Doctor Knows Best: Leveraging Pediatricians to Reduce the Use of Physical Punishment

Some people may think that the act of spanking a child has gone the way of T9 texting, dial-up Internet, and floppy disks, but roughly two thirds of parents are still using this form of discipline, despite warnings. Reducing the use of physical punishment is important because physical punishment has been shown to have adverse effects on IQ and cognitive development in children. Physical punishment has also been linked to increased behavioral issues in childhood, as well as higher rates of depression and aggression in adolescence and adulthood. According to research by Murray Straus, as many as 94 percent of low-income parents use physical punishment on their children. A number of programs, such as community interventions and home visiting, have effectively reduced this practice. However, these types of programs are intensive and costly. Research from Caitlin Canfield et al. hopes to determine whether two lower-cost, less time-intensive options implemented by pediatricians could be effective as well.

Working with almost 700 parent-child pairs, or dyads, the researchers collaborated with pediatricians to administer two interventions to two treatment groups. Parents were recruited through a local hospital and then randomly assigned to one of three groups. The first group received an intervention referred to as the Video Interaction Project (VIP), a program through which parents are filmed interacting with their child and then discuss the video with an interventionist who helps them identify and reinforce good interactions. Parents attended a total of eleven 25-30 minute sessions at their pediatrician’s office from the time their child was born until the child reached two years of age. The second group received an intervention referred to as the Building Blocks (BB) program, through which parents were mailed a parenting newsletter each month from birth to 36 months. There was also a third control group that received no intervention.

At 14 and 24 months, researchers assessed the type of discipline used in the home by asking parents which punitive behaviors they had engaged in within the last three months. They also assessed maternal depressive symptoms, parenting stress, and responsive parenting using questionnaires and structured interviews. With these data, they compared the likelihood of using physical punishment in treatment groups, relative to the control group, using ANOVA and chi-square tests.

The BB program showed no impact after 24 months. However, the VIP program showed a significant impact at 24 months, with only 75 percent of parents using physical punishment compared to approximately 85 percent in the control group. Increases in responsive parenting and decreases in maternal psychosocial risk (depression, stress, etc.) also decreased rates of physical punishment, leading the researchers to conclude that these variables mediated the impact of VIP.

Based on these findings, it appears that the Video Interaction Project administered through pediatric primary care may be a promising intervention for reducing the use of physical punishment. This intervention is less costly and time intensive than many alternatives, and, by using pediatric primary care, it can be disseminated to a large number of families. Researchers believe this intervention is effective because it encourages parents to reflect on their parenting practices alongside a professional, as opposed to the BB mailings, which can be more easily ignored.

Given the negative impacts of physical punishment, finding an effective intervention is critical. As evidenced by this research, the VIP shows a great deal of potential when it comes to improving parent-child relationships by changing the type of discipline used. This program could certainly be offered on a larger scale, thus impacting more families, than many other existing interventions.

Article Source: Canfield, Caitlin F., Adriana Weisleder, Carolyn B. Cates, Harris S. Huberman, Benard P. Dreyer, Lori A. Legano, Samantha Berkule Johnson, Anne Seery, and Alan L. Mendelsohn. “Primary Care Parenting Intervention and Its Effects on the Use of Physical Punishment Among Low-Income Parents of Toddlers,” Journal of Developmental & Behavioral Pediatrics 36, no. 8 (2015): 586-593.

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