Parental Physical Punishment of Young Children and Emotional and Behavioural Outcomes.

1. Parental Physical Punishment of Young Children and Emotional and Behavioural Outcomes. Dr Sonya Scott sonyascott@nhs.net

2. Is it ever right to hit a child? As the new BBC television series 'The Slap’ re-ignites the debate over smacking, author Christopher Wakling recalls the highly charged day he lost his temper with his son 

3. Current Legal Position in Scotland Adults are allowed to use physically punishment as “reasonable chastisement” of children under common law. Blows to the head, shaking and using an instrument to punish children is prohibited.

4. The Law cont. • Within the last ten years two attempts to change the law have failed • Criminal Justice (Scotland) Bill 2002 • Family Law (Scotland) Bill 2005

5. The Arguments for a Ban • Human Rights • Possible Harm

6. Limitations of Existing Evidence • Cross-sectional • Retrospective • No baseline assessment of mental health

7. Study Aim To determine whether there is an association between main parental caregiver use of smacking in the first two years of a child’s life and the subsequent development of emotional and behavioural problems.

8. Methods • Secondary analysis GUS • On-going prospective cohort: birth and child. • Birth cohort data used • Representative Sample Main caregivers and their children.

9. Methods: Measuring Baseline Behaviour “When you have had concerns about your child’s behaviour in the last year, from which of the following have you sought help, information or advice or have you not had any concerns?”

10. Methods: Sample Characteristics • 1600 parent-child participants • White, mothers aged 25-44y • 87% Living with their partners • 42% in two most affluent SIMD quintiles.

11. Methods Measuring Exposure to Smacking “Which of the following discipline approaches have you ever used with your child?”

12. Methods Measuring Outcome Two measures: • “How much of a problem has your child’s behaviour been in the last 3 months” • Strengths and Difficulties Questionnaire

13. Multivariable Analysis • Child sex and age • Parent sex and age • Parent ethnicity, educational attainment and mental health. • Sibling number • Family Transition • SIMD quintile

14. Results 1 • 20% of children smacked • 29% (95% CI 27-31) Problem behaviour age 46 months on parent assessment • 7% (95% CI 6-8) Emotional and Behavioural problems on SDQ

15. Results 2 Parental Assessment of Problem Behaviour • OR 2.5 (95% CI 1.9-3.2) • ORadj 2.4 (95% 1.8-3.2) Emotional and Behavioural Problems on SDQ score • OR 2.5 ( 95% CI 1.7-3.7) • ORadj 2.2 (95% 1.4-3.5)

16. Limitations • Subjective Baseline Behaviour Measure • Face validity • Limited reliability • Potential Misclassification bias • Exposure: recall and social desirability bias • Can’t exclude non-main caregiver smacking or other physical punishment for never smacked • Only main caregiver smacking • Other Confounders • Genetics • Caregiver expectations • Heterogeneity

17. Conclusion • There is a strong positive association between main parental caregiver smacking and EBPs • The association is plausible • The association is consistent • There is some measure of temporality in this study. • Further work is needed to address limitations of baseline behaviour measurement, exposure definition, potential impact of genetics.

18. Implications • Further work required • ?PH supporting a ban “I’ve a few times said, ‘Now, I’m going to smack you,’ because that’s all I’ve got left and I really don’t want to go down that road” • Parenting Support Programmes

19. Any Questions?