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Help me stop my child from (fill-in-the-blank)!

Sucking a thumb, picking a nose, nail biting - there are many annoying and sometimes unhealthy or unsafe habits that children adopt over time.

It takes effort and time to change behavior. Habits can be eliminated but only if children clearly understand what the habit is, they are aware when they are doing the habit, and are willing to change. 

Be patient, you can do it. Here are my recommendations for dealing with an unwanted habit:

Clearly define what the habit (problem behavior) is and how it should change

The first thing a parent must do is explain to the child what the habit (problem behavior) is, and how they would like to see the behavior changed.

Clearly define the behavior you are trying to eliminate.

For example, don't say "Don't pick on other people" - instead be specific - "When you are upset with someone, I do not want you to hit them."

Be specific about the change you want in the child's behavior.

For example, stop the habit, do something different in place of the habit, or continue the behavior in a different manner.

Use age appropriate language and examples.

Do not be vague or make the goal too complex. For instance do not say; "Don't pick your nose and wipe it on your clothing because it is naughty and dirty." Instead, say: "Do not put your fingers in your nose, always use a tissue."

Work on only one behavior at a time.

Master one habit, replacing it with the behavior you want. Don't start working to eliminate other unwanted habits until you are sure your child's behavior has changed.

little boy sucking his thumbExplain why the habit (behavior) should be eliminated

Point out to the child the consequences of the habit and avoid preaching. Involve the child in the discussion. Ask why he or she thinks the habit is problematic and why it would be good to stop it. Here are some guidelines for how to discuss changing a habit with your child:

Do NOT make the child feel guilty or ashamed.

Let a child know you are aware he/she does not always know when they are doing the behavior (habit). Tell the child you would like to help him stop because "it will be good for him (the child)". 

Do NOT mock or scold the child for having the habit.

For example if a child is thumb sucking, do not say: "Only babies suck their thumbs." or "Sucking your thumb is dirty."

Be clear and specific in what you DO say:

"You have been sucking your thumb for some time, and I know often you are unaware you’re doing it".  "Your dentist is worried it is affecting the position of your teeth." or "Your thumb has lots of germs on it; I do not want you to get sick from sucking it".

Avoid power struggles - put yourself and your child on the same side:

For example if a child is thumb sucking, do NOT say: "Now that you are a big girl/boy, you are too old to suck your thumb and you need to stop."

Instead, say: "I want you to have a great smile when you grow up and would like to help you stop sucking your thumb. I have some ideas on how we can work on this together."

Do not over-punish or set unpredictable/unrealistic ultimatums.

For example if a child is thumb sucking, do NOT say "If you do not stop sucking your thumb, I will take all your toys away" or "If you do not stop sucking your thumb by Christmas; Santa will not bring you presents".

Instead, say:  "This will take time and will not happen overnight. I know you will work hard and I will help you".

Increase the child's awareness of when he or she is doing the habit.

People - including children - are often unaware when they are involved in their habit. This can make it difficult to eliminate the behavior. A "cue" is one way to alert people. 

Types of "cues" that can help create awareness of the habit:

  • Painting the finger nails with a foul tasting substance (polish) can alert a "thumb sucker" or "finger nail biter" to when his/her fingers are placed in the mouth.
  • Habits often occur during "down times".  When a "thumb-sucker" is involved in a quiet activity (like watching TV or reading), have him/or her sit on their hands. Pulling the hand out to place a thumb in the mouth, can alert the child to his/her habit.
  • Placing a "band-aid" on the thumb may alert a child to when his/her the thumb is in the mouth, giving the child an opportunity to remove it on their own.
  • If a child has a habit of not listening, tell the child you will make a request no more than two times. If the first request is ignored, precede the second request by the words, "Number two", followed by the repeated request. If the child fails the second time than he/she will be placed in "time out".

To make a habit go away, one needs to stop rewarding unacceptable behavior, provide consequences for the behavior and nurture (reward) the absence of the behavior.

Motivate the child to stop the habit.

Children love attention and habits often elicit a great deal of attention from parents, siblings, peers, or teachers.  Sometimes children consciously increase the habit to get more attention. Avoid "power struggles" as they usually result in an increase in the behavior. 

Stop rewarding the unwanted habit.

Minimizing positive "payback" when a habit is observed will help eliminate it. This can be accomplished by ignoring the habit if possible and by not engaging the child in arguments or explanations regarding the habit.

Provide consequences to increase the child's awareness.

When the child is doing the habit, you need to use a consequence to help them realize they are doing the habit. I recommend "time out" as this consequence. However, because "time out" is often thought of as a punishment, it is important the child be told this "time out" is a reminder - not a punishment. Because it is a somewhat unpleasant reminder, it should discourage the behavior rather than encourage it.  

Call out the behavior when it happens.

When the child is observed doing the behavior (habit), unceremoniously note it by saying. "You are doing the habit now; place yourself in a "time out", set the alarm, and when the alarm goes off you can return to your normal activity."

Make it quick and easy - you are helping the child recognize the behavior is happening.

I recommend a cooking timer/alarm clock to monitor the “time out”.  I would encourage the child to set the timer himself/herself. Since the "time out" is not meant to be punishment, it should be very short in duration (one minute is reasonable) and uncomplicated (have the child stop playing and sit until the timer goes off).

When the timer goes off the child can return to their normal activity.

Training sessions help encourage the child

I recommend nurturing (rewarding) the absence of the habit during regular "practice times" with the child that I call "Training Sessions." By making this a time-bound practice each day, the parent can help the child build new habits to replace the unwanted behavior. Here is what I recommend:

Set a time each day

Designate a time when you can work with your child. Ideally, I recommend:

  • The same time of day each day. (helps with building a new habit)
  • A time of day when you, the parent, are not rushed or stressed.
  • A time when your child is not hungry, tired or distracted. Morning generally works well because children are more cooperative that time of day - but you know your child best.

Make the "Training Session" sound like fun.

The child will be more willing to participate if they think of the session as a game rather than work. 

Emphasize the "reward" they are working for, rather than the habit.

If the goal seems impossible to achieve, a child may become frustrated and give up (refusing to cooperate). 

Ensure early success.

Early success will give the child confidence. If he/she thinks, "I can do this", then the child will be more willing to continue.  For that reason, I recommend you make the initial goal very easy to achieve. You can do this by:

  • Choose the time to lead to success
    Working on the habit during a time of day when the behavior does NOT usually happen. Examples might be thumb sucking during meals or during a bath.
  • Keep the "training session" short, gradually increasing the time.
    Start with 30 minutes. Most children should be able to refrain from the habit for that length of time. Increase gradually to 60 minutes, then longer. This ensures the child will be successful quickly, and learn to recognize the behavior and control it.

Reward your child for his progress

Breaking a habit is hard work - whether you are a child or an adult. You can help your child succeed by approaching it as a team. Here is how I recommend beginning each session:

"We are going to work today on _____ (thumb sucking, losing your temper, biting your fingernails) and I am going to help you. I will set a timer/alarm, and when it goes off, if I have not observed your "habit" you will receive a "reward".  There will be no reward if I see the habit."   

Do not mention the reward again during the session. If you mention it, your child may sense they can't stop the habit, so why try? Wait until the timer goes off and then address whether the child receives a reward.

During the time of the session, you should go about your normal activities. When the habit is observed, do a "time out."

Reward ideas for your child

There are many types of rewards you can use to motivate and acknowledge your child's progress. Some may be praise, a sticker, small gifts or prizes.

Use a two reward system.

I find using an immediate reward following the training time plus a more permanent award work well with habits. Giving the child a reward immediately following the session reinforces the hard work they have accomplished. Then, placing a sticker or visible reward on a chart or document for others to see. Because you are gradually working toward a goal, you want to document each day's successes.  

Stickers may lose their appeal - create a special reward.

Stickers placed on a calendar are a good visible reward; however, over time a child may become bored with them. I recommend a special "fun" reward to keep your child engaged and enthusiastic about eliminating the habit. You can reward the child with the "fun" reward after he has placed 2 or 3 stickers in a row on the calendar.

Ideas for special rewards.

After the child can successfully avoid the habit during 2 -3 sessions in a row, you can lengthen the session and try some special rewards. I recommend customizing these to your child's interests. Using note cards, write special rewards for the child. Some ideas are:

  • Uninterrupted play time (30 - 60 minutes) with one of the parents. 
  • A portion (1-2 pieces) of a multiple piece item such as a puzzle, building block kit, doll wardrobe, etc.
  • Trip to the park
  • Trip to get ice cream
  • Extra 15 - 30 minutes at bedtime

You can place these in a bowl or bag and let the child draw a special reward out. You can then recycle the card back into the bag. The child can choose the rewards multiple times - which is part of the fun.

Giving the reward

When the timer goes off you will then either say:

The child did not avoid the habit

"The timer has gone off; I saw the "habit" during the session so there will be no sticker today. Tomorrow, we will work on it again, and I am sure you will be able do it. Remember, when you have gotten 2 in a row, we will have a special reward from the list." (or bowl or bag)

The child successfully avoided the habit

"Yea! You didn't ____ (suck your thumb, hit your brother, bite your fingernails)! Here is your sticker for today! Now let's place it on the calendar so Daddy (or Mommy, or your sister or Grandma) can see it! 

When others comment on the calendar, you should congratulate your child again for his/her accomplishments.  The congratulations are another positive motivator for the behavior.

Success!

As you move forward expect occasional set backs. At times it will feel as if you are stuck and going nowhere. 

Be patient. 

When the habit resolves, you can stop the "training sessions." If you have another behavior you would like to work on, I suggest you give yourself and your child a reasonable break before starting again.

I do not recommend working on habits before 3-4 years of age because kids younger than this are unable to understand what you are asking them to do."

 

Greg Severson, MD

Methodist Physicians Clinic HealthWest

Dr. Severson answers your questions about child development and parenting. One of the most gratifying aspects of pediatrics, for Dr. Severson, is watching an infant grow and change into a young adult. He is a natural teacher and he enjoys teaching parents how to provide the best care for their children. Dr. Severson loves kids and he is enriched by his interactions with them every day. He recognizes that children are unique and special. He hopes that his recommendations will help parents m ...

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