Cycles of abuse

 
September 18, 2011 -- A short but helpful August 25 item by Marianna Klebenov on the Examiner.com website reported that the National Association of Pediatric Nurse Practitioners (NAPNAP) had recently issued an official position statement opposing corporal punishment in homes and schools--another news item highlighting aggressive policy advocacy by a major nursing group on health issues related to current U.S. economic problems. NAPNAP noted that such punishment can lead to escalating levels of violence not only against the punished child, but also by the punished child later in life, as research shows. And sadly, today an Associated Press item reported that a new study published in Pediatrics links higher levels of child abuse, particularly of infants, to the recent recession in the U.S. The AP report, though physician-centric, underlines the importance of NAPNAP's policy position. We commend Ms. Klebenov and the Examiner.com site. And we salute NAPNAP for holistic patient advocacy that shows again that nurses can be strong public health leaders.

The Examiner site piece "NAPNAP calls for an end to corporal punishment of children" is apparently from the site's San Francisco component. The article is mainly a short, straightforward report about the NAPNAP position statement, issued in June, which "takes a direct stance in opposition to corporal punishment in the home as well as in schools and instead asserts support for 'alternative, non-violent, age-appropriate discipline strategies.'" The one element that goes beyond a description of the NAPNAP position itself is the note that pediatric NPs occupy a "strategic position" that enables them to observe and advocate for better parenting methods. The report might have explained that the NPs are in that position because they are highly qualified primary care providers who increasingly play a central role in pediatric care.

The report says that NAPNAP defines corporal punishment as "the use of physical force with the intention of causing a child to experience pain but not injury, for the purposes of correction or control of the child's behavior." NAPNAP observes that (in the piece's words) "spanking can often be a first step toward escalating violence and cycles of abuse, potentially leading to beating with fists, switches, belts, cords, or other objects." NAPNAP notes that studies show "the majority of American parents use corporal punishment," so education is vital to let parents know it can actually hurt a child in the long run. And hurt others: The statement also "cites studies which have directly linked corporal punishment to higher levels of violence by the individual throughout the life span including increased violent behavior in adulthood."

In fact, today an Associated Press item by Lindsey Tanner appeared on the ABC site and elsewhere reporting that a new study in the journal Pediatrics has linked a rise in child abuse to the U.S. recession. Lead study author Dr. Rachel Berger of Children's Hospital of Pittsburgh studied the cases of more than 400 mainly young children with abusive head trauma (such as shaken baby syndrome) in four U.S. states over a five-year period. The study found a 65% increase in the number of such cases; most of the affected kids suffered brain damage and 69 died. The AP notes that prior research has linked violence with economic declines. Like most mainstream press accounts, this one gives the impression that only pediatricians play any important role in pediatric health care. The report consults physicians and social welfare professionals, but no nurses--such as the nurses who recently issued an aggressive policy statement about corporal punishment--even though nurses are at least as concerned with the underlying socioeconomic aspects of patients' lives that can contribute to child abuse. Still, the report underlines the urgency and importance of the NAPNAP statement.

We thank the Examiner site for highlighting aggressive public advocacy by nurses on health issues linked to the ongoing economic crisis.

See the position statement of NAPNAP on corporal punishment.