little plastic bears: memories of a token system run amok

I.

At the age when most babies are beginning to use their first words, my little brother remained non-verbal. My parents went to a doctor regarding this. The doctor said, “Wait, see what happens.” My parents waited. Time passed and the doctor confirmed that he was experiencing a significant speech delay.

More time passed. At a certain point…around the age my brother was a toddler…my parents believed that he was beginning to use words, but that he was struggling to enunciate them correctly. And a specialist confirmed this. He was speaking, finally, but he had a severe impediment.

So for the first five or six years of my brothers life, he found words to be an enormous challenge. My parents and I, we could understand much of what he was saying…we slowly learned to decode his sounds and gestures…but to anyone not with him on a daily basis, he was unintelligible.

Even for us, it was difficult. He would talk, talk some more. We would get bits and pieces, understand one word in five, then have to guess as to the overall meaning of his statements. His writing was even more delayed than his speech, so we had trouble finding ways around his difficulty with words. We just listened and struggled through the decoding process.

This made him angry. If repeated attempts to communicate failed, he would despair, begin to scream and cry. Understandably, he would get so frustrated. He would say something…repeat it…then repeat it louder…then pull his hair, cry.

He saw a speech therapist to help him with the muscular component of speech. He had to learn to make the right shapes with his mouth, to match up the words in his mind with the physical mechanics of speaking.

And it worked. By the time he was five or six, he was speaking more clearly, to the point that anyone could understand him. He still had an impediment, an “accent” my mom called it. That persisted for years, a certain muffled quality to his words…but even that faded away eventually.

I’m only a few years older than he is, but my memories of that time period are sharp, painful.

I remember one day, when he was around 4 years old, he was frantic to communicate something. He spoke a few words, repeated them, then cried. And it seemed like he was wanting something, a specific action or object. He was visibly agitated.

Mom said, “Honey, can you point to it? I don’t know what you want. Help me understand.”

He repeated the sentence, slowly, loudly; his face red with frustration. Then he repeated the sentence many times in a row, over and over, until my mom began to cry. She said, “I don’t understand, honey. Can you point to what you want?”

He gave up; rolled around on the floor, screamed.

II.

Once he could speak, his teachers integrated him into the regular classes at school. He had a variety of learning disabilities, though, so his work load had to be tailored to his skill level.

His primary difficulty was dyslexia. It was severe and he would later say that words were not just reversed on the page, they appeared to move. They couldn’t settle, fix in his mind. For him, words were shifting, ephemeral things.

Dyslexia also made him angry. He would look at a word, try to pin it down with his eyes, but he just couldn’t capture it, not easily. Reading was a constant struggle.

To manage this, my parents sent him to an after school learning center that specialized in dyslexia. There, he was able to get one-on-one attention from a mentor, who spent an hour each day working with him on reading exercises. I don’t know what this entailed, specifically. But Monday through Friday, 6 to 7pm, my brother would go to this center, work on his reading skills.

So, there was a mentor…there were reading exercises…but what I mostly remember is that these remedial efforts were largely predicated on a token system. The mentor would work with my brother on a variety of exercises, and if my brother performed well, he would be given a small gift.

The tokens were these little plastic bears. They were small, maybe an inch high; most of them blue or yellow or red.

Each weeknight, he would leave the center with a pocket-full of these little plastic bears. I’d see him walk in the front door…dump the bears on the kitchen counter…plop down in front of the television. My mom would scoop the bears up, count them, say “Wow, seven! Good job tonight honey!” He wouldn’t say anything in response. He would just cross his arms, watch television.

My parents were encouraged to implement the same token system at home. When he began at the center, they were given a box filled to the top with the multi-colored bears.

If my brother attempted to read a book, he was given a bear. If he saw a word on the television screen and read it out loud, he was given a bear. Good reports from school, completing homework, reading billboards: more bears.

Over the three years that he attended the learning center, my brother accumulated hundreds and hundreds of the plastic bears. They became a ubiquitous presence in our lives. They permeated every nook and cranny of the house…you’d see them anywhere you looked; on counter tops, in drawers, scattered on the carpet. Exclamations of “Ouch!” usually meant a bear and bare foot had collided.

They liked to find their way into pockets, which meant that a batch of them would inevitably make it into each load of laundry. Clothes would be washed…put in the dryer…and that’s when the rattling would begin. Someone would ask, “What’s that rattling sound?” And mom would say, “Bears in the dryer. Again.”

Years after he had left the center, we would lift couch cushions…look under beds…and find them.

My brother was indifferent to the plastic bears. He didn’t dislike them, but he didn’t like them either. He was never motivated to earn more, to collect more. And after a certain point, there were so many available to him…so many crammed into drawers and pockets and piled about the house…that they lost whatever novelty value they might have initially held. The little plastic bears were everywhere, and therefore pointless. (If a token system functions like a currency, the same basic rules will apply. In this case, inflation kicked in.)

Three years at the center, and the impact was negligible. His reading skills stayed at the same level, his grades did not improve.

His mood was the only thing to change over the years. His anger steadily increased.

III.

I don’t know why I’m sharing this memory. I don’t know if there is a lesson or point. I just know, today, when I read about programs and centers offering hope for special needs…when I read about systems and cures and experts…I don’t always have a very good feeling.

I have a suspicion that help…the kind that is actually helpful…can only happen with an understanding of individuals; it can only happen when a mind reaches out to another mind.  And too often, programs and systems rest on broad rules and generalizations. They are made for people in the abstract, but never a specific person.

So, no story with a moral. No answers. Just memories. And the images they create in my mind:

Centers and programs lumbering along, turning into machines.

Machines made to dig deep holes and bury their waste…their candy and coins and plastic bears.

Machines for landfills and futile tokens.

Recent posts: I converse with a psychologist about how families perceive Asperger’s; I describe high school memories and toying with self-image; I interview Dawn Simmons about autism awareness and bullying. And, for some reason, you can find more Invisible Strings on You Tube, Facebook and Twitter. It’s a whole thing.
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Comments

  1. says

    This is sad and frustrating to read. I’m sorry that your brother had to go through all of that.

    I have had wars with school districts over using these simplistic reward systems to deal with some of the more complex issues which occur sometimes when students come into a community-based program. I call it the “I’ll give you a cookie” system. In one case, when I mentioned the Palov’s dog aspect to this type of “behavioral intervention”, I was told, “People and dogs, it’s all the same.”

    I think you are spot on with your assessment. Working with individuals takes effort. It takes building relationships, trust, bonding, and empathy. There is no easy way to do any of this. You invest in the person, period.

    Please keep in the cookies and bears to yourself.

    • says

      when i hear about positive experiences with programs, systems, etc…it’s always because a particular teacher or tutor took the time to connect with the child/teen involved. and in my own life, i had a very negative experience with a psychologist…and then a very positive experience with a different psychologist, all because she didn’t have the “answers” and magic solutions….she was just attentive and slowly worked on establishing a line of communication.

      more and more on social media, i’m hearing about new “centers” and programs that promise miraculous results for different issues, in addition to autism and it makes me uneasy. i know these things can give parents hope, yet leave the kids feeling lost at sea. and again, i’m sure some can have a positive experience, but i think respect for the individual has to be priority number one, and not the program itself.

  2. says

    It’s funny how that idea of “reward” works. Case in point: I was a frequent wetter of beds up to the age of 10. In desperation, my mother turned towards a reward system. It worked: I stopped wetting my bed after a few months.

    But not because of the reward. We had a calendar up on my bedroom door, and for every “dry” night I received a sunny picture. Several sunny pictures in a row would get me a gift. But my mother is the only one who remembers the gifts. In her mind, that’s what motivated me. The funny thing is, I can’t remember any gifts at all. It worked for me in two ways: first of all, it made me happy to see a pattern of sunny pictures on the calendar; and second of all, seeing the calendar was a visual reminder to go to the bathroom before closing my bedroom door.

    It was that simple.

    But my mother still insists that rewarding me with gifts I can’t even remember getting is what made me stop wetting my bed.

    • says

      that is a terrific story…it’s a great point that you had this system in place, yet you were perceiving it in a totally different way from your mother. that says so much, thx for sharing that.

  3. Sheila says

    Thanks for sharing your memories of this. How frustrating for your brother, first to have to struggle so mightily with speech and reading, but also to be “rewarded” with something that had no particular value to him. Working for pay would get very tiresome very quickly if I got paid in a currency that I couldn’t use to buy things that I want and need! To me, that’s what buckets and buckets of plastic bears would amount to.

    • says

      yes, good point, the “reward” was not very motivating…the bears were certainly something he never enjoyed or play with. i think the reward…and the timing of the reward…have to be implemented correctly…and they have to be tailored to the individual, not just a mechanized system that cranks out items regardless of the person involved.

  4. says

    Your penetrating story moved me. As a veteran of speech therapists prescribed to a little autistic boy who struggled with language, I say they did little for us. We learned quickly that tokens did not work, that therapy made frustration rampant, that outside pressure made everyone miserable. I *hated* therapy. It was a big ugly, head-shaking fail.

    Part of why I hated therapy had to do with my own dyslexia. I relate to floating words–mine swam, flipped back and forth and reversed. I was tagged as a remedial reader until the forth grade, when suddenly a window opened and I could fly through books. No one helped me. I just became.

    The brain can’t be predicted or hammered into a an improbable shape. One just is. I reject the idea of uniformity; the ugliness of civilization is the insistence of typical. Any flourishing system produces diversity. Only a machine seeks sameness.

    • says

      “I was tagged as a remedial reader until the forth grade, when suddenly a window opened and I could fly through books.”

      yes, i think this is exactly why school settings can be so challenging for folks with differences…the rigid structure just does not work well for all people. some of us just learn differently, at our own pace, no matter how much feedback or structure we’re given; it’s funny you mention reading…at one point during high school, i felt so unengaged by the classes, that I just started reading independently…i was reading college level books, learning a huge amount, yet failing my classes because i wasn’t doing the work or tests. the teachers were reprimanding me, giving me failing grades, having conferences with my parents…i just ignored it all, kept self-learning (and of course had to attend summer school due to the Fs; I was fine with that).

      “I reject the idea of uniformity; the ugliness of civilization is the insistence of typical.”

      beautifully put…I don’t know if you’ve seen this quote from Steinbeck, but your words remind me of it…it’s one of my favorite quotes:

      “Our species is the only creative species, and it has only one creative instrument, the individual mind and spirit of a man. Nothing was ever created by two men. There are no good collaborations, whether in art, in music, in poetry, in mathematics, in philosophy. Once the miracle of creation has taken place, the group can build and extend it, but the group never invents anything. The preciousness lies in the lonely mind of a man.
      And now the forces marshaled around the concept of the group have declared a war of extermination on that preciousness, the mind of man. By disparagement, by starvation, by repressions, forced direction, and the stunning blows of conditioning, the free, roving mind is being pursued, roped, blunted, drugged. It is a sad suicidal course our species seems to have taken.
      And this I believe: that the free, exploring mind of the individual human is the most valuable thing in the world. And this I would fight for: the freedom of the mind to take any direction it wishes, undirected. And this I must fight against: any religion, or government which limits or destroys the individual. This is what I am and what I am about. I can understand why a system built on a pattern must try to destroy the free mind, for it is the one thing which can by inspection destroy such a system. Surely I can understand this, and I hate it and I will fight against it to preserve the one thing that separates us from the uncreative beasts. If the glory can be killed, we are lost.”

  5. says

    I’m sorry your brother had to deal with this.

    There’s a part of the ADOS where kids are given a treat and then the container is put out of their reach to encourage them to ask for more. You would think the treat would be something the kids like, especially for potentially-autistic kids who are more likely to have strong food likes and dislikes. I’ve been told that almost all labs simply use Teddy Grahams for all the kids. Few researchers actually ask the parents beforehand what snacks their kids love and use those. And apparently, none of the parents ever say Teddy Grahams. It’s amazing how people don’t get that if you want to motivate someone, you’ve got to give them something they actually want. All these smart people who don’t even understand the meaning of the word “motivation.”

    I suspect a lot of the time token economies work for unintended reasons–they involve prompts, like Autisticook mentioned, or they make people feel secure by creating a consistent routine. What do you think?

    I think you’re right that what matters most is whether a clinician builds a relationship with someone and treats them like a person. But if that’s the essential ingredient, how can we ever determine whether any program or therapy is “evidence-based?” How can you objectively test whether relationships and respect are there? How can you tell a valid practice from snake oil, when some practitioners of the former will be mechanically applying a system like your brother’s tutors, and some practitioners of the latter will address the students’ individuality?

    • says

      “I think you’re right that what matters most is whether a clinician builds a relationship with someone and treats them like a person. But if that’s the essential ingredient, how can we ever determine whether any program or therapy is “evidence-based?” ”

      Great question, I don’t know that I have an answer…but I think in almost any profession, you have established techniques…techniques that will work or not depending on the skill level of the professional employing it. So a surgical technique may have proven to be very effective…but if a surgeon makes a mistake or has not been properly trained, they can still get it wrong. Doesn’t mean the technique is flawed, just means the doctor used it incorrectly.

      Terrible example…the application of research in social sciences to therapeutic settings is a topic I’m not educated enough about to really tackle…but the point is that we can establish credible “evidence based” supports that still fail if implemented incorrectly.

      To me, this all gets down to the quality of clinicians and mental health professionals…which in turn gets down to establishing a professional “culture” where it’s expected that clinicians working with people will understand the value of making connections, learning the needs of an individual. I think right now the “culture” probably leans too far in the “crank out the method” direction, and that does more harm than good. (Again, some of these issues are unique to therapeutic and/or educational settings…if you’re a surgeon, “cranking out the method” might be okay…the same doesn’t apply to therapeutic/educational settings).

      also, i only tell the story in this post because it allows me to pull from memory…but i’m concerned in a general way about the huge number of “centers” and “programs” that offer seemingly miraculous cures for various issues (autism, ADHD, etc)…I just think these turn into method factories, promise more than they can deliver…and ulitmately work against the very people they claim to help. Token systems are just the technique I can recall from personal experience, but really any system is a concern. “Brain Balance Centers”, for example, have expensive regimens that have no grounding in research. So for me, I think it’s important to carry a healthy skepticism for “methods” that promise too much. I don’t see this has having a negative impact on research, on evidence based conclusions…the issues that most concern me, and that i’m trying to examine in this post, are basically found in the trenches, where clinicians, mental health professionals are implementing these various “methods”.

      This doesn’t answer any of your questions…but I think the questions you raise are the big ones that we should all be asking ourselves, especially those who work with these various systems, programs.

  6. says

    Sounds like a very frustrating experience for your brother but also a real motivation killer to receive tokens with no value or no functional relation to the skill being developed. Unfortunately this is an all too common mistake of applying handbook style interventions as a one-size fits all under the guise of “behaviour intervention”. And sadly, some “ABA therapists” are doing this too, never mind analyzing one’s preferences or what schedule of reinforcement could be optimal. I’m sorry this clinician and others like them didn’t take the time to get to know your brother and how to motivate him.

    ~Tricia-Lee

    Would it be okay if I link to your blog post in a future post on my blog? I’ve been thinking a lot lately (and seen) the mis-use of token economies and this post highlights the many ways people get it wrong.

    • says

      certainly, you can link, thx Tricia.

      “sadly, some “ABA therapists” are doing this too”

      Yes, and I think when problems like this happen, it’s often due to the “culture” of a particular field. I personally had a very positive experience with a behavioral psychologist…but it was because she did not try to implement a technique or method…she just said, “Let’s figure this out together,” and put effort into listening, making a plan based on my particular personality. When I see situations going wrong, it’s often because the clinician insists on imposing a method that just does not fit the individual…and I get the sense that this happens because of their training. They do this because…that’s what you do, end of story. So I do think there are many bright, intelligent therapists out there…people who get it, who save lives. But as you point out, there are many who just insist on a technique without ever really tailoring what they do to the individual client…and that can be a recipe for disaster.

  7. Sheila says

    My family has been lucky to work with teachers and therapists who were very good at picking up on rewards that were both motivating and intrinsically helpful. For instance, they would ask my granddaughter to do some work, and then she would get to play with a toy she had already chosen that morning, or get to go for a walk or spend some time on the trampoline. The physical activity breaks help her return to the learning environment ready and able to focus. One of our ABA therapists was a delightful young woman who could usually playfully tickle my granddaughter out of a bad mood in a few minutes. I don’t think heavy-handed methods or a one-size-fits all mentality are appropriate ways to teach ANY child. If the child doesn’t feel liked and respected, then the therapist or teacher is on the wrong track in my opinion.

    • says

      Very good points, thank you Sheila. So glad you guys found therapists who were able to connect with your granddaughter…for me, that is the lesson I took away from these experiences…not that token systems are inherently bad, but that all interventions should be attuned to individuals and their unique personalities. And you are absolutely right, this holds true for all kids, not just those with specific challenges. Thx again.

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