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Discipline Part 2

Nick DeBlasio MD, Solomon Behar, MD, and Mizuho Morrison, DO

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Discussion with Sol, Mizuho & Nick regarding discipline in older kids.

In Part One, Dr. Deblasio lays down the framework for age-based discipline. In Part Two, Sol & Mizuho discuss with Nick specific challenges that parents and pediatricians face and how to approach these complex discipline issues. 

How do you handle a child who is head banging or having breath holding spells?

  • Head banging can be a normal behavior up until the age of four and for some children it can be a self-soothing behavior.
    • Remember, the frontal bone is very strong and children are unlikely to injure themselves from head banging.
  • Children usually outgrow breath holding spells by four or five years of age.
  • Episodes can sometimes be prevented by giving transition warnings.
    • For example, “we are leaving in five minutes, please get your shoes.”
      • This is in contrast to saying “we are leaving right now, get your shoes!” At this point, the child may already be head banging or starting a breath holding spell.
  • Treat head banging and breath holding spells like any other tantrum – ignore it!

How do you handle an actively tantruming child in a public setting?

  • Remove the child from the situation; children do not like “leaving the action.”
    • For example, if a child begins to throw a tantrum in the grocery store, the best thing to do is to let the people in the store know you will return but to leave the store and bring the child outside until he/she calms down.
  • Be consistent.

How do you handle siblings fighting?

  • Most sibling fighting is about who is getting the attention.
    • Therefore, make individual time for each child.

Are there any studies that evaluate discipline?

  • Literature exists with regards to spanking – and there is good literature on why one shouldn’t spank.
    • The reasons include: spanking is usually emotionally charged, inconsistent and it loses its effectiveness over time. It can also disrupt the relationship between a parent and child.
    • Several studies have shown that children who are spanked are more likely to be involved in physical fights, substance abuse and domestic violence.

With regards to spanking, when does one get concerned about physical abuse?

  • Spanking before two years of age is particularly concerning
  • If there any marks on a child concerning for physical abuse, report this to DCFS

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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