Does spanking lead to better or worse behavior? © Copyright 2010

Controversial subject Spanking elicits strong views Research is contradictory –Some studies associate spanking with long- term emotional and behavioral problems –Others find that spanking can be a useful disciplinary tool

Most parents spank Nearly 2/3 of parents of one- and two-year-olds report using physical punishment* 80% of fifth-graders say they’ve been physically punished.** 85% of high-school-aged children report having been physically punished; 51% of them say they’ve been hit with a belt or similar object.*** *Regalado et al. Pediatrics *Socolar et al. South Med J **Gershoff et al. Psychol Public Policy Law ***Bender et al. Dev Psychopathol

Many doctors endorse spanking 800 family physicians and 400 pediatricians randomly selected from Ohio State Medical Board’s roster 619 (61%) physicians responded Main outcome measure: whether they would tell a parent in their medical practice that spanking would be appropriate in any one of a series of childhood misbehaviors presented in the survey McCormick KF. JAMA

Results 70% of family physicians endorse corporal punishment 59% of pediatricians endorse corporal punishment Physicians younger than 40 were much more likely than those older than 40 to support it McCormick KF. JAMA

Most supportive of spanking in dangerous circumstances McCormick KF. JAMA

Spanking is decreasing over time The proportion of Americans in favor of physical punishment for children was: 94% in the 1960s 84% in % in 2004 Many nations have outlawed hitting children under any circumstances Straus, Mather. Family violence against children: a challenge for society Gershoff. Unpublished analysis of General Science Surveys

AAP concerns about CP Loses its impact May lead to escalation and, ultimately, child abuse Models aggression as a solution Impedes other forms of discipline, like time-out Alters the parent-child relationship Makes discipline more difficult as the child grows into an adolescent May appeal to parents as a release for their anger Committee on Psychosocial Aspects of Child and Family Health. Pediatrics

AAP bottom line “Because of the negative consequences of spanking and because it has been demonstrated to be no more effective than other approaches for managing undesired behavior in children, the American Academy of Pediatrics recommends that parents be encouraged and assisted in developing methods other than spanking in response to undesired behavior.” Committee on Psychosocial Aspects of Child and Family Health. Pediatrics

Does spanking work? Numerous studies Studies try to measure both efficacy and harms: - Does spanking reduce problem behaviors? - Does spanking cause anti-social behavior? - Does antisocial behavior lead to spanking? - Are spanked children better behaved? - Or do they develop psychological problems? Contradictory results

Some studies find that spanking leads to long-term problems

Does spanking improve behavior? 807 randomly-selected mothers Children 6-9 years old Quantified spanking in month prior to study Controlled for gender, maternal warmth, maternal cognitive stimulation, SES, ethnicity Measured anti-social behavior two years later

Children who were spanked more in the month prior to the study had more antisocial behavior two years later, after controlling for anti- social behavior at baseline, and a number of other predictors Straus MA et al. Arch Pediatr Adolesc Med

Risk factors for anti-social behavior Being male Having a history of anti-social behavior Having a mother of an ethnic minority Being spanked in the week before the interview Straus MA et al. Arch Pediatr Adolesc Med

Conclusions “When parents use corporal punishment to reduce anti-social behavior, the long-term effects tend to be the opposite. The findings suggest that if parents replace corporal punishment by non-violent modes of discipline, it could reduce the risk of anti-social behavior among children and reduce the level of violence in American society.” Straus MA et al. Arch Pediatr Adolesc Med

Same data, different conclusions Ten years later, researchers re-analyzed the same dataset and compared spanking with other disciplinary techniques – including psychotherapy, time-out, grounding and loss of privileges. Larzelere RE et al. BMC Pediatr

Most disciplinary tactics associated with anti-social behavior Larzelere RE et al. BMC Pediatr

Conclusion “The strongest causal evidence against customary spanking (Straus study) seems to be due to residual confounding because behaviorally difficult children cause parents to use all disciplinary corrective actions more frequently. When the measure of initial child differences is improved, the evidence against customary spanking becomes non-significant…” Larzelere RE et al. BMC Pediatr

Perhaps spanking effects are “dose–dependent” 2461 children from Fragile Families and Child Well-Being Study ( ) Interviews with mothers when children 3 and 5 (spanking measured at 3) Controlled for initial aggressive behavior and 8 other confounding variables: maternal child physical maltreatment, psychological maltreatment, neglect, intimate partner aggression, stress, depression, substance use, and consideration of abortion Outcome measure: child aggression at 5 years of age Taylor CA et al. Pediatrics

Outcome depends on frequency of spanking Spanking >2 times in previous month: odds ratio 1.49 for aggressive behavior two years later (p < 0.001) Spanking 1-2 times in previous month: odds ratio 1.17 for aggressive behavior (not statistically significant) Taylor CA et al. Pediatrics

Two meta-analyses come to different conclusions 88 studies done between 1938 and ,309 subjects 117 effect sizes Outcome measures: seven childhood and four adult behaviors Gershoff ET. Psychol Bull

Gershoff’s outcomes Child behaviors - Immediate compliance - Moral internalization - Aggression - Mental health - Delinquent, criminal, antisocial behavior - Quality of parent-child relationship - Becoming a victim of physical abuse Adult behaviors - Criminal and antisocial behaviors - Mental health - Aggression - Adult abuse of own child or spouse

Results Spanking associated with “immediate compliance” – so it works in the short run Associated with negative outcomes in the long run: –Aggression –Antisocial behavior –Poor mental health –Adult abuse of own child or spouse Gershoff ET. Psychol Bull

Findings nearly all negative Gershoff ET. Psychol Bull

Limitations of meta-analysis The 88 studies did not consistently control for the children’s aggression level at the outset Many studies measured corporal punishment and behaviors at the same time, further confounding the issue of cause/effect Corporal punishment and physical abuse are not always clearly distinguished. Didn’t distinguish a swat on the bottom from a punch in the face. Gershoff ET. Psychol Bull

Proposed solutions Base effect sizes on each study’s strongest data, whenever possible Analyze differential effect sizes between physical punishment and alternative disciplinary tactics Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

A different meta-analysis supports spanking in moderation Review of 26 studies –All children, on average, 13 or younger when disciplined –Study looked at one or more alternatives to physical punishment –At least one child outcome measured Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

A different meta-analysis supports spanking in moderation Review of 26 studies All children <13 at time of corporal punishment. Define four categories of physical punishment: –conditional (used rarely and under specific circumstances, as when a pre-schooler won’t stay in a time-out chair) –customary (non-severe) –overly severe (excessive force, hit with object, slapping in face) –predominant (parent’s primary disciplinary method) Compared spanking and alternative forms of discipline

Findings If administered infrequently and not severely, spanking does no harm, and may even be better than alternatives Conditional spanking reduced later noncompliance and antisocial behavior better than 10 of 13 alternative tactics Customary spanking never had worse outcomes than the alternatives Predominant and overly-severe spanking produced worse results than the alternatives Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

Results Infrequent, non-severe spanking better than alternatives Conditional spanking very effective Customary spanking similar to alternatives Predominant and overly severe spanking produced bad outcomes

Predominant and severe spanking are the worst. Customary, conditional spanking not so bad. Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

Spanking looks even better when compared to alternatives Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

Conclusions Spanking can effectively modify behavior if administered rarely and not too harshly It is most effective in response to defiant refusal to comply with milder disciplinary tactics, such as time-out Physical punishment, as well as other forms of punishment, does not enhance positive development, but only inhibits inappropriate behavior Larzelere RE et al. Clin Child Fam Psychol Rev. 2005

Bottom line (no pun intended) Tough to study the effects of spanking Studies give conflicting results Best to start with mild disciplinary tactics Spanking only effective if infrequent Spanking can escalate to child abuse Spanking can deter bad behavior, does not teach good behavior Other disciplinary tactics no better

Resources Straus MA, Sugarman DB, Giles-Sims J. Spanking by Parents and Subsequent Anti- Social Behavior of Children. Arch Pediatr Adolesc Med Aug;151: Spanking by Parents and Subsequent Anti- Social Behavior of Children Gershoff ET. Corporal Punishment by Parents and Associated Child Behaviors and Experiences: A Meta-Analytic and Theoretical Review. Psychol Bull. 2002;128(4): Corporal Punishment by Parents and Associated Child Behaviors and Experiences: A Meta-Analytic and Theoretical Review Larzelere RE, Kuhn BR. Comparing Child Outcomes of Physical Punishment and Alternative Disciplinary Tactics: A Meta-Analysis. Clinical Child and Family Psychology Review, 2005 March;8(1).Comparing Child Outcomes of Physical Punishment and Alternative Disciplinary Tactics: A Meta-Analysis Committee on Psychosocial Aspects of Child and Family Health. Guidance for Effective Discipline. Pediatrics, 1998 April;101(4): Guidance for Effective Discipline Gershoff ET. Report on Physical Punishment in the United States: What Research Tells Us About Its Effects on Children. Columbus, OH: Center for Effective Discipline.Report on Physical Punishment in the United States: What Research Tells Us About Its Effects on Children Horn IB, Joseph JG, Cheng TL. Nonabusive physical punishment and child behavior among African-American children: a systematic review. J Natl Med Assoc Sep;96(9): Nonabusive physical punishment and child behavior among African-American children: a systematic review