One. Background information of the recipient
1 Basic information: the payee is Lai Lai, an only child, born on June 26th, 2002. 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 in action, bold, 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; My mother used to be an employee of a foreign company, but now she is a graduate student. At present, there are five people in her family who live with her 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. Since birth, there has been no major illness and no family history of genetic diseases. Great sports, fine movements and language skills are well developed. They have never left their parents since they were born.
4 Previous parenting style: From birth to four and a half months, the mother is the main caregiver. After the maternity leave, the mother 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 and 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. Parents take care of them at night; Go to kindergarten after two years and eight months. Mainly taken care of by my mother, my grandparents moved in when I was 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, things that she wants to try. Let her do it as much as possible, and only help her if she can't do it in time. Therefore, she has flexible limbs and quick movements. At the age of two years and three months, she was able to eat skillfully with spoons and chopsticks. Grandparents' parenting style is arranged rather than arranged, for fear that children will eat less and start feeding as soon as they don't do it.
5 Reasons for seeking help: Mother thinks that eating is the most basic physiological requirement, 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.
6. Status of dietary behavior: Basically, you should feed your breakfast. Having lunch in kindergarten at noon, the teacher reflected that he could finish a meal by himself most of the time, and occasionally he had to feed, which was a phenomenon of procrastination. When eating, grandma feeds when parents are not at home. When parents are at home, about one-third of the time they can eat what they need voluntarily, one-third of the time they eat under intimidation and inducement, and one-third of the time they eat badly. And often ask for feeding, or just take a few bites before serving, and often play while eating. 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 food intake at dinner every day, only when the recipients independently eat the prescribed amount and control the time within half an hour. The observation records of the four weeks before the implementation of the plan are used as the baseline. (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; The 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 only when it is completely consistent can it be recorded as standard behavior. (4) Record: Record the behaviors observed before and after the implementation of the intervention plan according to the following table, and record "?" If it doesn't meet the behavior standard, record "×" once and get a "?" Every week. Number of times (5) Evaluation results: The patient can skillfully and correctly use tableware such as spoons, chopsticks and forks, and has no difficulty in swallowing and chewing, no gastrointestinal discomfort, can stay at the table for more than half an hour, has a fixed dining position at home, and is fully capable of eating independently. But at home, I usually don't want to eat by myself. I often ask for food. When I make a request, my grandmother always satisfies me unconditionally and even offers to feed me (one reason is that the children don't like it, and the other reason is that I eat too little). Mother usually refuses to eat at home. After refusing, they will cry, then run around the table, and then talk about the conditions (for example, they ask to eat on their mother's lap and tell stories while eating, etc. The methods adopted by mothers include verbal praise (constant encouragement throughout the meal), material temptation and other strategies (for example, deliberately leaving, competing, turning off the lights and eating, etc.). ). These methods were once effective. I can eat independently for about three weeks, and my grandparents will return to their original state when 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 plan 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 this problem should be solved first. First of all, parents should work together with grandparents to clarify the importance of cultivating good habits and the consequences of inconsistent parenting styles, and urge them to give up feeding behavior and be consistent with their parents. After grandparents agreed. 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 rewards every time he has expected behavior, he needs to change stimuli frequently, and he is prone to boredom or material dependence, so he decides to adopt the token system-the child recently likes to imitate the teacher's tick on the paper when he calls the roll. Considering that his name is ticked below, it shows that he has performed well, so he decides 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 to work, sharing with others, cleaning up her things, etc., and let her choose what she particularly likes. Make a big record sheet, write down the date and name, stick it at a conspicuous height that the children at home can get, 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 not considering other influencing factors, and make adjustments in time.
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 plan, 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. Feeding 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 plan is effective.
From the actual observation, after the implementation of the intervention plan, the children actively tried to change their behavior, and spontaneously came up with some new good behaviors (cleaning tables, cleaning dishes, 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 should promptly guide their children from material rewards to the acquisition of a sense of accomplishment. Every day, when she is asked to count the number of hooks by herself, her mother praises her, which makes her more concerned about 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 ticks began to disappear gradually, and parents only gave verbal praise in time after good behavior appeared. At present, the child can eat three meals a day alone and eat quietly on other occasions. At the same time, he has 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 reported that children gradually became sensible and capable.
On the basis of detailed evaluation, the 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 during 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 initially attracted by material rewards, then the focus shifted to the number of hooks, and finally only words were used to praise it. In addition, when carrying out the plan, we should always pay attention to some details, for example, in order to ensure our appetite, we should not eat for two hours before dinner, often change the food pattern, and the whole family should eat together to create an atmosphere, and so on. Only in this way can we achieve real results.