Child Abuse (cont.)

Medical Author:

Steven C Gabaeff, MD, FAAEM

Medical Editor:

Scott H Plantz, MD, FAAEM

Medical Editor:

Francisco Talavera, PharmD, PhD

Medical Editor:

Jeter (Jay) Pritchard Taylor III, MD

Basic Parenting Skills

General parenting guidelines

Raising children can be a successful and satisfying experience. Without basic parenting skills, the task is difficult and frustrating.

Children seek love and discipline. Discipline takes the form of structured environment, rules, and boundaries, not just physical punishment and obedience. Love is the complementary behavior to discipline. Both are necessary if you are to be a successful parent. Both are needed to create the correct balance of concern and caring required in raising well-adjusted and happy children. When love and discipline are blended correctly, your child will be mentally healthy, self-assured, responsible, self-controlled, and prepared for their own parenting experience.

Problem teenagers can be more difficult to manage, but social organizations, friends, parents, and other family members along with counseling and patience can help. Parents should be wary that bad behavior caused by poor parenting skills can sometimes be diagnosed as a mental disorder, hyperactivity, or attention-deficit/hyperactivity disorder.

Efforts to alter behavior through the thoughtful use of love and discipline should be tried before resorting to medication and other medical treatment. The use of drugs to control behavior can have lasting physical and mental effects on children and on their self-image as they grow up and associate with other kids.

When problems with children are severe, children need to be evaluated by professionals to determine if they have true psychiatric problems.

More than ever before, pediatricians and child psychiatrists are inclined to use potent psychotropic drugs (Ritalin and other stimulants, and Zoloft, Prozac and other selective serotonin reuptake inhibitors [SSRIs]) on children as a primary treatment for bad behavior. Psychotherapy is often more expensive and time consuming. The need for effective parental involvement in psychotherapy further influences a doctor's thinking in deciding between therapy and drugs. A drug-oriented approach is often considered desirable with so many problematic children to deal with, so little time, and pressure from drug companies to prescribe their drugs. Parents should be aware of these factors.

The effect of these drugs on children and their developing neurologic systems are poorly understood. Until recently, children were not allowed to be given these medications. These potent drugs should be used as a last resort to manage only the most severe psychiatric problems. They have no role in behavioral problems.

Parents can have an impact on the treatment their children receive, but they must be involved and speak up.

The limited role of corporal punishment

It is important for parents to understand the limited role of spanking and corporal punishment. Many parents have successfully raised children with no corporal punishment at all.

If punishment is to be used, it must be done carefully.

Light spanking or hand slapping with an open hand can be used to discourage dangerous behaviors such as a 1-year-old trying to play with an electric socket.

Other situations where light spanking can be employed are with children between the ages of 1-3 years who choose to ignore verbal direction in dangerous situations. Reserve this for very unacceptable behaviors such as leaning out windows or pulling at glasses of hot liquid, and always use it in conjunction with saying no. The goal is to reinforce responding to verbal directions and eliminating all corporal punishment as soon as possible.

Any physical punishment should be given with words that demonstrate love and concern for the child. Make it clear to the child that any and all punishment is done because you love the child.

Use words of discouragement and verbal directions in place of spanking as the child's language skills and level of maturity improve.

After the age of 3 years, there should be very little need or use of any physical punishment of a child. If behavioral and control problems continue through this age, seek counseling and work out detailed plans on how to deal with bad behavior.

Consistency in discipline, doing what you say you will, and coordination between parents about disciple policies, help the child know his or her boundaries and paradoxically decrease the need to spend more time on discipline issues.

Alternatives to physical violence

Ample evidence exists that the following forms of punishment are workable solutions that eliminate the need for any physical forms of punishment: