D is for Discipline

“He is out of control, doctor,” said a mother of a 3-year-old boy who was scheduled to see me for his asthma. I looked around the room and mom’s wallet, lipstick and cell phone were all on the floor. The paper that once covered the exam table lay in crinkled pieces all over the floor. “No! No! No! Don’t throw my cell phone!” the mother screamed. “Do you see what he is doing?! He drives me crazy!” she proclaimed.

I can sympathize with my patient’s mother. I am always running after my son, Ibrahim, who wants to touch, feel, press, push and pound everything that he sees. I am constantly saying, “No, Ibrahim, don’t go there." "Don’t do that." "Don’t touch that.” However, I am not proud of saying No to a child who is just exploring his environment. Children don’t always do what we want them to do, so I make a daily promise to myself that I will work hard to be a positive, loving and supportive parent.  

It is our job as parents to show good behavior and discipline our children.

Effective Parenting

There are different styles and approaches to parenting. An effective parent raises a child who is self-reliant, self-controlled and positively curious. Research shows that parents who are too strict and who over-use punishment as well as permissive parents who rarely use punishment are NOT effective parents. Effective parents respect and trust their child to do the right thing according to the child's age and understanding. Effective parents use clear rules and explain why these rules are important.

For example, the first time your 3-year-old uses crayons to "decorate" the living room wall, discuss why that's not allowed and what will happen if he or she does it again. You can say, “Crayons are for the paper only. If you write on the wall, you will not be able to use the crayons all day." 

-Instead of saying "Don't color on the wall." use a positive sentence: "Crayons are for paper only."

-Let them know the cost of misbehaving. When you tell them the cost of misbehaving you are both making an agreement to accept the consequences. Your child is agreeing to accept their punishment (which may not really happen) and you are agreeing to enforce the punishment (which must always happen if you want your discipline to be taken seriously). Instead of using empty threats like "I won't ever let you use crayons again!" give them a realistic punishment that you will fulfill: "If you write on the wall, you will not be able to use the crayons all day."

-Follow through and be consistent. If the wall gets colored again a few days later, remind your child that crayons are for paper only and then remove the crayons from their usual location to a safe place your child can not reach. Kids are very smart and remember well. If you don't follow through on something you said you would do, they will remember and will not believe you anymore.

Children learn from experience. Having natural and logical consequences for misbehavior helps children learn that they are accountable for their actions. A natural consequence occurs when a parent does not intervene in a situation but allows the situation to teach the child. The technique is based on the old saying that “Every generation must learn that the stove is hot.” A teenager who stays up too late may suffer the natural consequences of being tired the next day. When my son emptied the whole box of crackers, he soon learned that there were none there left to eat. When you use this method, don’t give in and rescue your child (by giving another him another box of crackers like I almost did).

This was the time when my husband and I had to talk about and agree on the disciplining consequences we would use when our son misbehaved. Parents should establish the rules and be consistent. Consistency and predictability are the cornerstones of discipline. You must follow through with the punishment you and your child have agreed upon every time in order to be an effective parent. If you give in your child’s tantrum by rescuing him with a cookie, you will be buying a lot of cookies for the rest of your life.

Consequences need to be logically connected to the misbehavior or mistake. “Do not warn, threaten or moralize” says Dr. Ken West, the author of The Shelbys Need Help: A Choose-Your-Own-Solutions Guidebook for Parents. The secret of a good consequence is its logical connection to the misbehavior. If a child writes on the wall with the crayons, it is not logical for him or her to lose television rights or endure a speech. None of these responses are related to the misbehavior. Having him/her help you clean the wall, however, is both logical and educational. Some experts call this method “fix-up”. If children damage something, they need to help in fixing it or in cleaning up.

Effective guidance and discipline focuses on the development of the child.
Here are some age-appropriate methods for discipline:

Ages 0 to 2 Years

Eliminate temptations and redirect. Babies and toddlers will naturally go after jewelry and cleaning supplies left on the coffee table.Telling them No will not be effective just remove the temptation (jewelry, crayons, cleaning supplies) to a place they can't access.

Ages 2 to 5 Years

Time-Out. This is a technique that works well when a specific rule has been broken. Once your child can sit quietly, choose a time-out spot. Set a timer so that she will know when the time-out is over. When giving a time out, be calm and firm. One minute for each year of the child's age is appropriate.

Ages 5 to 8 Years

Withholding privilege. When you tell your child that if she does not cooperate, she will have to give something up she likes. If a child breaks the rule about where they can go on their bike, take away the bike for a few days.

Ages 9 to 12 Years

Natural consequences. For example, if your fifth grader's homework isn't done before bedtime, don’t make him stay up all night. If homework is incomplete, your child will go to school the next day without it and suffer the resulting bad grade.

Ages 13 Years and up

Set limits and boundaries. Give your teenage more control and freedom but still provide guidance.

If you invest your time in listening to your child, setting limits and teaching responsible attitudes though a firm but gentle disciplining approach, it will be a worth your effort. Dr. Brazelton a renowned child development expert, states that children actually look for limits and this journey you take with your child can build a foundation for the rest of their lives. Positive guidance and discipline are crucial because they promote self-control and help children make thoughtful choices. Children need our help navigating their way toward independence.

Next time I saw my patient for a follow up appointment, his asthma and his behavior had improved. He had his own toy cell phone with fun music tones. He was playing with the numbers on the phone instead of pushing mom's buttons.

This morning when my son took out all the salad dressing bottles from the side of the fridge, I got down on my knees. I started shaking the bottles and teaching him how to put them back. Discipline can be an opportunity to strengthen the child-parent bond. According to numerous studies, nurturing your child while you teach and discipline them is extremely important.  Everyday I dedicate myself to be a warm, understanding and supportive parent and pediatrician- the kind of person I want my son to become.