Pediatrics Book

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Removal of Privileges

Aka: Removal of Privileges, Privilege Withholding, Behavior Extinction, Time Out, Time-Out
  1. See Also
    1. Discipline
    2. Verbal Punishment
    3. Positive Parenting Techniques
  2. Indication
    1. Time-Out: Discipline for ages 18 months to 6 years
    2. Examples
      1. Temper tantrum
      2. Whining
      3. Yelling
      4. Fighting
  3. Background
    1. Time-Out relies on good child-parent relationship
    2. Time-in must be valuable for Time-Out to work
      1. Parent must be attentive when behavior is normal
      2. Child notices when attention is withdrawn
  4. Technique
    1. Child instructed to go to pre-assigned Time-Out place
      1. Example: Sit in chair (away from TV, games, toys)
      2. Child must be removed from problem situation
      3. Environment must be boring and safe
    2. Child stays in Time-Out for specified length of time
      1. One minute of Time-Out per year of age
      2. Set a timer for specified length of time
      3. Timer restarted if child leaves prematurely
    3. General pointers
      1. No interaction during Time-Out
      2. Do not respond to bargaining for early Time-Out end
      3. Do not verbally reprimand child during Time-Out
      4. Child should be calm for at least last 15 seconds
    4. Modifications for age
      1. Preschool: Child ignored or attention removed
      2. Older child: Remove privilege for one day (e.g. TV)
  5. Complications
    1. Initially child acts out more (e.g. temper tantrum)
      1. Do not reinforce this (do not respond)
      2. Calmly place child back in Time-Out
    2. Time-Out not effective initially (common problem)
      1. Behavior changes may take some time to develop
      2. Time-Out is very effective as a long-term strategy
  6. References
    1. Wyckoff (1984) Discipline without Shouting, p. 8
    2. Banks (2002) Am Fam Physician 66(8):1447-52 [PubMed]
    3. Stein (1998) Pediatrics 101(4 Pt 1):723-8 [PubMed]

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