Child corporal punishment has been a widely debated topic in recent decades. Older research indicated that corporal punishment may or may not harm children, depending on the study. More recent research including meta-analyses, however, indicates a clear relationship between corporal punishment and negative outcomes for children. One negative outcome is increased risk of physical abuse. When caregivers have questions about child behavior and discipline, they tend to seek guidance from pediatricians. Over the years, the American Academy of Pediatrics (AAP) has recommended against corporal punishment. In December 2018, however, the AAP released an emphatic statement plainly recommending against corporal punishment because it harms children. This qualitative study explored how primary care pediatricians address corporal punishment, distinguish it from physical abuse, consider culture throughout the process, and whether they feel well-equipped to do so. Five participants, all primary care pediatricians in Oregon, completed semi-structured, in person interviews during mid-to-late 2018. After coding and interpretive phenomenological analysis of data, results revealed caregivers typically bring up concerns about behavior and discipline, including corporal punishment. Results also revealed participants’ guidance to caregivers on corporal punishment varies from participant to participant and from case to case. Participants’ guidance depended on personal and professional views, factors related to caregivers and children, type of discipline, and participants’ interactions with families. Four out of the five participants did not report considering, following, or sharing with families the AAP’s guidelines regarding corporal punishment. Participants reported that distinctions between corporal punishment and physical abuse tend to be obvious, and if a child’s injuries, or other clinical information, raise suspicion of abuse, they notify authorities. Participants all reported their ability to consider aspects of multiculturalism in these cases but have little need to due to the homogenous patient population. Overall, participants reported feeling well equipped to address discipline and physical abuse, broadly, but received less training on corporal punishment, specifically. Furthermore, participants mentioned interprofessional collaboration with behavioral health consultants when addressing child behavior and discipline. Much like the topic of corporal punishment and associated research this study highlights the complex and evolving nature of primary care pediatricians’ guidance to families. Also highlighted is the use of behavioral health consultants in pediatric primary care to address topics of child behavior and discipline. Results from this study point to a need for standardized corporal punishment screening in pediatric primary care and for pediatricians to receive training on guidance on the topic.
- Identify the complex and evolving issues pertaining to corporal punishment and how they arise in pediatric primary care.
- Consider research evidence examining pediatricians' current practices regarding corporal punishment.
- Discuss the implications of pediatricians' screening and guidance regarding corporal punishment in primary care.