Counseling parents of children with behavior problems: the use of extinction and time-out techniques.

The pediatrician is the professonal most frequently sought out for advice concerning disciplinary problems with children in the home. Behavioral psychologists have advocated the use of contingent ignoring and time-out procedures to help reduce problem behaviors; however, practicing pediatricians have found that these two procedures are often not successful. In fact, sometimes the two procedures seem to exacerbate inappropriate behavior. This paper documents the difficulties found in using the ignoring and/or time-out procedures in the home setting. Ptential pitfalls in the use of ignoring, including not specifying the target behavior, not taking a baseline, inadvertently, intermittently reinforcing the inappropriate behavior, response bursts, spontaneous recovery, and not reinforcing an appropriate alternative behavior, are described. In addition, several pitfalls in the use of the time-out procedure, including selection of isolation area, inappropriate selection of time intervals, interference from others in the family, and escape attempts on the part of the child are discussed. For each potential problem a remedy is suggested.