When Discipline for Your Child

July 3, 2009 by  
Filed under One Person's View

badchildMichael K. Davis, MD
July 3, 2009

Frustrated parents may ask pediatricians for guidance regarding effective means of discipline.  Pediatricians are often uncomfortable addressing this complex issue due to several reasons but perhaps the main reason is a lack of time to adequately assess the issue.

The term “discipline” comes from the Latin word “disciplinare,” meaning “to teach.”  However, the term is most often associated with the concept of punishment.  A good discipline strategy involves behavior modeling, attitudes, rewards and punishments.

Why do children misbehave?

Perhaps the main reason is a lack of adequate discipline.  Kids who are tired, bored or hungry are more likely to misbehave.  Kids also misbehave to gain the parents attention, and even if the parent scolds the child, an attention-deprived child may find this parent interaction worth the punishment.  Temperment plays a role in all child behavior.  A small proportion of children may have a behavior disorder such as ADHD.  Ask your doctor about this.

Discipline strategies should be based on the child’s age.  Detailed explanations may help older children understand their punishment but are useless if the child doesn’t have the capacity to understand the explanation.  Try explaining to a 3 year old why they can’t have a cookie for breakfast!  Children less than 18 months of age are typically unable to understand any type of punishment and an overwhelming desire to explore their environment makes punishment ineffective.  Two-parent families should formulate a united front.  Opposing discipline strategies between parents only offers a child a means to exploit the differences.  “Dad can I have a cookie?”  “No.”  “Mom, can I have a cookie?”  Sound familiar?

Discipline should be clear, concise and immediate so a child learns to appreciate the cause and effect relationship.  Punishment should be a logical consequence. For example, if a child does not eat dinner, then he doesn’t get dessert.

Positive reinforcement – Perhaps even more important than punishment, is for parents to recognize and reward good behavior.  If a child cleans her room, then she gets to spend more time with Mom or Dad.  Unfortunately it is the poorly-behaved child that often gets the most attention.  A simple “Good job, son!” or “What an awesome job cleaning your room!”  is golden to a young child.  Some parents have had success using a chart on the refrigerator in which the child is awarded gold stars for good behavior.  A certain number of stars awarded for good behavior is rewarded.

Punishment is a necessary part of discipline but it must be used together with positive reinforcement.  Time-outs are a popular strategy that can be very effective when used appropriately.  Send the child to the corner of the room or next to a tree for 1 minute for every year of age.  So, a four-year-old gets a 4 minute time out.  The time-out spot should be safe, but boring.  No interaction is allowed during a child’s time-out.  Once time out is over, “time-in” should involve positive interaction between parent and child.  Time-outs are not super effective short term, but can be very effective over time when used correctly.  Time outs probably work best for kids between 18 months and 6 years of age.

Verbal scolding should only be used sparingly.  If used too much, it can cause unnecessary anxiety or excitement in the child.  A parent should model good behavior and a tirade of insults will only be copied by the child at a later time.

According to one survey of the National Family Violence Survey more than 90% of families use some form of spanking to modify child behavior.  Attention-getting, open-handed, non-injury-causing pops on the buttocks, hand or leg are generally not considered abuse in the United States.  However, while the immediate shock value may change a child’s behavior, spanking is not the most effective means of discipline.  No child should ever be struck with an object, hit hard enough to leave a mark, or shaken.

It is important to understand the developmental milestones of children when deciding when and how to apply discipline.  A child less than 2 years old should not be punished for potty-training accidents because they may not have the physical ability to control bladder and bowel function.

Source: Banks JB.  Childhood discipline: challenges for clinicians and parents. Am Fam Physician. 2002 Oct 15;66(8):1447-52.

Dr. Tummy

Editor’s Note: We would like to know what you think? dan@youngchronicle.com

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