The Reward System: Accentuating the Positive
The expert: Katarzyna Bisaga, M.D., Ph.D., a child and adolescent psychiatrist and assistant clinical professor in Columbia University's Division of Child Psychiatry in New York City; married to Adam, a psychiatrist specializing in addiction problems; mother of three
Her professional philosophy: Discipline should be tailored to each child's personality and the specific misbehavior. "You can't have one technique for every problem that arises," she says. That said, Dr. Bisaga adds that "one very effective method I use with the families I work with, and with my own kids, is behavioral modification through positive reinforcement" -- in other words, rewards applied immediately after the desired behavior occurs.
Her own discipline dilemmas: "When my son, Marcin, was 7, we were having trouble getting him ready for school in the morning. We would say, 'Here are the clothes you have to put on. You have five minutes to get ready.' Sometimes he would just play and do his own stuff. I'd end up saying, 'I'm going to count to 10 and you need to get dressed.' We were having power struggles, and you don't want to get into a power struggle every day. It can destroy your relationship with your child," Dr. Bisaga says.
"My middle child, Emily, is different," she continues. "She's very independent. When she was 3, the discipline issues were more related to occasional tantrums." For instance, Emily would get angry and throw food on the floor or she would get too physical with her baby sister, Julia. Sometimes Emily would grab toys from Julia or push her if she was getting into her things. "When Julia arrived it was a big transition for everyone, and Emily was only 2 years old," says Dr. Bisaga. "Kids that age are pretty needy and demanding, and Emily became even more so after the baby came. The aggression became a problem when Julia started getting more mobile and interested in the toys Emily played with."
At-home solutions: Dr. Bisaga took cues from her kids. For Marcin, rather than dwelling on the negative aspects of his foot-dragging, she stressed the positives, made her expectations clear, and offered rewards for good behavior. "We wanted to remove the power struggle from the situation, and stressing positive behavior helps build self-esteem," she says. "The thinking is that once a child develops one positive behavior and gets a lot of praise, then he'll be more likely to cooperate in other situations too." At first Dr. Bisaga tried to reward Marcin with TV or computer time in the morning if he was dressed and done with breakfast quickly. "But we found that wasn't a good idea because it created another power struggle when it was time to turn the TV or computer off," she says.
A better solution was an incentive chart: "We had used a star chart when Marcin was about 2 and working on potty training. He wasn't interested in taking the time to sit down, so whenever he did I would give him a sticker. His potty training just took off from there." This time, Dr. Bisaga decided to use a point system to motivate him. "In the morning Marcin got points for getting dressed by a certain time, brushing his teeth, and eating his breakfast," she says. "When he came home from school, there were points for putting his coat and shoes away and for washing his hands. At night there were points for taking a bath and brushing his teeth." At the end of the week, the results were tallied and he earned 10 cents for every three points. Marcin would look forward to buying Yu-Gi-Oh! cards and Bionicles with his loot.
Because Emily's personality and issues -- impulsivity and aggression -- were so different from Marcin's, Dr. Bisaga needed another approach. She had to find a way to calm her daughter and help her think before reacting. What worked for Emily: time-outs. "There were specific situations in which we used the technique," Dr. Bisaga explains. "If it was a safety issue -- I told her to stop pushing the baby or not to run across the street -- and she didn't listen, she knew there would be a time-out. Or if she was getting frustrated and being aggressive, then we would give her a warning and tell her that she needed to stop what she was doing. It helped that Emily knew there was a procedure in place."
They also had to tell her what to do -- not just what not to do, says Dr. Bisaga: "You can't just say, 'I want you to behave.' That's too vague. You can say, 'I want you to take turns and share your toys with your sister until dinnertime.'" Here, too, you need to give positive reinforcement. "If you have a child with a tendency to act out, she'll never succeed if you tell her to keep her hands to herself for an hour," says Dr. Bisaga. "But you can start by giving her a reward for playing nicely for 15 minutes. Then, once she's successful, you can stretch it to 20 or 30 minutes, and so on."
Her parting advice: The key to making any discipline philosophy work, says Dr. Bisaga, is consistency. The reward system works well as long as you keep at it. And once a specific behavior is no longer a problem, you can target another, always making sure your goals are realistic and age-appropriate. A good thing about a reward chart is that it clearly states what is expected of your child. "But even simple star charts require a lot of energy, effort, and time," says Dr. Bisaga. "You need to be on top of your kids and monitor what they're doing and how they're doing it."
Bottom line: "As a parent, it pays to see the glass as half full," she says. "You should build a positive relationship with your children and underscore their good behavior. Otherwise, you let your experience of your kids be shaped by their negative actions."