Physical punishment and child outcomes: a narrative review of prospective studies

Lancet. 2021 Jul 24;398(10297):355-364. doi: 10.1016/S0140-6736(21)00582-1. Epub 2021 Jun 28.


Physical punishment is increasingly viewed as a form of violence that harms children. This narrative review summarises the findings of 69 prospective longitudinal studies to inform practitioners and policy makers about physical punishment's outcomes. Our review identified seven key themes. First, physical punishment consistently predicts increases in child behaviour problems over time. Second, physical punishment is not associated with positive outcomes over time. Third, physical punishment increases the risk of involvement with child protective services. Fourth, the only evidence of children eliciting physical punishment is for externalising behaviour. Fifth, physical punishment predicts worsening behaviour over time in quasi-experimental studies. Sixth, associations between physical punishment and detrimental child outcomes are robust across child and parent characteristics. Finally, there is some evidence of a dose-response relationship. The consistency of these findings indicates that physical punishment is harmful to children and that policy remedies are warranted.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Child
  • Child Behavior / psychology*
  • Child Protective Services
  • Child Rearing / psychology
  • Domestic Violence / psychology
  • Humans
  • Parent-Child Relations*
  • Punishment / psychology*