The Power of Praise in Type 1 Parenting

Stop hitting your sister. Don’t throw that. Please listen. Familiar? At times, it might feel like your children are conspiring against you—that nothing you try is working. The truth is that behavioral issues can be common among young children, and little ones with type 1 diabetes are no exception. Diabetes can add several layers of complexity, too. When faced with a challenging behavior, you may wonder, “Is this diabetes? Is this being a 4-year-old? Is it both? Neither? And whatever the reason, what can I do about it?” Telling kids what not to do is exhausting and usually not too effective. Instead, try praise, the positive reinforcement that is far more motivating.

Compliment and compliment often!

Compliments make kids (and parents!) feel good. Finding opportunities to encourage good behavior can be very effective in decreasing misbehavior. Focus your attention on telling your child when they do something you like. “Great job being gentle with your little sister” or “Thanks for setting your meter down on the table.”

Catch them in the act

Use praise and attention during or right after the behavior that you want to happen more often. Praise immediately and explicitly.

Be descriptive and specific

Make sure your kids know exactly what you like. “Great work! I am so glad that you brought me your continuous glucose monitor (CGM), so we can look at it together!” “Thanks for picking the spot for your pump site change!  You are so helpful!”

Give praise even for minor appropriate behavior

This can guide your child closer to the behaviors you would like to see more often. “I like it when you hold your hand still while I do your finger check—thank you!”

Avoid back-handed compliments

Praise is not effective when it also includes criticism. Try to highlight positive behavior without also bringing up negative behavior. An example of a back-handed compliment is, “You finally are eating the same food that everyone else is eating for dinner.” Instead try: “I really liked how you tried a new food for dinner tonight. Yum, yum!”

Praise can be verbal or nonverbal

Children respond to expressions and gestures as well as words. Effective nonverbal praise includes: a high-five, a thumbs up, nodding of the head, clapping of the hands and smiling. Or add a hug with your praise!

Don’t be afraid to be silly

Go nuts! Many young kids respond well to enthusiasm and silliness because it catches their attention and makes the praise something fun they want more of.

Praise is not just for young kids

Try it with your older kids, your spouse or even a co-worker. Thank you and acknowledgement of success can go a long way at any age.

Ignore misbehavior

To be most effective, you can pair praise and positive attention when your child is behaving nicely with ignoring or withdrawing attention when your child is misbehaving. Ignoring can be very difficult, but if your child is not hurting him/herself or someone else and it is a behavior that can be ignored safely, removing your attention can be very effective! Here are some guidelines:

• Ignore immediately
• Withdraw attention for a short period of time (around 10 seconds)
• Consistently ignore the undesirable behavior

Make ignoring obvious

Turn your body away, gaze into your phone, or lavish attention on siblings or others at the table. If your child is a bit older (5 years and older), you can make a brief statement like, “I will talk to you when you use your words and indoor voice.”

When not ignoring, make sure that the rest of your attention is very positive to reinforce any and all desired behaviors. The difference between praise and ignoring needs to be very obvious for this to work, so pile on the praise.

Be consistent

Ignoring can be hard to do consistently. It might feel like you’re not doing anything about your child’s negative behaviors because you’re not correcting it, but rest assured, you are teaching your child that inappropriate behavior doesn’t work to get your attention, but appropriate behavior does.

Just a reminder—don’t use ignoring for anything that is unsafe (e.g. hitting, running away from you).

Check blood sugar

You know your child’s patterns best and sometimes misbehavior may be related to a low or high blood glucose level. It’s always a good idea to check your child’s blood glucose level and treat as needed. Once you treat the blood glucose level, do your best to ignore any additional misbehavior. Ignoring works best when you can use it consistently.

If you have any questions or concerns, be sure to talk to your child’s diabetes care providers about diabetes and behavior. There may be psychologists or other behavioral specialists that can help tackle any behavioral concerns and find what works best for your family, your child and diabetes.

This work is funded by NIH DP3DK103998 and R01DK102561

Marisa E. Hilliard, PhD, is a pediatric psychologist and behavioral scientist whose work focuses on clinical care and research with young people with type 1 diabetes and their families. Her passion is promoting resilience, and her research focuses on how youth and families overcome the challenges of diabetes to maintain good quality of life, adhere to treatment recommendations, and have optimal diabetes control. She is especially interested in transitional times in diabetes management, such as adjusting to life with a new diabetes diagnosis, how family diabetes management shifts across childhood and adolescence and how teenagers prepare to manage their diabetes as young adults. Dr. Hilliard is an assistant professor of pediatrics at Baylor College of Medicine, in the Psychology Section of Texas Children‘s Hospital in Houston, Texas. 

Maureen Monaghan PhD, CDE, is a clinical and pediatric psychologist with a decade of experience working with youth with type 1 diabetes and their families. She is an assistant professor in the Department of Psychology and Behavioral Health and Center for Translational Science at Children’s National Health System and George Washington University School of Medicine in Washington, DC. Dr. Monaghan is an active clinician and works with youth with diabetes across the developmental spectrum, from early childhood through young adulthood. Her currently funded research examines the quality of health communication between adolescents and young adults with diabetes and their healthcare providers.

Read Counting Sheep and Getting Sleep for Young Children with T1D and Their Parents.