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US Pediatricians' Attitudes, Beliefs, and Perceived Injunctive Norms About Spanking

Taylor, Catherine A., PhD*; Fleckman, Julia M., PhD*; Scholer, Seth J., MD; Branco, Nelson, MD

Journal of Developmental & Behavioral Pediatrics: September 2018 - Volume 39 - Issue 7 - p 564–572
doi: 10.1097/DBP.0000000000000592
Original Article
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Objective: To assess United States pediatricians' attitudes, beliefs, and perceived professional injunctive norms regarding spanking.

Method: A self-administered questionnaire was mailed to a nationwide random sample of 1500 pediatricians in the US, drawn from a database maintained by IMS Health. Four survey mailings were conducted and cash incentives of up to $20 were provided. The response rate was 53% (N = 787).

Results: Most respondents were members of the American Academy of Pediatrics (85%), had been practicing physicians for 15 years or more (66%), and were white (69%) and female (59%). All US regions were represented. About 3-quarters of pediatricians did not support the use of spanking, and most perceived that their colleagues did not support its use either. Pediatricians who were male, black, and/or sometimes spanked as children had more positive attitudes toward spanking and expected more positive outcomes from spanking than their counterparts. Nearly 80% of pediatricians never or seldom expected positive outcomes from spanking, and a majority (64%) expected negative outcomes some of the time.

Conclusion: The majority of pediatricians in the US do not support the use of spanking with children and are aware of the empirical evidence linking spanking with increased risk of poor health outcomes for children. Pediatricians are a key, trusted professional source in advising parents about child discipline. These findings suggest that most pediatricians will discourage the use of spanking with children, which over time could reduce its use and associated harms in the population. This is of clinical relevance because, despite strong and consistent evidence of the harms that spanking raises for children, spanking is still broadly accepted and practiced in the US

*Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA;

Department of Pediatrics, Monroe Carell Jr. Children's Hospital and Vanderbilt University Medical Center, Nashville, TN;

Tamalpais Pediatrics, Larkspur, CA and University of California, San Francisco, CA.

Address for reprints: Catherine A. Taylor, PhD, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, Suite 2210, Mail Code #8319, New Orleans, LA 70112; e-mail:

Disclosure: The authors declare no conflict of interest.

See the Video Abstract at

Received November , 2017

Accepted April , 2018

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