Pediatrics Book

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DisciplineAka: Misbehavior

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  1. Causes of Misbehavior
    1. Intrinsic factors
      1. Child tired, bored or hungry
      2. Child needs greater adult attention
    2. Psychosocial confounding factors
      1. Parent divorce or separation
      2. Severe poverty
      3. Parental mental illness or Substance Abuse
    3. Associated conditions
      1. Attention Deficit Hyperactivity Disorder (ADHD)
  2. Components of an effective discipline system
    1. Positive, supportive parent-child relationship
      1. Playful and warm, affectionate relationship
      2. Respond to best behaviors with increased attention
      3. Keep consistent daily schedule and activity patterns
      4. Response to a given behavior should be consistent
      5. Listen, negotiate, and involve child in decisions
    2. Strategy for teaching and reinforcing best behaviors
      1. Examples: Sharing, good manners, empathy, studying
      2. Limit rules to a few clear, unambiguous rules
      3. Schedule special-time for one-on-one communication
      4. Listen to your child carefully
      5. Offer choices when possible and help them to evaluate
      6. Praise best behaviors frequently
      7. Consider point system to buy prizes with
        1. Win points for positive behaviors
        2. Lose points for negative behaviors
      8. Ignore trivial misdeeds
      9. Model respectful communication and collaboration
      10. Model organized and consistent behavior
    3. Strategy for extinguishing undesirable behaviors
      1. Clearly define the problem behavior
      2. Lay out in advance the consequences for that behavior
        1. Choose a strong and related consequence
        2. Explain why the consequence is related
        3. Example: withhold pens for drawing on wall
      3. Respond to behavior immediately with consequence
        1. Deal with behavior consistently each time
      4. Instruct and correct child calmly and empathically
      5. Use effective measures of discipline sparingly
        1. Time-Out
        2. Removal of Privileges
      6. Avoid less effective or harmful punishment measures
        1. Verbal Punishment (e.g. reprimand)
        2. Corporal Punishment (e.g. Spanking)
  3. References
    1. Wyckoff (1984) Discipline without Shouting, p. 8
    2. Banks (2002) Am Fam Physician 66(8):1447
    3. Stein (1998) Pediatrics 101(4 Pt 1):723

Discipline (C0237070)

Definition (NCI)Activities designed to promote appropriate behavior, conduct, or action including time out, limits, and controls.
ConceptsHealth Care Activity (T058)
EnglishDiscipline
Parent ConceptsClinical action (C0441472)
SourcesNCI
Derived from the NIH UMLS (Unified Medical Language System)



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