Early interventions and discipline training programs for parents may help decrease the use of spanking as a discipline method, according to a new Vanderbilt study published in the journal Clinical Pediatrics.
Spanking, previous research has shown, has adverse outcomes such as childhood aggression, child abuse, violence and mental health problems. Several leading professional organizations, such as the American Academy of Pediatrics, recommend discipline strategies other than spanking.
Investigators at Monroe Carell Jr. Children’s Hospital at Vanderbilt demonstrated several years ago that a brief intervention can shift parents’ attitudes about spanking. This new study explored how the program works to convince parents to stop spanking their children. Ultimately, parents cited education on alternative discipline strategies as the most common reason for changing their attitudes toward spanking.
During a well-child visit, the parent or caregiver was invited to participate in a five to 10 minute multimedia program called “Play Nicely.” The program teaches strategies to respond to childhood aggression. Of the 197 parents/caregivers who participated, 128 (65 percent) planned to change how they discipline, including looking to other discipline options beyond spanking. Additionally, 19 parents (10 percent) said they planned to spank less. A majority of these parents reported that the program works because it offers alternatives to spanking.
“To have a program that is capable of changing parents’ discipline plans in just five-10 minutes is truly remarkable. While we had previously shown that the program was effective, we did not know what about the program was convincing parents to alter their discipline plans,” said Julia Hudnut-Beumler, a fourth-year medical student at Vanderbilt University School of Medicine.
“To learn that educating parents on alternative discipline strategies is more effective than simply telling them why spanking is wrong has great implications for clinical practice. Providers can have more effective and efficient discussions with parents by focusing their efforts on teaching alternative discipline strategies rather than belaboring the problems with spanking.”
Hudnut-Beumler was a co-investigator with Seth Scholer, M.D., MPH, the creator of the Play Nicely program. Play Nicely was designed for parents and teachers to develop a behavior management plan for children with aggression or anger management problems.
“From a public health standpoint, the evidence is clear that parents should stop spanking their children,” said Scholer, professor of Pediatrics in the Division of General Pediatrics.
“This study indicates that one method to convince parents to stop spanking is to provide them with alternatives. Vanderbilt has developed and tested an intervention that, in five-10 minutes, can sway parents away from using spanking in a way that is culturally sensitive.”
During the study visits, which were conducted in July and August 2012 and again in May 2013, parents were given situations in which they would discipline their children.
For example, the program asked what parents would do if they saw their child hit another child, and the parents had to select four out of 20 possible discipline options.
For each strategy picked, the parents were then educated on whether their choice was a great, good or not recommended option and why, and then were given alternative “better” options, where appropriate.
“With parent after parent, I saw the program have an immediate impact on their discipline plans. Multiple parents turned to me and said things like, ‘You know, it really doesn’t make sense to teach my child not to hit by hitting him’ or ‘Instead of going straight to spanking, I’m going to try redirecting next time,’” said Hudnut-Beumler.
Participants were English- and Spanish-speaking parents or caregivers of children ages 1 to 5 who attended well-child visits at the primary care clinic at Children’s Hospital.
The average age of the participants was about 29 years, with 84 percent of them being female. Among the demographics, 41 percent were black; 31 percent were white; and 21 percent were Hispanic. Educational backgrounds varied.
Another concurrent study by Hudnut-Beumler and Scholer also explored if the “Play Nicely” intervention was culturally sensitive to parents of different backgrounds. The study was published in the Maternal and Child Health Journal.
Of those same 197 parents who completed the study, at least 80 percent of parents from each racial/ethnic group reported that the program built their confidence to care for their child, addressed their family needs, explained things in a way they could understand, respected their family values and was sensitive to their personal beliefs.
The authors concluded that regardless of cultural or ethnic background, it is possible to educate parents about discipline using a standard approach.
“For providers, discussing discipline with parents can be challenging, emotionally charged, and time-consuming,” Hudnut-Beumler said. “Creating a ‘one-size-fits-all’ discipline education program is often viewed as an impossible task due to the wide range of perceived cultural differences among families. To have a discipline program that parents of diverse racial and ethnic backgrounds found to be culturally sensitive and family-centered represents outstanding potential for population-based parenting interventions. The pediatric primary care clinic is an ideal setting for these interventions to occur.”
