DURHAM, N.C. -- Children with disabilities receive harsher punishment across the developing world, according to a new study based on interviews with nearly 46,000 caregivers in 17 low- to middle-income countries.
The study found that disabled children were more likely to be severely punished by being hit on the head or beaten with an object such as a stick or belt, said Jennifer Lansford, a research professor with the Duke University Center for Child and Family Policy. The work appears July 30 in Child Development.
Disabilities affect at least 93 million children worldwide, and are more prevalent in poor countries: Eighty percent of the world's disabled population resides in the developing world. Yet little scholarly attention has been paid to how children with disabilities fare in poorer countries.
Lansford said attitudes toward disabilities can vary markedly between cultures. While disabilities are often stigmatized, the opposite can also be true: In parts of India and Nepal, for instance, children with cognitive disabilities are believed to have divine qualities. Likewise, beliefs about appropriate discipline vary greatly from culture to culture.
The study is the largest to date to examine the link between children's disabilities and the discipline they receive. Field interviews were conducted with 45,964 caregivers of children between the ages of 2 and 9 in developing countries across the globe. The countries studied were: Albania, Belize, Bosnia-Herzegovina, Cameroon, Central African Republic, Djibouti, Georgia, Ghana, Iraq, Jamaica, Laos, Macedonia, Montenegro, Serbia, Sierra Leone, Suriname and Yemen.
The study found remarkable consistency in the harsh discipline that parents and other primary caregivers used with their children with disabilities. Of the countries surveyed, only Georgia varied from the pattern, showing less prevalence of harsh treatment.
Previous studies have shown similar connections between disabilities and harsh parenting practices, and even abuse, in the U.S., Canada and Western Europe. But much less is known about how children with disabilities fare in poorer countries.
The study considered children with cognitive, language, vision or hearing and motor difficulties. All four groups were more apt to receive violent treatment, such as being hit on the head or beaten with an implement. Children with motor disabilities, such as difficulty or delays in walking, fared particularly badly. Motor disabilities were most consistently associated with harsh treatment, ranging from psychological aggression to physical violence.
What remains unclear is whether disabilities elicit harsh discipline, or whether some disabilities are actually the result of harsh treatment.
Past studies have suggested that parents of children with disabilities suffer higher levels of stress, in part from the extra effort required to manage the disability. But harsh discipline can also cause some disabilities. For instance, shaking infants can cause brain damage resulting in blindness.
"I was disheartened by the results, but not surprised," Lansford said.
More research into parental attitudes could help clarify why children are receiving harsh treatment, and how to change that, she added.
"Parents may believe that children with disabilities won't respond to less harsh forms of discipline," Lansford said. "Or they may be frustrated, and may not know what else to do. If that's the case, then community-level interventions could make a difference in changing community perceptions of disabilities."
The researchers relied on caregivers' own reports of parenting practices within their household. Thus, the problem may be even more widespread than the current paper suggests, said Marc H. Bornstein of the National Institute of Child Health and Human Development, one of the report's authors.
"Our study shows that disabled children often encounter a kind of double jeopardy," Bornstein said. "In addition to their disabilities, they are at greater risk for harsh treatment from their caregivers. Community education could make a difference. Informing parents about child disabilities may give them a better understanding of what types of interactions are most appropriate, constructive and effective for already disadvantaged youngsters."
The study was a joint project of Duke University and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), a division of the National Institutes of Health. In addition to Bornstein and Lansford, the authors include Charlene Hendricks the NICHD and Kirby Deater-Deckard of Virginia Tech. The research was funded in part by the Intramural Research Program of the NICHD.
CITATION: "Associations between Child Disabilities and Caregiver Discipline and Violence in Low- and Middle-Income Countries," Charlene Hendricks, Jennifer E. Lansford, Kirby Deater-Deckard, and Marc H. Bornstein. Child Development, July 30, 2013.