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Discipline Part 1

Nick DeBlasio MD, Solomon Behar, MD, and Mizuho Morrison, DO
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Discuss practical methods of discipline based on age.

Does discipline equal punishment?

  • No: discipline is about teaching children appropriate behavior.
  • While discipline can be about eliminating negative behaviors, it is also about reinforcing positive behaviors. 
  • Positive reinforcement can be verbal (“I’m so proud of you”) or physical (using a token economy or reward chart). 

How early can one start to discipline a child?

  • Talk about discipline with families as early as the newborn visit.
  • Good discipline starts with good relationships, which are fostered from birth.
    • setting routines in infancy (ie: feeding, changing, bathing, bed) helps set a framework for daily habits. 
    • As the child gets older, daily routines naturally help set a ground rule for a parents’ expectation of their child (play time, dinner time, bath time, homework, bedtime etc). 

In order for discipline to be effective, it should:

  1. Be consistent.
  2. Be carried out by a calm parent or caregiver.
  3. Have explicit expectations outlined from the beginning.
  4. Be developmentally appropriate (see age breakdowns below).

 

Tips for realistic discipline by age 

Infant
  • Establish a good child/parent bond.
  • Set a general routine. This a subtle way to lay out expectations.
  • This routine can be any routine at all; it can be structured or it can be laid-back.
1-2 year old
  • Redirection!
  • Positive reinforcement.
  • Natural consequences; this means that the parent does not do anything.
  • e.g. child is slamming a toy car against the wall, the car breaks (lesson learned = if I play rough with my toys they will break.)
2-5 year old
  • Time outs.
  • Positive reinforcement.
5-8 year old
  • Time outs.
  • Positive reinforcement.
  • Withholding of privileges, with younger children, make sure this is immediate.
Preteens and Teenagers
  • Expectations must be set ahead of time.
  • Withholding of privileges when expectations are not met.
  • Being consistent is key.

 

What is the most effective way to carry out a time-out?

  • As a family, decide on a few behaviors that are time-out worthy (e.g. aggression towards another sibling, not helping to clean up).
  • Pick one spot that is not entertaining and talk about this spot with the child ahead of time.
  • If the child is performing a time-out worthy behavior, give the child a warning and if the behavior continues, follow through with the time out.
  • Explain what the time-out is for (e.g. “you are going on time-out because you hit your brother.”)
  • Once the child is in time-out, do not engage the child.
  • Once the time-out is over, there is no need for a big discussion.
    • The caveat to this is if the child has engaged in a dangerous behavior; it is better to bring it up the next day in the context of a general discussion about the behavior as opposed to the event that occurred.

How long should a child stay in time-out?

  • A child should stay in time out for a minute per age; (e.g. a two year old child would have a two minute time out). This technique is best for children two to five years of age.

What is a good example of positive reinforcement?

  •  “If you sit quietly during church, we will get pizza afterwards”
  • As always, set the expectations upfront and be consistent with follow through.
  • Positive reinforcement is only positive if you do it.

What is a good example of setting explicit expectations?

  • When a parent says “please clean your room” the child may look around the room, feel as though the room is clean and therefore do nothing.
  • A better approach may be to say “please pick up all of your books and hang up all of your clothes.”
  • This way, the expectation is explicit.

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These Crazy Kids Are All Elbows and Rashes Full episode audio for MD edition 203:42 min - 96 MB - M4AHippo Peds RAP February 2015 Summary 498 KB - PDF