Classroom Interventions for Children with
Attention Deficit Disorder
Time Out in the School Setting
Description
Time-out is a punishment procedure that involves the withdrawal of positive reinforcement as a consequence of inappropriate behavior. Time-out has been recommended for children as old as 9 to 10 years of age. The effectiveness of time-out in reducing inappropriate behavior is well-documented; however, the procedure has been somewhat controversial due to its potential for misuse (Abramowitz & O'Leary, 1991). Most concerns about time-out are related to the restrictiveness of the procedure; however, the degree of restrictiveness varies with the type of time-out procedure used. The least restrictive forms of time-out are those that do not involve exclusion or isolation. Examples of such nonexclusionary forms of time-out include: having the children put away their work for a time (which eliminates the opportunity to earn rewards for academic performance); the temporary removal of rewarding materials, such as taking away art materials; or having the children put their heads down on their desk (which reduces the opportunity for engaging in social interaction) (Barkley, 1990).
A more restrictive time-out procedure involves excluding a child from classroom activities by placing a child in a designated area for a period of time while attention and other rewarding activities are withheld. This may involve having the child sit in a chair facing a wall. The most restrictive time-out procedures involve removal of a child to an isolated room. In most schools, the principle of least restriction should be followed when selecting a time-out procedure, starting with the least restrictive procedure, and moving to the more restrictive procedures only after the others have been ineffective.
To ethically and effectively implement isolation forms of time-out in the classroom, the following guidelines are recommended (Abramowitz & O'Leary, 1991).
Prior to implementing time-out procedures that involve isolation, techniques for increasing appropriate behaviors and other punishment procedures that are less restrictive than isolation time-out should be properly implemented for a reasonable period of time and documented.
Staff must be fully trained in the procedure and physically capable of carrying it out.
Both the target behaviors and the specific time-out procedures should be clearly specified in writing and kept in the child's school records.
Determine how noncompliance to the time-out procedure will be dealt with in advance of implementing the procedure.
Information on the level of target behaviors prior to implementing time-out and during the implementation of time-out should be recorded to document the effectiveness of the intervention.
Each time-out should be recorded.
If these criteria cannot be met, other procedures designed to decrease disruptive behavior should be used.
Advantages
The effectiveness of time-out in reducing inappropriate behavior is well-documented. Time-out has been shown to be an effective component of an overall behavioral plan to reduce noncompliance and aggression. An additional advantage to time-out is that it is a punishment technique that can be administered immediately. Behavioral techniques, which can be administered as close to the behavior as possible, are appropriate for younger children and children with attention deficit disorders.
Limitations
Time-out is a highly technical procedure that is difficult to implement properly. There many ways that time-out can go wrong and become less effective. Time-out operates on the assumption that the activity that is withheld from the child is rewarding. Teachers should be careful that the child is not avoiding some unpleasant activity by going to time-out. For example, going to time-out for not staying on-task during independent math work actually may be preferable to doing math work to a child who dislikes math. Due to its restrictiveness and difficulty in implementation, time-out should be reserved for intervention with the most disruptive and unacceptable behaviors and only with staff that are trained in how it is properly used (Abramowitz & O'Leary, 1991).
A second limitation of time-out is that it is a punishment technique. As with all punishment techniques, punishment will only have the effect of decreasing or weakening the punished behavior. Punishment will not increase or promote appropriate behavior. Increasing or strengthening appropriate behavior will require positive reinforcement techniques. Furthermore, punishment results in negative interactions between children and caregivers, which can disrupt children's mood. To avoid this negative side effect, punishment should be used sparingly and only after an appropriate reinforcement program has been in place.
Time-out does not appear to be as useful with children older than 10 years of age.
Implementation of Exclusionary Time Out
Exclusionary time-out is a relatively technical procedure. If implemented properly, it can be an effective management tool for reducing unacceptable behaviors; however, if not implemented properly, time-out can be ineffective. The steps in implementing an exclusionary form of time-out are detailed below. These procedures can be adapted for use with nonexclusionary and isolation forms of time-out.
Step 1: Choose an appropriate time-out place.
Time-out is time out from attention or other rewarding activities. Therefore, the location of the time-out place should be relatively boring. The student should not have direct access to toys, books, people, windows, or any other potential reinforcement. It is often helpful to place a chair in the time-out place to serve as a reminder to the children. A chair in the corner or back of the room will suffice; some classrooms use a cardboard partition or a three sided-cubicle. The time-out place should be located where the teacher can easily monitor the child.
Step 2: Establish the rules regarding behavior during time-out.
In most time-out procedures, children need to fulfill specific criteria before they can be released from time out. Recommended criteria are detailed below.
The teacher should determine the duration of time-out. The time should be long enough to be punishing, but short enough for reasons of ethics and practicality. How children will respond to time-out appears to be somewhat dependent on how long previous time-outs have been for the child. For example, time-out is likely to be less effective if it has been preceded by a time-out of greater duration (Kendall, Nay, & Jeffers, 1975; White, Nielsen, G., & Johnson 1972). A rule of thumb used by clinicians is one to two minutes in time-out for every year of life.
Once in time-out, there should be no interaction with the child for the duration of time-out. Any verbal or nonverbal interaction can make time-out less boring and reduce its effectiveness. All comments, questions, pleas, and inappropriate talk should be considered attention-seeking and should be actively ignored.
Once in time-out, the child needs to stay in the chair until the teacher releases him/her. If the child leaves time-out prior to being released by the teacher, a back-up punishment should be delivered.
Release from time-out should also be dependent on a brief period of quiet. If a child is released from time-out while being disruptive, the disruptive behavior will be rewarded by being released. If the child stays in the chair for the specified period of time, the teacher should wait for at least a five second period of silence prior to releasing the child.
If the child was sent to time-out for noncompliance to a teacher request, the child should be asked if s/he is ready to do what s/he was originally requested. If the child answers "no," then the teacher should start time-out over by saying "Okay, then stay in time-out until I tell you to get up." If the child was sent to time-out for breaking a rule, s/he can be released with a reminder that if s/he breaks any more rules, s/he will have to go to time-out again.
Some children will refuse to go to time-out or will not follow the rules while in time-out. In these cases, some back-up procedures will be needed. One procedure is to allow the children to earn time-off for complying with the rules. Another is to add time to time-out or restrict some other school privilege for not complying with the time-out process. It also may be necessary to remove the child from the classroom to serve the time-out in another area, such as another classroom or the principal's office (see Figure 2). As with learning any new behavior, a child's time-out behavior may need to be shaped over time. The children will likely need to experience time-out several times before they learn that the teacher will be consistent in implementing time-out.
Step 3: Communicate effectively during the time-out sequence.
Punishment should follow a predictable sequence of communication. Sending a child to time-out for noncompliance to a teacher request should be preceded by a properly worded request and a warning. The qualities of an effective request are outlined below.
| Rule | Reason | Examples |
| Requests should be direct rather than indirect. | A direct request should leave no question in the child’s mind that s/he is being told to do something, giving no illusion of choice. | Indirect
request: "Let’s pick up the toys." "How about washing your hands?" "Why don’t you open your book?" "Do you want to throw that paper away for me?" Direct request: "Jimmy, pick up the paper, please." |
| Requests should be positively stated. | Positively stated requests give the child information about what "to do." Negatively worded requests only tell the child what "not to do." | Negative
request: "Stop running!" Positive request: "Come sit down next to me." |
| Requests should be specific. Avoid vague requests. | Vague requests are so general and nonspecific that the child may not know exactly what to do to be obedient. | Vague
requests: "Be good." "Be careful." "Clean up your act!" Specific requests: "Move away from the door." "Talk in a quiet voice." |
| Give only one command at a time. Avoid "hidden" requests. | Some children have a hard time remembering more than one thing at a time. You do not want to punish a child for having a short attention span or for failing to remember. | Stringing
requests: "Go close the door, then turn in your papers, and then go sit in your seat." Hidden requests: "Clean up your area." (This really is several requests, such as: put the toys in their place, straighten the chairs, stack your books, etc.) |
| Requests should be simple. | The child should be intellectually and physically capable of doing what you are requesting. | Too
difficult: "Draw a hexagon." (If the child does not know what a hexagon is.) |
After an effective request has been given, the teacher should expect compliance to begin within a reasonable time. This is called the "5-second rule." If compliance is begun within 5 seconds of an effective request, wait until the request is completed and give an enthusiastic praise. If compliance has not been initiated within 5 seconds of an effective request, a warning should be given. A warning is an "if-then" statement which connects the consequence with the behavior. Once the warning is given, the 5 second rule goes into effect. Compliance to the warning should be rewarded with an enthusiastic praise. Noncompliance to the warning should result in immediate time-out. Once it is decided to send a child to time-out, communication should be brief, clear, and direct. See Figures 1 and 2 for examples of effective communication.
Classroom rules should be clearly understood prior to sending a child to time-out for violating a rule.
This sequence will allow children to predict the consequences of their behavior, thereby, allowing them to exercise self-control. Children will likely need to experience this sequence several times before they learn that the consequences to their behavior (positive and negative) will be consistent.
Figure 1. Communication During a Compliance Sequence
Step 4: Explain the time-out procedure to the children prior to implementation.
At a neutral time, explain the time-out rules and what behaviors will result in time-out. Be sure to also communicate the rewards that can be earned for compliance to rules and requests.
References
Abramowitz, A., & O'Leary, S. (1991). Behavioral interventions in the classroom: Implications for students with ADHD. School Psychology Review, 20(2), 231-234.
Barkley, R. A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford.
Kendall, P. C., Nay, W. R., & Jeffers, J. (1975). Time out duration and contrast effects: A systematic evaluation of a successive treatment design. Behavior Therapy, 6, 609-615
White, G. D., Nielsen, G., & Johnson, S. M. (1972). Time-out duration and the suppression of deviant behavior in children. Journal of Applied Behavior Analysis, 5, 111-120.
Figure 2. Diagram of a Minding Sequence Using Time-Out