Periodic Survey of Fellows

AAP survey on corporal punishment reveals divergent views

Findings from a recent periodic survey of AAP members on pediatricians' attitudes and counseling practices regarding use of corporal punishment reflect the complicated nature of the issue; responses cannot be summed up in simple "for" or "against" statements.

The survey defined corporal punishment as "the use of spanking as a form of discipline. It does not include hitting, beating or other actions that might be considered child abuse."

Opinions about use of corporal punishment in the home vary: About one-half of pediatricians generally oppose the use of corporal punishment by parents, although pediatricians think the occasional spanking under certain circumstances can be an effective form of discipline. Almost one-third (31 percent) of pediatricians completely oppose parents' use of corporal punishment under any circum- stances, while 14 percent say they support, in principle, its limited use.

When counseling parents on child discipline, nearly all pediatricians recommend parents use positive reinforcement of good behavior and nonphysical methods of punishment for negative behavior, such as timeout or removal of privileges. More than half of pediatricians (53 percent) say they discuss the pros and cons of corporal punishment with patients' parents. Five out of 10 pediatricians discourage the use of corporal punishment under any circumstance. Four out of 10 pediatricians recommend corporal punishment be used only under limited circumstances and with specific conditions or rules. Nine percent make no recommendation regarding corporal punishment.

Most pediatricians (83 percent) are comfortable discussing corporal punishment with parents; 14 percent are unsure. More than three-fourths believe they have adequate knowledge of the effectiveness of various child discipline methods (78 percent) and adequate skills to counsel families on discipline methods (76 percent), while 16 percent are unsure of their knowledge or skills.

Pediatricians report, however, that most parents do not seek their recommendation regarding discipline: only 35 percent of pediatricians say all or most of their patients' parents seek their recommendation regarding discipline; 53 percent report some parents do so; and 12 percent say few or no parents seek their recommendation on discipline. Four out of 10 pediatricians say there is insufficient time in health supervision visits to address discipline issues, while 34 percent think there is suffi- cient time and 23 percent are unsure.

Although pediatricians oppose spanking as a primary form of discipline, only 50 percent agree with the statement, "Pediatricians must try to eliminate the practice of spanking as a form of discipline," 30 percent disagree and 20 percent are unsure. About one-half of pediatricians (48 percent) think there is a link between corporal punishment and child abuse, 21 percent think there is no link and 31 percent are undecided.

While 74 percent of pediatricians report being spanked as a child, only 12 percent say it was the form of discipline most commonly used by their parents. Only 35 percent of pediatricians say they use spanking as one form of discipline with their own children, and almost no pediatricians (less than 1 percent) say spanking is the most commonly used method of discipline for their own children.

AAP Periodic Survey #38 was conducted from October 1997 through March 1998. Surveys were mailed to a random sample of 1,629 active AAP members in the United States, with a response rate of 62 percent. Responses to the questions on corporal punishment are based on 603 post-residency Fellows who provide direct patient care.

Tables

Pediatricians' Opinions on Use of Corporal Punishment
(percent of pediatricians reporting)

Generally oppose the use of corporal punishment by parents, but an occasional spanking under certain circumstances can be an effective form of discipline Completely oppose the use of corporal punishment by parents under any circumstances Support, in principle, the limited use of corporal punishment by parents Unsure of opinion on the use of corporal punishment by parents

53.4% 31.4% 13.6% 1.5%

Current Counseling Practices on Discipline
(percent of pediatricians reporting)

Recommend parents use positive reinforcement of good behavior Recommend parents use timeout, removal of privileges, etc., for negative behavior Discuss the pros/cons of corporal punishment with parents Meet with some parents to change their discipline practices Discourage use of corporal punishment under any circumstance Recommend corporal punishment be used only under limited circumstances and/or with specific conditions or rules Make no recommendation regarding corporal punishment

99.1% 97.8% 53.4% 43.7% 49.0% 42.3% 9.0%

Source: AAP Periodic Survey #38, Division of Child Health Research