How to Discipline Your Child - Part 1/2

Host: Sometimes kids act not correctly and we now know there are laws, and California is already trying to get it where you can't even spank the kid. How do you coach a child that's a little bit out of control by today's way of thinking? Steven P. Shelov: First I must be very strong that I do not believe in hitting or striking a child, it isn't appropriate and disciplined. The Academy of Pediatrics strongly says that too, and we say that in the childcare book. But what do you do with a child who is out of control, or who is difficult to manage? First of all, it is a challenge, its not easy, but we do know that hitting never was the answer either. That it gave the child the wrong message, that they would often use that technique when they interacted with their friends or others or their younger siblings. So that's just got to be off the screen. So what do you use? Well, there have been a number of techniques and approaches, mainly around the issue of limit setting, of occasionally withdrawing a child to a place with no stimulation for a certain amount of time; not a long time, but a certain amount of time. Usually if you take they are three years of age, three minutes, four years, four minutes, something like that, where they are not going to do TV and they are not going to have any kind of a stimulus. Host: Well, like a timeout. Steven P. Shelov: Yeah, and timeouts; timeouts are not easy either. The key is, in a young child, distraction works, and also avoiding the situations that the child you know is going to be difficult. If you have a really difficult child who is in a difficult period, at two let's say, you don't take them to places where they have the potential to act out; whether it's a supermarket or whether it's public spaces. You just try and figure out ways around that, or do it at times when they are not so crowded, or other things that modify it. So avoiding situations where a child is likely to act out is the first step, that's a prevention. Second is using techniques that make the child understand that that behavior is not acceptable, and if you have to withdraw the child into a quiet room or a quiet place for a couple of minutes in order to reinforce that. Then there is the need sometimes to not reward, a very definite need; not to reward when that behavior happens, and be very conscious of doing that, and not giving mix messages about rewarding things when the behavior has been outrageous. So those are the kind of mixes of behavioral interventions. Hitting doesn't work, no matter what people think. It may make your frustration go away for a moment, but very quickly afterwards, when parents hit, they feel bad, because it doesn't feel good to hit your child, and it certainly doesn't feel good to be hit. Host: Sometimes parents do dumb things, sometimes they lose the temper, and maybe they did hit their kid and maybe it gets reported in the Bureau of Child Welfare. They get very upset because somebody did that to them, but if a kid gets reported to Bureau of Welfare, you should think of it, its a good think, they are checking out a situation, and if you did something that really is terrible, to how you should have approached it, is be honest, tell them the truth. They are on your side; we hear this all the time, the reports are going left and right. Get a little de facto voice. Why can't people use the Bureau of Child Welfare to get at the other parent; it records false charges. How do they record that? Steven P. Shelov: Well, it's a very difficult series of events that occur when the ACS or Bureau of Child Welfare get involved in domestic abuses or child abuse cases. They are very important however from the standpoint of, one, they must be done. We are required to report those cases that we become aware of as physicians or health care providers. Then it's most important, and I believe that the ACS is becoming much more sensitive to, to how to use those cases, to have families change, where there is a potential for change, because no one wants to see kids hurt, and no one wants to see kids hurt certainly a second time, if it comes to the attention of the authorities. So how can we as pediatricians or how can we as parents help that? The key is to respond, support the family, make it really clear that's not acceptable. Give them alternative ways of managing their own frustrations, and dealing with the child who is difficult, or a family situation is difficult. It's not a one time fix. It's not one of those things that okay, a year ago we found this. It probably may take repeated visits to see how things are going, and discussions. It's one of those things that ACS monitors, but as pediatricians, we can play a role in helping ACS, since we know the families, and have known them from when they brought their child to us from the newborn period. So we can play an active role in figuring out how to help the families use the sort of precipitant, which was the abuse or the striking situation, as a way to grow and not make it even worse for everybody around.