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One of the most commonly practiced strategies used by parents to alter long term behavior of their children is corporal punishment, commonly referred to as spanking. But use of the term spanking is problematic in that how caregivers interpret it varies widely, and there is frequent overlap with what pediatricians consider to be abuse. Despite a great deal of evidence showing that spanking is ineffective, is a risk factor for greater forms of physical abuse and can negatively impact the behavioral and cognitive development of children in a variety of ways, it remains a controversial issue in the United States. The American Academy of Pediatrics and numerous other professional organizations have come down firmly against the use of physical punishment by parents, but unlike 34 other developed nations there are no federal laws banning spanking.

Laws regarding corporal punishment vary from state to state. 19 states currently allow the striking of a child in any school setting. Of the 31 states and the District of Columbia that ban the practice in public schools, only New Jersey and Iowa also include private schools. Many schools give the misbehaving child a choice between suspension and being beaten with a paddle. It is also common for schools to require a parent to opt out of their child receiving corporal punishment rather than having to sign a consent form before such physical correction is applied. Corporal punishment in schools is more prevalent in the South and in lower socioeconomic school districts, leading to poor black children being by far the most likely to face it.

Currently no state has a law that explicitly bans corporal punishment in the home. In fact, most state laws have specific language in their statutes on abuse, assault, battery, or domestic violence that make exceptions for spanking by a caregiver. In 2012, new child abuse legislation in Delaware made the news because it might possibly be interpreted as making spanking illegal. The law was put into place to serve as a means of improving the ability to protect children from physical abuse, but the language was vague. The lawmakers claim that it is not meant to interfere with parents who choose to use “reasonable force”, whatever that means, and do not cause injury.

There are many examples of folks being arrested for “spanking”, but these invariably involve the use of an instrument like a spoon or metal rod, or the use of excessive force that leaves long lasting marks or bruising. The use of the word “spanking” in these reports confuses the issue. I certainly wouldn’t call it that and it doesn’t fit the definition of spanking used by the AAP. I was unable to find a single case of a parent or caregiver being arrested for spanking as defined by “reasonable people”. Again, whatever that means.

I have always felt strongly that spanking children is a parenting technique that reflects more on the poor coping skills of the caregiver than on the behavior of the child. Spanking is a practice that appears to be carried from generation to generation primarily by anecdotal reports of success, cultural momentum and weak science. Odd, at least to me, is the fact that many parents who spank seem to proudly wear their own history of being spanked as some kind of a badge of honor. “Look at me. I was spanked and I turned out just fine!” The psychology of this makes sense to me though. I doubt many parents look at a newborn child and plan to make use of corporal punishment to mold them into an upstanding citizen. More likely they do so out of anger and frustration, and only then find the need to justify the act.

But in any one individual case, it very well may be true that an adult who was submitted to recurrent episodes of corporal punishment as a child has turned out just fine. Of course they would have almost certainly turned out just fine if they had never been spanked. They might have turned out better though. The evidence just doesn’t support the practice, and many children almost certainly do not turn out just fine. Some end up being more severely abused, many have long term difficulties and most grow up to use corporal punishment as a technique themselves.

Examples of spanking apologetics are everywhere online. What inspired me to finally cover this topic, something I’ve been toying with for months, was when an acquaintance on Facebook recently “liked” a meme which blames spanking for the “psychological condition known as ‘respect for others.'” But that is just the tip of the iceberg. Here is a terrible article giving 8 Reasons to Spank Your Kids. Here is one that explains Why Spanking is Necessary that is based on the Biblical principle that young children must be absolved of their guilt through physical punishment as an act of love. If you aren’t scared already, this is the very same concept put forth in the infamous To Train Up a Child book which has led to several deaths. Religiously-motivated pro-spanking websites are extremely common.

In 2010 a study, that supposedly showing that children who were spanked grew up happier and more successful, made the rounds (1, 2, 3). There are countless links to these press releases and news reports on parenting boards and blogs attempting to endorse or justify spanking. All leave out important facts, such as how the study was a small and unpublished outlier. But if you google “benefits of spanking”, this is pretty much the only “science” you’ll find.

what is corporal punishment and when is it physical abuse?

Simply put, corporal punishment is the use of physical pain in response to behavior that has been deemed inappropriate. As with many behaviors, there is a spectrum of severity. Anything from a light slap on the back of the hand to holding your child’s foot in scalding water is technically corporal punishment. One end of this spectrum is clearly accepted as physical abuse by rational people while much of the rest of it is not, which is a big part of what makes this such a touchy subject.

Many parents who use one form of corporal punishment would take offense at the notion of being put in the same category as other parents who use a different form of corporal punishment. Not everyone agrees on where the line between acceptable physical punishment and abuse, or even between what are appropriate and inappropriate non-abusive techniques, should be placed. The AAP defines spanking as “striking a child with an open hand on the buttocks or extremities with the intention of modifying behavior without causing physical injury.” They differentiate spanking from other forms of physical punishment that incorporate the use of an object, target other areas of the body, leave bruises or red marks that persist more than a few minutes, or involve pulling the hair or jerking the child by an extremity.

The AAP lumps physical punishment doled out while angry, or with the intent to cause pain, with these and states that they are all unacceptable and should never be used. But how does one spank without the intent to cause pain? And available research doesn’t support that corporal punishment is able to be planned or initiated when the caregiver is calm, which is integral to the recommendations of most pro-spanking resources. In one survey, 85% of respondents “felt moderate to high anger, remorse, and agitation while punishing their children” with 44% reporting that more than half of the time they had “lost it.” This makes sense to me because it fits with how most episodes of more severe physical abuse occur when a parent or caregiver snaps. I imagine that few people in jail for hurting a child thought it was something that they were capable of before the event.

We are still left with the question of what is child abuse, or at least how do we differentiate it from spanking or other forms of less severe corporal punishment. When an angry parent uses a belt to slap a child on the buttock, are they committing child abuse or just using an inappropriate form of spanking? Unfortunately, many still find this completely acceptable. What if the belt leaves a bruise that lasts for a few days? What if a plastic pipe is used? What if they do this repeatedly over the child’s first few years of life? What if it is a 4-month-old? When should child protective services be notified? These can be tough questions. I know how I feel but am not always comfortable in my role as arbiter. I am considerably more comfortable when it comes to the discussion of effectiveness and risk of spanking.

The AAP, in their policy statement on the evaluation of suspected physical abuse, recognizes this problem:

The recognition and reporting of physical abuse is hindered by the lack of uniform or clear definitions. Many state statutes use words such as “risk of harm,” “substantial harm,” “substantial risk,” or “reasonable discipline” without further clarification of these terms. Many states still permit the use of corporal punishment with an instrument in schools; on the other hand, the American Academy of Pediatrics has proposed that “striking a child with an object” is a type of physical punishment that “should never be used” and has recommended that corporal punishment be abolished in schools. The variability and disparities in definitions may hinder consistent reporting practices.

I believe that this puts it lightly. And they don’t say that “should never be used” equates to child abuse or that use of an object should be illegal. I have little doubt that there are many children out there who are disciplined in ways that should probably be categorized as abuse but are not. I believe that many pediatricians and other pediatric healthcare professionals employ compartmentalization when it comes to acceptable corporal punishment versus physical abuse, and rationalize the probable abuse as a parental right. Many of us are likely hindered by a general discomfort telling parents how to raise their children. But more on what pediatricians think about corporal punishment later.

Who uses corporal punishment and who is on the receiving end?

Spanking is extremely common. I found a number of sources (1, 2, 3, 4, 5, 6) with slightly different statistics but all make it clear how prevalent corporal punishment in the home is. Data from the 1970’s revealed that more than 90% of families in the United States used corporal punishment in the home at least once. More recent data supports the continued high prevalence, with roughly 80% of young children and more than half of kids through age 13-14 years being disciplined by a caregiver with physical punishment several times each year.

There are many socioeconomic and cultural factors which increase the likelihood that corporal punishment will be used by caregivers, and that it will be used more frequently. Spanking is more common with boys and tends to be harsher. Use increases as family income decreases, and black children are much more likely to be spanked than white kids. Parents who were spanked are also more likely to spank their own children, as are caregivers who are more stressed in general.

Although corporal punishment is most widespread in low socioeconomic households, a 1996 survey revealed just how common, and how severe, it can be in middle class families. 25% of participants acknowledged weekly use and 35% admitted to occasionally using an object. An object was used half of the time in 17%. 12% of the occurrences of corporal punishment were felt to have caused considerable pain with 5% leaving lasting marks on the child’s body.

Spanking is most commonly used to discipline preschool and school-aged children, but sadly about 15% of children under the age of 1 year are spanked. This number is considerably higher in poor families, with about a third of infants being hit. Women who experienced physical or sexual abuse, or were exposed to violence in the home, are much more likely to practice infant spanking and to have a positive view of corporal punishment in general. Children this young, and often even older kids, do not understand the connection between the physical punishment and the undesired behaviors, and even the vast majority of spanking proponents do not recommend it in babies.

What about the evidence? What is so bad about spanking?

I’d love to make this section very short to save time as I sit in our neighborhood library during my first blizzard and a rapidly approaching subzero wind chill. The default after all should be that nobody should intentionally inflict pain on a child without evidence to support the benefit outweighing the risk, such as with an immunization or surgical procedure. And the burden of proof should naturally be on the proponents to provide this evidence. So far, there is no scientific evidence to support that corporal punishment is an effective behavior modification technique and only a meager gruel of studies which at best show that it may not be quite as harmful as most experts think. Done.

The problems with this approach, however, is that it is far too late. As described above, the use of spanking for behavior modification is commonplace, even among otherwise well-meaning and reasonable folks. And there is good, although imperfect, data showing that there are considerable risks. Even proponents of spanking, who question what the available literature appears to show, strongly recommend limits on its use. Limits, such as not using an object or leaving a persistent mark, or not hitting children under one or over six years of age, that are often not followed.

First and foremost, spanking doesn’t tend to work very well, and certainly is a less effective form of punishment than time-out strategies or other negative punishments like removal of privileges. A positive punishment like spanking may in the acute setting stop an unwanted behavior but it loses effect over time. Thus in order to achieve the same result, it often must be increased in intensity, which is part of why it can lead to clear abuse. So there is room to argue that in a very few specific instances, such as a child about to put their finger in an electrical outlet, an immediate slap on the hand might stop the behavior. Of course so would simply removing them from the area and putting a cover on the outlet, and explaining the danger once they are old enough to understand.

There are a variety of potential harms that studies have linked to the recurrent use of corporal punishment on children. In addition to the potential to lead to physical abuse, repeated spanking may cause agitation and lead to aggressive behaviors through observational learning of poor coping skills. Spanking risks negatively impacting the parent-child dyad, making other forms of discipline less effective when the child is too old/large for the use of physical punishment. Children who are spanked may come to accept it as a parental right, which increases the likelihood that they will spank their own children and even that they will abuse their spouse. Use of corporal punishment has also been linked to negative cognitive outcomes, in particular decreased receptive and expressive vocabulary. (1, 2, 3)

The ability to study the harm of spanking is hindered by a lack of prospective studies. It would be unethical to have a randomized trial where some children are intentionally subjected to corporal punishment. So the available data is retrospective and often based on maternal report. There have been few longitudinal studies and, as you can probably imagine, there are a number of potentially confounding socioeconomic and caregiver variables.

While discussing this recently on Twitter (@skepticpedi), I was asked how we know that bad and more aggressive kids aren’t just spanked more. That certainly sounds plausible. The two studies I provided links to above are the most recent and best to date, and provide solid evidence to support concerns that spanking actually plays a causal role in future aggressive behavior and interference with cognitive development. Using data from the Fragile Families and Child Well-Being Study, which was a longitudinal birth cohort study of over 4,000 kids from 20 major US cities through age 9 years, both were able to take into account a large number of potential confounders involving “family characteristics and risk with the potential to affect parenting stress and family functioning.”

What do pediatricians think about corporal punishment in the home?

The AAP periodically surveys its Fellows on a variety of topics. In 1998, one such survey looked into the attitudes and counseling on corporal punishment in the home. The results were based on responses from 603 post-residency Fellows who provide direct patient care. Here is what it revealed:

53.4% of responding pediatricians were generally opposed to the use of corporal punishment by parents, but not to an occasional spanking for certain reasons. I guess that is the finger in an outlet clause. 31.4% were completely opposed to the use of corporal punishment under any circumstances. Only 14.4% supported limited, which I take as non-abusive, use while just 1.5% were unsure of what they think about it. Sadly, only about half ever discussed the pros/cons of corporal punishment with parents. Of note, about 75% of pediatricians in the survey reported that they had been spanked as a child and a full third admitted to spanking their own kids, although less than 1% said it was their most commonly employed disciplinary strategy.

It’s entirely possible that this data is not reflective of current trends. Hopefully even fewer pediatricians are supportive today compared to 15 years ago. And hopefully more are taking time to discuss it.

Conclusion

The limited use of mild corporal punishment, in very isolated and specific circumstances, may have some benefit but prevention/protection is almost always a better option. Its use as a strategy to improve overall behavior is fraught with risk. Although imperfect, there is good evidence that recurrent use can lead to physical abuse, interfere with learning and increase aggression. And it may worsen behavior in the long run.

There is an absence of any data showing it to be more effective than other techniques, such as negative punishment strategies like time outs. Unfortunately, the internet is full of pro-spanking propaganda that relies on anecdotes, old fashioned thinking and one study that didn’t survive peer review. The best initial resource for questions regarding discipline should always be a child’s physician. We aren’t perfect, but most pediatricians accept that corporal punishment is a poor method of discipline and should be able to provide education and help accessing local resources.