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Positive Discipline: A Guide For Parents

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Suzanne Dixon
By Suzanne Dixon M.D., M.P.H.
"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Hardly anything is of more concern to parents than the challenges of disciplining a small child. We all want our children to be well behaved, but making this happen without squelching a child's creativity or diminishing his sense of himself is difficult. I've found that discipline is one area of parenting where lots of "ghosts from the nursery" show up and cause trouble. This phrase, coined by well-known child development expert Selma Fraiberg, refers to the childhood memories, past experiences, and established patterns of thinking and behaving we all bring to the job of parenting. These ghosts can make parenting even more complicated, because sometimes we say one thing but are really feeling and thinking something else underneath.



  Teaching and Learning

  Loving Limits

  Approval Matters

  When Disciplining Doesn't Work

  Frequently Asked Questions, Answered by Our Parenting Experts

Teaching and Learning

 

"Discipline" comes from a root word that means "to teach," not to punish. Teaching children the proper way to behave, how to stay in control of themselves, and how to show respect for others should be our goal. I've found that if parents clearly plan what they want to teach and keep in mind what their child can learn based on his stage of development, then the specific strategies are easier to work out. From the kids' point of view, the simpler the message being taught and the closer the link between the action and the consequence, the easier it is to learn what's expected.


Loving Limits

 

In contrast to popular opinion, children actually like to be disciplined, but only if it is done with consistency and love. Knowing clearly what the rules are and what will happen if they're broken provides security to a child. He can relax into play and exploration because he knows where the boundaries are. The most anxious young children I have seen in my office are those who are rarely or inconsistently disciplined. These children will run around, tease, sass, hit, use bad words, or otherwise test everyone in sight as they search for the limits and look for someone other than themselves to be in charge. Having too much power is scary for a little kid. After love, discipline is the most precious gift you can give a child.


Approval Matters

 

Most children want to do what their parents want them to do. A parent's love and attention are the strongest motivators in the world, and children will work very hard to get them. Problems arise when parents pay too little attention to their kids, or when they dwell on undesirable behaviors and don't notice the good things their kids do to please them. Often a discipline issue just melts away when the parent refocuses attention on the positive and strategically ignores some of the mischievous stuff. Rewards such as treats, stickers on a chart, or a special activity can help shape behavior, but nothing is as powerful as parental approval and a child's feeling that he can do what people want of him. These internal rewards are the big ones: They prompt a child to feel proud of himself and to respond to the next challenge that life presents.


When Disciplining Doesn't Work

 

Sometimes parents ask too much of a child given his developmental level and / or the circumstances. Here are some examples I hear about regularly, along with some strategies for getting better results.

 
    • The parent's instructions are too general. Requests like "Behave" or "Be nice" don't have much meaning for a child under about 10. Be specific about what you want your child to do. Tell him to "Stop yelling" or "Give Logan's truck back to him."
 
    • The task is too big for the child. Very few young children can handle "Clean your room." Children respond better to "Pick up the blocks" or "Put your clothes in the hamper." Many smaller jobs completed successfully fuel the child for completion.
 
    • The child misses the connection between his behavior and a reward or consequence. If the consequence comes long after the "crime," a child doesn't really learn anything. For example, rewarding a 3-year-old at the end of the week for accumulated good behavior makes no sense because his memory and sense of time aren't mature enough to know what it means. The younger the child, the closer the link needs to be.
 
    • Too much is expected of the child. Very young children know that "no" means to stop doing whatever they are doing, but they can't think of a substitute if the original temptation remains at hand. For example, the VCR buttons will remain too tempting for your child unless you give him another activity away from the machine.
 
    • Too many "no's." If a child's world is just a sea of prohibitions, then he'll quit paying attention to any of them. Parents should prioritize the issues and work on one or a few at a time. I suggest starting with behaviors that endanger life and those that cause serious bodily harm or major property destruction. Battles about food are never won and those about clothes are not worth the effort most of the time.
 
    • The kid is out of gas. Don't attempt discipline when your child is tired, hungry, very upset, or stressed. You'll be more successful if you remove the child from the situation, refuel with whatever is needed (a nap, a snack, a hug), and try again.
 
    • The parent is out of gas. When you are more upset than your child is, you are unlikely to teach him anything of worth. Give yourself a timeout. Although children will and should learn that parents have emotional responses to behavior — your facial expression, voice, and behavior are all ways he judges the world's response to his actions — be careful when you feel out of control. Both you and he will be frightened by your overreaction, and you will probably regret what you say or do.
 



Frequently Asked Questions, Answered by Our Parenting Experts

 

Q: We have 18-month-old twin boys. Neither one of them allows us to brush his teeth. The older one's teeth are already starting to decay. We are giving them fluoride every day. What should we do?

A: Struggles about control are common and normal in the second year, and this sounds like a control struggle. It's important to support the boys' growing sense of independence, but I'd be firm about issues that touch on health. If you're both firm and consistent about brushing and don't get into any discussion or negotiation about it, the boys will settle into this important routine. Let them have a part of it, such as squeezing a little bit of toothpaste or choosing the color brush they use, but don't ever imply that they have a choice about brushing. The less discussion the better. Be firm on this one: Bigger struggles are yet to come. Children feel more secure if they know that there are set limits that they can count on. Conversely, they feel anxious if the rules change or seem to be negotiable or if they have too much power in the situation. — Suzanne Dixon, M.D.

Q: My 3-year-old won't stay in his car seat. He always manages to get out. Every morning we have a big fight when it's time to go to day care and I have to get to work. This is making me crazy. Help!

A: Car safety is one area where there should be no compromise and as little discussion as possible. He has to stay in the seat, so adjust it to as tight as you can make it without it being really uncomfortable. Some children who are sensitive to touch do better if you line the straps with felt or velour. Be sure that the seat is in an upright position so that your child can see out. Check to be sure that the sun isn't in his eyes; get a sun shield for the window if that is a problem. Provide an incentive for him, such as a toy that is only for the car, or maybe a tape recorder or a hand-held electronic game. Keep it in the glove compartment and get it out only when he is in his seat and quiet. Stop the car whenever he gets out of the seat, even if it is a hundred times at first. There should be a minimum of talking and a prompt readjustment of him in the car seat. He will learn if you are firm and completely consistent in this. Plan for extra time in the morning, and be sure you are rested when you initiate this new, firmer approach. Announce it the day before with minimal discussion. The other part of this may be the trouble that you both have with saying good bye in the morning. This regular struggle may come out in part because of the sadness you both feel at separating for the day. He may know that he can prolong the leaving and get intense attention, although negative, from you with this car seat hassle. Give yourselves a little more time each day and develop a brief ritual that you both can count on, one that's safer than fights in the car. Make your reunion at the end of the day special. Leave dinner and the housework until you've had time to reconnect. — Suzanne Dixon, M.D.

Q: How can I keep my 19-month-old from throwing food? When he does it repeatedly and in defiance, I usually take away his dinner and tell him he will not get anything to eat while he throws food.

A: It sounds like you're both misinterpreting his behavior and unintentionally reinforcing it. All children this age play with their food; it's one of the ways they discover how the world works. It's not an act of defiance. It sounds like you're paying extra attention to your son when he throws food. Remember that even yelling at him can reinforce his behavior because it's a way he can predictably get your attention. This leads to the two-step answer to your problem: First, pay lots of attention to your son when he's eating his food without throwing it. Tell him what a good boy he is and how big he's getting. If he throws food, make a simple statement: "We don't throw food." Then ignore him for 15 seconds. He'll quickly learn that he gets more attention by eating without throwing. — Lawrence Kutner, Ph.D., clinical psychologist

Q: My daughter is almost 10 months old. What is the correct way to discipline small children? How do I get her to not touch our things? I'm afraid that if we don't teach her now, it will be too late when she gets to the age of 2. Is this the case?

A: It's very important that your daughter touch all sorts of things. That's how she learns. You just don't want her to hurt herself or to break anything valuable. That's why the best approach to discipline at this age is environmental control. No amount of talking to a child this age will work. If you don't want her to touch your expensive crystal vase, just put it on a high shelf out of her reach. If you don't want her to fall down a flight of stairs, put up a gate. Your approach to discipline will change as your daughter matures and can understand the consequences of her actions. Just keep in mind that discipline has to do with teaching, not punishment. Rewarding your daughter for good behavior is a form of discipline. — Lawrence Kutner, Ph.D., clinical psychologist

Q: My 19-month-old daughter has started smacking me in the face and telling me "no" when I won't give her what she wants. Is this a normal thing for a toddler her age?

A: Although many toddlers lash out when they're feeling frustrated, that doesn't mean you should ignore her behavior. Tell her "No hitting!" Do not hit her back. That will only make matters worse. Remember that she's hitting not because she's angry or you've done something wrong as a parent, but because she's feeling overwhelmed. Stay calm. That will allow your daughter to regain control of herself. With some children this age who have "lost it," it helps if you wrap your arms around them for a few seconds so that they can't hit anyone. It may also help sometimes to distract her when you see her getting worked up. As your daughter grows older, she'll feel more in control when she's struggling with strong emotions. — Lawrence Kutner, Ph.D., clinical psychologist

Q: I have an 18-month-old boy who has started hitting other kids quite a bit. He doesn't do it hard enough to really hurt. It is really his way of getting negative attention from me. I have no idea how to handle this. How do I react when we are in public and he walks up to a stranger and hits him / her? I have an older child, so it just doesn't work out that we can leave the situation because it isn't fair to my 2-year-old. Please help! I'm really stuck.

A: Your situation sounds very frustrating, though not at all uncommon, since many children around 18 months old communicate their feelings physically. As you rightly suggest, he is also probably asking you for your attention to be directed to him (though he doesn't think of it as "negative attention"). Children his age think in a very egocentric way — everything happens because of them, and they can only think about anyone or anything from their own point of view. This is not selfishness, it's just the limit of how they view the world. Try making a show of noticing when he communicates without hitting. Positive reward for acceptable behavior teaches better than negative consequences for bad behavior. Don't put him into social situations when you know he's about ready for a nap or is too hungry to hold himself calmly. And try to spend some time each day alone with him when you can give him your full attention as you play together. Model for him how to touch gently when you or he wants to express positive feelings toward someone. Hang in there. Soon he'll develop language that he'll find helps him communicate much more effectively. — Peter A. Gorski, M.D.

Q: My son is 14 months old and if he doesn't get what he wants, he throws a terrible tantrum, throwing himself on the ground or swatting at whoever happens to be close. Help! What can I do to break him of this terrible behavior?

A: Those tantrums that you describe sure can test the patience of any caregiver. For the 14-month-old child, however, they are about the best way he has to let you know that he's determined to enjoy something, eager to stop what he's doing, or feeling hot or cold or hungry or full, bored, tired, or rarin' to go. As language develops over the next six months or so, your child will be able to express his needs and interests more diplomatically. For now, first satisfy yourself that he is not in danger, then scoop him up and playfully distract him with a sing-song style of reassuring words and alternative activity. Know your own limits, too! If you're out of gas (and wishing you could throw a tantrum yourself), find someone you trust to lend a hand with your child. I wonder, by the way, if your boy might be an excitable, dramatic personality by nature. If so, he's probably just as boisterous when he's laughing with joy. He's the type who, in time, can funnel his intensity into great leadership skills and great efforts to be successful. — Peter A. Gorski, M.D.

Q: My 23-month-old son just spent two months with his grandparents, who spoiled him with attention. Now he wants attention all the time and has to have his way. When we take a stand, he throws himself on the floor and ends up hitting the back of his head. We can't let him ride it out because his tantrums seem never-ending. Should we get him evaluated by a child expert, or is it just part of the terrible twos?

A: Your son is going through a normal phase of growing up. It's quite common for children his age — and even older — to throw temper tantrums because they are frustrated. Once he develops better verbal skills, the tantrums will naturally decrease. When your son does throw a tantrum, it's important that you prevent him from hurting himself. Try picking him up, taking him to a safe place, and then talking to him calmly. Whatever you do, don't give in to his demands, or he'll quickly learn that he can get what he wants through tantrums. It sounds like your child is testing his — and your — limits, and you're caught in a vicious circle. He demands your attention. Because you fear that you're spoiling him, you hold back. He gets frustrated and begs for more. You both end up upset. Instead, try giving him lots of attention — cuddle, play, and talk — so that he feels safe and secure. If you hold back, he'll just want more. Once he has that extra safety, he'll become less demanding. You may even find that you spend less time paying attention to him this way than when you were battling each other. Hopefully, you will all feel better and the number of temper tantrums will diminish. — Lawrence Kutner, Ph.D., clinical psychologist

Q: My daughter is 22 months old and still nursing. She nurses only two to three times a day when we're at home, usually before bed and naptime. The problem is she asks (sometimes quite loudly) to nurse when we're out in public. Do you have any suggestions? Is she too old to continue nursing?

A: I'm sure you could get many different replies to your question. In some cultures, children nurse much longer than they typically do in this country. I sense, since you asked the question, that you are uncomfortable with your daughter's requests, especially in public. At her age, it would be reasonable to tell her you nurse only at home now. If she needs a drink, get her something in a cup or carry one with you. Toddlers often make many demands — that's one of their ways of showing their independence. But parents need to constantly set limits, often for safety's sake. It's okay to say no and try to redirect their attention to get their mind off what it was they were demanding; if you're consistent, they usually come around. If you still enjoy nursing her at home before sleep times, continue to do so. If you are ready to wean her, offer her a drink from a cup, read a story, have a hug or two, and put her down. If she asks to nurse, tell her she's drinking out of a cup now. If it's possible, have her dad put her down at bedtime to change the pattern. It may take some time since she's been used to this for almost two years, but she'll adapt to a new routine before long. Good luck! — Linda Jonides, P.N.P.

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