Worksheet for identifying and changing behavior patterns.

This worksheet is a tool to help you change a specific behavior by following a clear plan. Since you haven’t provided the specific situation (like "cleaning my room" or "doing homework"), I cannot fill in the blanks with your personal details.

However, I can show you exactly how to fill it out using a common example: "Getting ready for school on time." You can use this example as a guide to fill in your own topic.

Here is how you would complete the form step-by-step:

Step-by-Step Guide to Filling Out the Form

1. What shall she do instead of what she's doing?
* *Think:* What is the new, good habit?
* *Example Answer:* She will get dressed and eat breakfast before 7:30 AM.

2. What should prompt it (in the situation)?
* *Think:* What signal tells her it’s time to start?
* *Example Answer:* The alarm clock ringing at 7:00 AM.

3. How often and when does it happen?
* *Think:* When is this supposed to occur?
* *Example Answer:* Every Monday through Friday morning.

4. What reward will get her attention and make it worth her while to change the behavior?
* *Think:* What does she really want? (Keep it small and immediate).
* *Example Answer:* She gets to pick the music for the car ride to school.

5. How will you document performance?
* *Think:* How will you prove she did it?
* *Example Answer:* A checkmark on a calendar on the fridge every morning she is ready on time.

6. How often will you check on her/his behavior?
* *Think:* When will you look at the proof?
* *Example Answer:* Every night at dinner time.

7. How will you measure progress/improvements? (charts/checkpoints)
* *Think:* How do you know if the plan is working?
* *Example Answer:* If she has 5 checkmarks by Friday, she met the weekly goal.

If you answered all of the above, you're ready to help your child make changes.

Before she earns the following reward:
*(Write the reward from question #4 again)*
* *Example Answer:* Picking the car music.

If this negative behavior occurs or desired behavior does not occur:
*(What happens if she fails? Usually, she loses the chance to earn the reward)*
* *Example Answer:* She does not get to pick the music; the parent picks it instead.

***

Final Answer

To complete this assignment, replace the example answers above with your specific situation. Here is the structure you need to write in the blanks:

1. New Behavior: [Write the positive action you want to see]
2. Prompt: [Write the cue or signal that starts the action]
3. Frequency: [Write when and how often this happens]
4. Reward: [Write a prize or privilege they like]
5. Documentation: [Write how you will track it, e.g., a chart or list]
6. Check-in Time: [Write when you will review the tracking]
7. Measurement: [Write how you define success, e.g., 3 stars in a row]
8. Reward Reminder: [Repeat the reward from #4]
9. Consequence: [Write what happens if they don't do it, usually losing the reward]