International Variations in Harsh Child Discipline

BACKGROUND: Although the history of recognition of child abuse in Europe and North America extends over 40 years, recognition and data are lacking in other parts of the world. Cultural differences in child-rearing complicate cross-cultural studies of abuse.OBJECTIVE: To ascertain rates of harsh and less-harsh parenting behavior in population-based samples.METHODS: We used parallel surveys of parental discipline of children in samples of mothers in Brazil, Chile, Egypt, India, Philippines, and the United States. Data were collected between 1998 and 2003. the instrument used was a modification of the Parent-Child Conflict Tactics Scale, along with a study-developed survey of demographic characteristics and other parent and child variables. Women (N = 14 239) from 19 communities in 6 countries were surveyed. We interviewed mothers aged 15 to 49 years (18-49 years in the United States) who had a child younger than 18 years in her home. Sample selection involved either random sampling or systematic sampling within randomly selected blocks or neighborhoods.RESULTS: Nearly all parents used nonviolent discipline and verbal or psychological punishment. Physical punishment was used in at least 55% of the families. Spanking rates (with open hand on buttocks) ranged from a low of 15% in an educated community in India to a high of 76% in a Philippine community. Similarly, there was a wide range in the rates of children who were hit with objects (9%-74% [median: 39%]) or beaten by their parents (0.1%-28.5%). Extremely harsh methods of physical punishment, such as burning or smothering, were rare in all countries. It is concerning that >= 20% of parents in 9 communities admitted shaking children younger than 2 years.CONCLUSIONS: Physical and verbal punishments of children are common in high-, middle-, and low-income communities around the world. the forms and rates of punishment vary among countries and among communities within countries. A median of 16% of children experienced harsh or potentially abusive physical discipline in the previous year. Pediatrics 2010;126:e701-e711University of North Carolina School of Medicine Faculty Small GrantsLeBrun Foundation (United Stated)OxfamInternational Clinical Epidemiology Network, IncUniversity of the Philippines (Manila)International Center for Research on WomenFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São PauloUniv N Carolina, Dept Social Med, Sch Med, Chapel Hill, NC 27599 USAUniv N Carolina, Dept Pediat, Chapel Hill, NC 27599 USAUniv N Carolina, Dept Biostat, Chapel Hill, NC 27599 USAUNC Injury Prevent Res Ctr, Chapel Hill, NC USASuez Canal Univ, Fac Med, Dept Community Med, Ismailia, EgyptGovt Med Coll, Dept Pediat, Nagpur, Maharashtra, IndiaUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilUniv Presbiteriana Mackenzie, São Paulo, BrazilUniv Philippines, Coll Med, Dept Clin Epidemiol, Manila, PhilippinesUniv La Frontera, Fac Med, Temuco, ChileUniv La Frontera, Dept Psicol, Temuco, ChileUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilFAPESP: 00/14555-4Web of Scienc