Journal of Child & Adolescent Trauma, 1:341–348, 2008 Copyright © 2008 by The Haworth Press. All rights reserved. ISSN: 1936-1521 print / 1536-153X online DOI: 10.1080/19361520802505719

1936-1521 WCAT Journal 1536-153X of Child & Adolescent Trauma Trauma, Vol. 1, No. 4, October 2008: pp. 1–16

Early Childhood Professionals’ Recommendations for Spanking Young Children MICHELE KNOX1 AND JASON BROUWER2

Professionals’ M. Knox and J.Recommendations Brouwer for Spanking

1

College of Medicine, University of Toledo Department of Psychology, University of Toledo

2

The current study describes what professionals involved in the care of young children recommend with regard to spanking and other disciplinary techniques. Relationships between corporal punishment and multiple negative child outcomes are detailed, with emphasis on physical child abuse. Ninety-eight participants, including medical professionals, residents, mental health professionals, child development specialists, and early childhood service coordinators, were asked to report how often they recommended spanking within the past year. Twenty percent of pediatricians and approximately one third of mental health professionals and early childhood professionals recommended spanking at least once in the past year to parents of children age 5 years or younger. Implications for further research about the context of such recommendations as well as improved education for professionals are discussed. Keywords corporal punishment, physical punishment, parenting, child abuse prevention

Adults who care for young children are responsible for directing, teaching, and socializing children toward prosocial behavior and away from misbehavior. Adults have vital roles in creating healthy and safe learning environments for children, so that children can thrive and become fully capable, principled, and conscientious adults (Emde & Sameroff, 1989). To be effective, this needs to start in very early childhood, a period when children are primed to learn basic prosocial skills and incorporate long-lasting beliefs about how to conduct themselves in society. Research about early brain development indicates that early experiences form a foundation for a child’s learning and socialization, and can have lifelong effects (Anda et al., 2006). Research has identified corporal punishment of children as one of the most common forms of discipline in the United States (Regalado, Sareen, Inkelas, Wissow, & Halfon, 2004). Corporal punishment is defined as “the gratuitous intentional infliction of pain on children’s bodies for the purpose of modifying behavior” (Bitensky, 2006, p. 2). The most common form of corporal punishment is called “spanking” and this term therefore is often used interchangeably with “corporal punishment.” Spanking is defined as “to strike with the flat of the hand; to smack” (Webster’s Dictionary & Thesaurus, 2002). Similarly, childhood experts have defined it as “hitting a child with an open hand on the buttocks or extremities with the intent to discipline without leaving a bruise or causing physical harm” (Kazdin & Benjet, 2003, p. 100). Submitted May 1, 2008; revised August 25, 2008; accepted September 18, 2008. Address correspondence to Michele Knox, University of Toledo, College of Medicine, Kobacker Center, 3130 Glendale Avenue, Toledo, OH 43614. E-mail: [email protected]

341

342

M. Knox and J. Brouwer

Research on corporal punishment indicates that it is characterized by limited effectiveness and a likelihood of detrimental consequences. True experimental designs are not viable in this area of research, largely because random assignment of families to corporal punishment and no corporal punishment groups would be unethical. Nonetheless, the body of literature documenting the negative effects of corporal punishment includes no less than a dozen longitudinal studies documenting the temporal sequence of the relationship, with corporal punishment preceding negative child outcomes (e.g., Deater-Deckard, Dodge, Bates, & Pettit, 1996; Eron, Huesmann, & Zelli, 1991). Furthermore, several longitudinal studies have controlled for children’s previous behaviors to ascertain the directionality of the relationship (e.g., Olweus, 1980; Weiss, Dodge, Bates, & Pettit, 1992). Research findings substantiate associations between corporal punishment and child behavior problems. Most prominently, the link between corporal punishment and childhood aggression and antisocial behavior is now well documented (Brezina, 1999; Flynn, 1999; Stormshak, Bierman, McMahon, Lengua, & Conduct Problems Prevention Research Group, 2000; Strassberg, Didge, Pettit, & Bates, 1994; Straus & Donnelly, 2001; Straus & Kantor, 1994; Straus, Sugarman, & Giles-Sims, 1997). Such studies document increased fighting in school, hitting of parents, dating violence, and delinquent or disobedient behavior in children who were spanked. Importantly, these studies show links between corporal punishment and negative child behavior even in the absence of physical abuse. That is, even when parental physical punishment does not cross the line into physical abuse, it appears to contribute to aggression and antisocial behavior in children. Similarly, multiple other established negative outcomes, such as poor quality of the parent/child relationship, poorer child mental health, adulthood antisocial behavior, and poorer mental health in adulthood were demonstrated in studies of nonabusive parents using corporal punishment (Gershoff, 2002). The positive association between corporal punishment and physical abuse of a child has also been well documented in the literature (e.g., Gelles & Straus, 1988; Gil, 1973; Graziano, Hamblen, & Plante, 1996; Schumacher & Carlson, 1999; Straus & Kantor, 1994; Vasta, 1982; Wolfe, 1987; Zigler & Hall, 1989). The link between corporal punishment and physical child abuse has been so clearly delineated that many child abuse prevention specialists consider corporal punishment the first step in a continuum leading to child abuse. As Straus (2000) contends, “Ending corporal punishment should become an explicit goal of those concerned with preventing physical abuse” (p. 1110). To summarize the significant research addressing this issue, Gershoff (2002) conducted meta-analyses of published research on associations between corporal punishment and various child behaviors and experiences. The analyses were based on data from all available empirically sound research on the topic. This resulted in 88 studies, representing more than 36,000 participants, covering the years 1938 to 2000. The results indicate that corporal punishment of children relates to several negative factors, including increased child aggression, increased delinquent and antisocial behavior, decreased quality of parent/child relationships, decreased child mental health, and increased physical abuse of the same child. In addition, distal relationships were identified, including increased aggression in adulthood, increased adult criminal behavior, decreased adult mental health, and increased risk of abusing one’s own spouse or child. These results underscore the fact that the use of corporal punishment is related not only to short-term behavioral problems in childhood, but also to long-term antisocial behavior and mental health problems in adulthood. In light of the research on spanking, the American Academy of Pediatrics (1998) has recommended that parents be encouraged and assisted in the development of

Professionals’ Recommendations for Spanking

343

methods other than spanking for managing misbehavior. Today, many professional organizations such as the American Academy of Pediatrics, the National Association of Social Workers (2006), and the American Association of Child and Adolescent Psychiatry (1998) recommend against spanking and other forms corporal punishment and strongly recommend that parents choose alternative methods of discipline. Moreover, 23 nations have made it illegal for parents to strike their children (Center for Effective Discipline, 2008). Worldwide reform is increasing; of the 23 nations outlawing corporal punishment in the home, 7 have passed such reform within the past year. Furthermore, the United Nations Secretary General’s Study on Violence Against Children has recently called for explicit “prohibition of corporal punishment and other forms of cruel or degrading punishment” (United Nations, 2006, p. 26). Despite this world progress and interest in ending corporal punishment of children, very little is known about what professionals (e.g., pediatricians, mental health professionals, early childhood specialists) who work with families of young children are currently recommending with respect to corporal punishment of children. Despite these pronouncements, support of corporal punishment by professionals has been remarkably high. For example, McCormick (1992) documented that as many as 70% of family physicians and 59% of pediatricians supported the use of corporal punishment under certain circumstances. Approximately 42% of pediatricians report they recommend it under specific conditions (American Academy of Pediatrics, 1998). The “disconnect” between the research findings and the status of public support of corporal punishment is confounding, for “No other practice receives such widespread public support and yet also receives a near unanimous call for its abolishment by researchers” (Robinson, Funk, Beth, & Bush, 2005, p. 117). The primary aim of the current study is to examine what professionals involved with families of young children are currently recommending with regard to corporal punishment and other forms of discipline. The current discipline recommendations reported by early childhood professionals are described. Because this is a descriptive study, no hypotheses were posited.

Method Participants All participants identified themselves as professionals involved with families of young children. The final sample of participants included 98 adults (72 females, 12 males, 14 unknown). Table 1 reports the frequencies and percentages associated with participants’ reported professions. Table 1 Frequencies and Percentages of Professions Professions Mental health professionals Medical professionals/residents Child development specialists/service coordinators Unknown

Frequency

Percentage

19 21 44 14

19.4 21.4 44.9 14.3

344

M. Knox and J. Brouwer

Materials Participants were asked, “Over the past year, how often have you recommended spanking for parents of children ages 4 years to 5 years to prevent or deal with misbehavior?” Equivalent questions were asked for the child age ranges 1 to 3 years and for infants (ages birth to 1 year). The ages birth to 5 years were chosen because the prevalence of corporal punishment is highest during these years (Straus & Stewart, 1999). Participants were asked to rate items on a 5-point Likert scale comprised of the following response choices: all the time, often, some of the time, once or twice, and never. Participants were also asked to report their current profession. Procedure Professionals attending didactic or professional seminars were asked to complete anonymous questionnaires about their recommendations for spanking young children. Data were gathered at an infancy and early childhood mental health conference, a didactic seminar for physicians and pediatric residents at a medical school, a staff meeting for mental health professionals in a mental health agency, and a staff training for school personnel and mental health professionals in a mental health agency. Attendance was either incentivized with continuing education credits (early childhood professionals) or required for the attendees (staff, personnel, mental health professionals, physicians, and residents). Individuals attending the educational seminars were asked to complete a preseminar questionnaire and a background questionnaire. Participants were informed that the questions were anonymous and that participation was voluntary. Personal health information was not obtained in the study, and data were collected anonymously. The study was submitted for review by the primary author’s institutional review board and was categorized as “exempt” because this study did not impose any foreseeable risks to the participants; therefore written informed consent was not obtained. There was no cost to the participants and no compensation.

Results Table 2 lists the percentages of the total sample who recommended spanking for each age group studied, by frequency of recommendation. Of the total sample, 6.5% reported having recommended spanking to parents of infants at least once over the past year. Recommendations for spanking were made by 22.6% of the sample for parents of 1- to 3-year-olds. Nearly one quarter (24%) had recommended spanking to parents of 4- to 5-year-old children in the past year. Four participants (4.2%) recommended hitting a child with an object.

Table 2 Percentage of Sample Reporting Recommending Spanking by Frequency of Recommendation and Child Age

Infants Age 1 to 3 years Age 4 to 5 years

All the time

Often

Some of the time

Once or twice

Never

1.1 3.2 2.1

0 2.2 1.0

4.3 6.5 9.4

1.1 10.8 11.5

93.5 77.4 76.0

Professionals’ Recommendations for Spanking

345

Table 3 Percentage of Sample Reporting Recommending Spanking by Profession and Child Age Mental health professionals (n = 19) Infants Age 1 to 3 years Age 4 to 5 years

0 29.4 21.1

Medical professionals/ residents (n = 21) 10.5 21.1 20

Child development specialists/service coordinators (n = 44) 9.5 23.3 27.9

Frequency analyses were computed for each of the three occupational categories by child age. Table 3 reports the percentages of each professional group who reported having recommended spanking for each child age group. Twenty percent of pediatricians, 31.6% of mental health professionals, and 32.6% of early child professionals recommended spanking at least once in the past year to parents of children age 5 years or younger. Chi-square analyses were conducted to compare frequencies of endorsement of spanking across the three groups of professionals. For this analysis, the three child age groups were combined. This analysis revealed no differences between the professional groups on the history of recommending spanking, χ2(2, N = 84) = 1.14, p = .57.

Discussion The results of the current study indicate that, despite research clearly documenting possible deleterious effects of spanking, as well as professional and international criticism of this practice, a significant portion of early childhood professionals in the United States continue to actively recommend this practice. Twenty percent of pediatricians and approximately one third of mental health professionals and early childhood professionals recommended spanking at least once in the past year to parents of children age 5 years or younger. Also concerning is the small but significant percentage of professionals who have recommended disciplinary practices that carry a high likelihood of causing physical harm, such as hitting a child with an object (4.2%, N = 4) and spanking an infant (6.5%, N = 8). Limitations to the study include a nonrandom sampling of professionals from a restricted region of the country (the Midwestern United States). Results likely are not generalizable to groups of early childhood professionals in different locations. A larger sample size and national sampling would be needed to improve the generalizability of the findings of subsequent studies on this topic. Furthermore, it should be noted that participants’ attendance was either incentivized with continuing education credits (early childhood professionals) or required for the attendees (staff, personnel, mental health professionals). It is possible that some potential participants nevertheless may have chosen not to attend the seminars due to the subject matter being presented. It is likely that these would be professionals without an interest or experience in advising parents in corporal punishment. It is also possible that those who did not attend were not willing to consider alternative views on the issue, holding firmly entrenched beliefs either for or against corporal punishment of children. The current findings therefore may not be generalizable to these groups. Due to the paucity of research on mental health and child development professionals’ recommendations, it is not clear whether these findings indicate a reduction or,

346

M. Knox and J. Brouwer

conversely, an increase over time in these professionals’ recommendations regarding corporal punishment. The results do suggest a reduction in medical professionals’ recommendations, from 42% in the American Academy of Pediatrics (1998) study to 20% in the current study. It should be noted that the results of this study do not illustrate the percentage of professionals who support or condone corporal punishment of children, as did McCormick’s (1992) study. We chose to study practices, as opposed to attitudes, based in part on research indicating that beliefs and practices regarding corporal punishment do not coincide (Straus & Donnelly, 2001). It is also not known how many professionals provide implicit support for spanking by failing to discourage its use when parents report it. It remains unclear why some professionals recommend corporal punishment while others do not. Future research will be needed to better understand professionals’ reasons for such recommendations. While not explicitly studied, many professionals participating in the study reported to the researchers that they were not aware of their professional organizations’ stance on the issue of spanking. Research addressing professionals’ awareness and understanding of organizational statements on corporal punishment may be useful. Such research could also focus on whether methods other than or in addition to policy statements may be necessary to effectively educate professionals about corporal punishment. Building child development education into medical student training, providing continuing education to established early childhood professionals, and developing media campaigns are some possible strategies to address this issue. An improved understanding of the characteristics (e.g., aspects of training in child development and parenting, personal experience with corporal punishment, etc.) of professionals who do and do not recommend spanking may be useful in effectively developing and directing educational efforts. More details on the characteristics of families (e.g., severity of child behavior problem, family history of violence) who most often receive recommendations to spank also may inform such efforts. Research specifically addressing professionals’ reasons for changing their endorsement of spanking, and what factors accounted for this change, may be especially informative. Lastly, the role of early childhood professionals in child abuse prevention must not be understated. For example, 90% of pediatricians give advice to parents about discipline when providing anticipatory guidance to families (McCormick, 1992) Anticipatory guidance provided by an early childhood professional before the birth of a child or during infancy would provide an unmatched opportunity to educate parents about corporal punishment and provide effective, nonviolent alternatives. To achieve this, early childhood professionals must first be educated about corporal punishment, then helped to build effective strategies into anticipatory guidance efforts. Subsequent research addressing the education and practices of key professionals involved in the lives of families with young children may reveal important information about the prevention of corporal punishment and physical child abuse.

References American Academy of Pediatrics. (1998). Periodic survey of fellows, periodic survey #38: Attitudes and counseling on corporal punishment in the home. Elk Grove Village, IL: Author. American Association of Child and Adolescent Psychiatry. (1988). Policy statement: Corporal punishment in schools. Washington, DC: Author. Anda, R., Felitti, V., Bremner, J., Walker, J., Whitfield, C., Perry, B., et al. (2006). The enduring effects of abuse and related adverse experiences in childhood: A convergence of evidence from

Professionals’ Recommendations for Spanking

347

neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256, 174–186. Bitensky, S. (2006). Corporal punishment of children: A human rights violation. Ardsley, NY: Transnational. Brezina, T. (1999). Teenage violence toward parents as an adaptation to family strain: Evidence from a national survey of male adolescents. Youth & Society, 30, 416–444. Center for Effective Discipline. (2008). Discipline and the law: Legal reforms. Retrieved August 20, 2008, from http://www.stophitting.org/laws/legalReform.php Deater-Deckard, K., Dodge, K. A., Bates, J. A., & Pettit, G. S. (1996). Physical discipline among African American and European American mothers: Links to children’s externalizing behaviors. Developmental Psychology, 32, 1065–1072. Emde, R. N., & Sameroff, A. J. (1989). Understanding early relationship disturbances. In A. J. Sameroff & R. N. Emde (Eds.), Relationship disturbances in early childhood: The developmental approach (pp. 3–16). New York: Basic Books. Eron, L. D., Huesmann, L. R., & Zelli, A. (1991). The role of parental variables in the learning of aggression. In D. J. Pepler & K. H. Rubin (Eds.), The development and treatment of childhood aggression (pp. 169–188). Hillsdale, NJ: Erlbaum. Flynn, C. P. (1999). Exploring the link between corporal punishment and children’s cruelty to animals. Journal of Marriage and the Family, 61, 971–981. Gelles, R. J., & Straus, M. A. (1988). Intimate violence. New York: Simon & Schuster. Gershoff, E. T. (2002). Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review. Psychological Bulletin, 128(4), 539–579. Gil, D. (1973). Violence against children: Physical abuse in the United States. Cambridge, MA: Harvard University Press. Graziano, A. M., Hamblen, J. L., & Plante, W. A. (1996). Subabusive violence in child rearing in middle-class American families. Pediatrics, 98, 845–848. Kazdin, A., & Benjet, C. (2003). Spanking children: Evidence and issues. Current Directions in Psychological Science, 12(3), 99–103. McCormick, K. F. (1992). Attitudes of primary care physicians toward corporal punishment. Journal of the American Medical Association, 267, 3161–3165. National Association of Social Workers. (2006). Physical punishment of children. In Social works speaks (7th ed.). Retrieved September 16, 2008, from http://www.socialworkers.org/resources/ abstracts/abstracts/physical.asp Olweus, D. (1980). Familial and temperamental determinants of aggressive behavior in adolescent boys: A causal analysis. Developmental Psychology, 16, 644–660. Regalado, M., Sareen, H., Inkelas, M., Wissow, L. S., & Halfon, N. (2004). Parents’ discipline of young children: Results from the national survey of early childhood health. Pediatrics, 113(6), 1952–1958. Robinson, D. H., Funk, D. C., Beth, A., & Bush, A. M. (2005). Changing beliefs about corporal punishment: Increasing knowledge about ineffectiveness to build more consistent moral and informational beliefs. Journal of Behavioral Education, 14(2), 117–139. Schumacher, R. B., & Carlson, R. S. (1999). Variables and risk factors associated with child abuse in daycare settings. Child Abuse and Neglect, 23(9), 891–898. Stormshak, E. A., Bierman, K. L., McMahon, R. J., Lengua, L. J., & Conduct Problems Prevention Research Group. (2000). Parenting practices and child disruptive behavior problems in early elementary school. Journal of Clinical Child Psychology, 29(1), 17–29. Strassberg, Z., Dodge, K. A., Pettit, G. S., & Bates, J. E. (1994). Spanking in the home and children’s subsequent aggression toward kindergarten peers. Development and Psychopathology, 6(3), 445–461. Straus, M. A. (2000). Corporal punishment and primary prevention of physical abuse. Child Abuse & Neglect, 24(9), 1109–1114. Straus, M. A., & Donnelly, D. (2001). Beating the devil put of them. New Brunswick, NJ: Transaction.

348

M. Knox and J. Brouwer

Straus, M. A., & Kantor, G. K. (1994). Corporal punishment of adolescents by parents: A risk factor in the epidemiology of depression, suicide, alcohol abuse, child abuse, and wife beating. Adolescence, 29(115), 543–561. Straus, M. A., & Stewart, J. H. (1999). Corporal punishment by American parents: National data on prevalence, chronicity, severity, and duration in relation to child and family characteristics. Clinical Child and Family Psychology Review, 2, 55–70. Straus, M. A., Sugarman, D. B., & Giles-Sims, J. (1997). Spanking by parents and subsequent antisocial behavior of children. Archives of Pediatrics & Adolescent Medicine, 151(8), 761–767. United Nations. (2006). World report on violence against children. Geneva, Switzerland: United Nations Publishing Services. Vasta, R. (1982). Physical child abuse: A dual-component analysis. Developmental Review, 2(2), 125–149. Webster’s Dictionary and Thesaurus. (2002). New Lanark, Scotland: Geddes & Grosset. Weiss, B., Dodge, K. A., Bates, J. E., & Pettit, G. S. (1992). Some consequences of early harsh discipline: Child aggression and a maladaptive social information processing style. Child Development, 63, 1321–1335. Wolfe, D. A. (1987). Child abuse prevention with at-risk parents and children. In J. D. Burchard & S. N. Burchard (Eds.), Prevention of delinquent behavior (pp. 160–189). Thousand Oaks, CA: Sage. Zigler, E., & Hall, N. (1989). Physical child abuse in America: Past, present and future. In D. Cicchetti & V. Carlson, (Eds), Child maltreatment: Theory and research on the causes and consequences of child abuse and neglect (pp. 38–75). New York: Cambridge University Press.