Pilot Grants

Making Time for Time Out: Evaluating a Discipline Education Module for Caregivers of Young Children

Statement of Problem

Child behavioral concerns are extremely common and can lead to poor academic achievement, social difficulties and mental health disorders, among other negative outcomes. Many factors contribute to behavioral problems in young children, including problematic parenting, which can intensify these problems and, in turn, increase parental stress and risk for further harsh parenting.   

To address this issue, our team and collaborators at Cincinnati Children’s Hospital developed PriCARE, a six-session parenting intervention hosted within pediatric primary care that teaches caregivers techniques to support the social and emotional growth of their children. The program has shown to improve child behavior, strengthen caregiver-child relationships and decrease parental stress. However, while the strategies for promoting positive behaviors and ignoring minor misbehaviors taught in the brief PriCARE intervention are sufficient for some families, others may benefit from additional training on positive discipline techniques.


To build on the success of this parenting intervention, our team assessed a new five-session Positive Discipline Module with caregivers of children 2-6 years old who have completed the PriCARE program. The additional module is a group caregiver training program that builds on skills such as the 3P’s (praise appropriate behavior, paraphrase appropriate talk and point out appropriate behaviors), strategic ignoring and giving good commands taught in PriCARE. It is designed to promote the use of positive discipline techniques—such as behavior reward charts and effective time-out protocols—as well as skills for handling sibling conflicts and troubleshooting difficult discipline situations.

To assess the feasibility of access to this module, we measured enrollment by calculating the percentage of eligible caregivers who choose to enroll and the number of sessions they attended. Measuring feasibility of this module provided insight into whether caregivers were willing and able to attend five sessions following their attendance at six initial PriCARE sessions and if they viewed the topics covered in this module as beneficial.

Next, to understand the impact of the Positive Discipline Module on child behavior problems, parenting attitudes, quality of caregiver-child interactions, and child maltreatment risk, we conducted virtual interviews and video recordings prior to the intervention and then again two to four weeks after the program ended.

Lastly, after completion of the module, we assessed acceptability by administering the Therapeutic Attitudes Inventory, a 10-question satisfaction measure of caregiver training and caregiver-child treatment. We also collected feedback on participants’ experiences through a brief interview to inform our curriculum and identify ways to improve the program.

Next Steps

Between February 2021 and October 2022, we piloted the new Positive Discipline Module with eight groups. Currently, our team is analyzing the data collected on parent-reported behavior concerns and intensity, discipline strategies, estimated child abuse risk, and behavioral observations of play situations between the caregiver and child both before and after they participated in the Positive Discipline Module via a randomized controlled trial. We hope to be able to share our findings soon!

This project was an additional step in building evidence and creating a blueprint for providing supports to caregivers in the pediatric primary care setting for preventing child behavioral concerns. The Positive Discipline Module has the potential to reduce harsh parenting, a key risk factor for child social, emotional and behavioral problems, but also for child abuse. Through strengthening caregiver-child relationships and providing effective discipline, we can reduce these risks, improving long-term outcomes for children.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Making Time for Time Out: Evaluating a Discipline Education Module for Caregivers of Young Children [Online]. Available at: http://www.policylab.chop.edu [Accessed: plug in date accessed here].

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