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Behavior is something that parents frequently ask the pediatrician about.  While it’s not a physical health issue, it is part of development and raising a child.  I wish I had hour-long appointments like therapists do so that I could talk to parents in-depth when they have behavior concerns.  Unfortunately, the best I can do is give my general overview based on what I’ve been taught and my personal experience.  When typical fixes don’t work, I call in outside help from behavior experts.  Below you will find some of my usual recommendations when it comes to childhood behavior.


Behaviors are actions that children use to get what they want and the behaviors continue because they work.  That means don’t let it work for undesirable behavior!

We all understand the concept of positive reinforcement.  For behavior you like, give praise or rewards (more on this in a bit).  That will ensure the behavior continues.  Unfortunately, what many parents don’t realize is that behavior you don’t like is also rewarded with attention, even though it is likely negative attention.  So how should this play out?


Toddlers are in a crazy stage of development.  They understand more than they can say.  They want to do more than they physically can.  They have no concept of self-control.  They can’t do very much for themselves.  Sounds like a nightmare doesn’t it?  What I recommend is to always speak to your toddler like a normal person since they most likely understand you.  Calm begets calm so if you need to correct behavior calmly talk to them. Don’t use the word no.  Say short phrases like “that’s hot” or “not safe”.  Then redirect with a positive statement like “let’s play with blocks instead”.  This will frequently work, but when it doesn’t be prepared for protest.  If your toddler starts to have a tantrum don’t reward the behavior.  Calmly acknowledge that he/she is mad and then walk away.  No stage means no performance.  You will never, ever, talk your child out of a tantrum.  Ever.  So don’t try.  This attention causes the behavior to continue.

Preschool Age

By now your child can talk more so that means more conversation and more comprehension.  Talk to your child all throughout the day to give them updates on what is happening.  This removes the anxiety of not knowing what is coming and also helps transitions.  Give updates like “after breakfast we will get dressed and then we will go to the park” and warnings like “we have to leave the park after 10 more pushes on the swing”.  Again, you may still get protests but if you talk through it they are likely to decrease.  Since children at this age ask a lot of questions, try to use positive statements before negative ones.  For example, “yes we will go to the park but we have to put our shoes on first”.  And most importantly, never ask a yes/no question to your child.  Say phrases like “it is bath time now” instead of “do you want to take a bath?”  Unless of course you don’t mind if your child says no.  However, it is ok to give choices and this can really empower your child.  You can say “you need to brush your teeth and take a bath, which would you like to do first?”

Reward charts also work great at this age.  Always keep it very simple and be explicit about your expectations.  Only pick a few behaviors to work on at a time.  Start with 3 or 4 things that your child needs to work on like brushing teeth or staying in bed.  Let the child put a sticker on his/her chart when the expectation is met.  Your child will see their progress and will be able to earn rewards like a trip to the toy store.  (Try to avoid junk food rewards.) Don’t take stickers away for bad behavior.  These are earned and you don’t want to diminish the hard work.


Consequences need to be timely and logical.  You can’t take away dessert after dinner for bad behavior in the morning.  It just won’t register and you aren’t likely to follow through.  (This is actually a real example, I don’t recommend dessert at all!)  You can use a time out if you wish but time outs are not the only option.  If your child throws sand at the park, pick up and leave.  If he/she is unable to share with a friend or is hitting, end the play date.  Be very specific as well, “we are leaving the park because I have asked you not to throw sand and you did it anyway”.  Make sure you are giving expectations in advance.  If you have not given expectations initially, it is ok to give your child a warning and then make sure to follow through the next time the behavior happens.  Make sure to always use consequences that will be easy to accomplish.  Remember “don’t make me turn this car around” from your parents?  They never did so it didn’t work.


Praise is a tricky concept.  For so long there was concern about our children’s self-esteem so we developed the Everybody Gets a Trophy philosophy.  I think it’s pretty clear that the anxiety and depression that followed these children into adulthood meant that the philosophy didn’t work.  Now we know that kids need to learn some disappointment.  They can’t always go through life hearing the phrase “good job”.  That means praise given to encourage good behavior needs to be intrinsically motivating.  So how should praise be given?  Be enthusiastic, specific and matter-of-fact.  Try to make it about them and not about you even though you will have a strong desire to say thank you or how proud you are.  You want them to be proud of themselves.  You can say things like “you put your shoes on all by yourself!” or “you put away all of your books and now your room is so neat!”  This is also a good way to encourage children to work through things that are hard.  “You had a hard time figuring out the puzzle but you did it all by yourself!”  It can also be used to praise children when they do something challenging without putting up a fight or whining.  For example, if you say no to a request and your child accepts that, let them know.  “I said no and you handled it so well!”  Or if they begrudgingly do something you ask, instead of thank you say “you didn’t want to put your clothes away but you did it anyway!  Now you have neat clothes for school.”  These statements can also be followed by stickers on a chart or marbles in a jar.  As children get older, the reward can become an allowance.

Final word of advice

Stop having mommy/daddy tantrums.  I’m the worst example of this because after a long day at work I am just done.  I don’t have anymore physical, mental or emotional energy to control my anger, use my words and stay calm.  It takes a lot of practice.  However, it’s ok to apologize to your child and start over.  Your children need to see that you are a real person and that you too can change your behavior.

As always, if your child’s behavior seems to be out of range of expectation or you have any questions at all, please talk to your doctor.

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