Spanking May Make Kids More Aggressive

Updated policy encourages adults to avoid physical punishment, verbal abuse



Children who are spanked by their parents may be more apt to develop aggressive behaviors, and may also be at an increased risk of mental health disorders, according to new guidance from the American Academy of Pediatrics (AAP).

"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," according to an updated policy statement.

"The recommendation is that corporal punishment is harmful to children's physical and mental health; it is not effective and parents should use other methods of discipline," said Robert Sege, MD, PhD, of the council on child abuse and neglect, committee on psychosocial aspects of child and family health, at a press conference at the AAP annual meeting.

Sege, of Tufts University School of Medicine in Boston, said that this update to the 1998 recommendations relied on numerous studies over the past 2 decades that strengthened the AAP guidance. The new guidance goes a step further to highlight ways corporal punishment can be harmful:

• Corporal punishment of children age <18 month increases the likelihood of physical injury
• Repeated use of corporal punishment may lead to aggressive behavior and altercations between the parent and child and may negatively affect the parent-child relationship
• Corporal punishment is associated with increased aggression in preschool and school-aged children

In one study, children who were spanked more than twice a month at age 3 years were more aggressive at age 5 years. A follow-up study at age 9 "noted correlations between spanking at age 5 years and higher levels of externalizing behavior and lower receptive vocabulary scores at age 9," the authors wrote.

"This can lead to a cycle in which children who are spanked have more aggressive behavior, which results in more spanking," Sege said.

Another study showed that the impact of corporal punishment was short lived -- within 10 minutes of the punishment, 73% of children repeated the behavior for which they had originally been punished.

Sege and guidelines co-authors emphasized that pediatricians play a role in helping parents develop different methods for disciplining children.

"There are a number of approaches to discipline that pediatricians may discuss with parents during well-child visits and those visits that are designed to address discipline issues. These approaches are reviewed in Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents, on the AAP Web site HealthyChildren.org, and in the AAP program Connected Kids: Safe, Strong, Secure," they wrote.

For instance, the directive to "stop running" may be ineffective for younger children because they only discern the word "running," and keep going, explained Jennifer Shu, MD, editor of HealthyChildren.org, at the press conference. Instead, the parent could instruct the child to walk, she said.

Shu, of Children's Medical Group in Atlanta, also suggested making checklists for kids before school so there isn't last-minute chaos with "everyone scrambling to get out the door."

She emphasized that preparing children to be successful in day-to-day activities may work better than falling back on corporal punishment.

Sege told MedPage Today that legislation that would change corporal punishment in schools and at home was beyond the purview of the document. "In general, we are in favor of policies that make children safer and happier," he said.

He noted that 19 states permit corporal punishment in schools and all 50 states permit corporal punishment in homes. But "the most important relationships that each of us has is the relationship with our parents, and there is no need to put fear and violence into that relationship," Sege said.

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