Time-out refers to a discipline procedure used with preadolescent children.

During a time-out,
the child is denied access to one or more classes of positive reinforcement for a brief period,
usually 2 to 10 minutes, contingent upon a specific coercive behavior, such as noncompliance
or aggression. When first introduced into the child clinical literature in the 1960s, the more
apt but awkward expression time-out from positive reinforcement was used, since the
procedure resembled one used to suppress mistakes by laboratory animals engaged in various
operant tasks. Unlike a simple extinction procedure, the animal's mistake resulted in a brief
electrical blackout or the temporary discontinuation of reinforcement for a previously
reinforced operant. Different lab animals engaged in different learning paradigms consistently
adjusted their behavior to avoid these brief periods of time-out from positive reinforcement.
For children, the classes of reinforcers unavailable during time-out generally include attention
and toys. To prevent the child from seeking and obtaining attention and toys during the timeout interval, the child's mobility is invariably restricted. For example, Johnny and his little
sister get into a physical fight over a toy; mother immediately pronounces that There is no
fighting in this house; you both go to time-out. Each child is then quickly escorted to a chair
placed against a wall in the family room and told, Stay there and be quiet. The process
sounds rather simple and commonplace. Nevertheless, using time-out with clinically deviant
children has proven to be more difficult than it sounds and has even stirred some controversy,
since some would prefer to treat deviant children without the use of punishment of any kind.
Time-outs vary by at least the following five parameters: (1) positive reinforcers denied, (2)
location, (3) duration, (4) release rules, and (5) maintenance. Each parameter can vary
quantitatively or qualitatively, producing different time-out protocols.

The Positive Reinforcers Denied

In all published time-out routines, the child is ignored by available social agents (i.e., parents,
teachers, siblings, and/or peers), thereby denying access to the positive reinforcer of attention
from adults or other children. If a chair time-out location is selected, object access (e.g., toys)
is denied in addition to attention. In contrast, most room time-outs allow limited object access,
reducing the denied positive reinforcers to attention and objects outside the room. Both chair
and room time-outs restrict the child's mobility to a specific time-out location, thereby
preventing responses that could access attention and objects, not to mention an endless variety
of activity reinforcers available to a child with unstructured free time. Therefore, two classes
of positive reinforcers, attention and objects, are removed and/or restricted during time-out,
and one response class, mobility, is blocked during time-out. Note that a simple extinction
procedure (e.g., ignoring a pouting child) does not restrict a child's mobility and would not be
considered a time-out procedure. Restriction to a specific location for a short period of time is
considered a defining component of a time-out.

Time-Out Location
Children have been required to stand in corners or sit on chairs placed against a wall, in a
corner, or behind a moveable screen. Such time-outs are often referred to as exclusion timeouts, since the child is excluded from activities but not removed from the social context.
Bedrooms and other rooms located in homes, schools, and residential centers are referred to
as isolation time-outs, since the child is removed from the social context. In public settings,
parents can escort the child from the problem setting and find a relatively private place to sit
or stand for exclusion time-out, remaining beside the child at all times. Even more private

locations (e.g., public restrooms or the parked family car) are sought if isolation is needed to
manage intense resistance to exclusion time-outs in public.

Time-Out Duration
Minimum time-out durations have ranged from 10 seconds to 3 hours in the published
literature, but most clinical studies report using 2to 10-minute durations. Some association
with age seems to influence timeout duration decisions. Two-minute time-outs are common
for preschoolers, whereas 5 to 10 minutes is common for middle childhood.

Time-Out Release Rules

Many time-out protocols extend time-out conditions beyond the minimum duration if the
child continues to tantrum or otherwise make noise in time-out. A 10to 60-second quiet rule is
common prior to termination of time-out conditions. Consequently, a child facing a 2-minute
time-out might well spend 5 or even 10 minutes during initial time-out exposures prior to
calming down sufficiently to meet the 10-second quiet rule. A quiet rule is an extinction
procedure. All crying and noise making is ignored, and time-out conditions enforced, thereby
preventing any reinforcement (i.e., attention or time-out release) for crying or noise making.
Indeed, the child is negatively reinforced for calming down by release from time-out.

Time-Out Maintenance
Children tend to escape from time-out if given the opportunity. Children will avoid time-out
by inhibiting misbehavior (e.g., aggression) and by complying with instructions and warnings
that might lead to time-out for continued noncompliance. Therefore, like the lab animals in
the operant literature, time-out appears to be an aversive condition for young children. Escape
efforts are predictable and take the form of tantrums, verbal demands, and motoric efforts to
leave time-out chairs or break down barriers. Consequently, some mechanism to inhibit or
prevent escape from time-out conditions is specified by the protocol. Room timeouts, the first
used in the child clinical literature, can be maintained by simply holding the door shut for the
required period. Chair time-outs, in contrast, pose a more difficult problem. Tantrums and
noise making can be ignored during chair time-outs, but motoric escape cannot. Punishing
escape efforts from chair time-outs has proven controversial, since a procedure more aversive
than the chair time-out conditions must be devised to motivate inhibition of escape. The
original formulation dating back to the late 1960s was a spanking, once on the child's buttocks
with the adult's hand. The shortcomings of spanking (e.g., temporary pain, might become
abusive, models aggression, etc.), however, were apparent to many, spawning an array of
modern-day options. A 1-minute room time-out can be used to enforce chair time-outs. The
child is told, Since you won't sit on your chair, you must go to your room. After 60 seconds,
the child is returned to the time-out chair and given another opportunity to remain. Another
alternative to spanking is a brief restraint, called the two-chair hold procedure. Escape
following an initial warning results in a 45-second hold from behind on a different chair; the
child is then returned to the time-out chair with a reduced requirement to remain for only 5
additional seconds. Time-out duration is gradually increased thereafter. Three additional
enforcement procedures have been mentioned in the literature but inadequately studied to
date: fines, privilege losses, or work chores.

RESEARCH BASIS

The parameters of time-out protocols have been studied off and on for three decades. See the
reviews by Harris and MacDonough in the suggested readings. A summary of findings for
each parameter follows.

Positive Reinforcers Denied

The author is unaware of any experimental manipulations of attention, objects, or mobility.
Instead, theoretical interest has focused on the relative density of available response options
and positive reinforcers during time-in, compared to time-out. It is widely accepted that timein response options and reinforcers need to exceed those during time-out to achieve the timeout suppression effect. The foundation laboratory work with animals always adhered to this
principle.

Time-Out Location
Again, no definitive study exists contrasting isolation with exclusion forms of time-out. Ideas
about time-out location center around the reinforcers denied, the principle of least restrictive
treatment, and developmental issues. Room time-outs allow limited object access but
minimize inadvertent attention access (e.g., from a sibling or irritated parent) that might occur
during chair time-outs. Exclusionary time-outs have always been considered less restrictive
than isolation time-outs, since the child remains in the social context. Chair time-outs might
be safer for young children (25 years), since the child is always visually monitored by a
caregiver.

Time-Out Duration
Empirical work has established that time-outs less than 1 minute are generally ineffective.
Countless studies have used 2-minute or 5-minute time-outs with preadolescent children to
good effect. It is difficult to empirically justify a time-out longer than 5 minutes. Contrast
effects have been found, indicating that longer time-outs may actually degrade the
effectiveness of shorter time-outs and therefore should be avoided. Should middle childhood
referrals have longer time-outs than preschoolers? The author is not aware of an empirical
test.

Time-Out Release Rules

Quiet contingencies are associated with less noisemaking during time-out. The impact of quiet
rules on time-out suppression, however, is mixed. It appears that a clinician could release a
tantrumming child from time-out to reinforce nonescape without attenuating the time-out
effect, as long as a minimum time-out duration has been achieved. The adventitious
reinforcement of noisemaking can be temporarily tolerated.

Maintenance
Experimental contrasts with disobedient preschoolers have found that spanking and 60-second
room back-ups are equally effective, which thereby favors the room back-up protocol on the
grounds of potential adverse side effects associated with spanking. The two-chair hold routine
is effective but has not been experimentally compared to the spanking or room back-up
options. Almost nothing is known empirically about strategies for middle childhood that

include fines, privilege loss, and work chores. One might naively argue for a classic room
time-out procedure for all children, given the problems with maintaining chair time-out
conditions. The counterargument is that isolation time-outs are more restrictive, not available
in many important community settings, and possibly risky for preschool children who might
accidentally injure themselves when angry and unmonitored in a bedroom with a shut door.
The inclusion of time-out protocols (i.e., punishment) in the treatment of coercive children
continues to provoke controversy (see the McNeil article). Early empirical studies using
randomized assignment to positive-only strategies versus those that included time-out for
noncompliance repeatedly demonstrated the necessity of including a time-out component, at
least for noncompliant children. Noncompliance appears to be motivated by task avoidance.
Consequently, an all-positive approach to treatment is flawed, since it permits negative
reinforcement for noncompliance in the form of task avoidance. One must either use time-out
for noncompliance or pursue an endless quest for highly valued, idiosyncratic, satiationresistant positive reinforcers to induce child compliance. Theoretically, the child would have
to perceive the positive reinforcers for cooperation to be of greater magnitude than the
negative reinforcement inherent in task avoidance. The author finds the latter approach
socially invalid and infeasible. Furthermore, since noncompliance is a foundation response for
oppositional defiant disorder and conduct disorder, it would be difficult to treat any of these
children without a time-out component in the treatment package.

RELEVANT TARGET POPULATIONS AND

EXCEPTIONS
Time-out has generally been used to suppress coercive behavior in preadolescent children.
Coercive behaviors are presumed to be intentional, aversive actions displayed by a deviant or
unsocialized child to affect the behavior of social agents. Any number of frustrators could be
presented by a social agent that might set the occasion for reinforcement of child coercion. A
child's learning history with a specific social context and agent might well include both
positive and negative reinforcement for coercion. For example, tantrums, aggression,
noncompliance, and rude talk may all, at one time or another, have effectively resulted in the
removal of frustrators by social agents. These agents are simply responding to the
aversiveness of the child and attempting to reduce that unpleasantness in any way possible.
The behavioral trap is obvious and unfortunate for both the child and the agent. The child gets
positively or negatively reinforced for coerciveness, at least some of the time, and the agent
gets negatively reinforced for whatever stops the child's coercion. Unfortunately, the
whatever can include an array of child management mistakes, any one of which might
mollify the child or prevent coerciveness in the short run, but none of which seem helpful for
the long-run task of socializing the child. For example, to avoid or escape from child
coerciveness, social agents might give in to the child's unreasonable demands, withdraw
reasonable instructions, inhibit subsequent reasonable instructions, abuse the child, or even
work diligently to prevent the child from experiencing any distress. If one compounds such
processes over the course of thousands of trials across several years in multiple contexts, the
child is very likely to be diagnosed with disruptive behavior NOS, oppositional defiant
disorder, or conduct disorder at some point in the future. Consequently, it has been this large
response class of coerciveness that so often finds child clinicians recommending a time-out
procedure as a part of the treatment package. Time-out attempts to block all reinforcers
coerced by the child's aversiveness. Subsequently, coercive actions (e.g., child aggression,
noncompliance, tantrums, rude talk) no longer elicit a partial schedule of positive or negative

reinforcement. Rather, coercion is yielding no reinforcers at all for a brief but specific period.
Theoretically, coercion should eventually cease altogether if time-out is combined with
treatment components that promote prosocial alternatives to coercion (e.g., positive
reinforcement for play, cooperation, or rule following; social skill building programs). See
Patterson in the suggested readings for a thorough explication of coercion theory.
Time-out procedures have no known utility for reducing covert misbehaviors that occur
beyond the home or school (e.g., stealing, fire setting, vandalism, truancy). Furthermore, there
is no evidence that time-out is germane to the treatment of internalizing disorders, which may
include behaviors that are topographically similar to coercion (e.g., tantrums) but serve a
different function, such as escape from a fear-inducing setting. Developmental limitations are
also apparent. Time-outs are not generally recommended for infants or adolescents. Infants'
limited behavioral repertoire and nascent intentionality preclude the use of standard time-out
routines. A 10-minute withdrawal of toys, attention, and mobility is not likely to influence a
teenager except to irritate him or her for being treated like a younger child.

COMPLICATIONS
Time-out resistance can be sufficiently aversive that parents, teachers, or clinicians may
abandon the timeout routine. Predicting time-out resistance is easy; the more defiant the child,
the greater the likelihood of escape efforts. Managing time-out resistance is difficult. If a
room time-out is used, the child may physically resist the adult escort and/or violently attack
the door and/or destroy property once placed in the room. If a chair time-out is used,
punishing escape efforts is no easy feat. Spanking, the 1-minute room time-out, or the twochair hold procedure are all emotionally demanding routines. For middle childhood referrals
(i.e., 712-year-olds), very little empirical work exists to guide the clinician to more ageappropriate timeout enforcement routines, such as fines, privilege losses, and/or work chores.
It is the author's opinion that when treatment failures are documented for preadolescent
externalizing disorder youth, time-out resistance is a contributing factor to that failure. The
good news is that time-out enforcement procedures with 2to 7-year-old children are effective.
As long as the clinician monitors and adjusts the protocol as needed, time-out resistance
quickly abates. Specifically, escape efforts decline from the first to second time-out, and, by
the end of four weeks of parent-child interaction therapy, are virtually absent. The yield is
important. A successful time-out protocol establishes a noncorporal punishment procedure
that effectively suppresses intentional misbehavior and concurrently calms the child down.
The time-out protocol successfully replaces spanking, grabbing, shaking, screaming at,
threatening, demeaning, or otherwise abusing the coercive child.
Efforts to attenuate time-out resistance through modeling and awareness training have failed
to reduce initial resistance in clinic-referred, overtly noncompliant children. Therefore,
supporting parents, teachers, and staff members during initial time-outs and adjusting those
procedures on the spot seems essential. Given the child's reaction to time-out, the supervising
clinician can switch enforcement procedures (60-second room backup or traditional room
time-out or two-chair hold routine), reduce the time-out duration, reduce or abandon a quiet
rule, gradually shape time-out duration or quiet rules, introduce parent or clinician proximity,
or alter the post-time-out tasks. These are among the many nuances of the time-out protocol
considered by experienced child clinicians when faced with intense time-out resistance.

CASE ILLUSTRATION

Sean's mother was referred to the Psychology Clinic by the family's pediatrician for
apparent problems of conduct. Sean was a 5-year-old male residing with his 18-month-old
sister and a single-parent, working-class mother. The mother reported that Sean was very
stubborn, displayed tantrums when told no, hit or pushed his infant sister when she got in
his way, ran off in stores, and would not remain in bed at nighttime. A Child Behavior
Checklist profile indicated elevations on the Aggressive Behavior Scale and the Oppositional
Defiant Problem Scale (both T-scores over 70). Sean and his mother were observed
interacting in two standardized clinic analogs for 10 minutes each: Play (sometimes called the
Child's Game) and Clinic Task (toy cleanup). The Play data revealed a maternal frequency of
6.2 commands + questions + criticism per minute; the Clinic Task data indicated a compliance
ratio of 4%, a contingent praise ratio of 0%, and a vague/repeated instruction ratio of 82%.
Sean's mother tracked daily frequencies of aggression and tantrums in the home for 1 week,
revealing 2.6 fights and 4.3 tantrums per day. Sean met DSM-IV criteria for oppositional
defiant disorder. Parent-child interaction therapy (PCIT) was recommended.
During the third week of PCIT, time-out was introduced to suppress noncompliance with
instructions. The time-out procedure was modeled for Sean. A doll was sent to the time-out
chair for defiance to a warning. The therapist asked Sean what happened and why, providing
answers for him, since Sean refused to talk. The doll resisted time-out to show Sean the
mistakes and smart things to do if sent to time-out (i.e., stay there and be quiet). The
therapist then provided Sean's mother with a bug-in-the-ear device to allow communication
while the therapist was in the observation room. When the therapist left, Sean immediately
started demanding to go home but defied his mother's request to help clean up. The first timeout ensued. It was awful! Sean had to be sent to the backup room three times before staying
on the timeout chair, and 8 minutes later he finally calmed down to meet a reduced quiet rule
of 2 seconds. He refused to leave time-out when told he could, choosing to pout instead. His
mother was prompted to ignore pouting, and Sean left the chair 20 seconds later. He
disobeyed again right away, but his second time-out was considerably toned down (no escapes
and quiet within 4 minutes). Sean then proceeded to obey 10 tasks in a row (the standard
criterion), complaining the entire time. A phone check that evening indicated that Sean had
been sent to time-out once, and needed a room back-up, but did quiet down within 5 minutes.
Phone checks were discontinued after Sean's mother reported he had remained in time-out
without an escape effort. At the next clinic visit, Sean's home record card for the week
indicated two time-outs per day for defiance and a room backup/chair time-out ratio of 1 to 3.
Home record cards collected 1 month later indicated zero room backups and only three timeouts for the whole week. Sean's reaction to timeout was typical of this class of referrals.
Mark W. Roberts
Further Reading

Entry Citation:
Roberts, Mark W. "Time-Out." Encyclopedia of Behavior Modification and Cognitive
Behavior Therapy. 2007. SAGE Publications. 15 Apr. 2008. <http://sageereference.com/cbt/Article_n2131.html>.