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Internet Guidance on Time Out: Inaccuracies, Omissions, and What to Tell Parents Instead

Drayton, Amy K. PhD; Andersen, Melissa N. PhD; Knight, Rachel M. PhD; Felt, Barbara T. MD; Fredericks, Emily M. PhD; Dore-Stites, Dawn J. PhD

Journal of Developmental & Behavioral Pediatrics: May 2014 - Volume 35 - Issue 4 - p 239–246
doi: 10.1097/DBP.0000000000000059
Original Article

Objective: Pediatricians are frequently asked to address parents' behavioral concerns. Time out (TO) is one of the few discipline strategies with empirical support and is recommended by the American Academy of Pediatrics. However, correctly performed, TO can be a complex procedure requiring training difficult to provide in clinic due to time and cost constraints. The Internet may be a resource for parents to supplement information provided by pediatricians. The present study included evaluation of information on TO contained in websites frequently accessed by parents. It was hypothesized that significant differences exist between the empirically supported parameters of TO and website-based information.

Methods: Predefined search terms were entered into commonly used search engines. The information contained in each webpage (n = 102) was evaluated for completeness and accuracy based on research on TO. Data were also collected on the consistency of information about TO on the Internet.

Results: None of the pages reviewed included accurate information about all empirically supported TO parameters. Only 1 parameter was accurately recommended by a majority of webpages. Inconsistent information was found within 29% of the pages. The use of TO to decrease problem behavior was inaccurately portrayed as possibly or wholly ineffective on 30% of webpages.

Conclusions: A parent searching for information about TO on the Internet will find largely incomplete, inaccurate, and inconsistent information. Since nonadherence to any 1 parameter will decrease the efficacy of TO, it is not recommended that pediatricians suggest the Internet as a resource for supplemental information on TO. Alternative recommendations for pediatricians are provided.

This article has supplementary material on the web site:

Division of Child Behavioral Health, Department of Pediatrics, CS Mott Children's Hospital and University of Michigan Medical School, Ann Arbor, MI.

Address for reprints: Amy K. Drayton, PhD, University of Michigan Medical Center, 1924 Taubman Center, 1540 E Hospital Drive, SPC 5318, Ann Arbor, MI 48109-5318; e-mail:

Disclosure: The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions this article on the journal’s Web site (

Received November , 2013

Accepted March , 2014

© 2014 by Lippincott Williams & Wilkins