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- RE: AAP Authors of "Effective Discipline to Raise Healthy Children" response to "Should Pediatricians Base Their Parenting Advice on Advocacy or Science?"
In response to the comment by Larzelere, et al., we note that all American Academy of Pediatrics policy statements represent the collective work of the primary authors, the two sponsoring AAP committees and over a dozen highly qualified experienced reviewers and staff members within the AAP, and are subject to Board review and approval. Policy statements represents a synthesis of available evidence, and include recommendations based on that evidence.
The comment begins with claims that overlook or mischaracterize the content of the policy statement. Contrary to the authors’ assertions, (1) this policy 4 is based on a thorough review of the literature and the expert opinions of the authoring committees—advocacy groups played no role; and (2), many alternative approaches to spanking and supporting positive disciplinary strategies are discussed and endorsed—readers are referred to more comprehensive resources.
A careful reading of the statement can easily clear up these and other issues raised in their note. The suggestion that this statement is a “rant against spanking” is inaccurate.In regards to corporal punishment as a method of child discipline, the policy notes that it is (1) ineffective, (2) contributes to a cycle of corporal punishment and aggressive behavior, (3) is a risk factor for nonoptimal child development, and (4) that physiological changes have been observed in children who experience it. Of these four factors that support the policy...
Show MoreCompeting Interests: None declared. - RE: Effective Discipline to Raise Healthy Children
Another Aspect of The Disciplining of Our Children
I have wanted to write a response to the position paper on spanking of
children that has been presented by The American Academy Of Pediatrics
( policy statement, to be published in the December 2018 “AAP Says
Spanking Harms Children” )and, The New York Times.(“Spanking Is
Ineffective and Harmful to Children, Pediatricians’ Group Says”
By Christina Caron,Nov. 5, 2018)Over the years, I have had many opportunities to speak to parent groups about
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childcare, child rearing and of the many stresses of parenting. It has been
quite evident to me that the practice of spanking, warning of physical
consequences and administering pain is deeply engrained in the tradition of
discipline of children.
Despite the fact that I have counseled strongly against spanking or, indeed,
any corporal punishment for children, there is a very strong resistance to
change.
My advice comes from the very basic premise that parenting should be the
modeling of good human behavior.
In times of stress, disagreement and negativity it is NOT an acceptable
reaction to address the situation with physical aggression. When, after all,
is it a good idea for (we adults) to hit the mechanic that has done something
we see as wrong? When may we threaten bank tellers with a slap when they have
been rude? When should we strike a person in our lin...Competing Interests: None declared. - RE: Should Pediatricians Base Their Parenting Advice on Advocacy or Science?
The new AAP Policy Statement, Effective Discipline to Raise Healthy Children, appears to rely primarily on an advocacy group, the Global Initiative to End all Corporal Punishment of Children, whereas the previous AAP Policy Statement on discipline1 was informed by an AAP-sponsored scientific consensus conference on corporal punishment. Accordingly, the latest Policy Statement reads more like a rant against spanking than scientifically informed recommendations for “effective discipline.” With its prohibition of all physical punishment, only time-out is recommended for childhood misbehavior, citing only one study which concluded “There was no significant effect for timeout use.”2, p. e15 Privilege removal has been dropped in the current Statement.
Should pediatricians therefore conclude that the only key to effective parental discipline is simply to avoid spanking? The Statement’s cited evidence against physical punishment is drawn from one meta-analysis of unadjusted correlations, 55% of them concurrent correlations,3 ignoring another meta-analysis that reported “trivial” effect sizes in risk-adjusted outcomes.4 Would any medical therapy be evaluated using correlations that are not risk-adjusted (for differences in illness severity or in persistent defiance)? A new meta-analysis just showed that this correlational evidence against spanking disappears after accounting for the predisposition of some children to be more difficult to discipline than others.5
Th...
Show MoreCompeting Interests: None declared.