George Davis, MD NM Department of Children, Youth and Families€¦ · 65% Americans support the...
Transcript of George Davis, MD NM Department of Children, Youth and Families€¦ · 65% Americans support the...
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George Davis, MD
NM Department of Children, Youth and Families
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65% Americans support the corporal punishment of children
94% actually hit their toddlers
30% parents spank babies under one
Over 50% toddlers are struck more than three times weekly
Rate of physically punishing toddlers has not declinedPrevalence, Societal Causes, and Trends in Corporal Punishment by Parents in World Perspective, Murray Straus, 2010
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I was spanked and I turned out OK
This is the way I was raised
Spanking and abuse are two separate things
Talking to toddlers doesn’t work
Spanking is a last resort
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Comparisons to spouse abuse
Comparisons to other participants in interpersonal aggression
Corporal punishment in different settings—school, home, prisons, treatment programs
What does the research say?
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Harsh physical punishment is associated with increased odds of mood disorders, anxiety disorders, alcohol and drug dependence, and several personality disorders even after adjusting for family dysfunction and socioeconomic variables. (Afifi, Mota et al, Journal of Pediatrics, 2012)
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1,966 children were studied to determine the relationship between spanking before age two and later behavior problems when entering the school system at age six. Children who were spanked before age two had substantially more behavior problems at age six.
(Slade and Wissow, Journal of the American Academy of Pediatrics, 2004)
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2,461 children were studied to determine the long term effects of spanking before 3 years of age. The study determines that “even minor forms of corporal punishment, such as spanking, increase the risk for increased child aggressive behavior. Importantly, these findings cannot be attributed to possible confounding effects of other maternal parenting risk factors.” (Taylor et al, Journal of the American Academy of Pediatrics, 2010)
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806 children between 2-4 and 704 children between 5-9 were studied to determine how spanking might influence a child’s IQ over the course of four years. Children who were spanked had IQs between 2.8 and 5 points lower than children who were not. Those in the study who were spanked more showed a greater delay in cognitive development. (Murray Straus, 14th International Conference on Violence, Abuse and Trauma, San Diego, CA, 2009)
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63 West African children in kindergarten and first grade were studied to determine the effect of school corporal punishment on intelligence. Children in the school with corporal punishment performed significantly worse on tasks involving executive functioning—such as planning, abstract thinking and delayed gratification. (Talwar and Lee, Social Development, 2011)
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A West African study of 3-4 year old children in two different school settings, one of which employed corporal punishment and the other did not, suggests that “a punitive environment not only fosters increased dishonesty but also children’s abilities to lie to conceal their transgressions.” (Talwar and Lee, Child Development, 2011)
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23 young adults (18-25 years old) who had experienced harsh physical punishment were compared to 22 healthy controls. The subjects who had experienced harsh physical discipline had gray matter volume in the prefrontal cortex that was reduced by 19.1 %. Exposing children to harsh punishment has detrimental effects on brain development. (Tamoda et al, Neuroimage, 2009)
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The effects of “subtle forms of infant maltreatment” are not as well researched or documented. “Infants who received frequent corporal punishment (eg, spanking) showed high hormonal reactivity to stress.” Both corporal punishment and frequent emotional withdrawal by the mother resulted in elevated baseline levels of cortisol. (Bugental, Martorell, et al.
2002)
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DOES IT MAKE US STRONG OR HEALTHY ?◦ Parents often employ physical punishment with
their children to make sure that the children have strong social values, respect for authority and a clear mental health status. Unfortunately, a meta-analysis indicated that in 12 of 12 studies the frequency and intensity of corporal punishment was associated with poor mental health measures. Every single study saw an increase in depression, substance abuse, and general psychological maladjustment. (Gershoff, Psychological Bulletin, 2002)
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HOW DOES IT AFFECT OUR RELATIONSHIPS ?• Parents often endorse physical punishment in the
belief that they are inculcating strong family values. And yet, child corporal punishment also impairs the relationship between parents and children. 13 out of 13 studies found that physical punishment was associated with poorer quality parent-child relationships. (Gershoff, Psychological Bulletin, 2002)
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DOES IT TEACH WHAT WE WANT?◦ Parents often use physical punishment for either
aggression (hitting a sibling) or antisocial acts (stealing money) in order to communicate the seriousness of the offense. But in a meta-analysis of 27 studies, all 27 studies proved that physical punishment was associated with more rather than less aggression and antisocial behaviors. (Pagani,
International Journal of Behavioral Development, 2004)
◦ Another study proved that 12 of 13 studies positively linked corporal punishment and antisocial behavior. (Gershoff, Psychological Bulletin, 2002)
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It was established that 75% of established physical abuse happened during episodes that started and were intended as physical punishment. (Trocme, Fallon et al, 2005)
Another study found that children who were physically punished were 7 times more likely to be physically abused.(Clement and Bouchard, 2000)
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Almost never has any finding been proved so substantially and definitively—almost against the wishes of public opinion. Seldom has there been more reticence within in the scientific establishments like the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry to weigh in on the side of overwhelming research findings.
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WHY DOES THIS
HAPPEN…AND WHAT IS
THE MECHANISM?
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An infant needs connection to a caregiver in order to organize the brain’s functions in the moment, and to allow it to develop properly over time
Failure to receive the consistent, repetitive, positive, dependable and appropriate attention of the primary caretaker is the premier neurological insult
19
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The management of positive arousal and
gratification through mutual interactional
behaviors between two individuals
Involving multisensory interactions Olfactory
Visual
Auditory
Tactile
Vestibular
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Co-regulation is a right brain event It is an implicit, non-verbal, bottom up
communication schema that relies on affect recognition, facial matching, attunement and accurate contingent communications
It communicates the most basic elements of safety and security and mutual affect coordination
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Infant-Mother dyads (n=101) were assessed as to co-regulation patterns over the second 6 months of the first year
Trend toward increasing symmetry
Quality and symmetry of co-regulation patterns at 6 months predicted attachment status at 12 months
Symmetry at 6 mo also linked to psychomotor and mental development at 9 months (Evans & Porter, 2008)
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The most fundamental behavioral definition of attachment is “proximity seeking by a child when she/he senses discomfort or danger.”
Individual responses to stress are variable, based upon temperament and prior experience, but if there is a secure attachment they always involve proximity seeking toward an attachment figure
If there is not a secure attachment the proximity seeking differs in kind and quality
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The Strange Situation procedure measures
types of attachments—Secure and
Insecure
An additional category was added called
Disorganized Attachment—inconsistent,
approach-avoidant, freeze and isolate
>80% of maltreated children fall into this
category (Carlson et al, 1989)
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The intrusion of fear into the attachment relationship
The source of security becomes also the source of distress
The irreconcilable dilemma
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What we know for sure:The extended effects of early child abuse
cross the boundaries of attachment, affect, thought, behavior, personality and health
Early abuse vastly increases the likelihood of depression, anxiety, aggression, sleep disturbances, delinquency and criminality
We know that the effects of early childhood adversity are dose dependent
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At what point does corporal punishment, including routine spanking and harsh discipline, become damaging?
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US Alliance to End the Hitting of Children (endhittingusa.org) and (Stopspanking.org)
Academy on Violence and Abuse (avahealth.org)
Institute on Violence, Abuse and Trauma (ivatcenters.org)
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