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Treat corporal punishment as a risk factor.

WASHINGTON--The legal definition of what constitutes "reasonable" corporal punishment is contracting, making it more critical than ever to inquire about discipline, provide alternatives to corporal punishment, and address religious objections with culturally sensitive responses.

In delivering this message, Victor I. Vieth, J.D., founder and senior director of the Gundersen National Child Protection Training Center in La Crosse, Wise., stressed that spanking and other forms of corporal punishment are still widely practiced, and that the many parents who employ this form of discipline are open to considering alternatives that they can learn and believe in.

"The vast majority of parents are doing the best they know how.... They don't know the alternatives," Mr. Vieth said.

"Reasonable" corporal punishment is lawful in all 50 states, but the definition of reasonable is narrowing. Courts now will consider the child's size, frowning upon such punishment for children under the age of 2 years. They will consider where on the body the child is hit, generally viewing anything but the buttocks as unreasonable, and they'll look at whether objects have been used.

Courts even appear willing today to consider the "nature of the child's misbehavior," which "opens the door to even mild corporal punishment cases sometimes being considered unlawful," such as a parent hitting a child on the buttocks once or twice after milk is spilled, said Mr. Vieth, whose training center oversees a Center for Effective Discipline.

"Think about this as a mandatory reporter," he said at the annual meeting of the American Academy of Pediatrics. "The vast majority of corporal punishment cases we see probably are running afoul of criminal or civil codes today."

Shifts in case law are likely being driven by research showing that corporal punishment is a risk factor for both short-term and long-term physical and mental injury, he said.

It has long been known that even mild forms of physical abuse--what's been called "ordinary" physical punishment - can cause negative behavioral and psychological outcomes such as alcohol abuse, depression, behavioral problems, and low achievement.

More recent research has expanded the toll, linking acts such as pushing, grabbing, shoving, slapping, and hitting not only with higher risks of mental disorders and family dysfunction, but with higher risks of cardiovascular disease, arthritis, and obesity.

Ask parents about what form of discipline they're using, and educate parents who indicate using corporal punishment about the medical risks and mental health risks in the short and long term. It's important to then give parents "practical, concrete" tools that model alternative methods. Vanderbilt University's Play Nicely free online parenting program is one that Mr. Vieth often recommends.

The parental response of "my parents hit me and I turned out just fine" is not uncommon, and it can be handled in various ways, he said.

You could segue into a discussion of risks by saying, for example,

"Well, let's explore that. I've known you for a long time, and I think you did turn out well. And that's consistent with the research because the research doesn't show that if you receive corporal punishment, you're going to grow up to have negative outcomes. The research says that it's a risk factor, and the more you hit and the longer you hit, the greater the risk will be."

You also could compare corporal punishment research to research on smoking, Mr. Vieth said, by saying, "It's not that different from smoking. One cigarette in the back of the school house won't kill you, but two packs a day will dramatically increase the risk."

Religion is a top reason--if not the No. 1 reason--for the use of corporal punishment, and it's important to understand its influence on discipline and to develop culturally sensitive responses to parents who object for religious reasons to alternative approaches, Mr. Vieth said.

He recommended the following strategies when a parent cites religious grounds for physical discipline:

* Be aware of your own biases. Do not automatically label parents as neglectful or abusive.

* Refrain from pastoral work. "Assure the parent that you're not trying to take away her religious beliefs, that you're discussing religion because she's speaking about discipline that must fit within her belief system."

* Ask if the belief system "authorizes" or "requires" corporal punishment. If it is authorized, there's a clear basis for working together.

* Try to distinguish between parents who need education and those who should be prosecuted. Some parents may accept and use corporal punishment, but may be amenable to discussion and education.

* Emphasize the patient's strengths. Parental warmth, for instance, does not negate the risks of corporal punishment, but it can be a good foundation.

* Acknowledge the benefits of religion, such as its promotion of well-being and healthy behavior.

* Recognize the value of discipline and emphasize that you're advocating for "effective" discipline with the fewest risk factors.

* "Play in the parent's ball field."

If the parent believes she is God's representative to the child, consider asking questions such as "What is your child learning about God when you hit her? What did you learn about God from being physically disciplined?" Parents often will pause and reflect.

Mr. Vieth told the story of Carol, a deeply religious single mother who was raised in a home with corporal discipline and who believed that God's word in her Protestant faith told her that she must sometimes hit her 3-year-old son with an object. She confessed to a coworker that she was paddling her son on the buttocks, but did not like doing so and was scared of hurting him.

Carol's coworker called Child Protective Services. The subsequent multidisciplinary team investigation chose not to file criminal charges, but to file a civil child protection petition. Carol pledged to improve her parenting, but was unwilling to forgo the practice altogether.

Over time, it became apparent to the team working with Carol that she was heavily influenced by James Dobson, Ph.D., the founder of an organization called Focus on the Family. Unlike other more extreme advocates of corporal punishment, Dr. Dobson caps the number of spanks at two, with one for lesser infractions, and says spanking must never leave a bruise or injury ("From Sticks to Flowers: Guidelines for Child Protection Professionals Working with Parents Using Scripture to Justify Corporal Punishment," [St. Paul, Minn.: William Mitchell Law Review, 2014, p. 923]), Mr. Vieth noted.

"For Carol, his views trumped all medical and health research," Mr. Vieth said. "We had to figure out a way to play in her court." Working with a social worker, he found passages in Dobson's writing that conveyed the message that not every child needs corporal punishment.

"Once I started quoting Dobson, it changed the dynamic" and the team was able to work with her on embracing and learning alternative approaches. The petition was dropped, and Carol now is an advocate in her church for discipline methods other than corporal punishment.

Mr. Vieth reported having no relevant financial disclosures.

pdnews@frontlinemedcom.com

BY CHRISTINE KILGORE

EXPERT ANALYSIS FROM THE AAP NATIONAL CONFERENCE

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Author:Kilgore, Christine
Publication:Pediatric News
Date:Dec 1, 2015
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