ALLIE BARREIRO, MD NEMOURS A.I DUPONT HOSPITAL FOR CHILDREN Growing Together: Everyday Discipline.

ALLIE BARREIRO, MD NEMOURS A.I DUPONT HOSPITAL FOR CHILDREN

Growing Together:Everyday Discipline

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

What this is not…

An all-encompassing guide to discipline in every situation

A one-on-one behavioral consultA substitution for speaking with

your child’s healthcare provider

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!

Hot Topics

Basic PrinciplesA Word on

DevelopmentTime OutTantrumsSensible

ConsequencesPlanned IgnoringRewards

What is Discipline?

A. Something my child doesn’t need.B. Spanking my child when he/she

misbehavesC. Time out every time my child criesD. Teaching your child to learn self control

What is Discipline?

A. Something my child doesn’t need.B. Spanking my child when he/she

misbehavesC. Time out every time my child cries

D. Teaching your child to learn self control

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

The Golden Rule of Discipline

BE CONSISTENT

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.”

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!

Development Across the Years

Age Characteristics

0-1 Curious explorers, users of the five senses

1-2 Explore more with hands, use trial and error, start to understand cause and effect are able to follow simple directions

2-7 Egocentric (world revolves around them) mentality, do not have empathy

7-11 Logical thinking develops, but everything is black or white, wrong or right (no gray zones)

Key Principles of Discipline

1. Be Realistic 2. Anticipate and Set Rules Beforehand 3. Stick to Your Guns4. Be Timely 5. Choose Your Battles 6. Focus on Behavior, Not Child7. Stay in Control 8. Reward for Good

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”

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

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?

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 ageSafety is KeyRemove Yourself Be Consistent (it may take a while to sink in)Use Wisely Explain Reasoning

Tantrums

Your child’s way of blowing off steam

Relate to control (or lack thereof), frustration

Adult examples: road rage, passive aggression, difficult technology

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)

Dealing With Tantrums

Play it coolDon’t resort to physical violenceMake sure he/she is safeIGNOREDo NOT give in Give them time to cool off End with a hug

Crime Crime Punishment 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.

Sensible Consequences: “The Punishment fits the Crime”

Ignorable offenses Ignorable offenses Non-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?)

HittingBitingEscapingFoul languageAvoiding essentials

(taking medicine, teeth brushing)

Lying

To Ignore or not to Ignore…

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!

Rewards

Examples: Sticker charts Stamps One-on-one activities Verbal praise

Medical ProblemMedical Problem Red Flags 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

Medical Problems That Can Affect Behavior

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

Final Thoughts on Discipline

Golden Rule: Consistency is KeySet limits BEFORE bad things occurCatch your child being goodMake sure the punishment fits the crimeModel the behavior you want to seeDon’t resort to physical violenceLearn how to ignore- and don’t take it

personal

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

Other Resources for Parents