Growing Together: Everyday Discipline

1. Growing Together:Everyday Discipline Allie Barreiro, MD Nemours A.I duPont Hospital for Children

2. What this is… • A seminar to address principles of parenting and the struggles associated with disciplining your child • A forum to discuss tips and techniques for navigating the tough years of emerging independence

3. What this is not… • An all-encompassing guide to discipline in every situation • A one-on-one behavioral consult • A substitution for speaking with your child’s healthcare provider

4. Parenting and Discipline • Both are really, really hard. • I am not here to tell you what to do, just merely give some ideas that may make life a little easier! • Remember that although in the short term being a disciplinarian may be uncomfortable for you, in the long run you will be grateful when your child is well behaved in the future!

5. Hot Topics • Basic Principles • A Word on Development • Time Out • Tantrums • Sensible Consequences • Planned Ignoring • Rewards

6. What is Discipline? • A. Something my child doesn’t need. • B. Spanking my child when he/she misbehaves • C. Time out every time my child cries • D. Teaching your child to learn self control

7. What is Discipline? • A. Something my child doesn’t need. • B. Spanking my child when he/she misbehaves • C. Time out every time my child cries • D. Teaching your child to learn self control

8. Self Control • The most important things that will foster self-control and make discipline less painful are: • Developing your child’s self esteem • Building your child’s confidence

9. The Golden Rule of Discipline BE CONSISTENT

10. When to start? • Most experts say a child can respond to discipline techniques by 9 months of age. • This is the time they may start testing you, and will begin to understand the meaning of the word “NO.”

11. A word on Development • An important thing to consider in you discipline style is your child’s stage of development. • A 9 month old may have a different understanding of consequences than a 7 year old!

12. Development Across the Years

13. Key Principles of Discipline • Be Realistic • Anticipate and Set Rules Beforehand • Stick to Your Guns • Be Timely • Choose Your Battles • Focus on Behavior, Not Child • Stay in Control • Reward for Good

14. Sound Familiar? • “Just wait until I tell your father what you did!” • “I’m going to get the belt!” • “You are going to get a spanking when we get home”

15. Spanking • Don’t do it. • Think about how you’d like your child to behave- you are his/her role model • If you hit another adult, it is a punishable offense • It conveys the message to a child: “ I am bigger than you, and therefore it’s ok to use my strength against you” • Many of you may have been spanked and turned out ok… • But studies show children who are spanked have 50% more aggressive behavior than non-spanked kids

16. Delaware Code • “Force is justifiable if reasonable and moderate and by parent/guardian/foster parent/legal custodian/other similar person responsible for care and supervision. Force must be: -- For purpose of safeguarding or promoting welfare of child, including prevention or punishment of misconduct, and -- Intended to benefit child. Reasonable and moderate is determined in light of: size, age, and condition of child, location, strength, and duration of force. Force is not justified if it consists of: -- Throwing child, kicking, burning, cutting, striking with a closed fist, interfering with breathing, use of or threatened use of deadly weapon, prolonged deprivation of sustenance or medication, any act likely to cause or causing physical injury, disfigurement, mental distress, unnecessary degradation or substantial risk of serious physical injury or death. Criminal § 468. [Criminal Code] • …Remember how discipline is about fostering self-esteem?

17. Time Out • Can start as soon as your child understands consequences of behavior (around 9 months) • Rule of Thumb: 1 minute for every year of age • Safety is Key • Remove Yourself • Be Consistent (it may take a while to sink in) • Use Wisely • Explain Reasoning

18. Tantrums • Your child’s way of blowing off steam • Relate to control (or lack thereof), frustration • Adult examples: road rage, passive aggression, difficult technology

19. Can You Avoid Tantrums? • “Time In” • Give (perceived) Control • Give fair warning • Change it up (frequently) • Know your child’s limits • Be aware of your child’s requirements (sleep, food)

20. Dealing With Tantrums • Play it cool • Don’t resort to physical violence • Make sure he/she is safe • IGNORE • Do NOT give in • Give them time to cool off • End with a hug

21. Sensible Consequences: “The Punishment fits the Crime” Crime Punishment Your child turns your living room wall into a full on crayon mural. In the midst of Hurricane toddler your little one destroys his/her room Your child throws food at dinner time Every time you go outside, your child runs for the hills Your children are bickering in the back of the car on the way to xyz- and it gets out of hand He/she helps you clean up the wall He/she helps you clean it up He/she is excused from the dinner table No playing outside until he/she can show control “Don’t make me pull this car over—”…and actually do it.

22. To Ignore or not to Ignore… Ignorable offenses Non-Ignorable offenses • Temper tantrums (as long as they’re in a safe space) • Breath holding • Whining • Interrupting • Mismatched clothing (tutu and galoshes anyone?) • Hitting • Biting • Escaping • Foul language • Avoiding essentials (taking medicine, teeth brushing) • Lying

23. Rewards • Catch your child being good! (problem solving, cleaning up after him/herself, sharing) • Although this is about discipline, the more positive reinforcement you give your child, the more they are motivated to behave. • The younger (or more behaviorally challenged) they are, the more you may need to lay it on!

24. Rewards • Examples: • Sticker charts • Stamps • One-on-one activities • Verbal praise

25. Medical Problems That Can Affect Behavior Medical Problem Red Flags • ADHD • Autism • Oppositional Defiant Disorder • Intellectual Disability • Anxiety, Depression • Hyperactivity, impulsivity, inattention • lack of eye contact, repetitive behaviors, lack of attention seeking behavior, interest in inanimate objects • Easily loses temper, argues with adults, deliberately annoys people, angry, spiteful • Failure to meet milestones, trouble with ADLs • Excessive irritability, tearfulness, worry out of proportion to situations

26. When to Call Your Doctor • Your child is behaving aggressively or destructively on a regular basis. • You are concerned your child isn’t hitting his/her milestones • Your child is overly emotional or anxious • You think your child may have a medical problem which is affecting his/her behavior

27. Final Thoughts on Discipline • Golden Rule: Consistency is Key • Set limits BEFORE bad things occur • Catch your child being good • Make sure the punishment fits the crime • Model the behavior you want to see • Don’t resort to physical violence • Learn how to ignore- and don’t take it personal

28. Resources at Nemours • Child Behavior Consultation Clinic • Designed to help families and young children, birth to age 6, who show signs of a wide-range of developmental and behavioral concerns such as: parent-child conflict, sleep problems, toileting concerns, daycare difficulties, defiant behavior, sibling rivalry, Tantrums • ADHD Parent Child Conduct Clinic • Offers parents of children diagnosed with ADHD in-depth education about the condition and strategies to address common behavioral concerns related to ADHD. Pediatric Psychiatric Consultation Clinic • Pediatric Psychiatric Consultation Clinic offers pediatricians the opportunity to refer children and teens for consultation appointments with one of our psychiatrists. During this appointment, one of our psychiatrists will develop a treatment plan just for your child, and your child’s primary care doctor will provide follow-up medication therapy. • Behavioral Health @ Nemours: (302) 651-4500

29. Other Resources for Parents