The trainer may ask the child "Who goes first?" but this is the only decision the child makes. The trainer does not ask the child whether or not she wants to participate in the training. The trainer should not make any extraneous comments during the training. She should give positive reinforcement with a few short statements and non-verbal communication. The positive reinforcement is to help the child internalize the accomplishments, not to do it for someone else. If it is internally reinforced, the child is most likely to repeat the task over time. If external praise or tangible reinforcers are given too frequently, over time the child could become tired of them and have difficulty persisting in taking the medications.

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