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Care Givers' Skills Program: (9)
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USING TIME OUT CORRECTLY FOR THE IA OR HM CHILD

Time Out is extremely popular and is recommended in numerous books. You may be asking at this point, "Well, what's new here?" A lot! What you will learn in this section is an extremely rigorous application of time out. The steps you will learn are specifically designed for IA or HM (ADD or ADHD) children to train them to think ahead, which means they will have to learn to remember at all times that their behaviour will have consequences.

Traditional practices of time out fail with IA and HM children. You may already know that. Follow the steps taught here and watch the remarkable results.

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WHAT IS TIME OUT?

Calling time out means removing the misbehaving child from all material and social reinforcement and from all negative attention. When in time out, the child gets little or zero stimulation. In other words, it is completely boring. Children dislike time out more than spanking. It is the most effective form of discipline and has none of the usual drawbacks described earlier about punishment - physical contact or pain, the adaptation effect, or side effects such as anxiety or nervousness.

Our goals are to have the child develop a good sense of what is right or wrong, to pay attention to what she is doing at all times, and to think ahead of time about how she should behave. We will be using time out not just to control a behaviour but to focus on the cognitive components of thinking and paying attention.

Time out can begin at age three, although it has been used with even younger children.

This section explains how to use time out correctly in the home. Psychological research on time out offers a wide variety of methods, but what is presented here is very rigorously designed and researched specifically for IA and HM children.

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TIME OUT RULES FOR THE IA OR HM CHILD

The more problematic a child's behaviour, the more carefully we must apply our tools to bring specific, identified target behaviours under control. Once your child is brought under control, the need to use time out will lessen considerably, and the majority of your interactions will be positive. You will also enjoy the benefits of taking your child to many places and feeling confident of his good behaviour.

The following rules are designed to teach IA and HM youngsters to think and focus on their problematic patterns of behaviour:

Use Time Out for Even a Hint of Misbehaviour

Identify each and every target behaviour that is a problem. Being comprehensive is essential for the Caregivers' Skills Program to succeed. Begin with even a hint of a target behaviour. For example, if you told Johnny to pick up his toys and he begins to turn away from his toys, say, "Go to time out!" If Joanne has a target behaviour of talking back to you (defiance) and she merely looks at you in a glaring manner, immediately say, "Go to time out!" This may seem unduly tough, but with IA and HM children the CSP is designed to allow no quarter. It is designed for them to learn that they'd better pay careful attention to their behaviour and not show the slightest sign of misbehaviour. This is a far better alternative than putting them on Ritalin or any other amphetamine. After four or five months of this extreme rigor, their behaviour should be controlled well enough that you could lighten up a bit. But if you notice the target behaviour returning, tighten up again for another four months.

One of the most important differences between the CSP and other programs is that we discipline at a hint of misbehaviour - before the child loses control.

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Choose a Suitable Environment

The environment for time out is very important. Designate a large, comfortable, overstuffed chair for time out and move it away from windows. Because children have active imaginations and can fantasize, looking out a window can be stimulating and therefore reinforce the target behaviour.

Do not turn the chair to face the wall. That is humiliating - something we do not want. And do not place the chair where people can stare at the child because that can also be degrading and humiliating. Situate the time out chair in a well-lighted place. Darkness fosters daydreaming and fantasizing in some children, which actually can be reinforcing. Also, some children might develop a fear of the dark, while others may doze off. Once they fall asleep, discipline is over. The chair is best placed in a lightly trafficked area, so you can observe your youngster periodically to make sure she is all right, not getting out of the chair, and not doing something inappropriate, such as playing. A heavily trafficked area may provide too much stimulation and may therefore be entertaining and reinforcing. In an area without traffic where youngsters can hear the observer coming, they will quickly sit up and behave. You will not be able to catch them doing anything wrong. A child's bedroom has too many things that can distract, reinforce, or stimulate active fantasizing. It is only useful for time out if all these things are removed.

The ideal place for a time out chair is in a formal living room. Even if your house or apartment does not have a formal living room, you'll probably be able to find a suitable location. Your goal is to make the area around the chair as boring as possible. Sit in the chair and pretend to be your youngster. What can you find to amuse yourself? Remove it!

Never use a bathroom for time out. Bathrooms are havens for things to play with, including things that can be dangerous.

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Avoid Reinforcers near the Time Out Chair

Competing reinforcers can neutralize the effectiveness of time out. A competing reinforcer is any object that can be played with. Clear the area near the chair of props your child may use for play or fantasy. Coasters or ashtrays can become flying saucers, paper can be folded into airplanes, pens can be rocket ships. Empty the child's pockets of playthings before time out begins, especially for little boys.

Another competing reinforcer may be a television the child can watch from a distance. Simply moving the chair a couple of feet solves that problem easily.

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Use Time Out Everywhere

Time out should be used in all situations and under all circumstances. This is essential if the parent is to help the child extend the good behaviours beyond the home environment. If children are disciplined only at home, they will learn to be well behaved only in the home. It is assumed that all parents want to be able to take their children anywhere - church, shopping, restaurants - and not be afraid the children will be disruptive.

To use time out away from home, simply designate a convenient place such as a bench in a mall, an empty table at a restaurant or a corner of a grocery store; then ask your child to come to you. Firmly whisper in his ear to go to time out. Try to do this away from observers. If you embarrass your child, you may control the misbehaviour but risk psychological and emotional scarring. If no separate place appears safe or available, you can use the back seat of your car except in bad or hot weather. For safety's sake, keep your child under careful observation at all times.

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Choose the Right Amount of Time

You want your child to lose all sense of time, so look for clocks visible from the time out chair and remove them. Sitting in a chair even for a short time without being able to keep track of how much time has elapsed can seem like an eternity. If you doubt that, sit in a chair for ten minutes. Don't look at your wristwatch; have another adult keep track of the time for you. Those ten minutes will be the longest of your life. Imagine what it must be like for a seven- or eight-year-old with a highly charged, energetic body.

You, however, must keep careful track of time. A phone call or unexpected visitor can steal your attention and cause you to forget that your child is in the time out chair. Please get a timer with a signal loud enough to alert you but not to be audible to your child in the chair. If your little one can hear it, she is warned to stop any misbehaviour and sit up correctly for your approach. We want the child behaving in the chair for the full time, not only at the end at the sound of a timer. Carry a timer / alarm with you in the event your child deserves time out outside the home, e.g. an inexpensive wristwatch with a stopwatch feature.

How long should children be in time out? Research indicates many lengths of time are effective. The figures offered here are based years of experience.

Age   

Minimum Time

3 to 4   

3 minutes

4 to 5   

5 minutes

5 to 11   

10 minutes

Remember that these are minimum times. Do not let children out earlier.

Is there a maximum time in time out? Ideally, children should stay in time out until their behaviour is perfect-sitting up and being completely quiet, no matter how long it takes. But if their behaviour is perfect at the minimum time, they may come out. If they are whining, pleading, kicking, humming, or whistling, they stay in time out until their behaviour is perfect. If the child slowly and carefully slides down in the chair, his bottom is considered out of the seat. If he stands, his bottom is considered out of the seat. He does not then get to leave time out.

If children misbehave in time out, do not let them out while acting up, even if the time limit has been reached. That reinforces the misbehaviour. Instead, when they finally sit up and behave, time one extra minute of quiet and then let them out. For example, if they misbehave for seventeen minutes and then finally sit up quietly, clock one minute of perfect behaviour and then let them out. It is crucial for the IA or HM child that you follow these instructions precisely.

For children ages five to eleven, the average time for the first day is about nineteen to twenty minutes. Within three days, almost every child behaves within the minimum time.

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Do Not Talk to Your Child While in Time Out

Never talk to your child while he or she is in time out. Do not say, "If you stop crying, I'll let you out." Any interaction reinforces whatever misbehaviour is going on at that moment in time out. Any dialogue prolongs the time you will need to get results. If you wish to discuss anything with your child, wait until he is involved in a quiet activity. The methods in this program do not preclude or interfere with talking to your children about behaviours and expectations, but do it when they are behaving well, not during a time out.

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Never Physically Put a Child in Time Out

Avoid physically putting children into time out or physically taking them out, the only exception being if your child refuses to go to time out. Otherwise, youngsters must go in and come out on voice command. Physically putting your child in the chair can reinforce the very target behaviour you are trying to extinguish.

If your child refuses to go to time out, you must have a sterner back-up procedure. Spanking is out. So you'll have to resort to putting him in physically. If the child, however, consistently refuses to go to time out, do the following: Remove all reinforcing objects from his room. I know this is an inconvenience but it is essential. Put a lock on the outside of his door. Install a one-way peephole to allow you to check on his safety. He then has a choice - either go to the time out chair or go to the room. If he refuses to go to the chair, physically put him in his room, lock the door, and follow all the same procedures as you would when using the chair. The parent must establish who is the boss. Allowing the IA or HM patterns of behaviour to continue and putting a child on Ritalin is much worse for the child. Usually the mere threat of having to go to the locked room is enough to persuade a child to go to time out.

Sometimes a child in the room will get wild and have a terrible temper tantrum. Don't be dismayed. Within a few days the tantrums not only stop but the child readily goes to the chair.

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Deal with "I Need to Go to the Bathroom"

What if your child is commanded to go to time out and replies, "I need to go to the bathroom"? If the child is younger than five, let him go to the bathroom, then go back to time out. Children five and over can hold it for eight hours at night so they can certainly wait another ten minutes until the time out is completed. If a child over the age of five has an accident while in time out, he must clean up the mess. Once he finishes cleaning up, send him back to time out and start the ten minutes over. There will unlikely ever be another accident.

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Insist that the Child Remember the Misbehaviour

When children come out of time out, they are required to tell you what they did wrong. Ask them, "Why did you go to time out?" The burden of remembering is theirs (this is crucial for the IA or HM child), so do not remind them. After they tell you, then command them to do what they were supposed to do. Unless they comply immediately, they go back to time out and the time starts from zero.

They also return to time out if they can't remember what they did wrong. Begin the timing from zero. When the youngsters emerge, ask again, "Why did you go to time out?" You will be amazed by how rapidly their memory improves after the second time out. A crucial part of the CSP is that we train children to think, that is, to remember what they did wrong. A child may feigns an inability to remember what he did wrong. Don't buy it. Be strict. This is crucial in retraining the IA or HM child.

Repeat no more than three times, however. If they still cannot tell you, then they are really confused. Simply tell them what they did and require the correct behaviour.

For three- and four-year-olds, you can be less strict. If they cannot respond, it's all right for you to tell them. But after age four, they must assume the responsibility for remembering what they did to be sent to the time out chair. Remembering requires them to think; you are now training them to fire their brain cells. When you begin to get them remembering what they should do, you too will stop believing the disease theories about ADD and ADHD and that Ritalin was necessary. You'll find that, indeed, when properly motivated with rigorous contingencies, children can function quite well.

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Respond to Misbehaving on the Way to Time Out

What should you do if your child misbehaves on the way to time out by stomping a foot on the floor, kicking a chair, or cursing under her breath? When time is up, ask why she went in the first place. If the answer is correct, ask a second question: "What did you do on the way to time out?" Usually you will see a face covered with guilt. Tell your child to go back to time out for the full time.

Then ask, "Why did you have to go to time out a second time?" Once again she must tell you what she did wrong and then perform the behaviour she was supposed to have done in the first place.

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Reinforce Correct Behaviour

No form of discipline will work if the parent does not reinforce correct behaviour. Time out will reduce inappropriate behaviour, but it will not teach the child new correct behaviours. Reinforcement - especially social reinforcement - will teach the child correct and appropriate behaviours.

As a result, when they come out of time out and tell you what they did wrong, you say, "Now give Daddy a kiss, and do what you're supposed to do." In this way they learn that you judge their behaviour to be wrong but in no way have they lost your love.

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Be Tough Consistently - Allow No Testing

Each and every inappropriate behaviour, even an approximation of an incorrect response, should be met with time out. Don't let some target behaviours go past you while using time out for others. Inconsistency confuses the IA or HM child. If you err, err on the side of toughness. A good rule is "When in doubt, use time out." This is another crucial point of the CSP in working with IA and HM children.

Children will test you, and if you fail to use time out consistently, you'll be training them to test your limits constantly. This is the exact pattern of IA and HM children. If you allow testing behaviours, your child will become confused and won't learn the boundaries of his behaviours; you'll just prolong the time necessary to get him under control. You will also extend the need to discipline your youngster and that is not fair. Inconsistency and hesitation do the child no favours.

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Don't Bargain

Do not negotiate with your child. Once you have issued the command to go to time out, you should expect it to be followed immediately. Do not listen to the plea, "All right, Mommy, I'll pick up my toys," and back down. Any surrender on your part trains your sons and daughters to test behaviour limits, i.e., how far they can go with you and how badly they can misbehave. Always remember that the sooner you get results, the sooner your interactions with your child will be positive and reinforcing and, in turn, the sooner your child will be happier. This is the kindest thing you can do for the child. Bargaining is one of the biggest mistakes parents make. If an IA or HM child learns to bargain with you, he will not find it necessary to think preventively, that is, ahead of time.

Forcing the child to behave properly also moves him to the positive point where he gets the praise he needs so desperately. You do not help the IA or HM child by being weak. Being strict does not mean being punitive. Once misbehaviours are brought under control, the primary and predominant interactions between you and your child will be positive and reinforcing. This is what IA and HM children need. Bargaining is not being strict with your child. Bargaining merely perpetuates their pattern, which is not helpful at all.

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Be Consistent with the Other Parent

Whichever parent is with the child at the time of a misbehaviour should use time out. There should not be any, "Wait until your father gets home!" This makes Mum look ineffective and Dad seem like the bad guy. If Mum fails to be consistent, then the child learns to misbehave with her - the weaker parent. Then Dad does not understand when Mum reports how bad the child has been with her, because the child is so well behaved when he is present. Sound familiar?

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Respond Early and Quickly

Some behaviours begin with what we call preparatory behaviours - the child will do something mild and get progressively worse until finally he reaches a severe target behaviour. For example, rarely does the child begin with a temper tantrum. Usually he begins with not listening to you - non-compliance. Then he talks back to you - oppositional. Then the tantrum comes. Put him in time out as soon as the non-compliance occurs. It is important that you intervene during the preparatory actions while the responses are mild rather than wait until the misbehaviour is at its peak. Again, this is a key feature of the CSP.

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Offer No Warnings

Stand firm on not giving warnings as reminders. Warning trains the child to not think. He doesn't have to attend to his own behaviour. The child becomes reliant on the parent to remind him no behave, when actually the child should do the remembering. When you provide no warning, the child must constantly be aware of his ongoing behaviours if the consequences are no be avoided.

The technique of counting "one, two, three" is a warning. This reminds the child to pay attention. All youngsters, especially IA and HM children, must remember on their own what they are to do. Yes, when you warn or correct they will comply with the correct behaviour, but five minutes later they will resume their "not thinking" pattern, which is exactly what we are combating. Getting them to think is crucial. It is not compliance with warnings that we are targeting with IA and HM children bun remembering and paying attention to their own actions. That is the core of the CSP.

Sending the child to time out immediately, with no warning and no counting, is probably the most important rule to follow in the correct use of time out. Do it at all times. Make them remember!

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Treat Siblings Equally

When your children's interactions get out of hand, send each of them to time out in different locations. Remember, when a sibling fight occurs as a target behaviour, don't ask what is going on or who started it. Usually the innocent-looking one started it and the other child had the misfortune of getting caught. The odds are that both children amply contributed to the strife, so don't worry about punishing an innocent bystander.

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Explain Time Out to Your Child

You want to prepare your child for time out, not lessen confusion about the system. Explain time out only on two occasions: the night before you start and the night after you start. Never explain it again; experience will teach it well enough. You want your child to remember the rules. When you finish explaining, ask your child to explain it back to you. Clear up any misconceptions.

Do not become dismayed by his immediate reactions to your explanation. Some children cry, some laugh, and some shrug as if they could not possibly care less. No matter how children react to your explanation, they will soon learn to hate time out.

Keep the explanation simple. Don't review each target behaviour. Otherwise, if you forget one or two you may hear: "But you didn't say that." Simply tell your child that he will go to time out for any and all misbehaviour and will stay in for exactly ten minutes (or the minimum time mentioned earlier) if behaviour is perfect while in the chair. Explain that if he misbehaves while in time out, he will stay in until his behaviour is proper and quiet.

Tell your children that they must think about what they did wrong whenever they go to time out and that they must tell you what it was when they come out. Say, "If you can't remember what you did wrong, then you will have to go back until you do remember." Do this only when explaining time out. Do not repeat this for each incident.

After the initial explanation, don't tell them to think about what they did wrong each time you use time out. Do not "remind them to remember." From the moment the rule is explained, they will be required to remember or face the consequences. This aspect is crucial for IA or HM children. Warn them about the locked room if and when they fail to go immediately to time out.

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SOME THINGS THAT MAY COME UP

Here are some common occurrences parents have brought up:

1.    Your child may start to resume old habits. If so, you are probably being lax by not reinforcing enough or letting testing behaviours slip past you. Stay alert for warning signs that your child is starting to test you. Expect testing.

2.    Spontaneous reappearance of target behaviours is likely. Don't become dismayed. Remember the rules for ignoring apply here, too. Simply enforce the time out rules, and the testing will disappear quickly.

3.    Matters will get worse before they get better. Because time out removes both social and material reinforcers, target behaviours will get worse and new misbehaviours, or new testing behaviours, will emerge. This generally gets rough for three or four days. Again, remember the process we reviewed in the discussion of ignoring? It applies here, too. If you hang on, you will see dramatic improvement by the fourth or fifth day without resorting to putting Ritalin in children's bodies.

4.    Most important of all, the key to success is love-social reinforcement for behaving correctly.

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Care Givers' Skills Program: (9)
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Acknowledgement: The content of this program is based on Ritalin Is Not The Answer: A Drug-Free, Practical Program for Children Diagnosed with ADD or ADHD by David B. Stein, PhD (Jossey-Bass, 1999 paperback) 
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