martes, 14 de febrero de 2017

Is it harmful to smack your child? | MercatorNet

Is it harmful to smack your child?

Is it harmful to smack your child?

Is it harmful to smack your child?

Laws banning physical discipline of children are based on faulty science.
Robert E. Larzelere | Feb 14 2017 | comment 

In recent years, some medical organizations and many media outlets have claimed that disciplinary spanking causes emotional harm in children that predisposes them to aggressive behaviour when they are older. In an email interview with MercatorNet Professor Robert Larzelere of Oklahoma State University explains what is wrong with the studies on which this view is based. A more detailed critique of the studies by Dr Larzelere and Den A. Trumbull, MD, can be found at the website of the American College of Pediatricians.
The use of spanking – or, more broadly, smacking -- by parents to discipline their children has been banned in dozens of countries on the basis of studies that show it leads to aggression and mental health problems. The American Academy of Pediatrics “strongly opposes” spanking on these grounds. Isn’t this settled science?
Anti-spanking advocates would like to convince everyone influential that the worldwide trends for countries to ban spanking is based on settled science. But when they have to defend the adequacy of their science on a level playing field they have been unable to do it. We saw this in the 1996 scientific consensus conference on corporal punishment1 and when both sides of the scientific evidence were presented to three levels of the Canadian court system in a case finally decided in 2004.2
The position of the American Academy of Pediatrics, which co-sponsored the scientific consensus conference, was a compromise compared to the draft they had been planning to publish, because the conference exposed how weak the scientific evidence was against spanking.3 All invited participants were able to propose additional statements to the conference summary after thinking more about the scientific evidence and the complexity of various issues about the use of corporal punishment.
It was mostly participants who took a more balanced perspective based on the scientific evidence who took this opportunity, including Drs. Diana Baumrind, Den Trumbull, and Robert E. Larzelere.4 The only others were well-respected pediatricians, Robert W. Chamberlin and Rebecca Socolar, who are not known to be anti-spanking advocates but sincerely want to learn what the best advice should be for parental discipline. Those in the conference known to be anti-spanking advocates did not take the opportunity to add statements, or only voted for a few proposals that sided with them. I heard one of them say during the conference something like, “We might as well go home now, since we are not going to get an anti-spanking consensus statement.”
The balanced position differentiates between appropriate vs. inappropriate ways to use disciplinary spanking as well as other disciplinary methods and tries to use science to learn what is the best balance for parents to use when disciplining their children. In contrast, the most vocal anti-spanking researchers are primarily interested in imposing their agenda on the world, and producing and highlighting data that seems to support that viewpoint.
The AAP refers to spanking in the context of “harsh physical punishment, such as pushing, grabbing, shoving, slapping or hitting”. How do you define spanking? In what circumstances would it be appropriate for a parent to use it?
This illustrates part of the problem in the scientific evidence. The research against disciplinary spanking often lumps appropriate spanking together with overly severe physical punishment and punishment that is inappropriate in other ways. This is what the most-referenced study, the 2002 meta-analysis of the scientific literature by Elizabeth T Gershoff,5 as well as a 2016 update by her and A. Grogan-Kaylor,6 does. It makes for good advocacy, but lousy science.
The 1996 scientific conference defined spanking as a type of corporal punishment that is “physical non-injurious; intended to modify behaviour; and administered with an opened hand to the extremities or buttocks.” This is a reasonable approximation of what we consider appropriate spanking, if it is used in appropriate circumstances, such as when 2- to 6-year-olds respond defiantly to milder attempts to get them to cooperate.
Gershoff and colleagues’ latest review of the scientific literature claims to study spanking as defined by the scientific conference, but in fact, none of the studies that they use to support their conclusion is limited explicitly to spanking as so defined. For example, very few, if any of the studies go to the trouble of ruling out parents who physically abuse their children from the spanking group. The few studies that exclude abusive parents do not exclude spanking with a paddle or switch – methods that are also outside the definition.
(The type of spanking that has been shown to produce better child outcomes than most other disciplinary options is summarized in response to a later question.)
What exactly is wrong with the methods of Dr Gershoff and others?
We are especially critical of the fact that anti-spanking advocates rely so much on simple, unadjusted correlations, which not only do not prove causation, but make all corrective actions appear to be harmful. That is because correlations do not take account of pre-existing differences in the children being compared. Children who are more seriously oppositional or defiant may remain more so than others regardless of how parents discipline them, but that may be because their prognosis was worse to start with, not because of the corrective disciplinary action itself.
The analogy of chemotherapy may help because it is also a corrective action: correlations would indicate superficially and incorrectly that chemotherapy makes cancer worse, because patients who are receiving chemotherapy now or did so last year are more likely to have cancer now than the rest of us who didn’t need chemotherapy last year or this year.
Controlled longitudinal studies (summarised by Chris Ferguson in 2013)7 have concluded that children show superficial, trivial adverse effects of spanking that disappear for children under the age of 7. With Ronald Cox and Emilio Ferrer and others [Larzelere, 2010, Cox; Larzelere, 2010, Ferrer] I have replicated this strongest type of evidence against customary use of spanking and found very similar evidence against everything else that parents use to try to reduce oppositional defiance in young children, including privilege removal, grounding, sending children to their room, docking their allowance, and getting professional help (child psychotherapy or Ritalin).
In additional analyses, we showed that this trivial, superficially adverse effect is due to what remains of the poor prognosis for children who are frequently oppositional and defiant, not due to customary ways that parents spank their children.
What else does your research show?
With Brett Kuhn8 I compared the child outcomes of four types of physical punishment with all disciplinary alternatives that have been analyzed in the same studies with the same methods on the same families. We concluded that the outcomes of physical punishment were worse than alternatives only when the physical punishment was (#1) overly severe or (#2) was the  dominant method of discipline.
With other colleagues I have shown that alternative disciplinary tactics lead to the same results as does (#3) customary spanking or customary “physical punishment.”9,10 Getting professional help in the form of psychotherapy or Ritalin also appears to be just as harmful as customary spanking. In other words, when using the same statistical methods that provide the strongest causal evidence against customary spanking, Ritalin appears to be just as harmful as spanking. This shows additional evidence that the superficially harmful outcomes of spanking are due to the remaining poor prognosis of children whose behavior causes parents to use every kind of discipline more, rather than being due to any harmful effect of spanking.
Our review of relevant comparisons also found that the fourth type of spanking, conditional or back-up spanking, led to greater reductions in defiance or aggression than 10 of 13 alternatives it had been compared with. Conditional spanking is non-abusive (e.g., two swats to the rear end when parents are not out-of-control due to anger), used when 2- to 6-year-olds respond defiantly to milder disciplinary responses, such as timeout. A forced brief room isolation is the only alternative shown to produce equivalent outcomes in more than one study. Its equivalent effectiveness was noted in the American Academy of Pediatrics’ Guidance for Effective Discipline11 as a reason spanking could be replaced (Bullet Point #8, p. 728), but without specifying what that effective alternatives is, apparently because room isolations are also opposed by advocates on ideological grounds. Despite the fact that this evidence about conditional spanking was based on nine studies, including the four studies with the most valid causal evidence,12 anti-spanking advocates keep on claiming that there is no evidence of beneficial outcomes of  appropriate disciplinary spanking.
Since then, Dr. Majorie Gunnoe 13 has also shown that, if anything, children who were spanked are doing better as adolescents than never-spanked children, as long as the spanking ceased after 11 years of age. These are the kinds of evidence that anti-spanking advocates choose to ignore rather than to respond to.
Interestingly, one of the leading anti-spanking advocates also published a recent study 14 showing that spanking did not have any adverse effects if parents were no longer spanking at age 9, and such phased-out spanking was associated with better outcomes in conservative Protestant families, apparently because it was more likely to be perceived as appropriate parental discipline rather than evidence of parental rejection.
There is, however, an alarming amount of child physical abuse in some quarters of society. Isn’t it worth banning physical discipline altogether for the sake of children vulnerable to real abuse? Aren’t alternatives like time out and withdrawal of privileges enough for good parents?
This is the main rationale for spanking bans, using the same logic that was used for the Prohibition Amendment in the United States a century ago. Unfortunately most evidence indicates that enforced spanking bans lead to increases in physical child abuse as well as other forms of violence as children grow up without effective discipline.
Recent studies continue to show escalating rates of criminal assaults by minors in Sweden. The first country to ban spanking in 1979, Sweden has enforced this law more vigorously than most other spanking-ban countries. Physical child abuse, criminal assaults against minors by minors, and rapes of children under the age of 15 are occurring more than 20 times as often in 2010 than was the case in 1981, according to Swedish criminal records. 15
A five-nation comparison in Europe 16 found that some kinds of verbal and physical violence are higher in countries that have banned spanking compared to those who had not banned spanking. For example, 79% of intimate partners say that they insult their partners in Sweden, compared to 36% in countries without spanking bans. A surprising 34% of partners get tackled or hit in Sweden compared to 18% in countries without spanking bans.
The only evidence that physical abuse decreases after spanking bans comes primarily from countries where most parents were unaware that mild spanking had been banned! Because less than 1/3 of parents in Germany and Austria were aware that mild spanking had been technically banned, the five-nation study compared parents who thought mild spanking was legal (and only severe physical punishment was illegal) vs. parents who recognized that all spanking was banned. Those who thought they could still legally use mild spanking were less likely to resort to severe physical punishment.
There was a similar finding for how they were disciplined as children. Those receiving mild spanking but not severe physical punishment were less likely to use severe physical punishment with their children. This supports a speculation we made in 199917 that mild spanking can serve to bring a frustrating discipline episode to a conclusion before parents get so frustrated that they erupt by hitting the child harder than they otherwise would.
Also, haven’t the people who say that spanking, even if mild, teaches children that “hitting others is OK” got a point?
With that logic, we should quit fighting fire with fire, and we should unilaterally disarm rather than think that a strong military defense will help stop wars against us. Parents’ goals should always be to resolve disciplinary disagreements in the best way possible, such as finding a mutually acceptable compromise when applicable or explaining why, if that will help. But children need to learn that they cannot get their way by having increasingly worse tantrums or with increasing aggression, verbal or physical.
One of my mentors, Dr. Gerald Patterson started by trying to reinforce (reward) children for good behavior, assuming that their behavior would improve with that method alone. He still supports reinforcing good behavior, but said in his major book, Coercive Family Process, in 1982:18 “If I were allowed to select only one concept to use in training parents of antisocial children, I would teach them how to punish more effectively. It is the key to understanding familial aggression” ( p. 111). By that, he meant timeout, because he personally opposed spanking.
All the other gurus of behavioral parent training -- the primary psychosocial treatment supported for ADHD In the guidelines of clinical child psychologists, pediatricians, and child psychiatrists -- also used timeout, but they recommended a two-swat spanking to enforce cooperation with staying on the timeout chair -- until spanking fell into disfavour in the 1990’s.
So parents should prefer the mildest disciplinary response that can get acceptable cooperation from children. But children need to learn that persistent defiance in response to milder responses will not let them get their way. In such cases non-abusive spanking can be a very effective enforcement of milder disciplinary responses, which is why most behavioral parent training protocols recommended that from the late 1960’s, when they were developed, to the mid-1990’s. By then the gurus could no longer get research funding if they continued using the spank backup (but they never found anything more effective).
And what about children's dignity and rights?
As children grow up, they develop rights and responsibilities together. We require many things of children that are not required of adults (vaccinations, school attendance). A balance of love and limits, which is called authoritative parenting, has been shown to be optimal for children to achieve their potential. The polarized extremes of authoritarian parenting (limits without love) and overly permissive parenting (love without limits) fall way behind in developing their potential competencies across a range of outcomes. 19
The argument that children should not be subject to negative disciplinary consequences that would be unacceptable for adults is an argument against most negative disciplinary consequence, including timeout, grounding, etc. To maximize their potential, children need both love and limits when they are young, so they don’t need to learn lessons about cooperating with people around them when they are older and the negative consequences are worse and longer lasting.
Discipline is obviously an essential but challenging part of raising children. Can people rely on their instincts, or the way they were brought up, to find the right approach for their kids? Do we need more education for parents – new parents anyway?
I would like parents to be able to learn from the best available information, not just from the way they were raised. Unfortunately, the disciplinary messages that are emphasized in the media are based on ideological viewpoints and advocacy efforts rather than objective science. We are trying to provide the kind of fact-checking that seems to be needed more today than in previous generations.
Robert E. Larzelere is a Professor of Human Development and Family Science at Oklahoma State University, specialising in research methodology and the study of parental discipline. He was one of 7 experts invited to present evidence at the only scientific consensus conference on outcomes of corporal punishment, co-sponsored by the American Academy of Pediatrics. He was one of three expert scientific witnesses called by Canada’s Dept. of Justice to defend the use of reasonable force by parents to correct children’s behaviour. He has published research comparing child outcomes of physical discipline with alternative disciplinary responses based on his own data and on large national data sets from the United States and Canada. He has also published literature reviews of the most relevant studies in leading professional journals in paediatrics and in clinical child psychology.
Den A. Trumbull, M.D. is a founding member of the American College of Pediatricians and was one of 20 experts invited to the 1996 scientific consensus conference on outcomes of corporal punishment by the co-chairs of that conference.
1.            Friedman SB, Schonberg SK. Proceedings of a conference on "The short- and long-term consequences of corporal punishment". Pediatrics. 1996;98:803-860.
2.            Canadian Foundation for Children Youth and the Law v. Canada,, 1 S. C. R. 76, 2004 SCC 4 (No. 98-CV-158948) (2004).
3.            Friedman SB, Schonberg SK. [Personal statement]. Pediatrics. 1996;98:857-858.
4.            Friedman SB, Schonberg SK. Qualifying statements. Pediatrics. 1996;98:854-856.
5.            Gershoff ET. Corporal punishment by parents and associated child behaviors and experiences: A meta-analytic and theoretical review. Psychological Bulletin. 2002;128:539-579.
6.            Gershoff ET, Grogan-Kaylor A. Spanking and child outcomes: Old controversies and new meta-analyses. Journal of Family Psychology. 2016;30:453-469.
7.            Ferguson CJ. Spanking, corporal punishment and negative long-term outcomes: A meta-analytic review of longitudinal studies. Clinical Psychology Review. 2013;33:196-208.
8.            Larzelere RE, Kuhn BR. Comparing child outcomes of physical punishment and alternative disciplinary tactics: A meta-analysis. Clinical Child and Family Psychology Review. 2005;8:1-37.
9.            Larzelere RE, Cox RB, Jr., Smith GL. Do nonphysical punishments reduce antisocial behavior more than spanking? A comparison using the strongest previous causal evidence against spanking. BMC Pediatrics. 2010;10(10).
10.          Larzelere RE, Ferrer E, Kuhn BR, Danelia K. Differences in causal estimates from longitudinal analyses of residualized versus simple gain scores: Contrasting controls for selection and regression artifacts. International Journal of Behavioral Development. 2010;34(2):180-189.
11.          American Academy of Pediatrics. Guidance for effective discipline. Pediatrics. 1998;101:723-728.
12.          Larzelere RE, Baumrind D. Are spanking injunctions scientifically supported? Law and Contemporary Problems. 2010;73(2):57-88.
13.          Gunnoe ML. Associations between parenting style, physical discipline, and adjustment in adolescents' reports. Psychological Reports: Disability & Trauma. 2013;112(3):933-975.
14.          Ellison CG, Musick MA, Holden GW. Does conservative Protestantism moderate the association between corporal punishment and child outcomes? Journal of Marriage and Family. 2011;73(5):946-961.
15.          Larzelere RE, Swindle T, Johnson BR. Swedish trends in criminal assaults against minors since banning spanking, 1981-2010. International Journal of Criminology and Sociology. 2013;2:129-137.
16.          Bussmann KD, Erthal C, Schroth A. Effects of banning corporal punishment in Europe: A five-nation comparison. In: Durrant JE, Smith AB, eds. Global pathways to abolish physical punishment: Realizing children's rights. New York: Routledge; 2011:299-322.
17.          Larzelere RE, Johnson B. Evaluation of the effects of Sweden's spanking ban on physical child abuse rates: A literature review. Psychological Reports. 1999;85:381-392.
18.          Patterson GR. Coercive family process. Eugene, OR: Castalia Press; 1982.
19.          Baumrind D, Larzelere RE, Owens EB. Effects of preschool parents' power assertive patterns and practices on adolescent development. Parenting: Science and Practice. 2010;10:157-201.
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To tell the truth, I never knew that there was a science of spanking. (Not the how, but the why.) As one of today’s articles demonstrates, there are bitter academic battles about how effective and appropriate spanking is as a disciplinary measure.
Unlike most academic battles, this one has real-world consequences, as in some countries parents can be jailed for corporal punishment. In an interview with Carolyn Moynihan, Robert E. Larzelere, an expert on child discipline, says that the scientific evidence against spanking is weak.
No doubt this is a topic which can be debated endlessly, but he draws on some surprising statistics. In Sweden, the first country to ban spanking (in 1979), “Physical child abuse, criminal assaults against minors by minors, and rapes of children under the age of 15 are occurring more than 20 times as often in 2010 than was the case in 1981”.
Dr Larzelere concludes that “mild spanking can serve to bring a frustrating discipline episode to a conclusion before parents get so frustrated that they erupt by hitting the child harder than they otherwise would.”
What do you think?   

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