The Physical Punishment of Infants and Toddlers

(Originally published March 2014)

Eighteen European countries have legally banned use of corporal punishment of children. These countries include:

Sweden (1979)           Finland (1983)             Norway (1987)            Austria (1989)             Cyprus (1994)              Denmark (1997)        

Latvia (1998)               Croatia (1999)             Germany (2000)         Iceland (2003)             Bulgaria (2003)           Ukraine (2004)

Rumania (2005          Hungary (2005)           Greece (2006)             Netherlands (2007)    Portugal (2007)           Spain (2007).

 

There has been a lively scholarly debate regarding whether the Swedish law banning corporal punishment influenced social attitudes regarding disciplinary practices, or instead legislation reflected changing social attitudes.  Either way, according to community surveys the great majority of Swedish parents aspire to raise their children without use of physical force, so it may be that the combination of law and expert opinion regarding the pernicious effects of corporal punishment have combined to change parents’ attitudes and behavior.

 

In the U.S., there continues to be widespread support for use of physical discipline with children, ages 2-12, despite the opposition of American Academy of Pediatrics and the National Association of Social Workers.  Even more concerning than positive social attitudes regarding the spanking of  children  is strong public support for the view that “it is sometimes necessary to discipline a child with a good hard spanking.” (Smith,  et al, 2013). This view implies that parents may need to sometimes cause serious pain to convince children that they mean business. Support for corporal punishment is often combined with an implicit endorsement of intimidation of children that can only be maintained with an occasional “good hard spanking” or worse.   

 

Many adults (including professionals) who support use of “reasonable” corporal punishment of

children, 2-12, would probably not support spanking infants or toddlers younger than 2. Nevertheless, a number of studies published in the past several years have indicated distressingly high rates of physical punishment of infants and 1 year olds in the U.S.:

 

  • 1 in 20 infants 0-3 months of age

  • 1 in 10 infants, 6-10 months

  • 1 in 6 children 0- 12 months old had been spanked within the past week. 

  • Almost one in three (30%) 1 year olds had been physically disciplined during the past month, according to a recently published study by Lee, et al.

 

These percentages are probably underestimates as they are based on maternal self- report. In the study which found that 17% of infants 0-1 had been physically disciplined during the past month, a third of the mothers in the sample “volunteered that their infants were “too young to misbehave.” (Combs- Orme, et al, 2008). Obviously, the generalizability of findings from studies conducted in specific communities can be questioned. Nevertheless, the main points to take from these studies viewed as a whole are that (1) a surprisingly high percentage of infants and 1 year olds are physically disciplined (2) these percentages increase markedly as babies and toddlers become older, even as many parents question the purpose of using physical discipline with these young children.

 

A study of infant spanking in the U.S. South (Combs- Orme, et al, 2008) found that “mothers who spanked their infants tended to be younger, and to report more life stress and parenting stress related to their perceptions of their children as “difficult”. In addition, they reported less realistic developmental expectations, less empathy for their infants, more approval of corporal punishment and more expectations that their children would meet their own needs (role reversal).”  The likelihood that the spanking of infants and 1 year olds often occurs when parents are stressed out or frustrated, or at a loss for better responses,  increases the risk that physical punishment will escalate into life endangering abuse. Unfortunately, recent studies have not clarified the behaviors of babies and toddlers that elicit physical punishment. However, there is a distinct possibility that babies and toddlers are sometimes spanked or slapped for crying, or for crying after parents tell them (harshly) to stop. If so, hitting an infant for crying is more likely to exacerbate crying than suppress it. Inconsolable crying is a common precipitating cause of child homicide and non-lethal assault of young children. When parents respond to an infant’s or toddler’s crying with physical force, they have embarked on a dangerous path that can easily lead to serious inflicted injury or death.

 

The concern that the physical punishment of infants and 1 year olds may escalate into severely abusive behavior is well founded based on recent studies of serious inflicted injuries. Levanthal

and Gaither (2012) found that the rate of serious injury to infants less than one year old resulting from physical abuse was 58 in 100,000, about nine times greater than the rate of serious inflicted injury for children as a whole. The rate of serious injury due to abuse for infants in low income families was 133 per 100,000, more than twice the rate for all infants. A study of

minor possibly inflicted injuries published in 2013 found that more than a quarter (27.5%) of abused infants seen in hospital settings had prior “sentinel” injuries (Sheets, et al). Given this information, CPS caseworkers should never view minor suspicious injuries of infants and toddlers (such as pinch marks on the face or arms, or bruises on the buttocks or upper legs) as “low risk”. Rather, use of developmentally inappropriate physical discipline of infants and toddlers should be taken as a warning that much more serious injuries may occur if parents continue to spank, slap or use other types of physical force with these young children.

 

Physical punishment of toddlers

 

The use of physical punishment greatly increases for children 12-24 months of age as toddlers

learn to walk and as children’s oppositional behavior and tantrums become more frequent. Parents may feel that it’s useless to reason with toddlers, and that mild physical punishment is the most efficient way to stop or discourage unwanted behaviors. There is some research indicating that two year olds are physically punished more frequently than any other age group, which suggests that physical punishment is not very effective for children in this developmental stage. Nevertheless, some parents may be at a loss for what other disciplinary practices to use instead of spanking. 

 

Toddlers may find parental attention rewarding even when accompanied by punishment; and there is a large body of research indicating that parental aggression often leads to children’s aggressive behavior, either due to modeling or because children become angry due to harsh punishment. Physical punishment of children often leads to more, not less, aggressive child behavior which, in turn, may motivate parents to increase the severity of physical punishment.

 

What some proponents of corporal punishment fail to understand is that experiences of physical discipline influences young children’s attitudes and beliefs about caregivers, and possibly about the world, not just their behavior. Most 12 month old infants have an organized attachment style, e.g., secure, avoidant, ambivalent, that embodies a judgment about caregivers and a strategy for survival. Infants and toddlers are developing ideas about the people around them and about the world they experience. Physical harm at the hands of caregivers has a powerful potential to shape these ideas even at an age when children lack language. Once learned, these ideas, i.e., internal working models, are difficult to unlearn. Kim, et al, in their 2010 study of harsh parenting practices comment that “… early exposure to harsh parenting appears to disrupt the development of security, self- worth, and self- regulatory skills, all of which facilitate the development of positive adjustment across the life span.” This is not to assert that all physical punishment of infants and toddlers is harsh parenting; nevertheless, the potential for frequent or severe spankings (sometimes combined with verbal aggression) to negatively affect how children view caregivers and themselves is apparent.      

 

In her 2002 meta-analysis of the research on corporal punishment, Elizabeth Gershoff describes the association between the physical punishment of children and a wide range of negative child behaviors, including increased aggression, lower levels of moral internalization and compromised mental health.  Gershoff  hypothesizes “that parental corporal punishment affects children primarily by initiating and shaping emotional and cognitive processes in the children which in turn predispose them to certain behaviors.”  According to Gershoff, critics of corporal punishment have repeatedly pointed out that “When parents use physical means of controlling and punishing their children, they communicate to their children that aggression is normative, acceptable and effective -- beliefs that promote social learning of aggression.”  

 

Gershoff also found in her meta-analysis that use of corporal punishment increases the risk of physical abuse. In their analysis of data from the Fragile Family and Wellbeing Study (FFCWS), Lee, et al, found that “30% of 1-year-old children had been spanked at least once in the past month by their mother, father, or mother’s current partner.” Households in which one year olds had been spanked during the past month were a third more likely to have been involved with CPS “even after controlling for other important risk factors associated with spanking and CPS involvement such as maternal depression.” Lee, Grogan- Kaylor and Berger estimate that elimination of spanking at age 1 would result in a reduction of 8.4% in CPS involvement of families of children, ages 1-4.

 

Lee, Grogan- Kaylor and Berger advocate the use of several concrete strategies for integrating messages about the harmful effects of spanking infants and toddlers into the systems of care that these children and their parents utilize. However, in my view prevention programs and communication strategies discouraging spanking of young children are unlikely to be effective until groups of professionals who serve infants and toddlers unequivocally and strongly oppose use of physical punishment wit this age group. Pediatricians, nurses, social workers, parent educators and child advocates must speak out in a variety of forums for media messages to shape social attitudes. To date, these professional groups in the U.S. have not attempted to influence public policy and social attitudes regarding corporal punishment of any age group of children in the way their counterparts in Western Europe have done, in part because there has not been a consensus among professional groups regarding use/misuse of corporal punishment. In addition, advocates concerned with child abuse prevention have been unwilling to risk alienating public opinion by opposing corporal punishment. Nevertheless, it is time for professionals, child advocates and concerned citizens to take a strong stand against the use of physical punishment with infants and toddlers younger than 2, disciplinary practices that no credible person or groups support.

 

Strategies and Supports for Families Investigated by CPS  

 

Researchers often choose to tease out the causal influence of a single factor or behavior, for example use of corporal punishment, by controlling for factors with which it is associated. However, child welfare practitioners must do the opposite, i.e., assess the context in which behavior occurs and the connections between child maltreatment and the factors with which it is commonly associated, i.e., substance abuse, mental health conditions, domestic violence and poverty. The corporal punishment of babies and toddlers by parents with co-occurring substance abuse and mood disorders, and/or in homes with domestic violence, is usually much more of a risk than in families that lack these conditions. Furthermore, the stress on impoverished parents raising two or three young children in crowded inadequate housing without the support of family and friends suggests the urgent need for concrete resources such as respite care and child care, as well as ongoing emotional support, to reduce physical punishment and physical abuse abuseof young children.  

 

One thing is certain: giving information regard parenting practices such as guidelines for safe sleep, or the dangers inherent in physical punishment of infants and toddlers, will not be sufficient to protect young children in families with open CPS cases. Information regarding parenting practices needs to be provided on multiple occasions by professionals or persons parents trust.

 

It is also questionable to recommend alternatives to physical punishment such as “time- outs” to parents with CPS involvement without first knowing something about a child’s history of care. Time-outs may not be a good disciplinary practice for children with trauma histories; some experts recommend “time- ins” in which caregivers remain in close non-threatening proximity to children while they calm down. Even when advice offered parents is sound, parents who lack experience using alternatives to harsh verbal directives and reprimands and/or physical punishment will often need the opportunity to practice new skills before they can be counted on to use them under stressful conditions.  

 

References

 

Bussman, K.D., Erthal, C., & Schroth, A., The Effect of Banning Corporal Punishment in Europe: A

Five-Nation Comparison, 2009; retrieved on line.

 

Combs, Orme, T. & Cain, D., “Predictors of mothers’ use of spanking with their infants,” Child Abuse and Neglect, 32 (2008), pp. 649-657.

 

Kim, H., Pears, K., Fisher, P., Connelly, C. & Landsverk, J., “Trajectories of maternal harsh parenting in the first 3 years of life,” Child Abuse and Neglect, 34 (2010), pp. 897-906.

 

Gershoff, E., “Corporal Punishment by Parents and Associated Child Behaviors and Experiences: A Meta- Analytic and Theoretical Review,” Psychological Bulletin, Vol. 128 (4), 2002, pp. 539-579.

 

Lee, S., Grogan- Kaylor, A., & Berger, L., “Parental spanking of 1-year-old children and subsequent child protective services involvement,” Child Abuse and Neglect, (2014), pending publication.

 

Leventhal, J. & Gaither, J., “Incidence of Serious Injuries Due to Physical Abuse in the United States, 1997-2008,” Pediatrics, Vol. 13 (5), 2012, pp. 847-852.

 

Sheets, L., Leach, L., Koszewski, I., Lessmeier, A., Nugent, M. & Simpson, P., “Sentinel Injuries in Infants Evaluated for Child Physical Abuse, Pediatrics, Vol. 13 (4), 2013, pp. 701-707.

  

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