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Behavior Modification

Probably most parents have said something along the lines of "If I had a quarter for every time I told (enter your child's name) to stop doing (enter annoying discipline problem) then I would be rich!"  The word discipline is from a Latin word meaning "to teach"; but especially for young children, the lessons have to be taught many, many times.  The behavior challenges our children face and the techniques we use change over their childhood, but some basic principles hold true.

For children, one of the most motivating and rewarding aspects of their lives is their parents' attention and praise.  This fact provides us with a powerful tool.  The attention and praise we give to good behavior and habits helps reinforce to our children to do more of that behavior.  On the flip side, ignoring and not giving too much attention to bad behaviors, especially whining and temper tantrums, can help to decrease how often our children do these things.  Psychologists refer to this as "selective attention and strategic ignoring".   Another way to state it is "catch them being good".

Using praise and attention alone can often be enough to ensure good behaviors are repeated.  Praise is most useful when it is really specific, for example "I love it when you share your toys with your sister like that".  Small tangible rewards, such as a sticker or a few M&Ms, can work magic for younger children while allowance or extra privileges are powerful motivators for older children.  Of course, if it was that easy, child psychologists would probably be out of work.  So for bigger challenges, a very specific set of rules with a goal or "target behavior" for your child to meet might be required.  Having a very clear way of showing this goal and the rewards they can earn, like in a sticker chart for small children or in a written "contract" for older children, keeps everyone on the same page.

Unfortunately, negative consequences, or punishment, are often necessary when children break major rules or behave unsafely.  The AAP and the providers of PAMPA discourage the use of corporal punishment.  When used very often or with excessive force, this kind of physical discipline has been associated with long term behavioral problems into adulthood.   Most families are very familiar with the use of "time-out" and with taking away toys, treats or privileges.  When used consistently and with the opportunity for your child to earn privileges/toys back with good behavior, these techniques can be very effective.  Consistency is key; your child needs to know the rules and know that you will follow through on the consequence.

Time- out is a great technique that can be started as young as 15 months.  Time-out works because your child is removed from the situation causing the conflict and also removed from any fun.  In order for it to work, the time-out spot should be quiet, free of toys, and your child should not be able see/hear the TV or other fun.  You should not talk to your child until time-out is over; even scolding while in time-out is a form of attention and takes away from the boredom that makes time-out work.  In general time-out should last as many minutes as your child's age.

The providers at PAMPA are happy to discuss discipline challenges or concerns with you.  Many of these issues can be briefly addressed during a routine visit.  For a more long-standing or complicated behavior challenge, we ask that you call and request a consult visit so that we can dedicate the time required to this concern. Our website bookstore lists some recommended books on parenting and discipline as well.

Submitted by Tamara Nix, M.D. 


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PAMPA is a pediatric medical practice in north Atlanta, Georgia consisting of twelve pediatricians, five nurses,
and four locations in Roswell, Woodstock, Atlanta, and Marietta. area.
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