How It Is

Can Pediatricians Convince Black Parents To Stop Spanking?


The American Academy of Pediatrics is now requiring doctors to reveal the dangers of hitting their kids. But how will a largely white profession break through Black families’ skepticism of their scientific scholarship?



The American Academy of Pediatrics is now requiring pediatricians to tell parents that it’s dangerous to hit their children. Good luck getting Black parents, and even some Black pediatricians, to listen.

The new policy, which was released November 5, says spanking—which it defines as “non-injurious, open-handed hitting with the intention of modifying child behavior”—is not only ineffective for disciplining children, it can also impact brain development. Hitting, yelling at, or shaming children, they found, can elevate stress hormones and alter the brain’s architecture, sowing the seeds for a low IQ, aggression, future violence, emotional regulation issues, depression, drug abuse, and other chronic health outcomes later in life.

“The good news is fewer parents support the use of spanking than they did in the past,” said Dr. Robert D. Sege, an author on the revised policy and past member of the group’s Committee on Child Abuse and Neglect, in a statement. “Yet corporal punishment remains legal in many states, despite evidence that it harms kids—not only physically and mentally, but in how they perform at school and how they interact with other children.”

But we’re seeing very different conversations on social media, where viral videos of kids being shamed and beaten garner millions of shares, likes, and comments praising the parents and demonizing the children. Black children have long been the butt of jokes among comedians and urban radio show hosts who endorse beating kids, usually while sharing bittersweet stories of how they were beaten and “turned out fine.”

Just this week, I was tagged on dozens of posts where news outlets highlighted the AAP’s policy. Under the comment sections, the common refrains from folks were prominent. In addition to the usual, “I was whupped and I turned out fine,” came the misquoted Bible verse, “Spare the rod, spoil the child”; “That’s what’s wrong with these kids today, they’re not being disciplined enough”; and “These kids today are killing the parents.” Black folks responded the same way, adding comments like, “Better to be whupped at home than to be beaten by the cops or end up in jail.”

Decades of surveys have shown that the majority of Black parents—nearly 80 percent—are invested in hitting their kids. Never mind the fact that research has consistently shown that Black children are more at-risk of suffering from child abuse or child-abuse-related death than other kids. In fact, in 2016, the child abuse rate in the United States among African-American victims was 14.5 cases per 1,000 children. And over the last ten years, an average of 360 Black children per year died as a result of maltreatment, primarily at the hands of their parents. Black children face the same serious structural disadvantages their parents face in this racist society. The economic disparities that impact neighborhoods spill into parent-child relationships and increases risk for abuse.

Contrary to popular belief, these parents aren’t necessarily sadistic monsters who tortured their kids to death. Forensic pediatricians, social workers, and district attorneys will tell you that most abuse cases and fatalities are the result of parents who spank and had a moment when they went too far. They’ll also tell you that spanking is the No. 1 risk factor for physical abuse and fatalities.

Even knowing those statistics, pediatricians of all races will have an uphill battle trying to convince Black parents that spanking is harming their children. There are many reasons for this.

The first hurdle is the sordid history of the medical system exploiting and experimenting on Black bodies of all ages, resulting in a deeply rooted suspicion of any advice or treatment aimed at Black people. The pediatrics specialty, which was established in the late 19th century, has a long history of abusing Black infants and children. Leading pediatric journals are full of racist studies that called for sterilizing Black children. Doctors would describe Black children as hypersexual beasts that needed to be sterilized. There was a morbid fixation on their genitals, intense debates about why newborn babies had Black skin, theories that Black children had small brains that closed up during adolescence, and that Black girls experienced early puberty because they were precocious and racially inferior.

From the time of its founding as a medical specialty, pediatrics moved through the language of race and racism. The profession has never reckoned with this past. But Black folks have not forgotten. From these atrocities to the Tuskegee experiments to the cells of Henrietta Lacks, Black America has ample reason for suspicion and distrust.

So the question from Black Americans becomes: You’ve racialized, abused, and demonized our children and now you want to tell us how to raise them? Your science is white people shit.

How will a largely white pediatrics profession break through Black folks’ skepticism of mainstream scientific scholarship? The traditional Black American approach believes that we know best and that other groups are raising their children to be too soft, and that not spanking white children puts them at risk of becoming mass shooters and serial killers, even though we have zero proof that white mass shooters and serial killers were never hit.

How do pediatricians plan to open Black folks up to discussions about cortisol, oxytocin, adverse childhood experiences, epigenetics, trauma bonding, and alternatives to hitting? We are dealing with a racial group that truly believes that beating children will lead them to a more respectable place in life, that it will keep them out of prison, safe from the police and other harms.

So what do Black pediatricians say?

When I asked Dr. James A. Joyner, a Jacksonville, Florida–based pediatrician, whether he thought that doctors could convince Black folks to stop hitting their kids, his initial response was more personal than professional.

“My kids know I will beat their ass, so they don’t try me,” he said in a Facebook chat. “Now I never have to spank my kids because they know I will. I also read them bedtime stories, hug them and kiss them and tell them they are good and wonderful kids. They respond well to this.”

When it comes to his patients, Dr. Joyner said he emphasizes behavior approaches to discipline. “’Time out’ works best when ‘time in’ is awesome and makes the kid feel their goodness and power.”

Still, he maintains that he has done well in life because he knew his parents “would beat my ass or kill me if I acted a fool.”

Dr. Joyner admits that “there are no easy answers” when it comes to spankings. “In my humble opinion, our record number of bad-ass kids need spankings from loving parents when appropriate—not when the parents are frustrated and mad at life.” He also says that he sees “bad cases of child abuse as well, which make you terrified that human adults could go there with their babies.”

He says he always lets his patients know that his views and suggestions “are not endorsed by the American Academy of Pediatrics when they ask for my behavior and opinions.”

Dr. Joyner even allows his patients to be spanked in the exam room. “I had two kids being raised by an overwhelmed single grandmother who didn’t know what to do. I told her, ‘I’m gonna close this door and you need to spank these kids because they have no sense of respect, boundaries, or direction.’” Dr. Joyner added, “If DCF ever gives you a problem, this is my number and have them call me and I will explain it was necessary. I left the room and the screaming began. I told my staff to let them be for a moment. It’s okay.”

I asked Dr. LaTonya D. Russell of Chesapeake, Virginia, how most Black pediatricians feel about spanking. “I’m not sure how many of us there are. I think it’s probably 50-50 on who agrees with not spanking.”

She admits she never thought she wouldn’t talk about spanking in a positive way. “But as I’ve gotten older, my stance changed. I think most of us are progressive in our stance on spanking. Probably Southern and older Black pediatricians will be harder to change.” Generational differences might play a role, she says. “I think pediatricians under age 40 are more likely to advocate for not spanking.”

Dr. Russell also says that spanking is a touchy issue with parents because of how they were raised. “I do get a lot of pushback. For a while, I didn’t know how to approach the topic with parents, especially the Southern parents in my practice who believe in spankings, though not beatings.”

She says that it’s hard to talk about corporal punishment versus other options for discipline because it’s so ingrained in our society. “Most folks are amenable to hearing a different option, but often I get ‘But I was spanked and I turned out okay.’ I used to just make sure that the children were not being manhandled or outright abused, and just left it alone. Or I said subtle things about how they would correct their kids while they were in my office.”

Dr. Russell admits that, since she was spanked growing up, she had to transform her own thought process as a doctor. “Now I’m more upfront” in talking to parents about spankings. “Some folks don’t want to hear it but just like the anti-science on vaccines, I hold my ground and show them the literature or discuss the literature to try to prove to them that there is a better way to do things. I gently offer other ways of disciplining when they are in my office. If their child is acting out, I will sometimes correct the child in front of the parents to show them a different way of doing things.”

Another challenge for pediatricians of all races is trying to talk with parents about this sensitive and controversial topic within the time constraints of a typical office visit. Dr. Russell says she “ignores the time” and focuses on the child and their parents. “If I’m just doing anticipatory guidance like about challenges, especially in toddlerhood, I usually just incorporate my discipline talk into the regular visit time. I may talk a little less about other topics so that I can do more on the discipline side. And sometimes if folks aren’t receptive, I add some discipline handouts into the regular packet that I give them.”

Clearly there are many nuances and challenges to pediatricians approaching this topic—especially white pediatricians talking with Black parents.

What happens when you tell a Black parent not to spank their child? Often, they respond that “time out doesn’t work—that’s for white people.” But time out isn’t the only alternative to corporal punishment. Many Black parents don’t believe in reasoning with children—ever—and they are convinced that Black children must be hit in order to turn out well.

Black parents deserve to know about the many ways to effectively discipline their children, so that we can move past the popular and cherished notion that spanking is the best (and often the only) approach.

Pediatricians need to be trained about the side effects of hitting kids. I’ve done a number of grand rounds at hospitals and medical schools, and was shocked to learn that doctors are not trained in this area. They urgently need effective tools for communicating—especially across cultural and class lines—in the exam room so that they can effectively share this information with parents in a way that is culturally respectful, appropriate, and likely to be received.

Dr. Russell agrees that providers need to understand and respect cultural backgrounds and beliefs. “I think if you tell a Southern religious Black person and a Southern religious white person not to hit their child, you’ll get the same response. I think that when talking to folks of color on a lower socio-economic scale, especially Black mothers and fathers, they often feel that spanking is a way of keeping their children in line and preventing them from going down the wrong path. They think it’s the only way.”

The key to addressing these challenges is to train pediatricians how to better understand, respect and communicate about sensitive topics. Dr. Russell emphasizes that they start by “acknowledging and accepting the parents’ beliefs, and listening to their perspectives. Doctors being condescending and paternalistic just won’t do it.”

She adds, “I think focusing on a brain is a brain is a brain regardless of the racial, ethnic, cultural background is key. Folks think that they gotta talk to brown and Black people a special kind of way. My thing is just talk to them just like you’d talk to anyone else, with respect and love. Being condescending is never helpful. Hopefully folks have a good and trusting relationship with their pediatrician and the pediatrician wouldn’t come off as condescending.”

No doubt, the AAP’s policy is a huge step forward in the movement to stop violent forms of punishment against children. Yes, hitting is violence! While acknowledging the hurdles to getting Black parents to be receptive to this information, we must find ways to bridge the cultural gaps and overcome the legitimate lack of trust in the mainstream medical system to enable pediatricians of all races to share this vital scientific and medical information with parents.

Dr. Russell believes that because spanking is so ingrained in our culture, it will likely take a few generations before Americans of all backgrounds change the way they discipline their children. Perhaps the biggest challenge  will be convincing Black parents, and parents from other ethnic and racial backgrounds, that their children can turn out alive, healthy, and amazing without being hit. Besides, the idea that Black folks can’t turn out to be civilized human beings without their bodies being processed through violence is co-signing the slave master’s logic.

 

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