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Quick reference medical handouts used by Pediatric offices


Guidelines for using Time Out with Children and Pre-teens


Purpose of Time Out

Time-out means time out from positive reinforcement (rewarding experiences). It is a procedure used to decrease undesirable behaviours. The main principle of this procedure is to ensure that the individual in time-out is not able to receive any reinforcement for a particular period of time.

Time Out Area

The time-out area should be easily accessible, and in such a location that the child can be easily monitored while in time-out. For example, if most activity takes place on the first floor of the house, the time-out area should not be on an upper floor. A chair in the corner of the dining room is an excellent spot. Placing a kitchen timer on the table is a good way to keep the child informed of how much time he has left to serve.

Amount of Time Spent in Time Out

Generally, it is considered more effective to have short periods of time-out, 5 to 10 minutes, rather than to have long periods, such as half an hour to an hour. Children can fairly quickly begin to use their imagination to turn a boring activity into an interesting one. Children from 2 - 5 years old should receive a 2 to 5 minute time-out. A 6 year old child should probably receive about a 5 minute time-out while a 10 year old child would receive a 10 minute time-out. A general guideline can be: 6-8 years of age, 5 minutes; 8-10 years of age, 10 minutes; 10-14 years of age, 10 to 20 minutes. Some double the time-out period for such offences as hitting, severe temper tantrums, and destruction of property. (Note: ADHD children may benefit from shorter times than those suggested above).

Specifying Target Behaviours

It is very important the child be aware of the behaviours that are targeted for reduction. They should be very concretely defined: for example, hitting means striking someone else’s with the hand or an object, or coming home late means arriving home any time after 5:00 p.m.

Procedures for Time Out

When a child is told to go into time-out, a parent should only say, "Time-out for...." and state the particular offence. There should be no further discussion. Use a kitchen timer with a bell. Set the timer for the length of the time-out and tell the child he must stay in time-out until the bell rings. While in time-out, the child should not be permitted to talk, and the parent should not communicate with the child in any way. The child also should not make noises in any way, such as mumbling or grumbling. He or she should not be allowed to play with any toy, to listen to the radio or stereo, watch television, or bang on the furniture. Any violation of time-out should result in automatic resetting of the clock for another time-out period.

It is important that all members of the household be acquainted with the regulations for time-out, so that they will not interfere with the child in time-out in any way, for example, by turning on the radio.

Strategies for Handling Refusal or Resistance

While time-out works well, it can only work when the child actually serves the time out. There are a number of ways to handle refusal. None of them will work of all children. You may have to experiment to determine which one will work for your child.

Tell younger children that you will count to three and if they are not in time-out when you get to three the time-out will be doubled. Very difficult children, such as those with Attention Deficit Hyperactivity Disorder or Oppositional Defiant Disorder, may need to be placed on a short reward program. This could include a chart with 20 to 30 squares. Each time a child does a time-out, the child gets a star or sticker on the chart. When the chart is full they can earn a special treat for learning how to do time-out.

Use response cost. Select an activity or object you can take away. Tell the child that until they do the time-out, they will not be able to use the object or engage in the activity. For instance, you can remove the cord from the TV and tell them that they may not watch TV or play a video game until they do the time-out.

Alternatives to Time Out

Children 10 and over may decide they are "too big" for time-out because "it is for babies." Here are some other negative consequences that have been successful in reducing inappropriate behaviour. Tell the child that each time he displays the inappropriate behaviour, he will have to write sentences to remind him of how he should behave. For instance, every time you talk back you will have to write, " I will talk nicely and show respect to my parents." The first time this happens on a given day the sentence is written 5 times. If this does not help them remember then the next time the sentence is written 10 times. The number is increased by 5 or doubled (depending on the age of the child) each time the behaviour occurs on that day. The next day the first occurrence receives 5 sentences.

Remove privileges or objects that you can control. Make a list of privileges or objects (TV, ride bike, stay up late, go outside and play, etc.). Tell the child that each time the undesirable behaviour occurs, one item will be crossed of the list for that day. Each day the procedure starts over.

Advantages of Time Out

It is less aversive than other procedures, such as physical punishment. It eliminates a lot of yelling and screaming on the part of the parents. It increases the probability that parents are going to be consistent about what is going to be punished, when and how. The child learns to accept his own responsibility for undesirable behaviour.

The parents are not punishing the child; rather the child is punishing himself. The child should be repeatedly told that the parents did not put him or her in time-out but that the child put himself in time-out. The child more readily learns to discriminate which behaviours are acceptable and which are unacceptable. The child begins to learn more self-control. By keeping a written record of time-outs parents can see if the procedure is reducing the targeted behaviour. Also, reward can be tied to only receiving a certain amount of time-outs in a day or a smaller time period.

Guidelines For Parental Discipline

  • Never disagree about discipline in front of the children.
  • Never give an order, request, or command without being able to enforce it at the time.
  • Be consistent, that is, reward or punish the same behaviour in the same manner as much as possible.
  • Agree on what behaviour is desirable and not desirable.
  • Agree on how to respond to undesirable behaviour.
  • Make it as clear as possible what the child is to expect if he or she performs the undesirable behaviour.
  • Make it very clear what the undesirable behaviour is. It is not enough to say, "Your room is messy." Messy should be specified in terms of exactly what is meant: "You’ve left dirty clothes on the floor, dirty plates on your desk, and your bed is not made."
  • Once you have stated your position and the child attacks that position, do not keep defending yourself. Just restate the position once more and then stop responding to the attacks.
  • Remember that your behaviour serves as a model for your children’s behaviour.
  • If one of you is disciplining a child and the other enters the room, that
  • other person should not step in on the argument in progress.
  • Reward desirable behaviour as much as possible by verbal praise, touch or something tangible such as a toy, food or money.
  • Both of you should have an equal share in the responsibility of discipline as much as possible.

The "3 Fs" of Positive Parenting

Discipline should be:

  • Firm: Consequences should be clearly stated and then adhered to when the inappropriate behaviour occurs.
  • Fair: The punishment should fit the crime. Also in the case of recurring behaviour, consequences should be stated in advance so the child knows what to expect. Harsh punishment is not necessary. Using a simple Time Out can be effective when it is used consistently every time the behaviour occurs. Also, use of reward for a period of time like part of a day or a whole day when no Time Outs or maybe only one Time Out is received.
  • Friendly: Use a friendly but firm communication style when letting a child know they have behaved inappropriately and let them know they will receive the "agreed upon" consequence. Encourage them to try to remember what they should do instead to avoid future consequences. Work at "catching them being good" and praise them for appropriate behaviour.

This article was written by Dr. Robert Myers and originally appeared in volume 3, number 2 of the Practical Parenting Newsletter, developed by psychologist and social worker Dr. Any Gill.

 

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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