Tuesday, December 25, 2012

Smarter Ways to Discipline Children

Smarter Ways to Discipline Children. By Andrea Petersen
Research Suggests Which Strategies Really Get Children to Behave; How Timeouts Can Work BetterWSJ, December 24, 2012
http://online.wsj.com/article/SB10001424127887323277504578189680452680490.html

When it comes to disciplining her generally well-behaved kids, Heather Henderson has tried all the popular tricks. She's tried taking toys away. (Her boys, ages 4 and 6, never miss them.) She's tried calm explanations about why a particular behavior—like hitting your brother—is wrong. (It doesn't seem to sink in.) And she's tried timeouts. "The older one will scream and yell and bang on walls. He just loses it," says the 41-year-old stay-at-home mother in Syracuse, N.Y.

What can be more effective are techniques that psychologists often use with the most difficult kids, including children with attention deficit hyperactivity disorder and oppositional defiant disorder. Approaches, with names like "parent management training" and "parent-child interaction therapy," are backed up by hundreds of research studies and they work on typical kids, too. But while some of the approaches' components find their way into popular advice books, the tactics remain little known among the general public.

The general strategy is this: Instead of just focusing on what happens when a child acts out, parents should first decide what behaviors they want to see in their kids (cleaning their room, getting ready for school on time, playing nicely with a sibling). Then they praise those behaviors when they see them. "You start praising them and it increases the frequency of good behavior," says Timothy Verduin, clinical assistant professor of child and adolescent psychiatry at the Child Study Center at NYU Langone Medical Center in New York.

This sounds simple, but in real life can be tough. People's brains have a "negativity bias," says Alan E. Kazdin, a professor of psychology and child psychiatry at Yale University and director of the Yale Parenting Center. We pay more attention to when kids misbehave than when they act like angels. Dr. Kazdin recommends at least three or four instances of praise for good behavior for every timeout a kid gets. For young children, praise needs to be effusive and include a hug or some other physical affection, he says.

According to parent management training, when a child does mess up, parents should use mild negative consequences (a short timeout or a verbal reprimand without shouting).

Giving a child consequences runs counter to some popular advice that parents should only praise their kids. But reprimands and negative nonverbal responses like stern looks, timeouts and taking away privileges led to greater compliance by kids according to a review article published this month in the journal Clinical Child and Family Psychology Review.

"There's a lot of fear around punishment out there," says Daniela J. Owen, a clinical psychologist at the San Francisco Bay area Center for Cognitive Therapy in Oakland, Calif. and the lead author of the study. "Children benefit from boundaries and limits." The study found that praise and positive nonverbal responses like hugs and rewards like ice cream or stickers, however, didn't lead to greater compliance in the short term. "If your child is cleaning up and he puts a block in the box and you say 'great job,' it doesn't mean the child is likely to put another block in the box," says Dr. Owen.

But in the long run, regular praise does make a child more likely to comply, possibly because the consistent praise strengthens the parent-child relationship overall, Dr. Owen says. The article reviewed 41 studies looking at discipline strategies and child compliance.

Parents who look for discipline guidance often find conflicting advice from the avalanche of books and mommy blogs and the growing number of so-called parent coaches. (In 2011, 3,520 parenting books were published or distributed in the U.S., up from 2,774 in 2007, according to Bowker Books In Print database.)

"Many of the things that are recommended we know now to be wrong," says Dr. Kazdin, a leading expert on parent management training. "It is the equivalent of telling people to smoke a lot for their health."

Parents often torpedo their discipline efforts by giving vague, conditional commands and not giving kids enough time to comply with them, says Dr. Verduin, who practices parent-child interaction therapy. When crossing the street, "A bad command would be, 'be careful.' A good command would be 'hold my hand,' " he says. He also instructs parents to count to five to themselves after giving a child a directive, like, for example, "Put on your coat." "Most parents wait a second or two," he says, before making another command, which can easily devolve into yelling and threats.

The techniques are applicable to all ages, but psychologists note that starting early is better. Once kids hit about 10 or 11, discipline gets a lot harder. "Parents don't have as much leverage" with tweens and teens, says Dr. Verduin. "Kids don't care as much what the parents think about them."

Some parents try and reason with young children, which Dr. Kazdin says is bound to fail to change a kid's behavior. Reason doesn't change behavior, which is why stop-smoking messages don't usually work, Dr. Kazdin says. Overly harsh punishments also fail. "One of the side effects of punishment is noncompliance and aggression," he says.

Spanking, in particular, has been linked to aggressive behavior in kids and anger problems and increased marital conflict later on in adulthood. Still, 26% of parents "often" or "sometimes" spank their 19-to-35-month-old children, according to a 2004 study in the journal Pediatrics, which analyzed survey data collected by the federal government from 2,068 parents of young children.

At the Yale Parenting Center, psychologists have found that getting kids to "practice" temper tantrums can lessen their frequency and intensity. Dr. Kazdin recommends that parents have their kids "practice" once or twice a day. Gradually, ask the child to delete certain unwanted behaviors from the tantrum, like kicking or screaming. Then effusively praise those diluted tantrums. Soon, for most children, "the real tantrums start to change," he says. "From one to three weeks, they are kind of over." As for whining, Dr. Kazin recommends whining right along with your child. "It changes the stimulus. You will likely end up laughing," he says.

Researchers noted that not every technique is effective for every child. Some parents find other creative solutions that work for their kids.

Karen Pesapane has found yelling "pillow fight," when her two kids are arguing can put a halt to the bickering. "Their sour attitudes change almost immediately into silliness and I inevitably become their favorite target," said Ms. Pesapane, a 34-year-old from Silver Spring, Md., who works in fundraising for a nonprofit and has a daughter 10, and a son, 6.

Dayna Even has found spending one hour a day fully focused on her 6-year-old son, Maximilian, means "he's less likely to act out, he's more likely to play independently and less likely to interrupt adults," says the 51-year-old writer and tutor in Kailua, Hawaii.

Parents need to take a child's age into account. Benjamin Siegel, professor of pediatrics at the Boston University School of Medicine notes that it isn't until about age 3 that children can really start to understand and follow rules. Dr. Siegel is the chair of the American Academy of Pediatrics' committee that is currently reworking the organization's guidelines on discipline, last updated in 1998.