Riverview Hospital Staff Manuals. Richard J. Wiseman

OWN WITHOUT PAYING:

      Any child who enters another child’s room without paying or permission from a staff member will be fined.

      STEALING:

      Any child who takes anything which is not his or which is not supposed to be used at that moment or which he does not have permission to have will be fined. This is especially true of others’ dollars or belongings or things taken from the Nurses’ station. Stealing also includes taking part in an activity for which the child did not pay.

      SWEARING:

      Any child who uses any of the traditional Anglo-Saxon off-color words will be fined per word. All derogatory words, slang expressions and variations, including gestures, will be fined. Including: Hell, Damn, Fuck, Shit, Bastard, Goddamn, etc.

      FINE PROCEDURES

      IDEA:

      To stop the immediate incident and decrease its probability of re-occurrance. To clearly communicate to the child that he or she has been fined, the exact reason for the fine, the amount of the fine and that the behavior should stop. To do this in a business-like, non-challenging, non-punitive, non-sarcastic, but firm manner.

      PROCEDURE:

      Staff will cite infraction, amount fined, and ask child to stop any fined activity. For example, “David, you hit Joey. Stop hitting him! You are fined 20 dollars.” If the child stops, the staff will issue a fine slip, take the dollars from the child and give the child instructions to take part in the (an) ongoing activity. If the fine reduces a child to ground zero, then ground zero procedures will be followed.

      If the fine procedure does not stop the behavior, a second fine can be given. If that does not stop the behavior, the Beyond Fine procedure should be followed.

      RULES:

      1. Always fine liquid assets first, then savings.

      2. No child can ever be placed in a debt situation. A child can only be fined to zero liquid and savings assets.

      3. As soon as a child has no liquid assets, he is considered to be at ground zero. (See below.)

      DAILY ENTRANCE INTO THE SYSTEM:

      Any child who is not up (see definition for getting up) by 7:30 will not take part in the token economy that morning. His door will be locked at 7:30 and the child will be ignored until 12:00. At 12:00 a tray with Basic Lunch Meal #1 will be placed in the child’s room and the door relocked. The child is approached again at 7:00 a.m. the next morning. If the child refuses to get up and enter the system a second day, the same procedure is followed. If the child refuses to enter the system, a third day, the procedure is followed again. Every time a child refuses to enter the system three times, a case specific decision will be made by the staff.

      As noted above, a child who refuses to enter the system by not getting up will receive lunch, dinner and a bed during the time he is out of the system. He will not receive breakfast simply because he slept through breakfast! Child will be allowed access to bathroom during meals, but this should be the bathroom off his room. There should be a minimum of contact and bathroom should be locked after meal.

      GROUND ZERO:

      Definition – Any child who has entered the system, but due to fines, poor behavior, etc. has no liquid assets, will be considered to be at ground zero. If the program is at a point where no liquid assets can be earned, the child will be asked if he or she wants to earn. If the child says yes, he is presented with the list of make-up activities and asked to choose an activity. Upon completion of the task, the child is given his dollars and can buy any activity for which he has enough dollars. A child will continue in a make-up activity until either he has completed the activity and has liquid assets or until the ward program allows an opportunity to earn dollars. At the completion of a make-up activity, the child can cash in for one of the make-up rewards or save the dollars for another activity.

      If a child has no liquid assets and the group schedule does not allow for earning and the child refuses to do a make-up activity, he or she is placed in his or her room and the door is locked. The child is approached every 1/2 hour and asked: “Are you ready to earn?” If the child says yes, he then either chooses to do a make-up activity or he joins the schedule, assuming that there are earning opportunities. If there are no earning activities, a child can only choose a make-up activity. If the child chooses not to earn, his door is relocked and he is approached again 1/2 hour later.

      Come meal times, or bed time, any child who is still at ground zero will be provided Basic Meals and a mattress. The only difference between ground zero and not entering the economy is that at ground zero the child will be approached every 1/2 hour and asked if he is ready to rejoin the economy. Basic Menus and Mattress with betting will be provided.

      MAKE-UP ACTIVITIES

      Any child who is at ground zero is allowed to earn during those periods when no earnings are possible by choosing and completing a make-up activity.

      Make-Up Activities:

      1. Homework – Per assignment correct with a score of 80% or better $4

      2. Ward Jobs

a. Wash out showers, baths, toilets	2
b. Hop Long Hall	2
c. Sweep Long Hall	2
d. Mop and sweep office	2
e. Wash doors and walls in room	2
f. Wash doors and one side of walls in long hall	2

      3. Calisthenics

a. 20 jumping jacks	)
b. 10 sit-ups	)
c. 4 push-ups	)	Within 10 minutes	2
d. 30 toe touches	)
e. 20 deep knee bends	)

      A child can only earn 10 at any given time and must return to ground zero to start earning make-up again. For any spending done with make-up, there will be no savings. A child can only do make-up activities while there is no possibility of earning available. Once the ward schedule affords the opportunity of earnings, the child must stop the make-up activity and earn the dollars offered by the schedule.

      OUT OF CONTROL – BEYOND FINES

      IDEA:

      To help the child regain control and reenter the system as soon as is possible; to minimize damage to the child and people the child is in contact with; to minimize interaction, which may be reinforcing, with the child until child is back under control.

      PROCEDURE:

      If a child has been fined twice and is still continuing his or her negative behavior, the child will be told “You are out of control. You are going to the Quiet Room.” WITHOUT SPEAKING to the child, the staff member or staff members escort the child to the Quiet Room (QR) with whatever firmness is necessary. The child is to remain in the QR for a 15 minute base period and then three consecutive minutes of quiet.

      When the child is quiet for the three minutes, he will be removed from the QR. If there is an earning activity, the child will be asked to join the activity. If there is a spending activity in progress, the child can if he has enough dollars to buy into or back into an activity, he may do so, but loses all possible savings available for successful completion of that activity. If the child does not have enough liquid assets to buy into the activity, he goes to his room. If a child is placed at ground zero due to the fine, he can do make-up activities.

      Upon leaving the QR, the child will be informed of the fines he has accrued.

      RULES:

      1. A child will only be placed in the QR for being out of control.

      a. A child is considered out of control only after he or she has been fined twice over the same