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A Guide for Parents on Teaching their Children the Concept of "No"
By Jane Anderson, MD

It's important that your child learn the concept of "no" for many reasons:
  1. To learn what behavior is acceptable and what is not acceptable
  2. To demonstrate that he/she is a different individual than you, ie, that they have different thoughts
  3. To learn how to stop a behavior when told to do so
  4. To learn how to problem solve and be creative (eg, "If I can't touch the hot stove, what can I do for fun?")
You can teach your 9-month-old the concept of "no" by using the five "Ds":

Determine the rules
This is actually one of the more difficult tasks for first-time parents, since everything your child does will be new, cute, and exciting. The first time your child touches the remote control, for instance, you will probably laugh and enjoy the new activity. However, you need to be the adult in your child's life, and be able to look into the future. Will you continue to enjoy this childish behavior if the child does it repeatedly over the next week? Will it still be funny and cute, or will it become quite annoying?

If the answer is that it will be annoying, you may decide that this activity should be discouraged by using the word "no." (Or you may decide to move the object, changing the infant's physical environment.)

Demeanor changes
Parents should change their demeanor if they are going to use the word "no." Remember: infants and young children pay close attention to your face and tone of voice, responding more to your demeanor than words spoken. Turn your face away from your infant and finish laughing before attempting to use the word "no." Your face should be very serious and your voice lowered. Moms, especially, need to lower their voices so that the infant will recognize that this conversation is different and meaningful.

Displace the infant
Once you have said "no" to a behavior, move your child away from the offending object.

Now that your child is in a safe place, distract your infant with something else—a toy or a book. Your infant may choose to crawl back to the desired, forbidden item. Therefore, the next "D" becomes very important.

Diligence (because "consistency" didn't start with a "D"!)
Children learn from consistency. Consistency allows children to predict consequences of their actions, adjust their behavior, and ultimately develop self-control. Being consistent is very difficult for parents, but you need to remember that your child will learn that you mean what you say when you are consistent in your actions.

Most parents who do use the word "no" have experienced another situation. The infant is heading toward a forbidden object, reaches out to touch it, but first looks back at the parent to see what might happen. The infant is clearly incorporating the concept of "no" and while in the process of learning, wants to make certain that the parents will indeed be consistent.

Helping children learn the concept of "no" will begin to help them understand the rules of their world and will help them begin to respect your leadership in your home, just as they will need to respect the leadership of teachers and employers later in life.

If this approach is not working either because your young child does not respond, or you find the recommendations hard to follow, please let your pediatrician know.

2008 Advanstar Communications Inc.. All rights reserved.

Discipline Techniques in the 12-month-old child
A teaching tool for parents on the challenges of raising a 1-year-old.

Source: Contemporary Pediatrics Publish date: Sep 1, 2008 By: Jane Anderson, MD

The Terrible Twos: "So soon?"
At each 12-month visit, I remind parents that this is the beginning of "the terrible twos." Invariably, first-time parents will gasp and respond that they thought this did not occur until the child was 2 years old. This response allows me an opportunity to explain that the "terrible twos" refers to the second year of life, particularly between 18 months and 2 years of age. One of the reasons this next year will be difficult is because the toddler will be trying to resolve many internal conflicts during this time. These conflicts include:
  • The desire to be just like the parents and copy everything they do, while also having the desire to act and think differently. The best way for a toddler to do this is to say "no," which demonstrates that he/she is thinking differently from his/her parents.
  • The desire to be independent and explore the world (since the toddler now has the ability to walk and run away from the parents) versus the desire to return to the parents for safety when the world becomes frightening or dangerous.The desire to "rule the world" versus the developing reality that there are rules that limit the child's behavior, and keep the child safe.
Because of these major areas of cognitive dissonance, the toddler will often rapidly decompensate, exhibiting outbursts or tantrums as a result. Parents are often startled by the drastic mood changes, and question whether there is something wrong with the child, or with their parenting, to cause such outbursts. Just knowing that during this next year their toddler will normally demonstrate strange and new behavior will help parents feel more prepared, and less overwhelmed when the tantrums begin.

Toddlers are also trying out many new behaviors as they attempt to discover what activities will help meet their needs, and what the consequences of each action are. For example, toddlers will often demonstrate "anti-social behaviors" such as hitting and kicking as they attempt to learn whether these actions will help them achieve their goals. Advise parents that all these behaviors are normal.

Some Battles Can't Be Won
Another important concept that pediatricians can quickly convey to families at the 12-month visit is that children should view their parents as authority figures. Children feel more secure when they know that someone else is in charge, and that someone is there to make sure that they are kept safe. However, in order to do this in an effective manner, parents should also be smart enough to only pick the battles they can win! This will assure that parents will be viewed with healthy respect, while not becoming overly controlling.

There are obviously some behaviors that should never be taken on as battles. Feeding, sleeping, and toileting are all areas in which parents should never resort to battles, since their toddlers can—and will always—win. Force-feeding a toddler, for example, will often result in vomiting, while forcing a child to sit on the toilet can result in stool withholding. Therefore, parents should be encouraged to set reasonable expectations for their particular child and use different methods, particularly positive encouragement and rewards, to teach appropriate behavior in these areas. It is also important for parents to only pick a few battles, and ignore much of the childish behavior.

Pay No Mind, and the Concept of Gentle
When I mention to parents that hitting, kicking, biting, and pinching are normal behaviors for 1-year-olds, most parents will acknowledge that their 12-month-old has indeed been biting. The parent(s) will often then explain or excuse the behavior, saying the child is showing excitement, is trying to kiss the parent, or is teething. For most parents, however, the reason for the behavior is not actually important, since the behavior is often inappropriate and painful. So, parents will often appreciate learning a helpful way of teaching their child not to bite.

Kohlberg's laws of moral development teach that a child between 1 and 3 years of age learns what is right and wrong behavior by the immediate consequence that follows the behavior. So, providers should instruct the parent(s) to state in a firm voice, "no biting," and to then place the child down on the floor (since most of the time the parent is holding the child when these activities are attempted). Then tell the parent(s) to turn his or her face away from the child, for just a few seconds. This effectively tells the child that he/she will not receive parental attention for that kind of behavior. Over time, this will help extinguish the unwanted behavior.

Psychologists use the term "extinction" to describe the elimination of behaviors that are not reinforced, and this teaching tool can continue to be used effectively as the child grows. Whining, for example, is easily eliminated when the parent refuses to acknowledge or respond unless the child reverts to a more pleasant voice.

Some parents have asked me whether their child will feel abandoned if they use this technique. Since the parents only need to turn their face away from the child for a few seconds, it is easy to reassure these concerned parents that their child—who has received so much parental attention and love during the first year of life—will not be adversely affected by this brief loss of attention.

I have also been surprised at how quickly toddlers learn the concept of "gentle." Many parents are able to show their young child how to touch their own faces, that of their siblings, and household pets. Holding the child's hand and moving it repeatedly in a soft, slow way shows the child how to touch "gently." Practicing this behavior when the parent and child are relaxed and enjoying each other's company makes learning more effective, and the positive reward of the parent's smile of approval, and words of encouragement, will reinforce the toddler's behavior.

Even the young 12-month-old will respond to these techniques—ignoring the child when inappropriate behavior is seen, and positively rewarding the appropriate behavior of gentle touching. You can also remind parents that the five "Ds" (see above) will continue to be important teaching tools during this second year of life. Distraction becomes an even more effective parenting tool during the second year of life, and most parents quickly realize how easily a toddler's attention can be diverted, thus avoiding a full-blown tantrum.

At their Wit's End
Some children will by their nature pose greater challenges, and some parents will have a harder time being consistent and staying calm. The teaching tool of "time out" will be introduced at the 15-month-visit, but a modified version of time out may be initiated for younger children. Advise parents if these suggested techniques are not working, and if there are too many tantrums or too much anger in the house, to contact their pediatrician for additional help.

Dr. Anderson is a clinical professor in the Department of Pediatrics at the University of California, San Francisco, School of Medicine.

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