THINK TWICE: The Medical Effects of Physical Punishment (Part 1 of 6)
Steve Maurer
The following booklet was published in 1985 by my grandmother, Dr. Adah
Maurer, in her drive to educate the public about the dangers of corporal
punishment. I thought it would be of interest to the net, and so took the
liberty of entering it, and posting it.
Needless to say, it was a lot of work to enter this. However I feel
the cause to be worth it. But rather than talk on about my reasons for
spending over 100 hours of my time typing, I'd rather let the booklet speak
for itself.
Steve Maurer
st...@vicom.com
p.s. My comments in the text are at a bare minimum, but where they do
exist, they are surrounded by brackets. Followups have been
directed to misc.kids.
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THINK TWICE: THE MEDICAL EFFECTS OF PHYSICAL PUNISHMENT
by Lesli Taylor, M.D.
Adah Maurer, Ph.D.
Illustrations by Marianna Grenadier
[ illustrations are, of course, absent in this copy ]
Copyright (c) 1985 by Lesli Taylor, M.D. and Adah Maurer, Ph.D.,
All rights reserved.
Parts of this booklet may be copied for educational purposes,
as for use in parent education classes, but not for resale.
[ republished in electronic form with permission ]
Published by Generation Books, under the auspices of:
END VIOLENCE AGAINST THE NEXT GENERATION, INC.
977 Keeler Avenue
Berkeley, California 94708-1498
(415) 527-0454
[ additional booklets, which include illustrations, are available
for US $5.95 from EVAN-G. Also available: "The Bible and the Rod",
$1.95, "1001 Alternatives to Corporal Punishment, Vol 1" - $5.95,
"1001 Alternatives to Corporal Punishment, Vol 2" - $6.95, "The
influence of Corporal Punishment on Crime" - $2.00", and other various
literature, including their newsletter "The Last Resort" (subscription
$10.00, examples $1.00) EVAN-G is a registered charity (all donations
are tax-deductible). ]
ISBN 0-932141-05-6
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Many of the things we need can wait.
The child cannot.
Right now is the time his bones are being formed.
His blood is being made and his senses developed.
To him we cannot answer tomorrow--
His name is today.
Gabriel Mistral
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[ List of illustrations deleted ]
THINK TWICE:
THE MEDICAL EFFECTS OF PHYSICAL PUNISHMENT
A CAUTIONARY TREATISE
Page
The Fine Line, A Foreword........................ 1
Origins.......................................... 5
Eyes, Ears, and Brains........................... 7
Whiplash Injuries from Shaking.................. 12
Chest and Abdominal Injuries.................... 16
Indelible Scars................................. 23
Broken Bones and Bruised Muscles................ 25
"No Vital Organs There"......................... 30
"To Teach Him a Lesson"......................... 37
Aggression...................................... 39
Instead of Physical Punishment.................. 42
Appendix 1...................................... 50
Appendix 2...................................... 51
Appendix 3...................................... 53
Bibliography.................................... 55
About the Authors and Illustrator............... 60
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For
Michael and Rosanne
and
The Safety of Children Everywhere
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THE FINE LINE
A Forward
Kansas City TIMES Dec. 13, 1984
...Kimberly O. was taken to St. Joseph's Hospital
by her parents who said she had stopped breathing
after a spanking.
The medical examiner testified that an autopsy
of the child revealed numerous injuries including
hemorrhaging, bruises and a broken spine.... The
cause of death was trauma involving the abdomen
with internal bleeding.
The fine line between discipline and child abuse differs from one
family to another and physical punishment is often shockingly at
variance with accurate information about the vulnerability of the
immature bodies of small children. Spanking is currently accepted
by our society as a method of training and socializing children, but
frequently children are more seriously injured than intended due
to adults' underestimation of the amount of force they can impart.
A child may be severely injured by a blow that would cause only minor
bruising in an adult. Further, children can be injured unintentionally
during even mild punishment if they jerk away and the blows land off
target, or if they fall against the sharp edges of furniture or
other objects.
Research in the field of inflicted injuries is fraught with
difficulties. Scientific ethics do not permit the deliberate stressing
of children to measure damage, and researchers are rarely present when
punishment is given in homes or schools. Only the most serious
injuries resulting from punishment come to medical attention, and
these are usually said to have resulted from accident. Because of
this, information that would help doctors understand the amount of
force required to injure a child is not yet available. A further
difficulty is that many of the consequences of injuries to the brain,
internal organs, and bones that are received in childhood do not
become apparent until months or even years later, long after the
punishment is forgotten. Physical and psychological injury are so
intricately intertwined during punishment that tracing a developmental
impairment to a single cause becomes all but impossible.
No scientific studies have been done to document the amount of
force needed to cause various injuries, and adults cannot estimate
or do not wish to admit the amount of force they have used. It is
common knowledge that when we are angry, we can be unaware of our
own strength. If an open hand is used, the shock and pain to the
adult's hand and arm makes the adult aware of the possibility of
injury. The use of an instrument, such as a paddle or a hairbrush,
blunts even that feedback. Thus adults quite often go beyond what
they would tolerate themselves and inflict a tremendous amount of
damage.
Despite these obstacles, an assessment must be made. From the
field of forensic medicine, it is known that the severity of an
injury can be predicted by five factors: 1) the weight of the object
that strikes the tissue; 2) the speed at which the object is traveling;
3) the number of times the force is applied; 4) the area of the tissue
struck; and 5) other characteristics of the particular tissue. A
heavy object moving at a fast speed causes more damage than a light
slowly moving object. A fist or the edge of the hand causes more
damage than a blow from an open hand.
Medical journals, including The Journal of Trauma, The Journal of
Child Abuse and Neglect, Neurosurgery, and The Journal of Bone and
Joint Surgery supply further knowledge of the types of injuries that
occur when a child is physically punished. Studies of boxers' injuries
and those of adult torture victims also add to our store of information,
although care must be taken in applying the outcome of adult injuries
to the physical punishment of children. The types of injuries that
occur from accidental trauma cast considerable light on the matter
and valuable information comes from autopsy reports of children who
have dies after afflicted injuries.
The medical journals describe these injuries and autopsy findings,
but the general public does not ordinarily read these professional
journals and are not fully informed of how different forces can harm
children. A grandmother wrote to a syndicated columnist asking for
advice: should she interfere with a son-in-law who "played" with his
three-year-old son by holding him by the ankles and swinging him
around in large circles? It made the child dizzy and left him whimpering
but otherwise apparently unhurt. Was this dangerous? The answer was,
quite correctly, yes. If he refused to stop he should be reported.
No one in today's world should be uninformed of the effects of
physical force on children's bodies. Parents, teachers, coaches,
principals, day care workers, baby sitters, recreational directors,
camp counselors, and all adults who care for and discipline children
must be knowledgeable about the harmful consequences of physical
discipline. We hope this booklet will fill some of these gaps in
knowledge and reduce ignorance as a cause of childhood injury.
A social worker could not believe that a child could die from
spankings no matter how prolonged and asked us for proof. This
booklet was written, in part, to provide that proof. We have tried
to focus on the most common forms of punishment that cause serious
injury, permanent disability both immediate and delayed, deformity
and death. Not included are injuries caused by obviously maiming
instruments such as knives and guns, or by acts such as strangulations
or attempted drownings.
We propose that parents and caretakers can evolve ways to
discipline children without violence, force, or cruelty. Although
physical punishment has been used in the rearing of children since
history began, it can no longer continue to be accepted.
Lesli Taylor, M.D.
Boston, Massachusetts
Adah Maurer, Ph.D.
Berkeley, California
March, 1985
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ORIGINS
The traditional first spanking used to be given by the old
country doctor who yanked the newborn from the bloody birth bed,
held it up by the heels for all to see, and if it did not
immediately give out a lusty cry, swung it around and gave its
tiny bottom a right smart spank. An angry howl usually resulted.
Everyone laughed with great delight. A healthy baby!
It even came to be believed that the spank was essential to bring
the baby to life, that otherwise, it would never learn to breathe.
The birth cry was thought by some to confirm that this life was
indeed a "vale of tears" through which humans must suffer before they
could earn their way into some future paradise. Even for those who do
not hold such a dismal outlook on life, the birth cry brought about by
the first spank remains a folk belief of great persistence.
Such rough greeting to the world is no longer acceptable. It is
now recognized as the traumatic shock that it is. At birth, the
sudden change in temperature, the loss of the close enfoldment of the
womb and its total life support system, the cutting of the umbilical
cord, the sudden change in the mode of obtaining oxygen and nourishment,
the disappearance of the reassuring thump of the mother's heartbeat,
and the strange dryness of the swaddling blanket in contrast to the
ocean of amniotic fluid in which it had been swimming, are changes
that create quite enough shock. Further roughness can be only
stressful to the newborn.
Gentle birthing, including prenatal care, is now replacing
impersonal abruptness and excessive anesthetics which created the need
to spank the drowsy baby as if it were all his fault. Now the new
arrival is made welcome as would an honored guest. Spankings,
discomfort and disregard for anything but physical aliveness and the
normal number of fingers and toes are becoming memories of the past.
The old ways are not good enough for the people to be of the
twenty-first century.
Less than a hundred years ago, weak, fussy babies rarely survived.
Second summer diarrhea and a host of childhood diseases carried off
most of the weak and some of the strong. It took a generation of
dedicated doctors and other reformers with laws and public education
to clean up the polluted water, get rid of the flies, lice and other
vermin, provide universal vaccination and pasteurized milk. The death
rate dropped dramatically, but with the solution to those problems, new
expectations and questions have surfaced. What makes children
emotionally disturbed, the twentieth century epidemic? What causes
minimal brain damage and hyperactivity? Why are some children
accident prone, learning disabled or behaviorally disordered? What
is the cause of short attention span, an inability to sit still or a
penchant for picking fights? Are these medical problems? Are they
physiological abnormalities? Or is there a psychological virus
floating around in child's space? Is it a combination of inborn
weakness and environmental stress?
Among the pioneers in this quest for answers was Dr. Renee Spitz,
who discovered that institutionalized infants, although cared for with
the most meticulous attention to correct nutrition and sterile sheets
and diapers, nevertheless, by the end of the year were either dead or
severely retarded. He called the condition marasmus and concluded
that interaction with other human beings, being held, talked to,
responded to, having eye contact with, being cuddles and loved, was
essential to the health and well-being of babies. Neglect was thus
identified as one of the major factors that destroyed the personality
of the growing child, just as surely as a disease destroyed their bodies.
The public recognition of physical abuse as a child destroyer was
due to a ratio of pioneers: Fredric Silverman, a radiologist whose
x-rays displaying the existence of multiple fractures in various stages
of healing, proceed conclusively that a single instance of falling out
of bed could not be the true explanation for the injuries of battered
infants; and Henry Kempe and Ray Helfer, who alerted pediatricians to
what they did not want to believe: that the injuries to children described
by their caretakers as accidents had been deliberately inflicted, and
that this phenomenon of child abuse was wide-spread in all parts of
the country and among all classes. Their books, The Battered Child,
and Helping The Battered Child and His Family, were so effective that
every state enacted laws requiring that suspected child abuse be reported
to police or welfare agencies, and providing protection against
retaliation by those who were reported. Private and federal agencies
were mobilized, hospitals were alerted, and the identification and
counciling of abusive parents began.
But the problem is not solved. Many people still do not believe
that children can be damaged by so common an action as a jerk, a spank,
a slap, or a shake. Others resent what they consider to be an invasion
of privacy, and loudly denounce the "busybodies" who would interfere
with their right to punish children as they choose. Some proclaim that
they have been directed by God to chastise children. And despite a
strong effort to screen expectant mothers, to identify "at-risk" families,
to council individuals who have hurt children and despite considerable
publicity, the problem of abused children is still with us. Dead
children, murdered by overtly zealous punishers, still clutter the news,
and the plea of the abuser is still, "I didn't mean to hurt him."
It is time to put an end to that kind of lethal ignorance.
[ End Part 1 of THINK TWICE: The Medical Effects of Physical Punishment ]
Steve Maurer
EYES, EARS, AND BRAINS
The exact prevalence of idiopathic (not inherited)
juvenile mental retardation in the general population
is not known, but all responsible estimates indicate
that it is woefully high - as high as 2 million cases
in persons younger than 18 years.
John Caffey, M.D.
"He ain't quite right. Somebody must have dropped him on his
head when he was a baby."
Common folk expression
A child's developing brain is its most precious organ, yet the head
is a frequent target for physical punishment. Inflicted injuries to the
brain are the most common cause of death and long-term impairment in
abused children. Although a child's brain is protected by a bony skull,
it may still be injured in several ways. Direct blows to the head may
cause tearing and bleeding of the delicate blood vessels which line the
skull or of those which overlie the surface of the brain. An expanding
collection of blood within the bony skull causes two life-threatening
conditions known as epidural hematoma and subdural hematoma. These require
emergency surgery to drain the blood and relieve the pressure on the
brain. (See Figure 1) [ Deleted ] If the pressure is not relieved, death
can occur when the base of the brain is compressed against the bottom of
the unyielding skull, and the parts of the brain which regulate breathing
are damaged; this is brainstem compression and herniation. The death rate
from these brain injuries can be as high as 70%. Blindness, mental
retardation, paralysis or coma can be the long term sequelae for survivors.
Bruising of the brain tissue can occur from a direct blow to the head;
this causes a concussion or a cerebral contusion. Blood vessels within
the brain tissue may rupture and bleed. This is an intracerebral
hemorrhage. Any bruising of the brain causes it to swell. Children's
brains have a greater tendency to swell than adults' because of the
immaturity of the tissue. This swelling of the brain in a closed space
of the skull causes a decrease in the blood supply to the brain, and thus
in its oxygen supply. There will be a subsequent death of nerve cells
because they require a continuous supply of oxygen.
Special x-ray scans called computed tomography (CT) scans of adult
boxers who suffered repeated blows to the head show atrophy of the brain
due to cell loss. In fact, long-term mental deficits in boxers correlate
more with frequent pummelings than with the number of knockouts suffered.
This impairment in mental function is called the punch-drunk syndrome.
The boxer has problems with memory, speech, judgement, gait, and dexterity.
CT scans of the brains of children who have engaged in amateur boxing
show brain injury which was not detected by electro-encephalogram,
neurologic testing or medical examination. These findings, that repeated
blows to the head that do not cause unconsciousness can have a cumulative
damaging effect on the brain, were so convincing that the Committee on
Sports Medicine of the American Academy of Pediatrics has recommended
that boxing as a sport for children be abolished.
Children who have accidental or inflicted head trauma who later have
follow-up CT scans also show brain atrophy, and are at risk for the punch-
drunk syndrome. It is clear that those who try "to knock some sense" into
a child's head are doing just the opposite.
Forcefully pulling a child's hair can cause bleeding under one of the
layers of the scalp; this created a collection of blood there called a
subgaleal hematoma. This collection of blood may become big enough to
require drainage. (See Figure 2.) [ Deleted ] Direct blows to the skull
may cause bruising of the scalp. If more force is used, even with an
open hand, skull fractures can occur, especially in infants and toddlers.
An infant under one year of age is at six times greater risk of receiving
a skull fracture from blows to the head compared to an older child. The
fracture may be a simple straight crack called a linear fracture. If the
force is great enough, a depressed skull fracture may occur; pieces of
bone are forced directly into brain tissue. This injury requires urgent
surgery. A rough estimate of the small amount of force which can harm
the brain and skull of an infant is provided by several reports of infants
under one year of age who were killed by head injuries infliced by children
under eight years of age wielding objects. For example. a two-and-a half
year old boy caused fatal brain damage in his four-month-old brother by
striking him in the head several times with a metal toy.
Any of the injuries to the head and brain described above can occur
if a child's head in intentionally banged against a wall or an object,
if the child is dropped and strikes it's head on the floor, or if the
child strikes it's head on furniture or against a wall when thrown off
balance during physical punishment.
Slapping a child over the ears can injure the three bones of the
middle ear with subsequent partial or complete deafness. The eardrum may
rupture. Thomas Edison was boxed in the ears by an angry brakeman at
the age of twelve and suffered lifelong progressive hearing loss. Direct
blows to the ear cartilage can cause a blood collection there called
a hematoma which can lead to cauliflower ear, or wrestler's ear, a
permanent deformity.
Blows to the head can also cause bleeding in the back of the eye
called a retinal hemorrhage. Retinal scarring from the injury can lead
to various degrees of blindness. The force of the blow may cause the
lens of the eye to dislocate with impairment of vision. Few people
would intentionally strike a child in the eyes, but the eyes can be
injured by blows about the head that miss the mark. Vision can also be
damaged by swinging the infant about. Caffey reports the case "in which
subdural hematoma and retinal hemorrhages resulted from seizing the infant
by the legs and swinging him in a circle about the parent's head." Clots
of blood inside the skull and at the backs of the eyes leave no visible
scar. The child may only whimper in distress, but the damage remains
the rest of his life.
The pituitary and the hypothalamus are two structures of the brain
which release hormones that regulate many normal functions of the body,
including growth, sexual development and thyroid function. Children
can suffer impairment in growth with permanent short stature and
inadequate sexual development from injuries to the pituitary or
hypothalamus that occur during inflicted head trauma.
A child's brain may be injured by physical punishment in a much less
obvious way. Although it is difficult to extrapolate to children, there
is evidence from the study of adult torture victims that injuries
inflicted on other parts of the body may cause brain atrophy with
subsequent dementia. This brain atrophy has been documented by CT scan.
It is not yet clear exactly what causes the atrophy but it may be related
to high levels of a hormone produced by the adrenal glands called cortisol,
which occur in chronic stress and depression. Much study remains to be
done to determine whether children who suffer physical punishment to
other parts of the body are at risk for this brain atrophy.
It has been estimated that of all the children consigned to classes
for the trainable mentally retarded, one third were born with the genetic
anomaly of Down's syndrome for which no prevention has been found.
Another third have other birth defects that were due to damage in utero
or during birth. The final third were victims of damage, accidental
or deliberate after birth and during the first year or two of life.
Thus rough play and punishment destroy thousands of brains every year.
It is a waste our society can no longer afford.
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WHIPLASH INJURIES FROM SHAKING
After one infant was found dead without satis-
factory explanation, the nurse explained that
she had only tried to burp him. "I picked him
up to try to get the bubble up, I didn't do
anything wrong." After another of her patients
had succumbed unexpectedly, she admitted that
she "had given him a good shaking."
NEWSWEEK, 1956
Many adults who would not hit a child might be inclined to shake the
child if frustrated by annoying behavior, in the belief that this will
not cause injury. However, a child's brain may be seriously injured by
vigorous shaking. This is especially true for infants. An infant's head
is large in proportion to its body, compared to an adult. During a
shaking, the relatively weak neck muscles of the infant allow its head
to flop back and forth. The brain, which floats inside the skull on a
cushion of fluid, strikes the inside of its bony vault. Because the
infant's brain tissue is soft an poorly developed, a whiplash injury to
the brain occurs. (See Figure 3.) [ Deleted ] The brain tissue is bruised
(cerebral contusion) and blood vessels are torn; collections of blood
called subdural hematomas form, usually on both sides of the brain. The
vessels at the back of the eye may rupture and bleed; this is a retinal
hemorrhage. There may be no external signs of trauma, yet severe brain
and eye damage may have occurred.
In children under 15 months, the death rate and occurrence of permanent
brain injury from this punishment are quite high. Such violence can cause
irreversible coma, seizures, mental retardation, developmental delays,
blindness, cerebral palsy, paralysis or death. Less severe but repeated
episodes of this trauma will lead to smaller bleeds which accumulate to
become chronic subdural hematomas. These collections of blood put pressure
on the developing brain and cause cumulative loss of nerve cells with
impairment of intelligence. This is similar to the punch-drunk syndrome
where multiple small brain injuries, which may each go unnoticed, accumulate
to cause long-term mental deficits. A study by Dr. R.A. Zimmerman of the
Department of Radiology of the University of Pennsylvania Hospital found
that of 17 shaken children, all of them showed brain atrophy on follow up
CT scans. Older children are somewhat protected from this injury by their
stronger neck muscles, more developed brain tissue, and the fact that
their head is not so large in proportion to their body, but they can still
suffer brain injury.
The bones of the neck and lower spine can be injured during a violent
shaking. The vertebrae can be crushed down; this is a compression fracture.
This collapse of the vertebrae can lead to hunchback, a permanent deformity.
The fracture itself may not be recognized because it does not appear to
injure nerve roots, but at some point in the future, the spinal deformity
can be detected. Other fractures of the vertebrae can create chips of
bone which can bruise or tear the spinal cord. Paralysis may result.
A six-year old girl died from a fractured neck after a violent shaking by
her father. The ligaments between the bony vertebrae may be torn from their
attachments to the bone. The nerves of the neck may be pinched or bruised
during the whiplash injury. (See Figure 4.)
Before the age of two, the bones of the spine are quite flexible and
great force is required to break them. However, because a child's spine is
so flexible, it does not provide protection to the blood vessels which
surround the spinal cord. These vessels can be torn during a shaking,
causing bleeding and subsequent compression of the spinal cord by hematoma.
Permanent damage to the cord with paralysis may result.
In very young infants, the bones of the arms and legs can be broken
when they are jerked or squeezed during a violent shaking. Both the brain
injury and the fractures can occur when swinging a child by the ankles or
from jolting while upside down. An infant riding on a vigorously bouncing
adult knee to the tune of "Ride a Cockhorse to Banbury Cross" may suffer
these injuries.
An infant who has suffered serious injury from a shaking will be
irritable, which may have been the reason for the shaking in the first place,
and which may provoke further shakings. The child will also show lethargy,
floppiness, poor appetite and vomiting. The most worrisome sign is a
bulging of the soft spot on the top of the baby's head, an indication of
bleeding in the brain and swelling of the brain.
A chilling account of the lethality of this practice was disclosed in
1956 when a 223 pound nursemaid was discovered to have shaken three
babies to death and permanently maimed twelve others by shaking. She also
injured some infants by vigorous burping. This occurred over a period
of eight years. That she could continue to care for children for so long
emphasizes how harmless the practice of shaking seems, and how little
external evidence of serious injury there is initially. A 1984 report from
the Children's Hospital of Philadelphia of 20 cases of shaken babies with
three deaths and ten permanently brain damaged children documents that
shaking still occurs and that it causes severe aftereffects. Unfortunately,
we will never know the number of children who are born with normal
intelligence who have it shaken from them in infancy and childhood.
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CHEST AND ABDOMINAL INJURIES
Injuries to chest and abdominal organs are the second most common cause
of death from inflicted blows, after brain injuries. Children under the
age of three are at most risk of dying from such injuries. The muscles
of a child's abdominal wall are relatively thin, and do not provide as
much protection to the abdominal organs as those of an adult. Also, the
distance between the front of the abdomen and the spine is shorter in a
child. Their wide rib cage is not as protective of their internal organs.
Injuries occur when the abdominal organs are forcefully compressed against
the bony spine. (See Figure 5.) [ Deleted ] Most such injuries are
inflicted by a hand or fist. They can also occur if a child is kneeled
on, rolled on or sat on, kicked or squeezed, or if he falls against
furniture. There may be significant internal damage even though there
is no external bruising. The amount of force may seem slight. A 13-month
old boy received fatal internal damage when he was playfully but repeatedly
elbowed in the chest and abdomen by two teenage girls.
Blows to the chest may cause bruising of the lung tissue; this is
called a lung contusion. A forceful blow over the left chest or the breast
bone may cause the heart to be bruised, a cardiac contusion. Irregular
heart beat may result. Although it is rare, it has been reported that
a direct blow to the breast bone can cause a child's heart to stop
beating (cardiac arrest).
Blows to the rib cage can break ribs. Because of the great elasticity
of children's ribs, a great amount of force is required to cause such
fractures. Rarely, the sharp end of a broken rib punctures or tears the
lung and causes it to collapse. This is a dangerous condition called
a pneumothorax which requires immediate medical attention. If a blood
vessel is torn when the rib breaks, either a vessel beside the rib or one
in the lung itself, a condition called hemothorax results. Blood collects
in the chest cavity and causes the lung to collapse. This also requires
immediate medical attention. The child will become short of breath
and may faint from blood loss or lack of oxygen.
Squeezing an infant or toddler by the chest can cause multiple rib
fractures which can puncture the liver or spleen and cause serious
bleeding into the abdomen. This can lead to hemorrhagic shock, a
condition in which there is such rapid bleeding from the injured organ
that there is not enough blood within the vessels of the body to be
pumped to vital structures, especially the brain and the heart muscle.
Without a continuous flow of blood, the brain will die and the heart will
stop beating. Death can occur in a matter of minutes if the bleeding is
fast enough. There may be no external signs of these severe injuries,
as bruises take several hours to develop. There may be no external
bleeding, although the child may vomit blood in an extreme case. The
child will become lethargic, and eventually unresponsive.
There are seven major areas of the abdomen which can be injured. (See
Figure 6.) [ Deleted ] The organs can be injured by direct blows or by
squeezing of the abdomen, which causes them to rupture.
Blows to the right upper abdomen can cause tears in the liver which
can bleed profusely and cause fatal shock in a very short time. (See
Figure 5.) Children are at higher risk for such injury than are adults
because of their less rigid and therefore less protective rib cage.
Also, the liver of a child is large compared to the other abdominal
organs. Rarely, the more protected gall bladder and bile ducts are
injured and may require surgical repair.
Similarly, blows to the upper left abdomen or left flank can tear or
burst the spleen and cause fatal bleeding. (See Figure 7.) [ Deleted ]
Surgery is required to stop the bleeding, and the speen may have to
be removed.
Striking a child in the abdomen can bruise or tear the bowel or its
blood supply, the mesentery. Perforation of the bowel or complete
severance may occur due to shearing forces created when the bowel is
compressed between the abdominal wall and the bony spine. Although it
is not common for the bowel to freely rupture after blunt injury, if it
does, peritonitis results when stool leaks into the abdominal cavity.
The child may die in a matter of hours from overwhelming infection if
not treated immediately. The child will appear ill, and may become
unresponsive.
A common bowel injury which results from trauma to the mid-abdomen
is called a duodenal hematoma. This is bleeding of the wall of the
first part of the small bowel which occurs when it is crushed against
the spine. The bowel wall may swell with blood to the point that
bowel blockage is created. This injury requires hospitalization if
the child cannot keep food down. Surgery is sometimes needed to relieve
the blockage.
Blows to the abdomen may cause the stomach to rupture. In 1974, Dr.
S. A. Schechner reported the case of a four-year-old boy who was brought
to the hospital in a lethargic condition and was found to have a ruptured
stomach which had to be repaired by surgery. His father had "only
turned him over his knee and spanked him". Unfortunately, the child
had just eaten a huge meal of beans and franks, and the pressure of the
blows on the buttocks forced his abdomen against his father's bony
knees, causing his distended stomach to rupture. In this child's case,
it was possible to repair the rent because he was brought immediately
to the hospital. If treatment is delayed, the contents of the stomach
which have spilled into the abdomen cause peritonitis, which can lead
to shock from severe infection, and to death.
Bleeding of the organs or blood vessels which lie near the spine in
the space called the retroperitoneum can be caused by blows to the
abdomen. This collection of blood is called a retroperitoneal
hematoma. If bleeding here is swift enough, shock may occur and blood
transfusions may be required.
Blows to the pancreas, which lies in the upper mid-abdomen near the
spine, may crush it against the bony spinal column and disrupt its
delicate structure. (See Figure 5.) [ Deleted ] An inflammation of the
organ called pancreatitis results and hospitalization is necessary for
treatment. If the disruption allows pancreatic digestive juices to
leak out, a collection called a pancreatic pseudocyst forms; this
sometimes requires an operation for drainage.
Blows to the back, just below the ribs, may bruise the kidneys and
cause bleeding into the urine (hematuria) or around the kidney (perirenal
hematoma). (See Figure 8.) [ Deleted ] The blood vessels which bring
blood to and from the kidney may be torn. Although rare, a kidney is
sometimes so severely damaged that there is leakage of urine into the
surrounding tissue; removal of the kidney may be necessary.
A blow to the lower abdomen may cause bleeding into the wall of the
urinary bladder (bladder hematoma). If forceful enough, the blow may
cause the bladder to rupture with leakage of urine. This also requires
surgical repair.
[ End Part 2 of THINK TWICE: The Medical Effects of Physical Punishment ]
Steve Maurer
"TO TEACH HIM A LESSON"
The saying, "The burned child fears the fire", seems to imply that
the unburned child does not fear the dancing flames, and cannot be made
to understand the danger except by experience. When children with
inflicted burns on their hands are brought for treatment, their parents
explain that they held the little hand over the flame "to teach him a
lesson". Some parents whose children do not immediately obey their
commands seem to believe that personal experience and pain are the only
ways that children learn. The words "teach" and "punish" and synonymous
to them.
Toilet training was once recommended to be begun at three months of
age, and uninformed parents sometimes expect control of bowels and
bladder long before a child is physically capable of it. Since their
own upbringing consisted of "Warn once, and if the warning goes unheeded,
punish" their efforts to teach toilet training may be inappropriate. An
infant was brought to the hospital with his penis tied to prevent him
from bed wetting. He died of uremic poisoning. One drunken mother, whose
child had multiple linear burns on his buttocks, explained that she was
just trying to dry her baby's diaper, but she forgot to take the baby
out of it first. Unfortunately, many children have suffered serious burns
to their buttocks from hot radiators or pots of scalding water where
they have been placed by sober but uninformed parents "to teach her not
to soil her pants".
Misguided attempts to stop persistent crying can have tragic results.
A four-year old died from asphyxiation when adhesive tape was placed over
his mouth and nose in such an attempt. A school child was expelled for
insubordination when he ripped tape from his mouth which was stuffed with
toilet paper, put there as a lessor because he talked out of turn. He had
a bad cold and his nasal passages were congested, preventing him from
breathing through his nose. This case came to medical attention when his
cold worsened to pneumonia. Blocking any of the body's orifices is
fraught with danger, whether or not this is done as punishment.
Force feeding can be equally dangerous. A child with Down's syndrome
choked to death on a frankfurter which was rammed down his throat when he
refused to chew it. Refusal to eat certain foods is common among all
children, and "teaching" them with force will not make them like the food,
nor improve their table behavior.
Forcing a child to ingest noxious substances either as a punishment or
as an attempted lesson should be considered intentional poisoning. The
old-fashioned practice of washing the child's mouth out with soap to
cleanse it of the pollution of forbidden words can cause injury more
serious than just an upset stomach. A child died when he aspirated soap
into his lungs during such a lesson. Another death from asphyxiation
occurred when a mother poured the contents of a pepper shaker down her
child's throat. So much pepper went into the his windpipe that he could
not breathe. A six-year old boy died of potassium poisoning when his
foster father put more than two tablespoons of Morton's Lite Salt on his
food "to teach him the taste of salt". The child craved salt and ate
large quantities of it after he was placed in the foster home. The foster
father apparently thought that if the child got a large enough dose of
salt that he would stop craving it. In a small town in Missouri, the
principal caught two junior high school boys with cigarettes. His little
joke for years for teenage smokers has been "Bend over or eat 'em".
This time, the boys took his dare and ate 18 cigarettes between them.
Fortunately, they vomited the tobacco before it could poison them; a law
suit was filed claiming that one of the boys developed stomach ulcers
from this punishment.
Restraining a child in ways that prevent self-protection, or placing
a child in an inappropriate environment as punishment can be fatal. A
six-year old boy died from hypothermia (low body temperature) after being
tied to his bed in an unheated room. Had he been able to move, he might
have been able to find protective clothing or to generate enough body
heat through motion to prevent death. Other children have come down with
pneumonia after being locked outdoors in cold weather or placed in ice
baths "to teach them a lesson".
A two-year-old girl who had wet her pants was being taught such a
lesson. At 7 p.m., her step-father bound her and locked her in a room,
crying and struggling. By 2 a.m. the crying finally stopped and at
10 a.m. when the step-father went to get her, she was dead. Dehydration
was the immediate cause of death, but her condition of sickle cell anemia
was the reason that her inability to obtain fluid was fatal. In sentencing
the step-father for murder, the judge said that the child's illness in
no way excused him. Children with health problems are more vulnerable
to injury, and punishment by an adult who is not familiar with their
health history can be risky.
To bite a child who bites "to teach him that it hurts" belabors the
obvious. He knows that it hurts; that is why he does it. The
infliction of pain teaches only pain and violence. Were any of these
methods of "teaching" used on adults, they would be considered torture,
or cruel and unusual punishment, yet it has been acceptable to the past
to subject the more vulnerable bodies of children to these noxious
punishments in the name of discipline. What "lesson" does the child
learn? The violence, fear and pain most certainly distract the child
from learning the hoped for lesson.
- - - - - - - - - - - - - - - -
AGGRESSION
Some years ago a team of sociologists studied the 5-year-olds in
the slums of New York City. They were curious about why some children,
just as poor, just as crowded, just as lacking in playgrounds and
toys, grew up to be good citizens, held jobs, raised families and
stayed out of trouble, while others descended into crime, drugs,
alcoholism and unemployability that was supposedly due to poverty and
discrimination. From the same neighborhoods, some did well, others
carried knives, mugged vulnerable victims and had lengthy criminal
records. What was it that made the difference?
Ten years later they found out. From lengthy interviews with the
parents, school records, achievement tests and other data, the now 15-
year-olds were again studied. All the things that could possibly have
made the difference were tabulated, sent through computers and compared
to see which factors in the lives of the 5-year-olds could have predicted
viciousness at 15. One thing stood out above all others: spankings.
Those who had been frequently physically punished at 5 were aggressively
anti-social at 15. Those who had been raised gently, whose parents had
taken time to talk with them and explain things were doing well. It was
called the Family Research Project and was reported in Science News in
May of 1976.
Teams of psychologists studied punishment using laboratory animals:
white rats, guinea pigs, and monkeys, as the subjects and electric
shock as the punishing agent. They found that the first reaction to
pain was some form of avoidance behavior. The rats tried to get away.
Some, cleverer than others, discovered that they could avoid the shock
by standing on one foot or by turning over onto their backs since the
furry hide was better insulation than bare feet. Those who could not
escape scratched and bit at the bars of their cage; if a cage mate was
handy they attacked and fought.
Children's behavior can be described in similar terms. Their first
reaction to the pain of physical punishment is "avoidance behavior".
They attempt to escape as best they can by squirming, pulling away or,
as they grow older, by lying, blaming others, or running away. If there
is no possibility of escape or if the source of pain is also the source
of sustenance, they turn to fighting with their "cage mates" and to
destructiveness. The psychologist Ralph Welsh has examined and tested
several thousand delinquent boys and it is his considered judgement that
the aggressive repeat offender who has not been raised by the belt, board
or fist is virtually non-existent. Parents who spank a great deal
complain the most about their inability to control their child. "I've
spanked and spanked, but it doesn't do any good!" Thus it is strange
that in spite of all the evidence, both scientific and everyday
observation, there remains the firm conviction on the part of far too
many people that being spanked for fighting will keep boys from fighting.
It does not. Indeed it cannot. It is not only the example of powerful
people being able to beat up on small ones, but there is a strong
likelyhood that in internal physical derangement makes the unlearning
of the habit of violence very difficult.
Fear, rage and anger are accompanied by the release of adrenaline
into the blood stream. One theory has it that when the young and
helpless are hit and hurt but cannot retaliate, the adrenaline rises and
subsides only slowly. If the child is hit again and again, his
glandular secretions for flight or fight do not return to normal levels,
but remain elevated for reasons not yet understood. Such a child
becomes touchy, easily insulted and ever ready to fight.
He is prone to outbursts which often bring on more punishment. The
escalating spiral of violence results in extreme cases in an out-of-
control individual who is a menace to society and to himself. Bettleheim
described the rehabilitation of one such child in Truants From Life.
"Harry" had lived in a violent home where an alcoholic father and a
frightened mother had provided scenes of extreme destruction for the
helpless child. The incredible patience it took the staff to calm
Harry down to livable limits, over a year of loving and bolting down the
furniture, is quite impractical for general use. But prisons and death
rows are expensive and also do nothing to rehabilitate.
But what about moderate physical punishment? Is it a case where a
small dose cures even if a heavy dose destroys? Many people feel this
is true and their purpose is to locate the line at which correction
turns into abuse. Research efforts likewise have produced mixed answers
to this problem. Robert Larzelere begins his study thus: "It is well
established that people who are physically aggressive are especially
likely to have experienced sever physical punishment as children...
Whether the use of moderate physical punishment also contributes to this
cycle of violence has not been clearly established..." After a review
and critique of the reported studies, he made an extensive re-evaluation
of the Strauss data which consisted of interviews with over 1000 families.
Separating the data by ages of children showed that physical punishment
was greatest for the youngest, but that at every age, the results "support
the view that moderate physical punishment provides a training ground for
violence, a training ground that differs from child abuse only by a
matter of degree." He adds, however, that more research needs to be
done. "The influence on spanking on aggression may depend on the
extent to which parents provide nurturance, praise, growth encouragement,
clear limit setting, as well as reasoning... (But) even for parents
who use frequent discussions... spanking frequency was never inversely
related to child aggression."
Thus expressions of love and pride reduce the ill effects of rare
to moderate spankings, but spankings, whether few or frequent do nothing
to reduce a child's antagonistic behavior. Further, the mitigating
effect of family loyalty is not present in schools or institutions
where the amount of punishment is quite likely to determine the amount
of anger, that the physically punished child will carry around for the
rest of life. Individual cases will vary, of course, but it is clear
that spankings and other physical violence against children is a failed
method of child rearing.
[ End Part 4 of THINK TWICE: The Medical Effects of Physical Punishment ]
Steve Maurer
INDELIBLE SCARS
Punching children in the abdomen is not generally accepted as a
means of discipline. Does it happen? Would anyone deliberately
double up their fist and pound it into the soft, vulnerable belly of a
baby? The answer becomes clear from an analysis of the Lori Nathan
case in Clayton, California. Mrs Nathan, baby sitter, superb housekeeper,
and friendly neighbor was sentenced to 44 years to life in prison for
the death of one child and the abuse of dozens of others, between 1979
and 1983.
Matt C. was a healthy, normal one-year-old child, but when his
mother picked him up at the Nathan home after work, he lay limp and
unresponsive, and was making an unusual gurgling noise. After being
rushed to Oakland Children's Hospital, he dies a few hours later from
a severed duodenum. His abdominal cavity was filled with blood and
fluid. The pathologist reported that his injury could only have
happened from a severe blow to the abdomen. But the police investigation
was dropped due to "lack of evidence".
Darren S., just a year and a half, was picked up on his first day
at the Nathan home by his older brother Eric. He was "acting funny",
so Eric called his mother. When she got home, the baby could not
stand or sit, and he had little red marks on his face and neck. The
doctor made an outrageous diagnosis. He said that the baby had been
strangled. The red marks were tiny broken blood vessels called petechiae,
and although most people never see them, they are familiar to police
and child protection workers as characteristic marks of child abuse.
The doctor reported the case to the police as he was required to do,
and he had reported another case just two weeks before, that of Darren
McC. who had had seizures and evidence of injury to the retina of the
eyes. This could only have been caused by a severe shaking. As it
turned out, the child spent most of his days with the same baby sitter.
Michael G., 15 months, and his sister Shannon, 3 years, were also
left with the sitter. On the Wednesday of their second week with her,
Michael had two tiny bruises on his abdomen. On Friday he had a bump
on his head and seven tiny bruises in a circle around his navel. On
Saturday morning, he vomited all over his bed and room. The diagnosis
of an intestinal obstruction and the need for exploratory surgery so
shocked his parents that they pleaded with the three-year-old sister to
tell them what happened. But Shannon was mum. Only after being
promised that she would never go back to the Nathan home again did she
finally being to sob: "Lori did it. She put the booboos on Michael's
stomach."
According to Barbara Deane, writing in California Living Magazine,
the reason behind Lori Nathan's behavior involves the economics of
daycare. The average cost per child was $40 per week, which in the
case of some children meant as much as 60 hours... Day care is hard work
at barely a minimum wage -- unless you take 24 to 30 children in your
home. Then you could make thousands every month. But one person
could not handle that many children unless you organized them for
maximum efficiency... The younger ones could be kept in a bedroom,
sitting on diapers in order to stay clean. If they didn't eat or
drink, there would be few diapers to change. The couldn't be allowed
to talk or cry, of course. That would be disorderly. Or play. That
would mess up the house. And they mustn't tell. The punishment for
telling a parent must be swift and sure -- a blow of the fist, a shaking,
a finger poked into the eye or belly, a kick aimed at the stomach or
back. Though painful, the punishment would leave few visible marks,
only tiny bruises and little red dots on the face and neck.
One child dead, one blind in one eye, but the physical scars of the
others have all healed. Does this mean that they are okay now? Far
from it. The children who stayed with Nathan the longest were slowed
in their development and have had to repeat school grades. Nightmares
are common and sudden temper tantrums or crying jags for no apparent
reason are brought on by memories of the pain and terror. One mother
told of the effects on her two boys. "Jason was the sweetest, calmest
baby, and now he's very quiet, but a very mean child." Her other son,
who was choked by Nathan whenever he tried to speak, suffers from severe
speech problems and has regular nightmares. Many of the children are
receiving therapy under the California Victim's Assistance Act. Most
of the younger children have post-traumatic stress syndrome, just as
surely do war veterans. Their physical wounds have healed, but their
scars are indelible.
- - - - - - - - - - - - - - - -
BROKEN BONES AND BRUISED MUSCLES
A child's bones may be broken in several ways during physical
punishment. Any bone is vulnerable, but the most common sites of
fractures are the long bones of the arms and legs. Fractures of the
femur, the long bone of the upper thigh, occur mostly in infants less
than one year old. Inflicted blows are a much more common cause of
this fracture than car accidents. The skull is the second most common
site of fracture, and the ribs are the third. Ribs are broken by
direct blows or by violent squeezing of the rib cage, which causes the
ribs to snap in the back near where they attach to the spine.
There are three main mechanisms by which a bone may be broken.
Most obviously, a direct blow to the long bones of the arms or legs
can cause a fracture, particularly in an infant or younger child. This
is usually a transverse fracture (See Figure 9.) [ Deleted ] This fracture
may also occur if a child's limb strikes an object. There will be
swelling, and the child will be irritable and will refuse to use the
limb. Gripping or twisting of the arms or legs can cause a spiral
fracture. (See Figure 10.) [ Deleted ]
Jerking on a child's limbs or swinging the child by the arms or legs,
either as punishment or an play as in "cracking the whip", can cause
tearing of the delicate growth plate at the end of long bones in
children. This is an epiphyseal-metaphyseal fracture. (See Figure 11.)
[ Deleted ] Injury to this growth plate can cause failure of normal
growth of the bone with subsequent permanent limb shortening. Infants
are most vulnerable to this type of injury. This fracture is most
likely to occur during a violent shaking by the caretaker.
Jerking on a child's arm can cause injury in two other ways. A
sudden forceful jerk on the forearm can cause dislocation of the elbow.
The upper end of one of the bones of the forearm, the radius, is pulled
out of its ligamentous support, the annular ligament, at the elbow. This
is called a radial head dislocation, or a pulled elbow (See Figure 12.)
[ Deleted ] The usual cause of the injury is so common that it has earned
the name "nursemaid's elbow". It is also called "temper tantrum elbow"
because it tends to occur in children around the age of one or two.
Children may be more recalcitrant at this age, and have weaker ligaments.
The injury is rare after the age of nine. There is acute pain, and the
child will refuse to use the arm. No fracture will be seen on x-ray.
The radius will either re-locate spontaneously, or may require
manipulation by a doctor. Violent upward traction on the arm of a
child can also cause a fracture of the outermost part of the collarbone.
Many fractures that occur during physical punishment, particularly
in infants, will not come to medical attention, and they will heal
spontaneously. They will not be discovered unless the child has x-rays
for a subsequent injury, at which time the excessive calcification from
the healing of the old fracture is seen.
Wringing or squeezing a child's limbs may cause an injury to the
muscles called myositis. Doctors only recently recognized that this
condition could be caused by inflicted trauma. Bleeding into the muscle
occurs, and calcifications may develop there, leading to a painful
condition called myositis ossificans. Repeated trauma to a muscle, as
from frequent beatings, would also cause these conditions. The muscle
damage has been well documented to be caused by repeated blows received
in athletics, but it is not yet widely recognized in child abuse reports
because children are not seen by doctors after most beatings. The
severity of a beating that will cause these conditions is not known.
As described above, the severe beating causes muscle disruption and
bleeding into the muscle. As the body repairs this injury, a large
amount of hemoglobin, the breakdown product of blood, is released into
the blood stream and cleared by the kidney. Hemoglobin can cause kidney
failure by poisoning the kidneys. There have been two reports of this
complication occurring after a severe beating: a 20-month old boy went
into kidney failure after being beaten with the buckle end of the belt,
as did a two-and-a-half year old boy after a beating.
- - - - - - - - - - - - - - - -
QUOTES
"I'll give you something to cry about!"
"Just wait until your Father gets home...
he'll thrash you within an inch of your life!"
"Stop fighting or I'll bust your butt!"
"Someday you'll THANK me for this"
"I'll knock some sense into your head!"
"I'm only doing this for your own good"
"I hope this will teach you a lesson!"
"I've told you for the last time"
"This hurts me more than it hurts you!"
- - - - - - - - - - - - - - - -
"NO VITAL ORGANS THERE"
The reason most often given for choosing a child's plump bottom
as a site for physical punishment is that it is fleshy and well-padded
and "there are no vital organs there". Indeed, some say, "Babies'
butts were built for busting." Injuries that might blind, deafen,
cripple, retard or permanently injure the child are thus believed to
be avoided. In truth, there are many important structures in the
buttock area which can be injured.
Most superficially, paddling a child's bottom with a hard or an
object (wooden paddle, belt, brush) can cause soft tissue injury of
various degrees, depending on the force used. It may cause only
temporary reddening, raise welts or cause purple bruises. There may
be bleeding or the skin if an object is used and multiple swats are
given.
If a beating is more forceful, there can be bleeding deep into the
muscles of the buttocks. This is called a hematoma. Autopsies of
children who have dies from multiple injuries, including being beaten
on the buttocks, show old, deep scarring of the muscles along with
fresh bleeding from the most recent beating.
Medical reports document well the injuries that occur to the lower
spine of adults from forces applied there by accidental direct blows,
falls and blows sustained in car accidents. Bruising of the tailbone,
the coccyx, causes coccydynia, a persistent pain in the tailbone. Direct
blows to the buttocks can fracture the sacrum, the large bone at the
lowermost part of the spine. (See Figure 13.) [ Deleted ] Many nerves
pass through the sacrum to innervate the pelvic area. So profuse are
the nerves at the end of the spinal cord that they are called the cauda
equina, or the horse's tail. These nerves supply motor function to the
bladder, the rectum, the genitals and the legs. Tearing of these
nerves by a fracture of the sacrum causes problems with bladder and
bowel function, such as inability to empty the bladder and lax rectal
tone, which causes soiling. Such fractures are often no suspected
because proper x-rays are not taken.
Thus far, doctors have paid little attention to the injuries to the
spines of children that might occur from paddlings. Certainly, paddling
on the buttocks could bruise the coccyx; more serious injuries, such as
sacral fracture and nerve damage, could result if enough force is used.
If the paddle hits below the buttocks, on the back of the upper thigh,
it can bruise the sciatic nerves which are close to the surface there,
and which supply motor function to the legs. (See Figure 14.) [ Deleted ]
This bruising can cause partial or complete paralysis of the legs,
depending on the amount of injury to the nerves.
Paddling of the buttocks sends force waves through the entire length
of the spine. There has been virtually no study of the consequences of
this. At the very least, the nerve roots which exit between the vertebrae
are jarred, and the soft paddings between the vertebral bones, the disks,
are forcibly compressed. The vertebral bodies are forced into
misalignment, enther temporarily or possibly permanently. If enough force
is used, compression fractures of the vertebral bones can occur, which
can lead to deformity. The true long-term sequelae of such trauma is not
known. Low back pain is a common adult ailment. Could paddlings received
in childhood contribute to the degenerative changes in their vertebrae and
discs that produce this pain?
It has been said, "The shortest way to a boy's brain is through the
seat of his pants." This may be literally true, even though doctors have
not studied the effects that paddling of the buttocks has on the brain.
Because the bony spinal column and the spinal cord are continuous with
the skull and brain, some force must be transmitted to the brain during
paddlings. (See Figure 14.) [ Deleted ] It is conceivable that the jolts
to the brain could cause bleeding and swelling there, and that this could
lead to permanent brain damage. The amount of force that would be needed
to cause such an injury is not yet known. It is known that in communities
where beatings on the buttocks are daily occurrences, the level of
educational achievement tends to be below average. Such beatings should
be discontinued until the matter has been thoroughly studied for the
effects on children's brains.
The Sex Organs
In the days of sailing ships, when the cat-o-nine tails was used to
punish drunken or mutinous sailors, the lashes were given on the bare upper
back for the stated reason that "there are no vital organs there" that
could be permanently damaged. The sailor, no matter how badly his back
was lacerated, was still able, after a short recuperation, to scrub decks
and haul sail, to hear and obey orders. Why was the sailor beaten on the
upper back, and not the buttocks? In the case of both the sailor and the
child, the sites for chastisement were chosen to avoid permanent damage
by destruction of vital organs. Why then the difference of the site?
The sailor was beaten on the upper back for the excellent reason that
there is a vital organ lower down, in fact, one of the most vital organs
a man possesses. The taboo in boxing and in playground fights is the same
as for the sailor: "No hitting below the belt." The sex organs are
sacrosanct.
Children, on the other hand, were considered to be sexless by the
Victorians and their predecessors who pronounced, "It's the place Nature
made for spanking." But children are not sexless, and what is more
obvious, neither are adolescents. Indeed they are especially vulnerable
to stimulation of the extensive network of nerves that supply sensation
to the whole area, including the buttocks, the rectum, and the sex organs.
Injuries to the sex organs and sexual functioning can occur in several
ways from spankings.
Damage to the genitals by blows to the buttocks occur if the instrument
hits the scrotum or if the penis is rammed against the object the child is
leaning on. Injuries to the testes are not rare. In Florida, a middle
school student was paddled for tossing stones at a maintenance building.
Thirty minutes later, he was on the operating table, undergoing surgery on
his testicles. The doctor who performed the operation stated that the
paddling contributed to the aggravation of a congenital condition of the
child's testes in which their attachment to the inside of the scrotum was
loose. During the paddling, one of the testicles twisted 60 degrees,
cutting off the blood supply and causing excruciating pain. Another case
of injury to the testes occurred when a boy was paddled on the buttocks
with his legs spread apart. He suffered a testicular hematoma from
bleeding into his testes.
Although their sex organs are internal, girls are not immune from
injury during a paddling on the buttock A young woman of 17 was given
six hard blows by the vice-principal for a day's absence. She hemorrhaged
for two days, and suffered nightmares and post-traumatic stress syndrome.
When she was asked to testify for a Senate sub-committee, she told the
lawmakers: "It was the worst pain I ever felt in my life. I felt violated."
Some school systems specify that when girls are punished, there must be
a female teacher present to officiate, thus recognizing the sexual aspects
of paddling "where Nature ordained".
In his book, The Naked Ape, anthropologist Desmond Morris emphasized
the sexual aspects of the paddling act: "The female rump presentation
posture in an appeasement gesture... with rhythmic whipping replacing
the pelvic thrusts of the dominant male... It is doubtful whether school
masters would persist in the practice if they fully appreciate the fact
that in reality they are performing an ancient primate form of ritual
copulation with their pupils."
Another effect of paddling on girls is demonstrated by the case of
the 14-year-old Texas girl who was paddled so hard that first blow knocked
her to the floor. When she attempted to crawl out of danger, the principal
used his belt to strike her on the legs, arms, back, neck, and head.
She ran from the building and was chased by the belt wielder until she
found shelter in a friend's home. She was treated for emotional trauma
and bruises. Her menstruation stopped for several months.
Many of the nerve roots of the cauda equina supply sensation to the
genitals in both males and females, and control erection in boys.
Fractures of the sacrum which can tear these roots would cause loss of
sensation of the genitalia and the inability to attain erection in boys.
Psychosexual damage caused by excessive stimulation of the erotic
zone that includes the buttocks is actually more likely to occur from a
paddling than is direct or indirect injury to the genitals. This
stimulation of the erotic zone can lead to subsequent distortion of the
normal sexual response. David Bakan writes in his book, Slaughter of
the Innocents:
"The buttocks are the locus for the induction of
pain in a child. We are familiar with the argument
that it is a safe 'locus' for spanking. However, the
anal region is also the major erotic region at
precisely the time the child is likely to be beaten
there. Thus it is aptly chosen to achieve the result
of deranged sexuality in adulthood"
Jean Jacque Rousseau in his Confessions described how he discovered
at the age of 11 that the erotic stimulation provided by the spankings
of a much admired schoolmistress outweighed the discomfort. To secure
a repetition of the sensation, he planned ways to misbehave so he could
be spanked again. He credits his adult distorted sexuality to this
early experience.
The discovery that the pain and pleasure centers in the brain are
vulnerable to "getting their wired crossed" was made long before Freud.
Ian Gibson in his thoroughly documented study The English Vice: Beating,
Sex and Shame in Victorian England and After traces the first book on
the subject to seventeenth century Germany, to a Dr. Meibom whose thesis
was "a serious attempt to establish as fact that flogging can indeed act
as a stimulus to erection in the victim and to manage an explanation
of this phenomenon". Gibson describes brothels where prostitutes
dressed as "strict governesses" applied the birch to men who, having been
subjected to this distortion in boyhood, could not function in any other
way. With unexpurgated quotations from English poets and men of letters,
he leaves no doubts in the reader's mind that painful punishment on the
buttocks of schoolboys deranged the normal procreativity of a great
many males.
Sexual abuse of children has gained much current concern. Incest
and other adult misuse of the bodies of children has been found in the
background of runaways and promiscuous teenagers, prompting a strong
trend towards enlightened sex education. Teaching children to protect
themselves against sexual abuse by learning to say, "No!" is probably a
good idea, but of limited use. Children have been saying no to spankings
without success. Beating on buttocks must be recognized as a form of
sexual abuse just as surely as is touching any erotic zone.
[ End Part 3 of THINK TWICE: The Medical Effects of Physical Punishment ]
Steve Maurer
INSTEAD OF PHYSICAL PUNISHMENT
Babies are born neither bad nor good. They are human, and their
first duty is to stay alive. Their second is to learn as much as they
can about this world in order to live a full and successful life. Babies
will do whatever they can to attain these goals.
Although a baby's body is seperate from the mother's, its emotions
are not. When the mother is frightened, the baby becomes frightened.
When one is happy, the other laughs with joy. When held, the baby feels
the mother's heartbeat, they rhythm of her breath, and the tension of
her muscles. These are signals about the state of affairs, and the baby
responds in kind. Thus, the nervous mother will have a nervous child.
The serene mother is blessed with a calm child, and the angry parent will
have a hostile child.
Most parents want well-behaved, obedient, lively but pleasant
children. The way to get them is a bit indirect. The route? First,
look at yourself. Do you like yourself? You must if you would like your
child. You are a good person. You have many good qualities. What are
they? If you were overcriticized as a child, you may find it embarrassing
to concentrate on your bright side. Never mind that. Think of every-
thing good about yourself. You survived childhood; that took strength
of character. You have had friends ;they likes you. You have had a
baby; that's a wonderful ability. Give yourself a hug; you are a good
person.
You want your child to be obedient? Teach her how by obeying her in
the earliest weeks and months of her life when she cannot help herself.
Answering your child's requests as best you can will insure that she will
respond to your requests when she grows older and is capable of it.
Your child believes implicitly that whatever you do is right, and the
only way. His imitation of you has limits of course. He will get
hungry when his stomach is empty, not yours. He will fall asleep when
weariness overcomes his brain, not yours, and never in response to your
wish for freedom to do something else. The most important determinant
of your child's behavior is your behavior. If he is handled roughly,
he learns to be rough with his toys, his playmates, and the family pet.
If he is hit, he learns to hit. He is not behaving willfully; he has
been taught by example and knows no other way. Without being taught the
Golden Rule, he acts as he has been acted upon; he treats others as he
has been treated. From this it is easy to see that the formula for
raising a good child is to be a good caretaker.
One more bit of self-awareness may help. You were once an infant,
and you, too, learned to act as you were acted upon. Those memories,
buried deep in your primitive mind where there are no words to explain
them still rise as impulses. They are "what comes naturally". If you
were spanked as a child, it will seem right and natural to spank your
child. If you were seriously abused, the impulse to loose your temper
and abuse your child will be very strong. The subconscious where all
those non-verbal memories are stored is a persistent cuss. It takes
conscious effort, and a strong determination to use new information. To
change from what comes naturally (what happened to you) to new behavior,
to which you have given thought, will give your child a better chance
than you had. When he is grown, tell him what you did so that he too
can improve still more. That is the way civilization grows.
The following suggestions of what to do instead of spanking may
seem unnatural at first, or too much trouble. The impulse to hit will
fade only slowly. That is why we named the book Think Twice. Your
second thought will be what you have learned as an adult, even though
the first thought remains what was taught to you by actions before
your conscious memory began. The Golden Rule works whether we want it
to or not. We do as we have been done to. Better by far is the more
thoughtful version:
DO UNTO OTHERS AS YOU WOULD HAVE THEM DO UNTO YOU
Infancy
Spanking in some families begins early. One mother was observed to
slap her infant's face for falling asleep instead of paying attention
to her when brought to nurse. The child was one day old. More often,
the first little slaps begin when the vigorous child kicks and wiggles
about as you are trying to change its diaper. Yes, a slap on his fat
calf will work. He will hold still. But he will also stare fixedly
at you and your hands, watching for them to strike again. He has become
tense and stiff, all joy has fled. His first lesson in self-preservation
has defined your hands as dangers to be avoided if possible, or tensed
against and endured. As his small body becomes accustomed to them, the
slaps will need to become harder and must hurt a little more to produce
the shock effect that will convert his natural exploratory movements into
rigid attention. Already he knows that he must defend himself against
his very source of life. A mixed message. Ambivalence begins early.
When then instead? Well, singing. If you think of your infant as
uncivilized, remember the old saying, "Music has charms to soothe the
savage breast". Unless she is in pain or very hungry, and sometimes
even then, a tuneful ditty will hold the rapt attention of even the most
restless child. If you never learned the traditional lullabies of your
tribe, sing anything that comes to mind, even television jingles. She
will love it. Her spirits will soar with yours.
If you cannot sing, at least talk. Tell him that he is a goooood
boy. Tell him what's for dinner. Recite the days of the week, the
months of the year, or just count. Direct the words right at him. Look
into his eyes. He is absorbing every word you say and they are words
that he will eventually speak. This is not an exercise in futility.
You talk to the family pet, don't you? Never mind if your spouse makes
fun of talking to the baby. He would love to have all that concentrated
attention himself. Don't let his misplaced humor deter you from
communicating your affection to your child. Your baby cannot grow
without it.
Parents used to be cautioned not to pick up their baby every time it
cried for fear of "spoiling" it. New information now encourages parents
to pick their baby up frequently when it is not crying, even when the
child is feeding or sleeping. This practice has been found to reduce
the amount of crying by half. As Renee Spitz proved, human touch is vital
in a baby's life. A modern prescription states that children need four
hugs a day to survive, eight hugs to thrive and twelve hugs to grow. Some
children misbehave and seek physical punishment because it is the only
way they can get their parent's attention and touch. How much better is
is to offer a child an abundance of gentle touch from the start of life.
As children grow in response to reassuring hugs, they will be less likely
to provoke their parents into hurtful contact to fulfill their need for
touch and recognition.
Emerson said, "The child is father to the man". Your child's
personality is growing and being shaped at all times. The inner core of
what will be an adult is there now in your baby in all its naked
vulnerability, and yours is the rare delight of being able to instill good-
naturedness, love and every virtue that you are able to display to your
child. You can implant ambition by playing clapping games to the tune
of "Paula for President" or "Charlie for Chairman", or any natural
expression of your belief that this little one has a great destiny. You
are proud of your baby, of course, but only part of you is willing to let
it show. The other part is embarrassed or afraid that the baby will get
a big head. There is nothing wrong with a big head unless you are so
busy "knocking sense into it" that you knock out all the ability to be
somebody. The core of self-confidance or uncertainty that you instill
in the first few years will bless or haunt your child for the rest of
their life.
Getting Into Things
The scenario of the precious vase set on the low coffee table in the
same room with a lone toddler, which he breaks and must be spanked for
sounds much like a fable. If it ever really happened just that way, it
was a set-up, a sting operation, and the child was not guilty by reason
of entrapment. Much of the seeming destructiveness of small children
is really a clash between the child's drive to learn about their world
and the complex niceties of modern living. The child's natural instinct
is to explore, and that occasionally means broken treasures and messes
unless you consciously child-proof your home, and provide soft, attractive
playthings.
Saying "No."
At about a year and a half, the normal child learns to say "No."
Parents who interpret this as defiance, or willfulness, or as a personal
insult to themselves are making a serious mistake. Punishment for a
necessary developmental step is certain to distort the learning and
maturational process. Is the child never to use a negative? How else
is he to practice the meaning and effect of "No", unless he tries it
out? Saying, "No" to an offer of a cookie and then grabbing for it
strikes some parents as naughty. Others laugh. Fortunately the newer
wisdom regarding sexual abuse makes a point of teaching the child to
say, "No", if his or her body is touched in the wrong way or by the
wrong person. Obedience to all adults under all circumstances, once
a virtue, is now known to be a mistake. When the child first experiments
with "No", let the response be a reasonable acceptance if possible, or
a good natures explanation of why or why not.
Adults must also be prepared to say, "No". The curious notion that
not spanking also means giving in to the child's every whim, is an
exaggerated form of sabotaging any effort to change. Of course the
child must be told "No" and the restriction enforced by removal of the
forbidden object, or of the child from the scene if the child is
persistent. Changing the subject, offering a distraction (a story is
better than a cookie), rearranging the space, or any reasonable action
that the circumstances permit takes a second thought, but the results
are spectacular.
If a parent can manage the first three or four years without spanking,
the necessity for severe correction in later years does not arise.
Mutual trust has replaced defiance; differences are resolved or tolerated
without pain.
Stepping Off The Curb
A popular belief about two-year-olds is that penchant for suicidal
behavior. Any group discussion about toddlers and spanking starts with
the questions, "What about teaching them not to run out into the street?"
If the truth be known, most toddlers who are killed by cars have been
inside them, unrestrained by a kiddie seat. Yet the panic at the
thought of the baby being killed by a motorist who would not notice a
toddler on the road overrides the statistics. As a reason for spanking,
it has no peer. A primordial panic grips the parent and nothing but
violence seems to relieve it. Is there a solution? How can parents
"teach" this important safely lesson? A father writing to MS Magazine
did it this way:
In my opinion "whapping" a child on the butt
for any reason is a form of child abuse. Certainly
whapping sends a crazy message to the child who
ran into traffic. The message goes like this: "You
almost got hurt by the traffic, therefore, I will
hurt you for almost getting hurt." If that isn't a
form of emotional abuse, I don't know what is.
When my daughter has put herself in danger, I have
picked her up, hugged her tightly, and told her how
scared I was that she almost got hurt. I've said,
"Daddy loves you. I would hurt very much all my
life if something happened to you." What is the
message she gets? "Daddy loves me, and I am im-
portant to him." No abuse is given here.
MS Magazine, July, 1984
The father may not have realized it, but the tight hug that held
the child against his wildly beating heart communicated "Danger"
far more effectively than his words, "You almost got hurt". His
rapid breathing and deep sigh of relief alerted the child's non-
verbal reflexes better than, "Watch out". Most importantly, his
actions identified Daddy as her savior, not as her punisher. Thus,
trust and obedience based on respect are born.
Crying For Candy
When children cry for candy in the supermarket, their parents may
feel that they are naughty, selfish, spoiled and in serious need of a
public spanking. In truth, children do not cry for candy; they cry
for recognition of their hunger for attention and love. Haim Ginott,
in his book Between Parent and Child, proposes a formula for handling
children in the store who are unable to resist the temptations of toys
or candy. It involves a three step negative. First, compliment the
child on his good taste or sharp eyes. Next, talk about how nice it
would be to have the item by saying, "It looks like a lot of fun,
doesn't it?" Finally, explain the practical aspects of finances or
other restrictions that prevent the purchase, and propose a plan to
make a future purchase or find a substitute or a homemade version.
The child may be disappointed, but his desires will have been
recognized and dignified. He is not consumed by defiance, and does
not make a public display by whining.
Fighting
If you are determined to raise your son to be a street fighter,
there is no better formula than to punch, beat or knock him about.
Whether he is being punished for fighting or any other reason, the
result is the same. Research findings are unanimous, whether for
animals or people: Violence begets violence. The violated young
becomes the violent youth. In humans, the impulse to fight has been
blamed on heredity, on glands, on learning and on the immediate
situation and on all of these combined. The impulse to fight in
defense of one's body an possessions is probably a built in behavior
but used only when necessary. The difficulty lies in the perception
of "necessary". At every level from international politics to nursery
school, the necessity to fight is not always realistically judged.
The gently raised child rarely finds it necessary to protect himself
physically. Experience and intelligence combine to suggest other
ways out of most dilemmas. The physically over punished child, on
the other hand, often senses danger where is does not exist or where
it could be defused by other than physical means. Learning to
handle conflicts diplomatically and without blood shed or damage is
the most urgent need in today's world, and such learning must begin
early if it is to prevail.
The responsibility for a non-violent world thus depends ultimately
on parents.
- - - - - - - - - - - - - - - -
AFTERWORD
In more primitive times, when the birth rate was astronomical and
the death rate was almost as high, damaged children could be tolerated
or destroyed. Now that fewer children are born, and infanticide is
considered murder, civilization, with its proliferation of intricate
technology, will soon have less need for strong backs with dull minds,
or even sharp minds with sadistic quirks or paranoid compulsions. The
need now is for physically and mentally healthy individuals who are free
to think logically, innovate, enjoy nature's bounty without leaving
poisonous residues behind, and share this earth and the heavens around
without killing each other over it. To this end, every child that is
born must be a wanted child, loved and nurtured with elegance, respect
and joy. In such a time, and it is not very far into the future, there
will be no place on this earth for violence against the next generation.
[ End Part 5 of THINK TWICE: The Medical Effects of Physical Punishment ]
Steve Maurer
APPENDIX 1
AMERICAN ACADEMY OF PEDIATRICS
Committee on School Health
Corporal Punishment in Schools
The American Academy of Pediatrics is opposed to the use of
corporal punishment in schools, and urges all parents, educators,
school board members, legislators, and other adults to seek the
abandonment of corporal punishment and its leagal prohibition in
all states.
Employment of alternative methods (1,2) for implementation of
self-control and responsible behavior is recommended.
COMMITTEE ON SCHOOL HEALTH, 1982-1983
J. Ward Stackpole, M.D., Chairman
Conrad L. Andringa M.D.
Michael A. Donlan M.D.
Leonard L. Kishner M.D.
Kenneth D. Rogers M.D.
Maxine M. Sehring M.D.
Joseph R. Zanga M.D.
References
1. American Academy of Pediatrics: Committee on Psychosocial Aspects of
Child and Family Health: The pediatrician's role in discipline.
Pediatrics. 1983;72:373
2. Christophersen ER: The pediatrician and parental discipline.
Pediatrics. 1980;66:641
Bibliography
Hiner NR: Children's rights, corporal punishment and child abuse. Bull
Menninger Clinic 1979;43:233
Hyman LA, Lally D: Discipline in the 1980s: Some alternatives to corporal
punishment. Children Today Jan-Feb 1982, pp. 10-12
Hyman LA, Wise JH: Corporal Punishment in American Education: Readings in
History, Practice and Alternatives. Philadelphia, Temple University
Press, 1979
Smith JD, Polloway EA, West GK: Corporal punishment and its implications
for exceptional children. Except Child 1979;45:264-68
Wessel MA: The pediatrician and corporal punishment. Pediatrics 1980;66:639
Wise JH (ed): Proceedings: Conference on Corporal Punishment in Schools: A
National Debate. US Dept. of Health, Education and Welfare document
No. 729-22/566, National Institute of Education, Washington, DC, 1977
- - - - - - - - - - - - - - - -
APPENDIX 2
Frederic L. Goodwin, M.D.
Physician and Surgeon
Orthopedic Surgery and Fractures
17214 S.E. Division Street
Portland, Oregon 97236
Phone 761-5022
December 5, 1974
Sandra Lee Evans
Route 1, Box 1410
Troutdale, Oregon 97060
Re: Paddle I reviewed for discipline in a local school
To Whom It May Concern:
In reference to a so-called paddle that I was asked to review, and
give an opinion on, which is used for disciplinary measures in a local
school, please note that I reviewed this so-called paddle on December
3, 1974, and I might say that the initial sight of this so-called paddle,
and the fact that it was called a paddle, was rather startling to me.
It represents more as a club, or semi-brutal weapon. This so-called
paddle measures some 33" in length from the tip of the paddle to
the tip of the paddle part, it measures 10 3/4" across the base through
the paddle, and 16" in length of the paddle part, with the handle
being 17" in length. Also, it is some 15/16" thick, with plastic
lamination on both sides, and apparently the basic construction of one
of the plywoods. This is a very solid and sturdy so-called paddle, and,
in the review of this paddle for disciplinary measures, I would consider
it more in the category of a club, rather than a true paddle, although
it has multiple holes in the paddle part.
From an orthopedic standpoint this would be considered as a very
dangerous weapon, rather than a disciplinary paddle for school. There
are multiple reasons for this. 1. The length of the paddle would give
it such leverage that the impact on the buttocks of a child could be
such that it could give him several of the following. (1) It could cause
subdural hematoma from the so-called contrecoup effect, (2) it could
cause particular hemorrhages in the brain from the same type of
traumatic jar, as well as subarachnoid hemorrhages. (3) Also, in
reference to the gluteal muscles of the buttocks, it could do considerable
damage to these, with the impact of the paddle with the muscles between
these, and underlying bones of the pelvis. (4) Also, if the paddle did
not hit quite sharply, and was turned slightly obliquely, this paddle
could cause severe damage to the sciatic nerves in the gluteal area,
as well as if it happened to hit in the right place, could cause fracture
of the bones of the pelvis, and/or the femoral femur. And if the above
is not enough reference to this paddle, (5) certainly it could knock
even a grown adult of my size, something like 200 pounds, off his feet,
and the extent of the damage that could be done wielding this type of
club, which that kind of impact, when he was knocked off his feet to the
floor, and/or into a wall, etc., could be multiple, and many.
In reviewing this paddle, or so-called paddle, which I prefer to refer
to as a club, let me say (1) I am quite startled which I see such a so-
called paddle, or club, used in one of our local institutions, whether
it be a school, or even a disciplinary detention center, such as a jail,
or juvenile home, etc. I would consider this more as a club than a
paddle, and also in the category of dangerous weapons. (2) From my own
personal opinion, I would consider beating with this club as more in
the realm of personal assault with a dangerous weapon, rather than as
a true disciplinary measure. (3) I am astounded that such a paddle, or
so-called paddle, or club, would even be used in the modern school.
This would remind me more of the pictures and history of the days of
barbarism, rather than modern society. I cannot conceive of this having
any place in disciplinary measures in our current school system, and/or
even our penal system.
The above considerations and opinions are given at this time on the
basis of (1) as a human being, and consideration for other human
beings, (2) also as a father, and consideration of children, and (3) as
a professional orthopedic, and consideration of true medical injuries,
which could result from the use of such an instrument.
Sincerely
F. L. Goodwin, M.D.
- - - - - - - - - - - - - - - -
APPENDIX 3
TEXAS CHIROPRACTIC COLLEGE
December 21, 1982
Mr. Jimmy Dunne, Executive Director
People Opposed to Paddling of Students, Inc.
10903 Wickersham
Huston, Texas 77042
Dear Mr. Dunne:
Thank you for your inquiry about the possible effects of paddling
on the spinal health of school-aged children. I am pleased to provide
this very abbreviated summary of my professional opinion as a
specialist in applied spinal biomechanics, and you have my permission
to reproduce and publish this letter or any part of it. I hope this
information may help P.O.P.S. to educate the public and responsible
school officials about the dangers of this unrecognized health hazard.
The most obvious possible effect of striking a child about the
buttocks with a board or other implement is frank tissue trauma. Of
course extensive bruising will result, which could predispose, for
example, myositis ossificans. The greater danger, however, is that
the sciatic nerve or sacral plexus will be damaged, or that a bone
(most probably the coccyx, or tailbone) will be fractured or dislocated.
These dangers are more pronounced if the child is struck in a fully
standing position, without being bent over a desk or table, but are
by no means absent in any position.
A less obvious but much more probable effect of striking the
buttocks of the child is the production of spinal subluxations. A
subluxation is a condition in which one of the spinal segments or
a related structure has been deranged from its proper juxtaposition
with adjacent structures, to an extent less than a dislocation, resulting
in adverse mechanical tension upon the nervous system and interfering
with its proper function. It is this condition which chiropractors
specialize in correcting. Subluxation reduces the organism's
capacity to adapt optimally to its environment and can cause or
contribute to an extensive variety of symptoms and disorders.
When a child is paddled, leveraged force is being applied to the
developing bones of the pelvis: the sacrum, the coccyx, and both
innominates. The resulting misalignment is predictable from the
known biomechanics of the region and will vary depending upon the
magnitude of force applied and its exact direction and point of
impact. In general, two types of misalignment will occur: anterior
displacement of the coccyx, potentially affecting the coccygeal and
fifth sacral nerves and gangleon impar; and rotation of the pelvis,
producing derangement of the biomechanics of the sacrum and consequent
spinal imbalance, or subluxation. One possible result of this type
of subluxation is scoliosis, or lateral curvature of the spine.
Some school officials who administer corporal punishment in the
form of paddling may mistakenly believe that it is safe to strike the
child just below the buttocks, on the back of the thighs. Aside from
the very dangerous possibility of injuring the genitals, this practice
also applies leveraged force (in this case, from a third-class lever)
to the innominates through the femur heads at the hip joints. Again,
misalignment of the pelvis may occur. Additionally, this practice
concentrates force at the femur heads and may result in slipped
capital epiphysis or avascular necrosis of the femur head (Legg-Calve-
Perthes' disease).
Mr Dunne, I want to point out that in chiropractic we have
adjustive techniques with which we can audibly reposition bones in
a corrective manner with as little as two ounces of pressure at the
skin contact. Likewise, we have corrective techniques using special
tables with support pieces that drop three-eighths of an inch in
response to the doctor's adjustive thrust, in order to give bio-
mechanical advantage to the adjustment. Imagine, if you will, how
much harm can be done by a full-grown man, with no practical knowledge
of spinal and pelvic biomechanics, swinging a two- or three-pound
paddle through several feet of arc to strike a child's buttocks.
I want to emphasize that this is a very brief and incomplete
summary of possible spinal hazards of paddling, and that my opinions
and views do not necessarily represent the official position of
Texas Chiropractic College. Please do not hesitate to call on me
for more information, or whenever I can help you make people aware
of the fact that paddling can cause serious physical injury.
Sincerely,
Elmer A. Addington, M.A., D.C
Department of Principals and Technique
- - - - - - - - - - - - - - - -
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ABOUT THE AUTHORS
ADAH MAURER, Ph.D. taught school in Chicago and studies with
Bruno Bettleheim at the University of Chicago to become a school
psychologist and child counselor. She is also a lecturer and
writer. She organized and heads the Committee to End Violence
Against the Next Generation (EVAN-G) and edits its newsletter,
The Last Resort. She served on the first Task Force on the Rights
of Children and Youth of the American Psychological Association.
She has published a book, Paddles Away and over 60 professional
papers, including "The Child's Knowledge of Non-existence", "Ado-
lescent Attitudes Towards Death", "Corporal Punishment", "Religious
Values and Child Abuse", "Institutional Abuse of Children" and
"The Shock Rod Controversy".
She has contributed chapters to ten books, including Corporal
Punishment in American Education by Hyman and Wise.
LESLI TAYLOR, M.D. is a 1981 graduate of the Jouns Hopkins School
of Medicine. During the summer of 1979, her interest and training
in child abuse began when she worked with Dr. Eli Newberger,
director of the Child Abuse Team at Children's Hospital in Boston.
Together they wrote "Child Abuse in the International Year of the
Child" for worldwide distribution by UNICEF. This article was also
published by the New England Journal of Medicine. She is currently
training in general surgery in Boston and plans a career in
Pediatric Surgery with emphasis on childhood trauma and inflicted
injuries.
MARIANNA GRENADIER has a Masters in Medical Illustration from the
Johns Hopkins School of Medicine. She is currently working as
a medical illustrator in Houston, Texas.
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Comments, questions, suggestions, personal experiences, case
reports and research data on the immediate and long-term effects
of force on the physical well being of children will be sincerely
welcomed.
Please address: Lesli Taylor, M.D.
EVAN-G
End Violence Against the Next Generation, Inc.
977 Keeler Berkeley, California 94708
[ End Part 6 of THINK TWICE: The Medical Effects of Physical Punishment ]