PORTLAND, ORE. – When time-outs don’t work, it’s often because they aren’t being done right, according to Dr. Barbara J. Howard.
Time-outs are "the best evidence-based consequence to change unwanted behavior," effective from as early as 9 months old – when some children are already hitting – and most effective between ages 2-6 years, said Dr. Howard, an assistant professor of pediatrics at Johns Hopkins University in Baltimore.
Dr. Barbara J. Howard
But parents first need to be taught how to do time-outs right, and practice them; that’s best done before they’re ever needed.
They should know that time-outs should be reserved for just a few serious offenses, such as hitting, kicking, or swearing, and that they are not a substitute for good parenting. If "the kid’s in time-out more than once a day, they are probably not getting enough positive attention for positive behaviors," Dr. Howard said at a conference sponsored by the North Pacific Pediatric Society.
Time-outs for aggressive behavior shouldn’t come with a warning beforehand. Instead, the child should get a brief statement of the offense – for instance, " ‘No hitting, hitting hurts, you’re in time-out.’ Then put [the child] in an uninteresting, but not-scary place." There should be no interaction while the sentence is served. Restraints are an option if the child squirms out of the chair, as is restarting the clock if they act up, said the pediatric developmental and behavioral specialist.
The general rule is 1 minute for each year of age, but if a child with attention-deficit/hyperactivity disorder (ADHD) is unable to sit for a few minutes, even 15 seconds can work. "Have the parent sort of watch them out of the corner of their eye. As soon as the child gives in to the fact that they are sitting there" – lets out a sigh, for example – "that’s the time to [let] them out," she said.
There shouldn’t be a discussion or lecture about what they did wrong when the time’s up. "They are so delicate when they come out of being given a consequence that they fall apart very easily, so it’s better not to talk about it at that moment because they can’t [hear] the lesson." A discussion is just likely to rekindle the situation, Dr. Howard said.
Instead, "return to the scene of the crime and distract them onto some new activity that they can be praised for. Find something positive about their behavior to talk about, or at least give them neutral attention," she said.
And "don’t ask them to apologize. First of all, are they sorry? No. So, if you force them to apologize, you are telling them to lie. That’s not good. [However,] it is appropriate for the adult to apologize to the victim" by saying something like "Oh, I’m sorry you got hurt. That must hurt a lot." The offender just might incorporate the example into their own behavior, she said.
It’s time to revisit the offense later on, after the storm’s passed. The child can be asked what they could have done differently, and given some different options. Role-playing helps.
Parents also need to know that "it’s quite common" for children to go back and do the exact same thing that got them into trouble in the first place, "but that doesn’t mean that the time-out didn’t work; the same thing is true if they get [spanked]. So you can reassure parents they aren’t crazy if they see [that time-outs are] not immediately effective. Tell them to hang in there, and expect change over time," Dr. Howard said.
Dr. Howard is the creator of CHADIS and president of Total Child Health, the management company that licenses its use.