Why is my toddler hitting out?
“Consequences” is where the child is warned that Y will happen if they do X. For instance “if you hit your brother, you will not watch your favourite TV programme”. It is only suitable for children who understand the relationship between their behaviour and the later consequence. Some mature three-year-olds can make the connection, but most can’t manage it until about five years.
Time out is not as simple as it looks; it is labour-intensive and easy to get wrong. It needs a lot of advance planning and should never be a “punishment” for bad behaviour.
The full psychological term is “time out from positive reinforcement”, whereby the child goes to a less interesting designated place until everyone, and not just they, have cooled down. It works from about age three onwards, and the rule of thumb is one minute of time out for every year of the child’s age.
Any intervention tends initially to make things worse and many parents give up at this point because they think it’s not working. I highly recommend The Incredible Years by Carolyn Webster-Stratton (about €20) as an excellent no-nonsense guide to parenting and behaviour management in two- to eight-year olds.
You’re at a loss in relation to your child’s behaviour, so it is probably a good time to seek expert advice. This is why professional child guidance services exist, and yours would be a typical referral to a local public child and family, or child and adolescent mental health service (CAMHS).
Your GP is the starting point for any referral. They will carry out an initial health screen and, if necessary, refer you onwards. Given the sometimes long public waiting lists, it can be tempting for worried parents to go private. A problem with the private route is that individual practitioners don’t usually work with an inter-disciplinary team.
In your case, your child’s needs might be best addressed by a therapeutic public team who can view the issues from a range of perspectives including general development, occupational therapy, parenting, speech and language, psychology, psychiatry etc. It is likely that psychology would have a key role in your case. Their input generally involves detailed history-taking, observations, possibly some psychometric assessment, and then working with you to implement strategies that are likely to work.
Dr Sarah O’Doherty is a clinical neuropsychologist.
Dr John Sharry is on leave.
Queries can be sent to healthsupplement@irishtimes.com
