Research In Action

I recently came across this article that questions the use of time-out as a healthy behavioral strategy. Simple messaging about time-out is not easy, but I think that there are some ideas from this article that need clarification. To start, I agree with the author that a loving and responsive connection between parents and children is a critical foundational piece of healthy child development. We, as adults, need to be mindful of what children are or are not developmentally capable of doing and maintain reasonable expectations for their behavior.

That being said, time-out strategies have a time and place when implemented in the correct or appropriate manner. I often hear from parents that time-outs simply don't work for their children. However, time-outs as a behavioral strategy can be very effective in reducing attention-seeking behaviors that are inappropriate, dangerous and injurious. 

Young children, especially those with ADHD, are highly motivated by generating adult attention, whether positive ("Great job waiting your turn!") or negative ("Why did you take that from your sister? What did I tell you about that?"). We want to teach all children that appropriate behavior is more effective than inappropriate behavior to gain adult attention.

Here are some tips on using time-out in an effective way:

• Catch your child being good. To teach that appropriate behavior will get an adult’s attention, I generally counsel parents to significantly increase their praise and attention for appropriate behavior and recommend a goal of providing positive attention at least 50 times a day (about every 5-10 minutes). Parents (myself included) frequently pay a lot of attention when our children are acting inappropriately, and, let's face it, it's pretty easy to ignore a child when they are playing quietly and cooperatively. But that's actually sending the message that inappropriate attention-seeking behaviors are effective to gain our attention. 
• Be consistent. A behavioral strategy is not going to be effective unless parents are consistent in using the strategy. That being said, putting a child in time-out multiple times a day is unpleasant for all involved and makes it harder to be consistent. I typically recommend that a parent choose the most problematic one to two specific behaviors that will lead to a time-out. All other inappropriate attention-seeking behaviors (unless safety is at risk) should be ignored during this time. Examples of a specific behavior might be throwing a toy at a sibling or kicking the table. "Not listening" is not a specific behavior and can be a confusing standard for a child and also for a parent to enforce. 
• Be on the same page. Parents and caregivers need to agree on the strategy to be fully effective. I sometimes recommend that families write down the rules which, when broken, can lead to a time-out. Decisions about behavioral strategies tend to be better when made during moments of relative calm, not in the heat of the moment.  
• Use the strategy to reduce attention seeking-behaviors. If a child is put in time-out for behaviors that are not attention-seeking (e.g., receiving a bad grade), it will not be effective and is therefore not appropriate. 
• Use a simple phrase. The time-out itself should start with a simple phrase, "You threw a toy at your sister, time-out," with the parent wordlessly leading the child to the time-out spot. Time-out means time out from parent attention, both positive and negative. A time-out should not involve negotiating, arguing, or chasing back and forth-- these are all forms of attention. 
• Make the duration age-appropriate. The duration of a time-out should be about a minute for each year of age, and the child should remain in time-out until he is able to calm down and stay calm for at least 15 to 30 seconds. I don't recommend making the child apologize to be removed from time-out. 
• Know when to discuss the behavior. After the time-out, not during the time-out, is an appropriate time to calmly discuss the behavior with the child.
• Expect that attention-seeking behaviors will increase at first. These behaviors will decrease once the child learns that the parents will no longer respond to these behaviors any more except with a time-out.

Many parents tell me that their kids "don't get it," don't seem sorry when in time-out, and therefore believe the strategy doesn't work. I remind them that time-out is not designed to make their children think and apologize for certain behaviors.

By taking them out of current activities and formally removing attention, the time-out is designed simply to send a message that an inappropriate, attention-seeking behavior will not receive attention. For time-outs to be effective, children do need to have enough language skill and some understanding of action and consequence, which is why we do not recommend time-outs for children under 2 years of age.