Time Outs: Helpful or harmful? Here’s what the research says

Pediatricians and researchers commonly recommend that parents use time outs when kids misbehave.  Time outs are promoted as an effective, evidence-based parenting strategy - although the real reason they’re so highly recommended is that they cause less damage to children than hitting. But if we’re already using respectful/gentle parenting strategies most of the time, could there be any benefit to adding time outs when our children don’t comply with more gentle methods? This episode delves into the research on:

• Which children and families researchers think time outs are effective for (it’s not the same group of children who are usually study participants!);
• The precise time out script that has been shown to be effective (and why it works);
• Whether time outs harm children or not (this is one of the biggest controversies in the Gentle Parenting world)

If you’ve heard that time out is an effective strategy to gain children’s cooperation but weren’t sure whether it fits with your Gentle Parenting approach, this episode will help you to decide for yourself whether it’s a good fit for you and your family.   Other episodes mentioned:

Episode 154: Authoritative is not the best parenting style

Episode 148: Is spanking a child really so bad?

Episode 072: Is the 30 Million Word Gap Real: Part II

Episode 066: Is the 30 Million Word Gap real?

  Jump to highlights: 00:03 - Introduction 10:23 - Historical context and research on timeouts 17:26 - Critical analysis of timeout research 28:36 - Effective implementation of timeouts 33:59 - Challenges and limitations of timeouts 41:49 - Jen's personal experiences and emotional impact 49:29 - Alternative perspectives and values 57:39 - Conclusion and next steps   [accordion] [accordion-item title="Click here to read the full transcript"] Kelly 00:03 Hi! This is Kelly Peterson from Chicago, Illinois. There's no other resource out there quite like Your Parenting Mojo, which doesn't just tell you about the latest scientific research on parenting and child development, but puts it into context for you as well, so you can decide whether and how to use this new information if you'd like to get new episodes in your inbox, along with a free infographic on 13 reasons your child isn't listening to you and what to do about each one. Sign up at your parenting mojo.com/subscribe if you'd like to start a conversation with someone about this episode, or you know someone who would find it useful, please do forward it to them. Thank you so much. Jen Lumanlan 00:55 Hello and welcome to the Your Parenting Mojo podcast. Before we get started today, on our topic of time outs, I wanted to share a few words from a listener who's also been in both of the parenting and the learning memberships. She read my book parenting beyond power when it came out over a year ago, and I only just got around to asking her permission to share her thoughts on where the book ranks compared to the 100 or so other books that she's read. Here's Theresa. Theresa 01:20 I've just finished your book. Amazing, really good. It was really like, yeah, and I'll describe it. I was like, I read it, and I was like, yay. It's like, all there in this really neat book. And I could just, like, refer back to the book, because it's like, you know, you managed to, like, funnel it all into a really and really easy to read. And really, what's the word, like reference. Like a reference. I want to just check that thing was that page, and you're like, Oh yeah, that was that bit. And, like, little scripts. It was, Yes, super helpful. I was gonna say, like, I've read probably I'm embarrassed about this or proud of this, but I've probably read over 100 parenting and yours rates up there like top five, top five. Jen Lumanlan 02:04 Thanks so much for the kind words Theresa. Parenting beyond power is available in local bookstores, on Amazon and in audio book format, so you can even hear me read it to you. Now. Let's hear from listener, Melissa, who asked me a question about time outs. Here's Melissa, Hi, Jen, Melissa 02:21 I have a question about timeouts. So my understanding is that timeouts are not great because timeouts are punitive and they're socially isolating, and they're often used when a child is dysregulated and the child actually needs connection and understanding. But then I read a blog post by Dan Siegel, who authored the whole brain child, and he alludes that there may actually be a potentially appropriate use of timeouts when used as part of an intentional parenting strategy. So I'm a little confused. I'd like to know if there is such a thing as a good and appropriate use of timeout, especially for things like misbehavior, rather than in response to emotions or tantrums, and is there a way of using a timeout that is effective? It might actually be an appropriate strategy in the respectful parents toolbox. Thank you so much. Jen Lumanlan 03:12 What an interesting question to explore. So let's break down the elements of Melissa's question so we can address them one by one. In this episode, we'll look at whether there is a way of using timeout that is effective, which will become an entry to thinking about the origins of timeout and the research available on it. We'll also look at a related topic, which is whether timeout is harmful in any way to our kids. I tried really hard to fit everything into one episode, but I couldn't compress it enough to make it listenable. So in our next episode, we'll look at using timeout in incidences of misbehavior rather than in response to emotions or tantrums, as well as the last part of the question about whether timeout can ever be an appropriate strategy in the respectful parents toolbox. Before we dive into the first formal question, let's just make sure that we're on the same page about what timeout is, because it's described very specifically in the research. Researchers define time out as, "the contingent withholding of the opportunity to earn reinforcement. It consists of time away, usually for one to five minutes from rewarding stimuli, including attention from the parent as a consequence of some form of misbehavior, parents learn a simple routine that requires the child to have conned or settled before being allowed to rejoin the rewarding activity that they've been removed from." Sounds so simple, right? The name time out is a shortened form of the phrase time out from positive reinforcement, which is derived directly from B, F Skinner's behaviorist theory in the 1940s behaviorists investigated whether they could change pigeons and then chimpanzees behavior by removing access to food when they didn't do a task, and then they moved on to research on changing children's behavior. Essentially, what we're doing is we're seeing that children view their parents love and attention as a positive thing, which in behavior. Is called a reinforcement, and when we give time out from positive reinforcement, we're saying that the pigeon or chimp or child doesn't have an opportunity to access positive reinforcement for a period of time. The procedure was developed for children by Doctor Arthur Stotts in the 1950s who still very much believed in it when he was interviewed for an article in the Washington Post in 2019 he initially tested it on his own daughter, and now they have a family joke that her behavior was so bad that her dad had to invent time out. Longtime listeners to the podcast know that I do a lot of hedging here on the show. There's a lot of well, the studies say this, and if you squint at the data in just the right way, you can indeed see a statistically significant result in the case of time out, the research is surprisingly unequivocal. I'll quote from a 2019 paper by Dr Rachel Knight at the University of Michigan Medical School and her colleagues. She says, "time out has been studied for almost six decades, with applied research in children first reported in the 1960s overall, time out has been found to reduce many types of problematic behavior, such as non compliance and oppositionality, aggression, destruction of property and yelling, slash inappropriate vocalizations. Timeout is also a treatment component in several evidence based, manualized parent management training programs. In addition, timeout is effective in addressing problematic behavior across several ages, including infants, toddlers and preschoolers, school aged children and adolescents. Despite the voluminous research on timeouts effectiveness, the popular media frequently portrays time out as harmful, ineffective, or both." So this is a fairly typical statement that opens a modern paper on time out, and each of the main ideas in it is supported by a citation. So I went through them one by one. The citation for the assertion that time out has been studied for almost six decades with applied research in children first reported in the 1960s is a paper by Montrose Wolf, who was actually Dr starts as graduate assistant. Also other authors on this paper were Todd Risley and Hayden Mills, and this was published in 1963 if the name Todd Risley rings a bell, it's because he was also involved in the research on the so called 30 million word gap that we looked at in a couple of different episodes. This paper was more about the behaviorist ideas behind time out rather than timeout itself. Though, the researchers behavior space conditioning methods that timeout is related to and how the researchers used these to get a three and a half year old autistic boy named Dickey, who had a slew of other diagnoses as well, to stop having tantrums and start wearing his glasses so his vision wouldn't be lost. The authors would withheld Dickey's food until he complied with their demands, rather than making any attempt to understand why he was hurting himself during tantrums and why he wouldn't wear his glasses. From the researchers perspective, this case was successful, but we have no idea how Dickie turned out in the long term. As far as behaviorist researchers are concerned, once the behavior has changed, there is nothing more of interest to learn or do. We don't know if the self harming behavior ever returned or if Dickie developed other habits that his parents found difficult. After all, nothing's changed in the circumstances in their home. The only thing that changed was Dickey's behavior. If Dickie was self harming as a stress response, it seemed likely that he may have developed other stress response behaviors. Later on, researchers didn't help Dickie to learn any new tools for managing his stress response, only that when he expressed it, as he had been doing via tantrums in which he hurt himself, that so called privileges like food would be removed. Dr Knight went on to describe the different kinds of behaviors that could be addressed using time out. The first of these were non compliance and oppositionality, aggression and destruction of property, there were two studies cited in support of this claim. In the first one, researchers worked with four children and their parents in a lab setting, parents were told to give children instructions like, come here or give me the truck. Wait five seconds for the child to comply, give a verbal reasoning for a time out, put the child in timeout while ignoring them, return them to timeout if they tried to escape, and then release them from timeout after the timeout period, plus three seconds of quiet at the end, and then the parent would immediately ask the child to do the original task again. The procedure was moderately successful in changing behavior, although compliance hovered around 60% after the Time Out procedure, which is far from total. The second study looked at 71 kids with ADHD, 44% of whom also met Oppositional Defiant Disorder criteria. These children were subjected to a time out procedure that was so complicated, there was a flow chart in the paper to describe it that involved reward points and timeouts that were extended for bad behavior, and could be cut in half for good behavior. Five children refused to go or stay in the timeout area and exhibited high rates of negative behavior during time outs. These children were rewarded for the time they were not in time out. For example, one child earned a nickel for every 15 minutes he was not in time out and. He could spend the money at the end of the day in a vending machine, although this is not an accepted part of timeouts, as parents are currently trained on them. The authors concluded that time out significantly suppressed the rate of problematic target behaviors for children with ADHD in the context of this intensive program. But the abstract fails to mention that they also had to add rewards for the children who resisted time out. Jen Lumanlan 10:23 The citation for yelling and inappropriate vocalizations is a study of two children aged 12 and 14 with an IQ of 52 and 55 and if it's been a while since you've worked with IQ scores, a score of 100 is considered, "normal," and so an IQ in the 50s comes with significant challenges. In this study, a teaching assistant started distributing food rewards randomly in class, an observer in the class decided when a child had misbehaved and would covertly signal to this teaching assistant to put an orange card on the child's desk and state name of the child you have misbehaved, you cannot receive treats for the next 10 minutes. Neither the teacher nor the student was ever told what behavior was incorrect. The Children's vocalizations decreased by 55% and 53% respectively. Although it is not clear whether it was only problematic vocalizations that decreased or whether the children just stopped participating in class. Time Out is indeed an important component of three evidence based programs that Dr Knight describes, including parent child interaction therapy, which we'll talk a bit more about in a bit. Dr knight goes on to state the different ages at which time out can be used. The study on infants was on four children aged 10 to 12 months, whose mothers were trained to start praising their children a lot and then give playpen time outs for what the researchers called Engaging in dangerous behavior, and this occurred between about a third and half of the observed intervals before the study began after treatment, this dangerous behavior only occurred in roughly 10% of observed intervals. This was not a short process, though, training sessions were conducted every four days, lasting between two and two and a half months, except for one mother and infant pair, where the mother's illness and work schedule resulted in training periods every 12 days over a period of 10 and a half months. And this is probably why time out is generally not recommended for children under the age of two. The study supporting using timeouts with toddlers and preschoolers is kind of an odd one, because it focuses on a rarely used form of timeout called deferred timeout. If the child refuses to stay in timeout, they're told they owe timeout to the parent before the parent will help them again with a task or by playing with the child. The effectiveness of timeouts in school these children is supported by studies we've already discussed. While the assertion that timeout is effective for adolescents draws on a 1988 study of timeouts conducted in three psychiatric hospitals for children and adolescents, some sort of facility that courts had sent children to, and a day treatment program. So as we return to Melissa's question on whether timeout is effective, we see that researchers who cite evidence in support of timeouts effectiveness often cite research that Canada doesn't really relate to our children if our children are not in an institutional setting. As a side note here, having done a number of episodes now, such as the two episodes on the Wonder weeks, as well as the episode on why authoritative is not the best parenting style, where researchers deliberately select white, middle class samples of normally developing children and parents with no known problems of their own, so the researchers can try to, as they put it, understand what actual development looks like before studying problematic populations. It's really interesting to see the timeout research taking a very different approach much of the time. Art research focuses on the most difficult cases, often consisting of case studies that only involve a very few subjects. It's very rare to find a case study that describes any procedure as failing, because these tend not to get published. It's well known that journals are more likely to publish significant findings than null findings. So it's possible there are a litany of unsuccessful and unpublished cases out there leading us to an erroneous conclusion about timeouts effectiveness. The only unsuccessful one that I found was actually by our old friend, Dr Todd Risley. He worked with a six year old girl who had brain damage caused by meningitis with, "an overlay of emotional disturbance and autism. He used a combination of time outs, shouting at her, shaking her and giving her electric shocks to stop her from climbing furniture and engaging in artistic shaking behavior, which today we would call stimming. At no point in this study did anyone try to understand why she was climbing so much or facilitate it in a safe way, and despite all the abusive treatment that she received in the lab, the paper says that no aggressive behavior toward any person or object occurred in the laboratory." Perhaps the real headline of this story should have been that this girl had more amazing emotion...