It is curious how cautions expressed in research findings are often ignored when they become editorial opinion. Harriet MacMillan and colleagues, in their research study of slapping and spanking in childhood, conclude that "limitations of design and measurement in this study require caution in interpreting the findings."1 In the accompanying editorial, however, Murray Straus argues strongly that it is time to ban corporal punishment of children on the basis of the research findings.2
There is to my mind an untested hypothesis from the study that deserves careful consideration. Children who have inborn externalizing behavioral problems, for example, attention deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder, are much more likely to be slapped and spanked by their families than their peers without behavioural problems, simply because their behaviour is so much more difficult to control.
In my experience working with behaviourally disordered children, some families need to use physical punishment as the last step in trying to control their children. Like all potentially toxic treatments in medicine, however, there must be strict guidelines for this intervention. I usually advise that it be done in an emotionally neutral state and that the child be struck only once or twice, on their bottom with an open hand. This is never a first-line intervention. The risks involved in using controlled spanking must be balanced against the risk of having children who are out of control - for example, a placement in a foster situation. Having said this, I retain an open mind on the issue of whether spanking should be banned, but I must say that I do not find the research of MacMillan and her coworkers compelling in this regard. Using their methodology, one might conclude that children who inject insulin are more likely to have diabetes as adults.