Thumb Sucking Plan

New! A Supplement to Rewards for Kids! – This sample reward plan is written in the same style as the plans in the book, and provides detailed guidance as to how to design a reward plan aimed at gradually reducing a child’s thumb sucking.

STOPPING THUMB SUCKING

Six-year-old Kate sucks her thumb regularly whenever she is watching television, listening to bedtime stories, first goes into her classroom, and during the middle of the night. The dentist has warned you and Kate that if she doesn’t break this habit soon, she will have a spacing problem with her permanent teeth which will require braces. You have tried reprimanding Kate each time you see her suck her thumb but she either ignores you, stops for a brief time (until you leave the room) or takes it out of her mouth just long enough to shout “Leave me alone!” But now Kate may herself have some motivation. The other day Kate came home quite distressed because a child in her kindergarten class began calling her a baby.

FIRST, TALKING ABOUT IT:

You sit down with Kate and talk about how she felt when she was teased about being a baby. You realize Kate’s probably a little anxious when she goes to school, but that’s normal. Besides, she sucks her thumb when she’s snug as a bug in bed!

“It was mean,” she says furiously. “I hate her. I can suck my thumb if I want.”

This isn’t exactly what you wanted to hear, but you do however admire her willingness not to be cowed by classmate.

“She is being mean,” you empathize. “But this might be a good time to work on stopping this habit. Dr. Small has told you many times you’re heading for lots of braces if you keep this up and braces aren’t fun.”

“But sucking my thumb feels good,” Emily says in a tiny voice.

You take her hand and hold it up gently. Her thumb has a raw red look. “This feels good?” She pulls it away. “I think you do this because it feels comforting. Kind of like how you felt when you walked around with your Teddy bear,” you say sympathetically. “But I think it would be better if we talked about what other things could make you feel cozy...”

“I’m not a baby,” she insists. You’re glad she’s still worrying about the social experience she’s just had. It’s the one that will really motivate her to stop. You’re sure of it.

“You are certainly NOT a baby” you assure her. Your schoolwork is looking so grown-up. Your letters are great and I know your teacher thinks you’re doing wonderfully. Also you’ve been remembering your own lunchbox every morning. That is VERY responsible of you.”

Kate is now beaming.

You push on. “I’ve been thinking that maybe you are ready to stop thumb sucking. I bet if we figured out a plan to stop little by little, you could do it.”

“No.” Kate says firmly. She sticks her thumb in her mouth to illustrate.

“What’s more, I think since it might feel like hard work, that you should earn some rewards for working at it.”

Kate looks up at you, now a wee bit interested. Slowly she removes her thumb. “Like what?”

THE REWARD PLAN:

You decide to go for the TICKET plan, and allow Kate to earn a ticket every time she manages not to suck her thumb for a half-hour period. You propose the following “ticket exchange” system.

• 4 tickets buy Kate’s favorite dessert
• 8 tickets buy a trip to the park
• 12 tickets buy a beach outing
• 40 tickets buy a new doll

To keep track of all those tickets you offer Kate an empty coffee can and some shiny wrapping paper. Together you tape the paper on the can, finishing the job by adding some stickers and ribbons. Voila! Her very own ticket bank…and she’s the teller! You can see Kate likes being in charge. “I choose the dessert!” she sings out, “Cookie-dough ice cream!”

Next the two of you decide which time of day would be a good time to stop thumb sucking. Kate says TV hour in the afternoon would be a good choice. “I can just hold one of my dolls and feed her while I watch,” she reasons.

“A brilliant idea,” you say approvingly. You decided to leave the classroom problem out of this. Your sense is that Kate will take care of that herself.

Almost immediately Kate starts to worry. “What if I forget though?”

“How about a Band-Aid for your thumb?” you suggest. “The minute it touches your lips you’ll remember not to suck because it’ll feel funny.”

Kate replies “A brilliant idea!” she giggles. “Can I watch TV now and try it?” she asks.

“Would you like your Princess water bottle with the straw while you’re watching TV?” you respond. (You’ve heard that sucking a straw may satisfy the same need as sucking a thumb.)

You decide to keep an eye on Kate the first few times. You sit at the kitchen table within sight of your daughter, and cut up the vegetables for dinner. Occasionally you notice Kate’s hand leave her doll and move towards her mouth, but she hastily withdraws it when the Band-Aid touches her lips. After two days of this Emily totals four half-hour periods without thumb sucking and earns the cookie-dough ice cream for dessert. You make a big deal about it during dinnertime.

After dinner you bring out the chart of rewards for inspiration. Kate decides to work towards the beach outing. For the next four days during her favorite two half-hour TV shows, she succeeds in refraining from sucking her thumb. She earns two tickets each day. Kate gets to choose which beach to go to, and again you make it a celebration. You tell Kate that you notice she’s not sucking her thumb as much at other times of the day and point out it looks a lot less raw now.

“It feels better!” she volunteers.

“You’re growing up!” you tell Kate warmly. “And so is your thumb!”

You then suggest to Kate that she might be ready to add another time period and wonder whether nightly story-time would be a good time Kate looks disconcerted and you imagine she’s thinking how cozy it is to snuggle beside you and enjoy her thumb. You propose that maybe she could hold something in her hand that would make her feel good, such as a soft blanket or warm water bottle. As you suggest this, you yourself feel a twinge of sadness as you think about your little girl growing up. But Kate is feeling a blossoming sense of pride in her self-control. To encourage her efforts, you remind her about the doll for which she has been pining. You point to it on the list.

“How long would it take?” Kate wonders.

Seeing Kate’s interest, you figure at one ticket per night, in about 13 days if she succeeds in not sucking her thumb at story-time and while watching TV she could earn the 40 tickets. You take down the kitchen calendar and underline the next 2 weeks. “Bet you can do it!” you encourage Kate.

Kate does indeed, after two weeks are up, earn the doll and at this point is rarely sucking her thumb during the day. Night-time is the only hurdle left. You wonder out loud to Kate whether she needs more than a Band-Aid on her thumb to remind her during the night since it’s easy to pull the Band-Aid off when sleeping. “What about wearing a glove or a sock on your hand?” you ask.

Kate laughs at the idea of a sock on her hand, but then worries, “What if I can’t sleep without sucking? What if I wake up and can’t go back to sleep. Then I’ll wake you up and...”

“Well, I think maybe one more reward might help?” you suggest gently. “How about if your new doll Eva gets to have her best friend Tia? I’ll tell you what, if you can get through ten nights without putting your thumb in your mouth, along will all the other times you’ve stopped thumb sucking, we’ll buy you Eva’s best friend doll!

Kate decides to try the glove.

Early the next morning, you check on her and, alas, the glove is on the floor besides the bed. Kate hears you enter, sees what’s happened and bursts into tears. “I couldn’t help it,” she sniffles. “I don’t remember doing that!”

You hug her tight and reassure her, saying everything else has come so easily. Why should such a habit she’s had for so long disappear without a struggle? She’s done beautifully so far! “Maybe, it would help though if we taped the glove around your wrist so that in order to get it off you’d have to struggle a little. That would surely wake you up enough to think and stop.”

Kate nods vigorously.

“Bet you’ll do it tonight,” you reassure her.

Kate does indeed earn the doll. She is not only thrilled, but is delighted she has broken her “baby” habit. She announces gleefully that she NEVER sucks in class anymore at all. You had a feeling that would happen.

“Still, I think I’ll wear the glove a few more nights,” she says “just to make sure I don’t start again.”

You notice there’s no reward in the offing at all. Kate it’s simply too pleased with herself to need anything else.

THE INVISIBLE REWARDS:

There really are none. The rewards are plentiful and out there. Your child feels more grown up and realizes she’s leaving herself less open to teasing. Her thumb heels, her teeth won’t be in so much jeopardy and she now has a wonderful feeling of accomplishment!

ALSO WORKS WELL:

This kind of “add-on” program works well for any habit that might take a while to break. You start small and keep adding on time and challenges until the coast is habitually clear! You might try this with: nail biting, sucking on hair, twirling hair into knots, picking at nose or scabs, snorting instead of blowing the nose, and more...

Author’s Note: I’d love to hear how this plan worked for you and your child! Please feel free to e-mail me with feedback.