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Spoiled Child Syndrome Bruce J Spoiled Child Syndrome Bruce J. McIntosh Pediatrics 1989;83;108-115 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://www.pediatrics.org PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007. Copyright © 1989 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275. Downloaded from www.pediatrics.org at Nova Southeastern University-Health Professions Division Library on April 15, 2009 SPECIAL ARTICLE Spoiled Child Syndrome Bruce J. McIntosh, MD From the Family Practice Residency Program, St Vincent’s Medical Center, Jacksonville, Florida ABSTRACT. People often speak of children as being Most standard pediatric texts make no reference to “spoiled,” and many parents worry about the possibility the condition, and even sources dealing specifically ofspoiling their infants and children. Many pediatricians, with the management of behavior disorders fail to however, are uncomfortable with this term because it is mention it.25 A search of the literature during the a poorly defined and derogatory expression. Some would even deny that infants and children can be spoiled. Avoid- past 10 years revealed only one article specifically ing the use of the expression spoiled can create difficulties including the term spoiled in the title.6 Dr Benjamin in communicating with parents concerned about their Spock,7 who is frequently criticized for encouraging children’s behavior. In this article, the spoiled child syn- excessive permissiveness, actually has more to say drome will be defined and those patterns of behavior that on the topic of spoiling and its avoidance than other characterize it will be distinguished from other patterns of difficult behavior which may be confused with it. The writers in the field. spoiled child syndrome is characterized by excessive self- Those health care professionals who tend to centered and immature behavior, resulting from the fail- avoid the term spoiled child do so, in part, because ure of parents to enforce consistent, age-appropriate lim- it has no clearly defined meaning and, in part, its. Many of the problem behaviors that cause parental concern are unrelated to spoiling as properly understood. because it is a derogatory term that seems to iden- Such behaviors are often age-related normal behaviors, tify a fault in the child him- or herself. This neluc- reactions to family stresses, or patterns of behavior de- tance on the part of some to use the term persists termined by factors inherent in the child. Pediatricians despite the practitioner’s daily contact with chil- can provide counseling and reassurance for such behav- then whose inappropriate behavior cannot easily be ions and, by helping parents understand the etiology of true spoiling, can encourage the use of behavior modifi- summarized by any other expression. Avoidance of cation techniques for its prevention and treatment. Pe- the term and denial of the existence of the pattern diatnics 1989;83:108-115; spoiled child syndrome, behavior of behavior it describes can lead to difficulties in problem, behavior modification. counseling parents concerned about the possibility of spoiling their child. Parents may not be fully reassured by generalizations such as, “You can’t spoil a baby.” “Perhaps not,” they think, “but chil- People often speak of children as being “spoiled.” dren do get spoiled. When does it start, and how Parents worry that certain approaches to managing can we avoid it?” their infants and children may result in spoiling them, and friends and relatives often encourage DEFINITION this belief with predictions of bad outcomes. How- ever, although every grandmother can recognize a The spoiled child syndrome is characterized by spoiled child when she sees one, many health care excessive self-centered and immature behavior, re- professionals are uncomfortable with the concept.’ sulting from the failure of parents to enforce con- sistent, age-appropriate limits. Spoiled children dis- play a lack of consideration for others, demand to Received for publication Oct 23, 1987; accepted Jan 20, 1988. have their own way, have difficulty delaying grati- Reprint requests to (B.J.M.) Family Practice Residency Pro- fication, and are prone to temper outbursts. Their gram, 2708 St Johns Aye, Jacksonville, FL 32205. PEDIATRICS (ISSN 0031 4005). Copyright © 1989 by the behavior is intrusive, obstructive, and manipula- American Academy of Pediatrics. tive. They are difficult to satisfy and do not remain 108 PEDIATRICS Vol. 83 No. 1 January 1989 Downloaded from www.pediatrics.org at Nova Southeastern University-Health Professions Division Library on April 15, 2009 satisfied long. They are unpleasant to be around, infant. Such crying is not an indication of being even for those who love them, and one often gets spoiled. the impression that they do not enjoy being with Parents often worry that holding a fussy baby themselves. will spoil him or her, making the infant excessively Although most parents would agree with this demanding in the future. A study by Taubman9 description of the spoiled child’s behavior, many concerning the management of colic has essentially would not understand the etiology of the problem. put that concern to rest. In this study of infants The common misconception is that children are less than 3 months of age with excessive crying of spoiled by overindulgence, by being given too unknown cause, it was found that modification of much-too much time, too much attention, too the parent-infant interaction often decreased the many things. This is incorrect. Indulging children infant’s colicky crying time. Taubman’s approach is one of the joys of being a parent, and when was to instruct parents to assume that the crying combined with a positive parental presence in the infant was attempting to communicate a need and form of clear expectations and limits it does not to make a systematic attempt to identify that need produce unpleasant, demanding children. Indul- by feeding, holding, or stimulating the infant or gence can result in spoiling when the parent, lack- allowing him or her the opportunity to go to sleep. ing confidence, time, on energy, attempts to meet Parents were specifically instructed to try never to the child’s complex developmental needs with ma- let the baby cry. If extra attention could lead to tenial gifts and uncritical acceptance while failing spoiling the young infant, it might be supposed that to provide essential guidelines for acceptable be- these instructions would have that result. In fact, havior. however, the posttreatment crying of these infants was markedly reduced from baseline and was not BEHAVIOR PATTERNS NOT INDICATIVE OF different from that of untreated noncolicky control SPOILING infants. Parents may be reassured that they need not Frequently parents and other care providers will hesitate to comfort a crying baby because of fears be concerned that certain behaviors are indications of spoiling. Beyond 3 or 4 months of age the infant’s that a child is becoming spoiled when these behav- cry becomes a less accurate indicator of genuine ions are really unrelated to spoiling as properly needs. Older infants may begin to use their crys in understood. The behaviors that provoke these con- a manipulative way, and the application of behavior cerns are often behaviors that are normal for a modification techniques becomes appropriate to given age or are predictable responses to either prevent the development of true spoiling. usual on unusual stresses in the child’s life. Al- The Toddler Who Gets Into Everything. When though not true indicators of spoiling, these behav- infants become mobile, they are driven to explore ions often provide opportunities for spoiling to occur the environment. First crawling, then cruising, and if parents are not aware of appropriate responses finally walking, they set out to discover the world. to them. If they can see an object, they will try to reach it; if they can reach it, they will put it in their mouths. Age-Related Normal Behavior Patterns Many parents are unprepared for the intensity of The Young Infant Who Cries. It is surprisingly this urge to investigate the environment. They find common for parents to believe that it is abnormal themselves following the child around, continually for an infant to cry except when he on she needs cleaning up messes, rescuing fragile possessions, feeding on changing. This is particularly true of snatching the child away from danger, and probing inexperienced parents who may be quick to label his or her mouth with their fingers to remove small the infant who cries without apparent reason as objects. Their habitual response becomes a shouted either “colicky” or spoiled. Bnazelton8 has provided “No!” as they start from their chairs to intercept useful information regarding this subject with his some new trajectory of discovery. Eventually, they survey of crying behavior in normal infants. Daily begin to suspect the worst, that the baby is spoiled. records maintained by mothers of infants in his They may then attempt to regain control by in- study indicated that healthy infants spend an av- creasing the frequency and severity of spankings enage of 2#{188}hours pen day crying in the first 7 weeks and other punishments, creating a state of contin- of life. Some infants cry much more. This crying uing conflict as the child finds normal impulses often comes in “paroxysms” of fussing not appar- repeatedly frustrated. ently associated with pain. Brazelton hypothesized Being aware of this developmental stage allows that such crying may be a homeostatic mechanism, the health care provider to warn parents of what is serving to discharge accumulated tension in the to come.
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