In addition to working as an exercise physiologist at the Children’s Hospital of Philadelphia, I have a small business called GrowingStronger, which is an exercise conditioning program for children, teens and young adults with special needs.

Many of my “athletes” fall under the autistic spectrum and I feel blessed with the opportunity to work with such awesome kids. However, I must make an out loud suggestion to some of the caregivers of these great kids. If at all possible, avoid food rewards for jobs well done.

We are all guilty of this concept. Even with our own kids, we may reward them with an ice cream or a trip to McDonalds if they are good. And as a mother, we all know that when kids know there may be a food reward, especially a kid’s choice cuisine, better behavior is often achieved. Frankly, sometimes you just need to give in, for your own sanity!

However, when we are speaking of kids, teens and young adults with chronic special concerns, food rewards have been notoriously used to instigate positive behavior in various settings which can additionally complicate their condition by adding on unnecessary weight and encourage overeating.

This idea of food rewards simulates BF Skinners, a well known psychologist (1904-1990), theory of operant conditioning. Reinforcement was seen as a central mechanism in the shaping and control of behavior.

“To be clear, while positive reinforcement is the strengthening of behavior by the application of some event (e.g., praise after some behavior is performed), negative reinforcement is the strengthening of behavior by the removal or avoidance of some aversive event.” (

Simply put, you can often reinforce a behavior by giving or taking away the rewards.

The question to most behaviorists and even parents is then “what can we replace the food reward with so that the child accomplishes the task and the caregiver is happy with the results?” As we know, each child is uniquely different and it may take a little bit of trial and error to find what works best. Popping a treat in their mouth in order to get them to perform an activity seems contradictory especially if the activity is exercise.

We, as parents, may additionally want to take this into account with the snacks that are offered after one hour of play on the soccer field. Healthier rewards, such as verbal encouragement or even high-fives may do the trick. But it may not be the only way to get positive conduct.

Sometimes a combination of intermittent snack rewards, so the child doesn’t perform only for food, along with verbal encouragement reward may be the key. And of course, the healthier the snack choice, the better.

All of us, whether we have chronic concerns or not, are alike. We all want to be appreciated for our efforts. While snacks can be an option, sometimes a simple pat on the back or even a hug will do.

Contributor Annie Linton, M.Ed, is a Pediatric Clinical Exercise Physiologist at Children's Hospital of Philadelphia, owner and program director for GrowingStronger, E-mail: She resides in Springfield.

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