Riverview Hospital Staff Manuals. Richard J. Wiseman

an activity period in terms of Visitor in Room or Game in Room.

      We will move toward a group interest savings plan. This will mean that the greater the number of dollars earned, the greater the savings to each individual above and beyond what he individually earned. For example, if the total BLEU program is averaging 10,000 BLEU dollars per week, we will notify the children that for each 10 BLEU dollars over that each child will receive one extra BLEU savings dollar. This and other schemes will attempt to encourage group contingency behaviors.

      There are actually three levels of negative consequences for maladaptive behavior:

      Level 1 is losing opportunity for earnings or savings rebate on activities.

      Level 2 is being fined.

      Level 3 is being fined and isolated, i.e. out of control.

      Any child paying for an activity and changes his mind can switch to a higher cost activity by paying the difference or to a lower cost activity but will not receive any liquid rebate. Thus, if a child chooses to have a game in his room for 4 dollars and changes his mind and wants to watch T.V. for 10 dollars, he pays 6 dollars. Conversely, if a child, having paid for T.V. at $10 wants to have a game in his room, he leaves the T.V. room and gets the game in room without paying any extra or receiving back the $6 difference.

      RISING ROUTINE

      1. Up

      a. Definition: A child will have earned his dollars if by 7:30 the child has two feet on the floor and has verbally responded to the staff member’s questions, prompts, etc.

      b. Idea: To get the children up on the right side of the bed with minimum hassle and bad feelings for all involved.

      c. Procedure: All children will be approached 3 times during the half hour and given some type of verbal prompt. For example: “Time to get up, Andy. Good morning!” On the third prompt, weep and wail some about how much the chill will miss by sleeping. If no response, lock door and go to entry into economy procedure. In many cases the verbal prompt may be accompanied by a motor prompt.

      2. Washed

      a. Definition: All children who have no “sleep” in their eyes, whose face is not greasy and who have damp hair around the temples and/or forehead will have earned their dollars for washing.

      b. Idea: To get the child to wash. To get each child to begin to take some interest in personal grooming. Once again, this should be done with a minimum of hassle for all concerned.

      c. Procedure: Once up, all children will be told to wash 3 times during the half hour. Any verbal prompt S^d such as “Wash up” or “Don’t forget to wash your face, Andy” can be used. There should be no reason for a child to receive a motor prompt for washing unless he or she does not know how to wash.

      3. Teeth Brushed

      a. Definition: Any child who gets his or her toothbrush, and whose breath smells from toothpaste and who does not have any obvious food particles in or on his teeth will receive credit.

      b. Idea: To get the child to brush his teeth with minimum hassle.

      c. Procedure: This is included as part of the wash-up routine. Thus, along with being told to wash, a child should also be reminded to brush his teeth a maximum of 3 times during the half hour.

      4. Hair Combed

      a. Definition: Any child whose hair is not tangled, snarled, matted and looks like it has been placed in a styled manner will receive credit.

      b. Idea: As with Teeth Brushing, the idea is to teach and motivate the child to look presentable.

      c. Procedure: Along with the other washing prompts, each child should also be reminded up to three times during the half hour to comb his or her hair.

      5. Dressed

      a. Definition: Any child who puts on assigned or chosen clothes in the manner for which the clothes were designed. This will include: underwear; shirt or blouse tucked in if have tails; pants; skirts; dresses, etc., all buttoned and zipped; socks on; shoes tied. All children who are dressed by the end of the period will receive credit.

      b. Idea: To have the child dressed in an appropriate manner.

      c. Procedure: All children will be provided with clothes and told to get dressed a maximum of 3 times during the half hour.

      BONUSES FOR RISING ROUTINE

      a. Complete – Any child, regardless of number of prompts who by 7:30 has completed tasks 1-5 will receive credit.

      b. Non-Prompted – Any child who completes tasks 1-5 with only one individual prompt per task will receive bonus credit.

      c. Quality Job – Any child who completes task 1-5 such that at 7:30 he or she looks wide awake, well groomed, and neatly dressed will receive credit.

      BREAKFAST ROUTINE

      6. Entry to Dining Room off Ward Payment and

      7. Quiet in Line to Dining Room

      a. Definition: Any child who is in line without pushing, shoving, yelling, running or lagging from inside the ward door until reaching the Dining Room tray area will be given credit. Children who take meds must take meds as provided to receive credit.

      b. Idea: To get the children from ward to the Dining Room in an orderly, well behaved fashion.

      c. Procedure: All children will be asked to line up at the ward door closest to the Dining Room. The line-up call will be made only twice, with at least 30 seconds between calls. Children who line up will receive the dollars that they have earned from the Rising Routine if that has not been done already. The staff member at the door (hopefully the control person) will collect payment to leave the ward. The door to the ward will be unlocked and children will proceed to the Dining Room.

      8. Breakfast

      a. Procedure: Children will pay the control person for their breakfast at the tray holder. It is the responsibility of the control person to inform the dining room staff of each child’s menu choice. The control person will collect the dollars from each child and issue meal tickets.

      Yellow Meal Ticket – Basic Menu

      Red Meal Ticket – Menu 2

      Blue Meal Ticket – Full Menu

      Yellow and Red tickets should be collected as the child receives meal. Blue tickets are collected at end of the meal.

      We will try to get plastic meal tickets with children’s pictures on them. Three colors per child, so that child can get whichever meal ticket he or she chooses.

      9. Good Table Manners

      a. Definition: Any child who eats in the dining room using appropriate utensils, having napkin in lap, eating neatly; not verbally agitating others, not leaving his or her seat without permission, and uses please and thank you as well as returning quietly back to the ward will receive credit upon returning to the ward.

      b. Idea: To have a pleasant, non-hassled meal for all concerned.

      c. Procedure: Each child will be reminded only once during each meal to use good manners as the staff member at the table deems there to be a need for such a reminder. Any child who has to be reminded more than once will not receive credit. Upon returning to the ward, each child who met the criterion will be told he or she will receive savings credit for Good Table Manners.

      Clean Up – Room Routine

      10. Make Bed

      a. Definition: Every child whose bed has two sheets and a blanket tucked in on all sides, with a spread tucked in at the bottom and folded such that the pillow is covered will receive credit for a made bed. The bottom sheet must be tucked in on all sides; the top sheet and blanket on three sides; the spread tucked in at least on the bottom.

      b. Idea: To have child make his own bed.

      c. Procedure: Upon return from breakfast, all children will be told to “Make your beds”. Each child