Parenting Strategies for Sick Children

Photo by Sharon Garcia on Unsplash

By Leanne Page, M.Ed, BCBA

bSci21 Contributing Writer

“Dear Behavior BFF, my kids have been sick a lot lately and their attitudes have been horrendous. I know they feel bad, but I expect them to be able to perform super basic tasks without talking back or melting down. Is there anything I can do??”

Changes in a child’s environment can totally affect their behavior. We have to take into consideration things like overall health and wellness, fatigue, major transitions or family changes, you name it. We refer to these things as setting events.

Setting events don’t necessarily trigger a problem behavior (they aren’t antecedents), but they do increase the possibility for problem behavior.

When your child doesn’t feel well, of course, they act differently. But does that mean we as parents have to tolerate major meltdowns and huge problem behaviors any time they are sick?

Our goal overall is to reinforce desired behaviors.  Catch them being good. Sometimes it feels impossible to catch them being good.  What do we do when we can’t find anything to reinforce?

When those pesky setting events start ruining your positive behavior support mojo, help your kiddos out. Help them to engage in the desired behaviors so that they can receive the positive reinforcement. Tell them what to do, show them what to do, do it with them, model the correct verbal response, whatever it takes to assist them in completing the appropriate behavior so that you can shower them with positive reinforcement.

What does this look like? Let’s compare some normal days to off-days (days when setting events in the environment are throwing off your typical contingencies or routines).

Normal day: Finish your chores.

Off day:  You need to clean up your room. I will do it with you today to get the job done faster so you can have some screen time.

Normal day: Pick up all your toys.

Off day: Pick up 5 toys. You can say “yes ma’am” or “okay”.

Normal day: Eat the dinner I made for our family.


Off day: You need to eat some food. What would you like to eat? Let’s count the bites to get you to earn a reward after you eat.

Normal day: Go find your shoes.

Off day:  Go find your shoes. You can say “Help please, yes sir, or okay”.

It feels like you’re dropping the expectations, lowering the bar. And maybe you are for a day or two or however long it takes. Be clear with your child- “I’m going to help you do these things because of _____. “ And then when the coast is clear, the setting event has passed- “I’m no longer going to help you do these things because _____ is over and I know you can handle it.”

When life gets rough, use some prompting and modeling to help your child still access that positive reinforcement. If you can’t catch them being good, then help them to ‘be good’ and reinforce those prompted behaviors.

Life happens. We can help our kids still engage in appropriate behaviors and receive reinforcement.

Suggested readings:

Bhutto, Z.H., & Siddiqui, S. (2013). Application of positive reinforcement for improving mealtime eating of a child in home setting: A case study. Journal of Behavioural Sciences, 23(1), 26-38.

Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis, 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall.

Gabor, A.M., Fritz, J.N., Roath, C.T., Rothe, B.R., & Gourley, D.A. (n.d). Caregiver preference for reinforcement-based interventions for problem behavior maintained by positive reinforcement. Journal of Applied Behavior Analysis, 49(2), 215-227.

Sulzer-Azaroff, B., & Mayer, G. R. (1991). Behavior analysis for lasting change. Holt, Rinehart & Winston.

Wahler, R. G., & Fox, J. J. (1981). Setting events in applied behavior analysis: Toward a conceptual and methodological expansion. Journal of Applied Behavior Analysis14(3), 327–338.

Leanne Page, M.Ed, BCBA

Leanne Page, M.Ed, BCBA has worked with kids with disabilities and their parents in a variety of settings for over 10 years. She has taught special education classes from kindergarden-grade 12, from self-contained to inclusion. Leanne has also managed a center providing ABA services to children in 1:1 and small group settings. She has extensive experience in school and teacher training, therapist training, parent training, and providing direct services to children and families in a center-based or in-home therapy setting. Since becoming a mom, Leanne has a new mission to share behavior analytic practices with a population she knows needs it- all moms of littles! Leanne does through her site and through her book ‘Parenting with Science: Behavior Analysis Saves Mom’s Sanity”.  You can contact her at

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