Factors associated with discipline counseling for parents of infants and young children

Objective: The aim of this study was to identify and better understand the factors associated with discipline counseling at health visits and how parents' needs for discipline counseling are being met. Methods: Cross-sectional data analyses from the 2000 National Survey of Early Childhood Health. Participants were 1216 parents of children aged between 10 and 35 months. Main outcome measures were parents' reports that their health care provider discussed discipline practices with them in the previous year, and if not, whether this would have been helpful (an unmet need). Results: Discipline counseling was more common when the health care provider discussed other developmental and psychosocial topics, did a developmental assessment, received higher ratings of family centered care and provided longer visits, and when parents indicated having the opportunity to ask all their questions. However, parents who reported less support for child rearing and parents who reported greater use of spanking were less likely to receive discipline counseling. Spanish-speaking Hispanic parents and parents who reported less support were more likely to report an unmet need for discipline counseling. Higher income respondents were less likely to report an unmet need for discipline counseling. Conclusion: Discipline counseling at health visits is associated with a family-centered orientation and the delivery of other developmental and psychosocial services. However, many parents who might have benefited from discipline counseling were less likely to receive it and more likely to report this as an unmet need. These data suggest that discipline counseling may be more accurately tailored to parents most likely to benefit.