Pediatricians’ Group Says Spanking is Ineffective, Potentially Harmful

It’s official: spanking is out. Time-outs are in. That’s the lead message of a new policy statement from the largest pediatricians’ group, in its strongest warning yet against the use of spanking or other harsh punishments–ever–by parents and others charged with caring for children. It’s the American Academy of Pediatrics’ (AAP) first update to its policy guideline on discipline since 1998, when it discouraged but did not specifically proscribe spanking. This time, the message is clear: spanking doesn’t work and may cause harm. Ditto for harsh verbal reprimand that shames or humiliates.

The policy, which is intended to guide clinicians in their interactions with parents, cites 20 years of scientific research it says overwhelmingly demonstrates that corporal punishment is not only ineffective as a disciplinary measure, but may be harmful. Spanking in and of itself is associated with adverse outcomes that are similar to those seen in physical child abuse.

“All of what we know says parents should never hit their children,” Robert Sege, M.D., Ph.D., the policy’s coauthor and a pediatrician at the Floating Hospital for Children at Tufts Medical Center in Boston, said in an interview in JAMA, the Journal of the American Medical Association.

He pointed to evidence that corporal punishment initiates a cycle of aggression that often followed children into adulthood and raised their risk of mental illnesses, including depression and anxiety.  A 2009 brain-imaging study found that young adults who were spanked as children had reduced gray matter volume in the prefrontal cortex and anterior cingulate, suggesting they may be on a trajectory of altered brain development. Those who had been spanked also performed worse on IQ studies.

“Aversive disciplinary strategies, including all forms of corporal punishment and yelling at or shaming children, are minimally effective in the short-term and not effective in the long-term. With new evidence, researchers link corporal punishment to an increased risk of negative behavioral, cognitive, psychosocial, and emotional outcomes for children,” the policy statement asserts. The AAP Council on Child Abuse and Neglect developed the statement, which was published in December in the AAP journal Pediatrics.

The policy guideline comes at a time of heightened awareness of the long-term brain effects of child abuse and neglect in all its forms. In November, the US Preventive Services Task Force issued its own recommendations for primary care physicians on child abuse prevention, citing evidence of the ill effects of childhood abuse and neglect and finding current preventative efforts insufficient. “Child abuse and neglect, also referred to as child maltreatment—words or actions that cause or fail to protect children from harm, potential harm, or the threat of harm—is associated with negative physical and emotional health outcomes that persist and can lead to serious disorders throughout the life course,” the Task Force said in its statement.

Spanking in particular has been the subject of recent debate as well, with some arguing it should be designated as an Adverse Childhood Experience (ACE), just like physical and emotional abuse, and therefore recognized as a risk factor for mental health problems in adulthood. An analysis of data from 8,316 adults tracked in the CDC-Kaiser ACE study found that spanking was associated with increased odds of suicide attempts, moderate to heavy drinking, and use of street drugs in adulthood, even when concomitant physical and/or emotional abuse were controlled for.

Instead of corporal or harsh verbal punishment, the AAP policy emphasizes “positive parenting,” which includes modeling the type of behavior that is expected, preparing for situations that might elicit unruly behavior, and reinforcing good behavior in children. When a rule is broken and the need for stronger discipline arises, the AAP suggests age-appropriate interventions such as redirecting the child’s attention elsewhere (for infants/toddlers) or a time-out period equal to one minute per year of age. Time-outs can help older children and even teenagers learn to self-manage their behavior by directing the child to end the time-out when the child feels ready and in control.

Advice for parents and caregivers:

“Where We Stand: Spanking” (American Academy of Pediatrics HealthyChildren.org website)

“What’s the Best Way to Discipline My Child?” (American Academy of Pediatrics HealthyChildren.org website)

Positive Parenting Tips (Centers for Disease Control)