SALT LAKE CITY — Spanking is not an effective disciplinary tool and could cause long-term harm to children, according to a new policy statement from the American Academy of Pediatrics that also warns parents against harsh verbal discipline designed to shame or humiliate their kids.
In the statement, released Monday during the group's annual conference in Orlando, the nation's largest pediatric association recommends pediatricians help families adopt strategies that teach children right from wrong and improve behavior long term using positive-parenting techniques. The guidance is online in the journal Pediatrics.
"Spanking and verbal abuse don't have desirable long-term effects. If you think of discipline at its roots as teaching, that's not an effective way to teach children better behavior," said Dr. Paul Wirkus, president of the Utah Chapter of the American Academy of Pediatrics. Spanking and harsh or belittling verbal discipline teach "behaviors that probably make children more aggressive over the long haul and less respectful."
The policy statement calls corporal punishment and harsh verbal discipline "aversive disciplinary strategies" and deems them "minimally effective in the short-term and not effective in the long-term. ... Researchers link corporal punishment to an increased risk of negative behavioral, cognitive, psychosocial and emotional outcomes for children."
The report includes in its definition of corporal punishment and spanking "noninjurious open-handed hitting with the intention of modifying child-behavior."
Although the academy as early as 1989 discouraged spanking, the wording is much stronger now and it's the first time in policy the group has addressed harsh verbal abuse, said policy statement co-author Dr. Benjamin S. Siegel of Boston Medical Center and Boston University School of Medicine.
Wirkus rejects the notion that "my parents spanked me and I turned out just fine." It's akin, he notes, to claims that Aunt Jenny smoked her whole life and lived to be 105.
"Even controlling for other factors, kids who are spanked tend to be more aggressive over time. It doesn't improve things like self-esteem and learning how to be a better citizen. The thing I think we all ought to be looking at is positive ways to teach our children, like rewarding good behavior," he said.
The do-nots are not the only important piece of the new guidance, according to Siegel. "Part of the statement is how we can help parents become much better and more effective in terms of discipline. A lot of the paper refers to positive parenting — thinking ahead of time about what the child's developmental needs are."
Instead of using spanking to interrupt bad behavior and deter future bad behavior, which evidence doesn't suggest actually happen, "we should be thinking how do we help kids learn better behavior to begin with," said Wirkus.
The two pediatricians say members of their profession are often asked for suggestions on discipline and for guidance in various areas where parents struggle as they raise and care for their children.
"Some of (the behavior) is age-related and expectations may be unrealistic," said Wirkus, who notes that when parents ask how to keep a 16-month-old from getting into stuff all the time or why a 16-year old is disrespectful, he responds that "it's in the wiring. There are things related to a child's age that are developmentally appropriate. We have to work within those constraints. We are not raising babies. We are trying to raise trustworthy adults whom we love and respect. So how do we guide them and get them there?"
A 2016 survey of nearly 800 pediatricians found only 6 percent held "positive attitudes toward spanking," while just 2.5 percent said it leads to positive outcomes. Three-fourths disagreed that "spanking is a normal part of parenting."
Studies of adverse childhood events — ACEs — show that spanking and other forms of physical punishment create an independent risk for unwelcome outcomes, Siegel said.
The most famous ACE studywas conducted by Kaiser Permanente and the Centers for Disease Control and Prevention in the late 1990s and involved about 17,000 participants. The majority had experienced some adverse childhood event: alcoholism, corporal punishment, spanking, yelling, parents' divorce, lots of variables. It found those who had two or more ACEs were more likely than others to become adults who developed physiological problems like high blood pressure or heart disease or mental illness. They were more apt to abuse alcohol or drugs or engage in early or risky sexual behavior. The more ACEs, Siegel said, "the more likely you are to have adverse outcomes."
The policy report said research links spanking to greater risk for suicide attempts and substance abuse, "independent of the risks associated with having experienced physical and emotional abuse." Among other study findings on corporal punishment and harsh verbal discipline:
• Punishing small children that way increases likelihood of physical injury.
• Over time, such discipline may lead to aggressive behaviors and harm the parent-child relationship.
• Children subjected to corporal and harsh verbal discipline are more likely to be defiant.
• Such discipline is associated with increased risk of mental illness and cognition issues.
• Harsh verbal discipline is associated with increased depression and other mental health problems.
Wirkus said he's had parents tell him they can no longer spank their kids hard enough to get their attention, which worries Wirkus. "If time-out goes wrong, it means you leave a child in double the time, not that you smack them so hard you regret it afterward."
Siegel finds it noteworthy that adults spanked as children can often describe the spankings, though they've forgotten the behavior that prompted it. "The fact they remember means it's embedded in their long-term memory."
Nor is it clear that all parents who were spanked turn out OK, he added. "We have good data that spanking causes a stress response in the brain; it can alter the brain. I imagine it's a dose response. So parents who may occasionally spank and then are also very positive in their parenting" would not have the impact as those "who spank repeatedly and yell and scream and reprimand children without providing positive support. Severe cases may come close to or become child abuse or neglect."
The academy report notes that after corporal punishment, most children soon return to the undesired behavior. It finds negative punishment strategies reinforce negative behavior "in a complex negative spiral."
Even used infrequently, physical and harsh verbal punishments simply don't work, Siegel said. And they are most often employed when parents are frustrated or angry. "Parents, reacting during a meltdown, don't have their usual restraint," he said. "If they have instead thought through positive parenting techniques, though, they are more likely to turn to those."
Discipline itself is not the problem. The report says child development is enhanced by effective, age-appropriate discipline, which teaches children to self-regulate behavior, keeps them safe and improves their cognitive, emotional, social and executive function skills. It also recommends parents visit HealthyChildren.org for suggestions.
Among positive strategies are time-out, redirection, praise for good behavior, clear and constructive consequences, setting limits and giving children attention.
Siegel said the young parents he encounters have largely gotten that message and are more likely to use time-out and cool-down techniques.
Polls show national approval of spanking shrinking. The academy cites a 2013 Harris Interactive poll that shows support for a "good, hard spanking" dropped from 84 percent in 1986 down to 70 percent in 2012. Among younger parents, the report says, fewer than half report spanking their children.
"Our recommendations are in a sense twofold We want to prevent child abuse. We want to prevent changes in the brain and in child development associated with spanking and harsh verbal punishment. And we want to provide positive parenting, from a public health point of view to keep society healthy," Siegel said, noting parents are a child's first teachers and preventing toxic stress in families and in children is crucial to growing healthy adults.
Positive reinforcement is a tool that works, said Wirkus. Rewarding good behavior instead of obsessing over bad behavior is likely to prompt more good behavior.