Intended for healthcare professionals


Giving guidance on child discipline

BMJ 2000; 320 doi: (Published 29 January 2000) Cite this as: BMJ 2000;320:261

Physical punishment works no better than other methods and has adverse effects

  1. Tony Waterston, consultant paediatrician
  1. Community Paediatric Department, General Hospital, Newcastle upon Tyne NE4 6BE

    The consultation document issued this month by the Department of Health on the physical punishment of children states clearly that “many parents would welcome support in learning effective measures of disciplining their child which do not involve physical punishment” while adding that “there may still be occasions when parents … may consider it appropriate to discipline a child through physical punishment.”1 Most British parents do use physical punishment2 and this fact is used by the government to justify continuing to allow some form of smacking in their proposals for new legislation. At a time when parenting has become a political issue and when child behaviour is causing difficulties both at home and in school, is there a consistent line which health professionals can follow in giving advice on discipline?

    Most research on child discipline has been done in the United States. The American Academy of Pediatrics consensus conference on corporal punishment3 and guidelines on effective discipline4 identified three essential elements: a learning environment characterised by positive supportive parent—child relationships; a strategy for systematic teaching and strengthening of desired behaviours; and a strategy of decreasing or eliminating undesired or ineffective behaviours. Each component needs to function adequately for discipline to result in improved child behaviour. Most of these principles have been developed over many years …

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