Q: My 5 1/2 year old son is very very mean to his little sister. She is 4 and he will hit her constantly, take her things and do whatever he can to make her cry. It seems as though he enjoys it. He finds is all funny. Time outs, raising my voice, even a spanking has not helped. It is driving me crazy. Sometimes he leaves bruises.

A: When a young child hits others, the following interventions are often helpful:

Work on increasing the opposite, positive behaviors.  Let's say a child engages in 10 behaviors in an hour: five "good" and five "bad".  If we increase his "good" behaviors to 6, by default there is less time for "bad" ones, and so the 10 behaviors then becomes 6 "good" and 4 "bad".  The more positive behaviors such as sharing and treating a sibling nicely that a child engages in, the fewer instances of hitting he should have, as a person can not be cooperating and fighting at the same time (well, I guess unless he is in Congress).  So parents should "catch" a child being good and really praise it.  Parents should also make a chart with a list of good behaviors, and each time the child engages in one a sticker is placed on the chart, and after a certain number of stickers he gets a reward, such as watching television (but he is not allowed to watch any television, for example, until he gets that right number of stickers).  Behaviors that are rewarded or praised tend to increase.

Set a "Zero Tolerance" policy for hitting.  Explain to the children that no hitting at all will be tolerated, and set in advance what the penalty is for hitting (for example, extra chores or no television for 2 hours), and consistently apply this penalty any time there is any hitting. Also, make sure that "being mean" is not rewarded (for example, make sure that when he snatches a toy from a sibling that he does not end up getting to play with it).

Help a child redefine his relationship with his sibling. Focus on catching a child being a "Great Big Brother" and lavishly praise him whenever he treats his sibling nicely.  Hopefully, eventually he will pride himself on being a "Great Big Brother".

Avoid situations, when possible, that lead to hitting.  If a child hits because he is bored and it is fun to see his sister cry, make sure that he is kept busy doing things that are more fun than this.  If siblings fight about whose turn it is to watch t.v., set a schedule in advance.  Supervise the children well around each other, to catch problems before they escalate.

Make sure that you and others model the behaviors that you want your child to exhibit.  You can't expect a kid to do better than the adults in his life, and you're fooling yourself if you think "Do as I say, not as I do" will have any effect at all. Be sure you and other important people in his life act towards family the way that you want him to act - with kindness and respect – and that they handle their anger well.  And keep in mind that spanking a child sends the message that sometimes it is alright to hit others!

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Answered by Dr. Wayne Fleisig