Sticker/Star Chart

A sticker or star chart is a behavior change program that involves the delivery of a sticker or star to a child as a [Page 1055]reward for engaging in an appropriate or desired behavior. The sticker or star is typically placed on a chart that is visible to the child. The chart commonly displays descriptions of the specific behaviors that have been identified for improvement. Sticker/star charts are typically designed to increase the frequency of desired behaviors by rewarding desired behaviors that do not occur frequently enough. For example, behaviors identified for improvement might include doing chores, completing homework, remembering to brush teeth, and so on. However, sticker/star charts may also be used to decrease the frequency of undesired behaviors by rewarding other behaviors that interfere with the undesirable ones. For example, sticker/star charts might be used to reward a child for squeezing a “stress ball” rather than chewing on his or her fingernails or to reward using the toilet before bed to reduce nighttime wetting.

Stickers/stars are thought to be rewarding to children because (a) the stickers/stars themselves are attractive, interesting, or novel, (b) the stickers/stars are delivered along with praise and recognition, or (c) the stickers/stars can be exchanged for some other type of tangible reward (e.g., candy) or activity (e.g., staying up late). In addition, the chart itself may contribute to the success of the behavior change program because it may serve as a visual reminder to the child of things they need to work on and of past successes. Sticker/star charts may be effective for any or all of these reasons. Indeed, research has demonstrated sticker/star charts to be effective in increasing desirable behaviors such as appropriate social behavior, work completion, and chore completion. In addition, research has shown the sticker/star chart to be an effective behavior change program for decreasing undesirable behaviors such as thumb sucking, lip biting, bed-wetting, and soiling. Although a sticker/star chart program may be used effectively for most preschool and school-aged children (up to age 12), it is most commonly used for children under age 7 where the stickers themselves and the praise associated with delivery are often adequate for holding the child's attention and motivation. Given that the effectiveness of a sticker/star chart behavior change program depends heavily upon the stickers/star to provide the child with motivation to change behavior, older children may need for the stickers/star to be paired with other tangible rewards and privileges. As a result, once the child is above age 7, it may be beneficial to consider the use of alternative behavior change programs such as a point system.