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Staff Responses When Parents Hit Children in a Hospital Setting

Font, Sarah A. PhD; Gershoff, Elizabeth T. PhD; Taylor, Catherine A. PhD; Terreros, Amy DNP; Nielsen-Parker, Monica LCSW; Spector, Lisa MD; Foster, Rebecca H. PhD; Budzak Garza, Ann MD; Olson-Dorff, Denyse PsyD

Journal of Developmental & Behavioral Pediatrics: November/December 2016 - Volume 37 - Issue 9 - p 730–736
doi: 10.1097/DBP.0000000000000343
Original Articles

Objective: Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it.

Method: Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting.

Results: Of the hospital staff who completed the survey (N = 2863), we found that 50% of physicians, 24% of nurses, 27% of other direct care staff, and 17% of nondirect care staff witnessed parent-to-child hitting at their medical center in the past year. A majority of physicians, nurses, and other direct care staff reported intervening sometimes or always. Nondirect care staff rarely intervened. Believing staff have the responsibility to intervene, and having comfortable strategies with which to intervene were strongly predictive of intervention behavior. Staff who did not intervene commonly reported that they did not know how to respond.

Conclusion: Many medical center staff witness parent-to-child hitting. Although some of the staff reported that they intervened when they witnessed this behavior, the findings indicate that staff may need training to identify when and how they should respond.

*Department of Human Development and Family Sciences, University of Texas at Austin, Austin, TX;

School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA;

Division of Child Abuse and Neglect, Children's Mercy Hospital, Kansas City, MO;

§Department of Psychology, St. Louis Children's Hospital, St. Louis, MO;

Department of Pediatrics, Washington University School of Medicine, St. Louis, MO;

Department of Pediatrics, Gundersen Health System, La Crosse, WI;

#Department of Behavioral Health, Gundersen Health System, La Crosse, WI.

Address for reprints: Sarah A. Font, PhD, Department of Human Development and Family Sciences, University of Texas at Austin, 1 University Station A2702, Austin, TX 78712; e-mail:

The authors acknowledge grants from the National Institute of Child Health and Human Development (T32 HD007081, PIs: Kelly Raley and Elizabeth Gershoff; R24 HD042849, PI: Mark Hayward) awarded to the Population Research Center at The University of Texas at Austin which supported the design and conduct of the study, data management and analysis, and preparation of the article.

Disclosure: The authors declare no conflict of interest.

Received April , 2016

Accepted June , 2016

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