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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Saturday, September 7, 2013

Stop Spanking Children? First, Let's Stop Intruding On and Frightening Them

Like many other people, the psychologist Elizabeth Gershoff is opposed to spanking children, and she argues strongly against the practice in an article called “Spanking and child development: We know enough now to stop hitting our children” (Child Development Perspectives, 2013, 7(3), 133-137). Gershoff points out the unlikelihood that parents will manage to use physical punishment effectively and discusses spanking as a human rights violation.

But interestingly, a foremost evidence-based intervention program for at-risk foster children does not  tell parents not to spank. ABC (Attachment and Biobehavioral Catch-Up), the program created by Dr. Mary Dozier of the University of Delaware, does not include suggestions about spanking in its coaching of foster parents of infants and toddlers. Answering questions about this at an infant mental health organization’s meeting yesterday, Dr. Dozier said the research group had decided to omit this issue rather than destroy their credibility with parents by coming across as “weird psychologists” telling people not to spank--  when in fact most parents world-wide do  occasionally spank their toddlers.

ABC is most concerned with encouraging sensitive and responsive caregiving for infants and toddlers with backgrounds of serious neglect or abuse. These at-risk children need foster parents who can provide the optimum environment for improved development by understanding their needs and sensitively reading their signals.  ABC coaches foster parents to be aware that these children need nurturance although they don’t appear to want it. In one video clip, a toddler was seen falling down, starting to get up, then lying down again--  all without crying or calling to his foster mother. But the mother had been made aware that he needed nurturing even though he did not seem to “say so”, and she went to pick him up; both smiled and the pick-up had clearly been what he needed. ABC also coaches foster parents to behave contingently by imitating a child’s movements or by following the child’s lead in play rather than doing something that is instructional or “more interesting” and ignoring the ideas that have engaged the child.

Parents who increase their nurturing behavior, who read signals sensitively, and who follow the child’s lead are less likely to get into situations where they see no option but spanking. In that sense, ABC follows the old behaviorist model of reinforcing desirable behavior and leaving less time or opportunity for undesirable behavior. And even though the ABC program does not mention spanking, it does focus specifically on some undesirable behaviors and try to  diminish them.
Even parents who have increased their level of nurturing and contingent behavior toward young children may still have habits of approaching the children in undesirable ways that disrupt progress toward good communication and biobehavioral regulation. One problematic behavior is intrusiveness. Intrusive parents tickle, chase, or tease young children excessively and fail to pick up cues that the children are distressed--  cues that are often subtle or difficult to read in infants and toddlers who have been neglected or abused. Intrusive parent behavior can be dysregulating, especially if the unobservant parent does not realize that the child has been pushed to the point where some calming and nurturing is needed. (Parental intrusiveness over the years has been related to later mood and behavioral disturbances by the psychologist Brian Barber.) Certainly, parents who are habitually intrusive will have a hard time following the child’s lead as the ABC program encourages them to do. Yet, just as it is hard to get children to stop doing things we don’t like, it is hard to have any success in telling intrusive parents to stop being so intrusive. For ABC coaches to try to do this would be likely to frighten or anger parents and damage their alliance with the coaches, so the approach required is to wait for non-intrusive behaviors and comment on them positively, pointing out how well the child responds to this.

In addition, to undesirable intrusive behavior, parents may habitually behave in frightening ways. These may involve yelling, looming over the child, giving angry looks, or even giving intentional frights by jumping out of hiding or threatening to leave. Parents may act frightening in order to intimidate a child and keep him uncertain in ways the parents think will increase compliance--  but in fact the dysregulating effects of fear and uncertainty may make it even more difficult for the child to stay calm and understand what is wanted of him. Some parents may behave in frightening ways simply to “get a rise out of” the child, who seems to them unsatisfyingly unresponsive or inattentive, and others may do so simply in imitation of adult behavior they have seen or experienced. Increasing empathy and sensitivity to child cues can help parents reduce their frightening behavior, especially if they also discover that nurturing and contingent parenting can help the child be more responsive to them.

Which would be better, a parent who never spanked, but often behaved intrusively and frighteningly, or one who occasionally spanked but rarely intruded or frightened in other ways? My bet would be that the better outcome would result from the second way of parenting—and we do have evidence that people can be helped to stop intruding on and frightening children. Concentrating on spanking gives a lively topic for unending discussion, but perhaps is not of much help with respect to actual improvements in parenting.


P.S. A query: what do you think many neighbors and family members would say to the mother in the ABC program who picked up the child who had fallen but was not crying? “You’re spoiling him” is what I hear in my imagination. And perhaps this would be an unwise move for a healthy child from a stable, caring family background--  but don’t forget, we’re talking here about infants and toddlers who are in foster care, very possibly because they have been neglected and abused. Nevertheless, we can learn a lot about parenting in general from seeing what works for foster parents of at-risk children. 

2 comments:

  1. While nurturing and mirroring/attending are an absolutely essential part of being a good foster parent, there are also many situations where encouraging a child to develop (or simply uncover) mastery is equally important.

    One of the complexities of the lives of many foster children is that they're radically undeveloped and unsophisticated in some ways because of the lack of interest their abusive/neglectful parents took in exposing them to age-appropriate enriching learning opportunities (though "enriching" is overstating how one might teach a child to peel a banana before eating it, for example). A good deal of "babying" (or "spoiling") is more than appropriate, especially when it comes to helping them learn to identify and express emotions, and develop self-regulation and self-soothing abilities.

    But these very same children may also not have been expected to do much of anything in the way of work, chores, self-care, or schooling that would be age-appropriate and normal in non-abusive/non-neglectful homes. As any parent knows, it's often much more difficult to teach a child to do a task than to do it ourselves. So, a child who has plenty of upper-arm strength in a playground situation with peers, but who falls to his knees in the driveway because the one grocery bag he's been asked to carry by his foster mother is "too, too heavy," might need coaching to get on with the chore more than coddling. While he certainly feels weak and perhaps vulnerable in that situation, there's no good reason to support that misguided sense of self-image.

    We can mirror back to our at-risk children what we know them to be capable of, and count that as nurturance. They need to be both soft and strong.

    It's a tough balance to get right, though. The same child who will weep over an imaginary paper cut may walk around on a fractured foot for several days without so much as a peep.

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    Replies
    1. Hi Marianne-- your comments are very useful with respect to older foster children (as usual!). Buffering challenges to children and guiding them to good life strategies is a job that all parents have, but not all perform-- perhaps feeling it's "too heavy".

      The ABC program I described is for infants and toddlers, whose important developmental goals are having fun with other people and communicating with them. They do need nurturance as it is usually defined, to support the developmental tasks of their age. What might be seen as "coddling" of an older child is developmentally appropriate for the youngest ones.

      One of the goals of ABC is to help the toddler learn to ask for help when it's needed, so he or she doesn't grow into the school-age child walking on a fractured foot and not telling anyone-- but of course, if the child has already reached that stage, the ABC program is not designed to correct all that was missing in the past.

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