Clinical Reference Systems: Pediatric Advisor 10.0
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Time-out consists of immediately isolating a child in a boring place for a few minutes whenever she or he misbehaves. Time-out is also called quiet time, thinking time, or cooling-off time. Time-out has the advantage of providing a cooling-off period to allow both child and parent to calm down and regain control of their emotions.

Used repeatedly and correctly, the time-out technique can change almost any childhood behavior. Time-out is the most effective consequence for toddlers and preschoolers who misbehave--much better than threatening, shouting, or spanking. Every parent needs to know how to give time-out.

Time-out is most useful for aggressive, harmful, or disruptive behavior that cannot be ignored. Time-out is unnecessary for most temper tantrums. Time-out is not needed until a child is at least 8 months old and beginning to crawl. Time-out is rarely needed for children younger than 18 months because they usually respond to verbal disapproval. The peak ages for using time-out are 2 to 4 years. During these years children respond to action much better than words.

CHOOSING A PLACE FOR TIME-OUT

• A time-out chair

  When a chair is designated for time-out, it gives time- out a destination. The chair should be in a boring location, facing a blank wall or a corner. Don't allow your child to take anything with him to time-out, such as a toy, pacifier, security blanket or pet. The child shouldn't be able to see TV or other people from the location. A good chair is a heavy one with side arms. Placed in a corner, such a chair surrounds the child with boundaries, leaves a small space for the legs, and reduces thoughts of escape. Alternatives to chairs are standing in a particular corner, sitting on a particular spot on the floor, or being in a playpen (if the child is not old enough to climb out of it).

  Usually the chair is placed in an adjacent hallway or room. Some children less than 2 years old have separation fears and need the time-out chair (or playpen) to be in the same room as the parent. When you are in the same room as your child, carefully avoid making eye contact with the child.

• A time-out room

  Children who refuse to stay in a time-out chair need to be sent to a time-out room. Confinement to a room is easier to enforce. The room should be one that is safe for the child and contains no valuables. The child's bedroom is often the most convenient and safe place for time-out. Although toys are available in the bedroom, the child does not initially play with them because she is upset about being excluded from mainstream activities. Forbid turning on the radio, stereo, or video games during time-out in the bedroom. Avoid any room that is dark or scary (such as some basements), contains hot water (bathrooms), or has filing cabinets or bookshelves that could be pulled down on the child.

• Time-out away from home

  Time-out can be effectively used in any setting. In a supermarket, younger children can be put back in the grocery cart and older children may need to stand in a corner. In shopping malls, children can take their time- out sitting on a bench or in a restroom. Sometimes a child needs to be taken to the car and made to sit on the floor of the back seat for the required minutes. If the child is outdoors and misbehaves, you can ask him to stand facing a tree.

HOW TO ADMINISTER TIME-OUT

• Deciding the length of time-out

  Time-out should be short enough to allow your child to have many chances to go back to the original situation and learn the acceptable behavior. A good rule of thumb is 1 minute per year of age (with a maximum of 10 minutes). After age 6, most children can be told they are in time-out "until you can behave," allowing them to choose how long they stay there. If the problem behavior recurs, the next time-out should last the recommended time for their age.

  Setting a portable kitchen timer for the required number of minutes is helpful. The best type ticks continuously and rings when the time is up. A timer can stop a child from asking the parents when he can come out.

• Sending your child to time-out

  Older children will usually go to time-out on their own. Younger children often need to be led there by their wrist, or in some cases carried there protesting. If your child doesn't go to time-out within 5 seconds, take her there. Tell your child what she did wrong in one sentence (such as, "No hitting"). If possible, also clarify the preferred behavior (such as, "Be kind to George"). These brief comments give your child something to think about during the time-out.

• Requiring quiet behavior in time-out

  The minimum requirement for time-out completion is that your child does not leave the chair or time-out place until the time-out is over. If your child leaves ahead of time, reset the timer.

  Some parents do not consider a time-out to be completed unless the child has been quiet for the entire time. However, until 4 years of age, many children are unwilling or unable to stay quiet. Ignore tantrums in time-out, just as you should ignore tantrums outside of time-out. After age 4, quiet time is preferred but not required. You can tell your child, "Time-out is supposed to be for thinking, and to think you've got to be quiet. If you yell or fuss, the time will start over."

• Dealing with room damage

  If your child makes a mess in his room (for example, empties clothing out of drawers or takes the bed apart), he must clean it up before he is released from time-out. Toys that were misused can be packed away. Some damage can be prevented by removing any scissors or crayons from the room before the time-out begins.

• Releasing your child from time-out

  To be released, your child must have performed a successful time-out. This means she stayed in time-out for the required number of minutes. Your child can leave time-out when the timer rings. If you don't have a timer, she can leave when you tell her, "Time-out is over. You can get up now." Many parents of children over 4 years old require their children to be quiet at the end of time-out. If a child is still noisy when the timer rings, it can be reset for 1 minute.

BACK-UP PLANS

• The younger child who refuses to stay in time-out

  In general, if a child escapes from time-out (gets up from the chair or spot), you should quickly take the child back to time-out and reset the timer. This approach works for most children. If a child refuses to stay in time-out, the parent should take action rather than arguing or scolding the child. You may temporarily need to hold a strong-willed, 2- or 3-year-old child in time-out. Holding your child in time-out teaches your child that you mean what you say and that he must obey you. Place your child in the time-out chair and hold him by the shoulders from behind. Tell your child that you will stop holding him when he stops trying to escape. Then avoid eye contact and any more talking. Pretend that you don't mind doing this and are thinking of something else or listening to music. Your child will probably stop trying to escape after a week of this approach.

  A last resort for young children who continue to resist sitting in a chair is putting them in the bedroom with a gate blocking the door. Occasionally a parent with carpentry skills can install a half-door. If you cannot devise a barricade, then you can close the door. You can hold the door closed for the 3 to 5 minutes it takes to complete the time-out period. If you don't want to hold the door, you can put a latch on the door that allows it to be temporarily locked. Most children need their door closed only two or three times.

• The older child who refuses to stay in time-out

  An older child can be defined in this context as one who is too strong for the parent to hold in a time-out chair. In general, any child older than 5 years who does not take time-out quickly should be considered a refuser. In such cases the discipline should escalate to a consequence that matters to the child. First, you can make the time-out longer, adding one extra minute for each minute of delay. Second, if 5 minutes pass without your child going to time-out, your child can be grounded. "Grounded" is defined as no TV, radio, stereo, video games, toys, telephone access, outside play, snacks, or visits with friends. After grounding your child, walk away and no longer talk to her. Your child becomes "ungrounded" only after she takes her regular time-out plus the 5 minutes of penalty time. Until then, her day is very boring. If your child refuses the conditions of grounding, she can be sent to bed 15 minutes earlier for each time she breaks the grounding requirements. The child whose behavior doesn't improve with this approach usually needs to be evaluated by a mental health professional.

PRACTICING TIME-OUT WITH YOUR CHILD

If you have not used time-out before, go over it with your child before you start using it. Tell your child it will replace spanking, yelling, and other forms of discipline. Review the kinds of negative behavior that will lead to placement in time-out. Also review the positive behavior that you would prefer. Then pretend with your child that he has broken one of the rules. Take him through the steps of time-out so he will understand your directions when you send him to time-out in the future. Also teach this technique to your babysitter.

CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:

• Your child hurts himself during time-out.
• Your child runs out of the house to avoid time-out.
• Your child has to be kept in her room with the gate up for time-outs for more than 1 week.
• Your child needs his door closed and locked at night for more than 1 week.
• Your child refuses to take time-outs despite being grounded for 3 days.
• Your child refuses to cooperate with time-outs after using this approach for 1 month.
• Your child has many other behavioral problems.

For more information, see

What to Do When Time-Out Doesn't Seem to Be Working