on the effort involved in earning them and what really interests your child. Involving kids in choosing the reward or prize they are working towards is also a good motivator.
Here are a few ideas:
Family time – this could be as simple as an extra story at bedtime, their choice of what to have for the family’s dinner or full-on family outing (although make sure that you do actually have time before you promise!)
Building up toy collections – Lego, train sets, dolls house furniture, dolls clothes are all good candidates for this type of prize, although the lack of variation can mean kids loss interest relatively quickly
Treasure box – fill a small box with little toys like balloons, pens, craft supplies and party-bag presents and let your little one chose form the box each time they earn enough stickers. It’s a good idea to feed in new items regularly to keep the box interesting.
Voucher book – make up a book of vouchers for trips to the local soft play area or swimming pools, new books, time playing computer games, a DVD from the local library…. You can involve your child in coming with treat ideas and drawing pictures to go on the vouchers.
If you are really lucky, your little one will have learnt to stop scratching their eczema and lost interest in their sticker charts without any other action from you. If they don’t move on by themselves, try not to suddenly stop using a sticker chart. Stopping suddenly makes it much more likely that your child will go back to scratching as much as before.
There are a number of ways to move away from a sticker system: you could gradually increases the length of time between stickers by making the goals longer; or slowly increase the number of stickers needed to gain prizes; or even phase out the stickers in favour of just giving the praise; or, if you have gone down enthusiastic praise route in a big way, gradually reduce the enthusiasm of the goal celebrations.
Over 60 Ways to say ‘Well done’
Well done! You are very good at that! You’re doing a good job there! That’s the best you’ve ever done! I knew you could do it! Now you’ve figured it out! Now you have it! Great job! You make it look easy! That’s the right way to do it! You’re getting better every day! Sensational! That’s the way to do it! Best yet! Perfect! Terrific! Much better! You’ve just about mastered that! Outstanding effort! You did that very well! Fantastic! You’re really improving! Superb! Keep it up! Tremendous! Good thinking! I’m so proud of you! I think you’ve got it now! You figured that out fast! Clever boy/girl! That’s great! Way to go! Now you have the hang of it! You’ve done a great job! Congratulations, you got it right! That’s really good! Good work! You’ve just about got it! That’s it! Congratulations! You’re learning so fast! Good for you! Couldn’t have done it better myself! You did it that time! That’s the way! Super duper! You haven’t missed a thing! Keep up the good work! Nothing can stop you now! Excellent! Wonderful! You’re on the right track! High five! That’s better than ever! Now that’s what I call a fine job! You must have been practicing! You’re doing beautifully! Right on! You’re doing fine! You outdid yourself today! Splendid! Good going! Marvellous! Well, look at you go!
These ideas really helped us, what is your experience of using sticker charts to stop children scratching eczema?
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