1. Beal, Judy A. DNSc, RN, FNAP, FAAN

Article Content

Time-out, a long-standing and empirically supported effective discipline for young children, has recently come under fire again in the popular parenting literature. Use of time-out has been endorsed by the American Academy of Pediatrics (1998; reaffirmed in 2014), Society for a Science of Clinical Psychology, American Psychological Association, and Canadian Paediatric Society (2004). In a special feature of Clinical Psychologist, decades of research on time-out was reviewed and the authors determined that "despite abundant evidence documenting the effectiveness and utility of time-out, highly visible, non-evidence-based cautions and recommendations against its continued use continue to be written and publicly disseminated" (Quetsch, Wallace, Herschell, & McNeil, 2015, p. 4). Citing a particularly inflammatory and empirically unfounded article in Time by Siegel and Bryson (2014), Quetsch et al. concluded that this type of discourse does nothing but stoke the flames and confuse parents.


Time-out was first defined by Staats (1971) as a time-out from positive reinforcement. Everett, Hupp, and Olmi (2010) conducted a comprehensive review of 445 time-out studies reported between 1977 and 2007 and operationally defined a best practice time-out procedure and criteria for implementing time-out. These criteria include a verbalized reason, verbalized warning, short-term physical placement in a chair, repeated returns for escape, and contingent release (Everett et al.).


Opponents to time-out cite overuse, misuse, inconsistent use, the child's perception of punishment fueled by parental frustration and anger, as well as a lack of understanding by the child as reasons that time-outs are so controversial (Duval, 2012). Quetsch et al. (2015) debunk several of these myths including time-out: 1) is counterproductive, rather loving, positive parenting works better; 2) does not meet individual needs of children; 3) can trigger trauma reactions; 4) is harmful; and, 5) should not be taught to parents because it could be used improperly. Through an extensive review of the research, the authors counter each myth with evidence and conclude that "time-out represents a safe, effective form of discipline, which in the context of a larger environment dominated by positivity, consistency, and predictability, has been shown across hundreds of research studies to be beneficial to the overall emotional and developmental functioning of young children" (Quetsch et al., p. 14).


The Canadian Paediatric Society (2004) position paper Effective Discipline for Children delineates the role of pediatric providers, goals of effective discipline, and specific guidelines from a developmental perspective. They likewise conclude that time-out, if used consistently and unemotionally, is highly effective. Some suggestions from this position paper include: 1) time-outs are not effective before 2 years (although others cite 4 years); 2) the location of the time-out should not include rewards, such as television or toys; 3) time-outs typically should last 1 minute per the age of the child, not to exceed 5 minutes; 4) the reason for the time-out needs to be verbalized; 5) with children under 4 years of age, the parent should remain nearby; and 6) move on to a new activity after time-out is over (Canadian Paediatric Society).


Pediatric nurses can play a vital role in assisting parents to appreciate the plethora of empirically based evidence for effectiveness of time-outs while supporting their decisions to implement or not. They can discuss valid resources and organizations. If parents are supportive, specific guidelines are critical to successful implementation.




American Academy of Pediatrics Committee on Psychosocial Aspects of Child and Family Health. (1998). Guidance for Effective Discipline (Policy Statement; Reaffirmed April 2014). Pediatrics, 101(4 Pt 1), 723-728. [Context Link]


Canadian Paediatric Society. (2004). Effective discipline for children. Paediatrics and Child Health, 9(1), 37-41. [Context Link]


Duval D. (2012). Time out for toddlers: Controversy. Child Therapy Chicago. Retrieved from Accessed August 17, 2016. [Context Link]


Everett G. E., Hupp S. D. A., Olmi D. J. (2010). Time-out with parents: A descriptive analysis of 30 years of research. Education and Treatment of Children, 33(2), 235-259. [Context Link]


Quetsch L. B., Wallace N. M., Herschell A. D., McNeil C. B. (2015). Weighing in on the time-out controversy: An empirical perspective. The Clinical Psychologist, 68(2), 4-19. [Context Link]


Siegel D. J., Bryson T. P. (2014, September 23). 'Time-outs' are hurting your child. Time. Retrieved from[Context Link]


Staats A. W. (1971). Child learning, intelligence, and personality: Principles of a behavioral interaction approach. New York, NY: Harper & Row. [Context Link]