Dr. Mom explores Tips for Managing Ear Infections in Children

Parents often come into my medical practice asking for help or advice on parenting techniques, disciplining their children or managing unwanted behaviours.  I also often get asked what the best methods of discipline are for children of all ages.  Madi has definitely had moments when she would throw a tantrum and scream bloody murder loud enough to clear a room.  Parenting is super challenging and can have many ups and downs, and consistency can be key in managing kids.  Many parents will seek parenting information or parenting advice from their family doctor.

I always try to do the best I can to share the current evidence behind styles of discipline.  After-all, some forms of discipline like spanking have been very well studied and shown strong associated with negative outcomes in childhood.

Why do children throw tantrums, act up, or misbehave?

Children misbehave for all sorts of reasons.  They may be bored, tired, or hungry. Sometimes they see another child misbehave and copy them, which is a normal part of social development.  Parents may also model behaviours in the home environment such as yelling, cursing, or ignoring that children might pick up on and copy. Children can also act out when they are not receiving enough adult attention at home.  

Children might also misbehave or act out when families are going through divorce, separation, or struggling with other issues such as poverty, substance abuse, and mental illnesses.  Some children may have temperaments which make them more vulnerable to act out or throw tantrums, and other children with Attention-Deficit / Hyperactivity Disorder (ADHD) might have difficulty controlling their impulses. It is important to explore why your child may be acting in a certain way and address it at its source if possible.

Parents sometimes unintentionally reinforce undesired behaviours, or do not discipline children effectively, leading to continued issues with tantrums or acting out.

Praise and punishment helps with temper tantrums

There have been many studies that analyze discipline methods and the effects on childhood behaviour.  Harsh discipline methods, especially physical punishment, have been studied and strong associations have been made to their ineffectiveness and possible worsening of child misbehaviour.

How can I effectively discipline my child?

Parental modelling of desired behaviour is one of the most effective tools for young children to learn how to behave.  Discipline is also important when parenting children, however different types of discipline are appropriate at different ages.

Effective Discipline Methods have been well studied in the psychology literature

Different parenting techniques are effective and recommended for disciplining children and modifying behaviour at various ages.

Infants: 0-1 years

Positive reinforcement and redirecting are the most appropriate methods for behaviour modification at this age.   Babies obviously don’t understand speech yet, and therefore need nonverbal cues. When Madi would grab at my earrings I would gently redirect her to play with a toy instead.  When Madi would be quiet and not fuss when I changed her diaper, I would smile and cheer and give her hugs and attention. This reinforces the good behaviour.

Toddlers:  1-3 years

The same techniques for infants are still effective for toddlers, as they are still learning to communicate. .  The “Time-Out” might also be introduced here. This is very effective provided the parent knows how to give their child a “time-out.”

A “Time-Out” consists of:

1) removing your child from the situation in a quiet spot.  Try to make the spot the same every time if possible, such as in their crib or bed or a chair where you can keep an eye on them.  

2) Gently tell your toddler what is wrong with their behaviour in terms they can understand.  They may seem like they don’t pick up on things, but they are smarter than we give them credit for. If you can’t explain why the behaviour is “bad,” reconsider why you feel the need to discipline it.

3) Keep your toddler there for a few minutes.  If needed, help them calm down. At this age their concept of time is still developing, so setting an egg timer and allowing them to see it wind down will help them understand how long a “five minute time-out” really is.

School Age Children: 5-12 years

When your child is school-aged, they have a  better understanding of language and directions, therefore you can introduce verbal instruction and more complex explanations into your discipline techniques.

Establishing household rules and sticking to them will be helpful.  If your child misbehaves, having a pre-established consequence for their actions such as “grounding” or withholding a privilege is appropriate and effective.

Adolescents: 12-onward

Now that your child is an adolescent, their brain is starting to mature into an adult brain.  All the same methods of disciplining your school age child are still useful, with two exceptions. The disciplining methods of “Time-Out” and “redirection” are likely no longer effective or age-appropriate.

What is positive reinforcement and how can I do it?

The “Positive Reinforcement” parenting technique is one of the healthiest proven methods of child rearing and is appropriate for all ages of development from birth to adulthood.  Positive reinforcement involves paying attention to the good behaviours your child exhibits and praising them, rather than punishing negative or “bad” behaviours. For example, you can give your toddler praise after they say “thank you,” or allowing your teenager to use your car when they get a good grade.  

Negative reinforcement, on the other hand,  is a style of parenting in which you encourage a positive behaviour by removing a negative outcome.  E.g., “If you do your homework, you don’t have to clean your room.” Positive reinforcement has been shown to be more effective in modifying behaviour than negative reinforcement.

Contrary to what some parents think, just because a child is more temperamental or challenging to raise does not mean that they will grow into problematic adults.   Some children just need more structure and reinforcement than others. The key to parenting is follow-through and consistency.

Here is Discipline boiled down to a list:

  1. Choose age-appropriate disciplining methods and stick to them.
  2. If your child misbehaves, try and follow through with your consequence as much as you can (if possible, every time). Children recognize idle threats very early.
  3. Be gentle and supportive, yet take a firm stance when disciplining your child.
  4. Spanking is largely ineffective and may lead to worse outcomes.
  5. You should not punish accidents or behaviours that are part of normal development (such as bed-wetting, or accidentally dropping a mug).
  6. Try not to scold your child.  Scolding may be ineffective, provoke anxiety, or lead to your child ignoring you.
  7. Establish household rules early.  Explain that different households may have different rules, but these are the ones that must be obeyed here.  
  8. When your child misbehaves, follow up with a consequence.  Consequences should be age-appropriate and correlate to severity of the misbehaviour.  An appropriate consequence for a toddler might be that she does not get to watch “Peppa Pig” when she misbehaves.  For a teenager, it might be that they do not get access to their phone for certain periods of time.
  9.  Do not reward bad behaviour in your child.  For example, if your child throws a tantrum because they want to play on your iPad, do not give them the  iPad to stop the tantrum. If your teenager is skipping class, do not reinforce their behaviour by giving them your car to drive to school every day.   

Despite knowing these guiding principles for discipline, I sometimes give in and give Madi the iPad when she is having a temper tantrum, or have snapped when she accidentally spills something. I try my best to use positive reinforcement and to be consistent, but I sometimes fail! I think it’s ok to make mistakes as a parent as long as we learn and grow the way we want our children to.

Learn more from Dr. Mom about parenting:

What can I do as a parent to help my child with ADHD/ADD
Is spanking bad for your child?
How much TV and screen time is OK for your child?
Everything child wellness


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Illingworth RS. Discipline and punishment. In: The normal child: some problems of the early years and their treatment. 10th ed. New York: Churchill Livingstone, 1991:245–54.

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  1. BURTON BANKS, M.D., James H. Childhood Discipline: Challenges for Clinicians and Parents. Am Fam Physician. 2002 Oct 15;66(8):1447-1453.


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