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EXTRACTS FROM OTHER JOURNALS RELATING TO CHILDREN, YOUTH AND FAMILIES — IN THE FIELDS OF HEALTH, SUBSTANCE ABUSE, EDUCATION, PSYCHOLOGY, SCIENCE

May 2002

US: 7% of Grade School Kids Have Attention Deficit
(Reuters Health) - Seven percent of US children aged 6 to 11 have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), according to results of a national survey this month by the US Centers for Disease Control and Prevention (news - web sites) (CDC).
The survey also found that half of children diagnosed with ADHD are told they have a learning disability as well. This brings the total number of children diagnosed with at least one of these disorders to 2.6 million, according to the CDC.
"These results show that ADHD and learning disability are among the most common chronic conditions affecting school-aged children in the United States," Dr. Patricia N. Pastor and Cynthia Reuben write in the report, which was published online at www.cdc.gov/nchs.
These findings were obtained from national surveys conducted between 1997 and 1998, which included interviews with family members of 8,647 children between the ages of 6 and 11.
Significant differences exist in the frequency of diagnosis of ADHD and learning disability by gender and ethnicity, Pastor and Reuben report. Boys were three times as likely as girls to be diagnosed with ADHD alone, and twice as likely to have both conditions. In addition, white children were told they had ADHD twice as often as Hispanic and black children.
Children with learning disability were five times as likely as those with only ADHD to be enrolled in special education programs, and more than 23 times as likely as those without either condition.
Children with either condition used healthcare services more often than their peers, the investigators note. Kids with ADHD most frequently took prescription drugs on a regular basis, at rates of 54% among those with ADHD alone and 61% in those with both conditions. In contrast, only 6% of children with neither condition reportedly take prescription medications regularly.
Parents of kids with both disorders were more likely to say that their children had visited both mental health and general healthcare professionals, with 51% of kids with learning disability and ADHD using mental health services and reporting at least four healthcare visits within the past 12 months.
Of children with neither disorder, the investigators note, only 23% visited a doctor as often, and only 3% saw a mental health professional.
Children diagnosed with learning disability alone were more likely than others to live in a low-income or single-mother home, and children living in families with health insurance were more likely to be told they have ADHD without learning disability.

Harsh, Lax Parenting Ups Boys' Dating Violence Risk
(Reuters Health) - Children who are disciplined by regular slapping or scolding and those who experience lax parental monitoring may be more likely to be involved in violent dating relationships during their later teenage years, new study findings show.
"The family is an important place where you learn violence," lead study author Dr. Francine Lavoie of Laval University in Quebec, Canada, told Reuters Health.
In families that use psychological violence and physical punishment, children learn ways of expressing themselves and "learn that violence is efficient," she said. Also, "not being monitored is another type of message: that you can do whatever you want (and) that there are no consequences to what you do."
These findings are based on Lavoie's investigation of the effect of family dysfunction on dating violence. She and her colleagues studied 717 boys over an 8-year period, beginning when the boys were 10 years old.
At ages 10 to 12, slightly more than one third (35%) of the boys said they were regularly slapped, called names or otherwise subjected to harsh parental discipline over at least a 2-year period, the investigators report in the May issue of the Journal of Adolescent Health. Eighteen percent reported being improperly monitored.
Furthermore, by the time the boys reached the ages of 16 and 17, roughly 40% of them said they were psychologically violent in their dating relationships, 3% said they were physically violent and nearly 18% described themselves as both psychologically and physically violent.
Overall, reports of harsh parental practices were directly linked to later dating violence, so that boys who said they were consistently subjected to psychological and physical parental abuse were more likely to be violent in dating relationships.
Lax parental monitoring during childhood, on the other hand, was indirectly linked to dating violence through the boys' subsequent reports of antisocial behavior, or delinquent acts, such as theft, vandalism and substance abuse.
"If you were not properly monitored by parents and become delinquent, you are at risk of perpetrating dating violence," Lavoie said.
The findings indicate that early interventions are needed to help families develop positive ways of interacting, such as expressing warmth, proper discipline and monitoring, according to Lavoie.
"Dating violence prevention should be offered to delinquents in their teens, because they are at risk of abusing their partner emotionally or physically, especially if they also report substance abuse problems," Lavoie said.
SOURCE: Journal of Adolescent Health 2002;30:375-383.

Full-time childcare 'harmful'
LONG periods in childcare could harm a child's social and academic development by the time they started school, according to new research.
The study of 200 children by the University of Melbourne showed that those who spent more than 30 hours a week in childcare started school at a disadvantage to those who were looked after at home. They were also more difficult to control.
Dr Kay Margetts, from the university's Department of Learning and Educational Development, who conducted the study, said the results showed that extensive use of childcare should be discouraged. She said government policy should be changed to dissuade parents from leaving their offspring in childcare for longer than was good for them.
"The children who spent extensive time in formal care displayed significantly lower measures of social skills and academic competence as well as more problem behaviours than the others," Dr Margetts said in a statement. She stressed that it was not the type of care that hindered children's development, but the amount of time spent in that environment, combined with the child's age.
Centre-based childcare, family day care and occasional care all had a role to play in society she said, although care had to be taken with infants because they needed a lot of one-on-one attention.
Dr Margetts said part of the difference in performance on starting school could be explained by the greater range of experiences open to children who were not spending long periods in childcare. "It may be that extensive centre-based care is too isolating and restrictive for very young children," she said.

Boys with Anorexia Lose Bone Mass, Too: Report
Reuters Health  Just like girls, boys with anorexia can develop weakened bones as a result of the eating disorder, new research shows.
The researchers, based in Barcelona, Spain, also note that anorexic boys, like girls with the disorder, can "catch-up" with their peers in bone strength if they return to normal weights.
These findings demonstrate "that young boys with a relatively short duration of anorexic disorder can already have a reduction of bone mineral density, and that with total weight recovery it can be reversed if they are still in their adolescence," said lead author Dr. Josefina Castro of the Hospital Clinic Universitari.
In the study, the researchers measured bone mineral density (BMD)--a measure of bone strength--in 20 boys aged 12 to 17 years diagnosed with anorexia. The investigators then repeated BMD measurements in 15 of the boys up to 2 years later, and noted how much weight they had gained.
Castro and her colleagues found that 35% of the boys had reduced bone mineral density. This proportion is similar to that seen in girls with the disorder, with previous studies documenting loss of bone strength in 41% to 44% of adolescent anorexic girls.
The bone mineral density in boys was associated with how long they had the eating disorder, with the longer the period of weight loss, the lower the bone mineral density. Boys were also more likely to have weakened bones if they consumed lower amounts of calcium, and had relatively little physical activity.
According to the follow-up measurements, boys who only regain part of the needed weight experienced a continued decrease in bone mineral density. However, boys who regained their normal weight experienced a rapid increase in bone mineral density--at twice the rate seen in non-anorexic boys--allowing them to catch up with their peers.
The same effect has been observed in female adolescent anorexics, although studies indicate that female adult anorexics are unable to fully regain bone mass after recovering a normal weight.
"It seems that the potential for bone mineral density normalization is preserved only during adolescence," the authors note in the May issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
In an interview with Reuters Health, Castro said that since anorexia is relatively rare in boys, it can be difficult for them to accept they have the disorder. For example, during inpatient or day hospital treatment programs, male patients are usually surrounded by girls.
Castro added that her findings demonstrate the importance of studying bone mass in boys, as well as girls, given that they can regain any losses while still in adolescence.
"It is necessary for psychiatrists to not permit young patients to be underweight during long periods of time," Castro said.
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry 2002;41:613-618.

Male Relative Who Is 'Father Figure' May Help Kids
Reuters Health   - Young children of single mothers appear to benefit if they have a male relative who serves as a father figure in the place of a biological father, researchers report.
"If kids had a social father who was the male relative, they had higher scores on measurements of school readiness. That's a positive thing," study co-author Dr. Ariel Kalil, an assistant professor of public policy at the University of Chicago, Illinois, told Reuters Health. Children whose father figure was their mother's romantic partner did not fare as well, although the investigators caution that the study could not determine if the father figure was actually a cause of problems.
Kalil and colleague Dr. Rukmalie Jayakody, lead author, an associate professor of human development at Pennsylvania State University, investigated whether there was a link between children who had a male "father figure" in their life and the quality of their emotional and cognitive development.
"Simply because children are living with single mothers does not mean there aren't men with whom they interact," Kalil noted. "Often, mothers nominate these men as father figures."
The researchers surveyed 749 black, single mothers of preschool-aged children in the Atlanta area, asking them whether their child had a man they considered a father figure and who that person was. The investigators also examined the cognitive and emotional development of the women's children.
According to the findings, published in the May issue of the Journal of Marriage and Family, the mothers reported that around half the children had no father figure present in their lives. Of the remaining children, around 30% had a mother's boyfriend or romantic interest serving as a father figure, while 20% had a relative such as a grandfather or uncle in the role.
The researchers found that having a male relative serving as a father figure was associated with a higher degree of school readiness in the preschoolers than having no such father figure.
"There's a theory to suggest that a male relative might be more invested in the child's well-being," Kalil explained. "We can hypothesize that man is an added benefit, he's doing educationally enriching activities with the kids."
However, the team also found that having a male father figure who was the mother's romantic interest was associated with a worse emotional maturity in the children.
Kalil emphasized that because of the type of study, it cannot be concluded that the male father figure was actually causing harm to the child, possibly by increasing their insecurity or competition for their mother's attention.
It is also possible, for example, that the mothers of emotionally disturbed children were more likely to have brought in a romantic figure to serve as a male role model for their children. "It's fair to say it does sound a cautionary note about the role of romantic partners," she said.
These findings suggest that although many public policy initiatives emphasize the involvement of a child's biological father, it is possible that other males such as relatives can also have a positive impact on a child's life.
"There are obviously lots of other men who can play a role in children's lives," Kalil noted. "You wouldn't want to discount the fact that other men can play important roles in children's development."
SOURCE: Journal of Marriage and Family 2002;64:504-516.

Study: Mom Is Best Weapon Against Teen Drug Abuse
Reuters - A caring mother is the single most important factor in preventing teenagers from abusing drugs and alcohol, researchers said on Friday.
An international study showed that teenagers living with both parents are less likely to suffer from alcohol and drug problems but a strong maternal bond is the most effective barrier to substance abuse.
"These findings suggest that living with both parents may inhibit drug use but only if availability through peer networks is not very high," said Dr. Paul McArdle, of Newcastle University in northern England, who led the study.
"They also suggest that attachment, particularly to mothers, is a more potent inhibitor and that this is truly across cultures and substances."
The report, published in the journal Addiction, involved nearly 4,000 teenagers in England, Ireland, Italy, Germany and the Netherlands. They were questioned about their use of cannabis, amphetamines, ecstasy, LSD, tranquilizers and alcohol.
The teenagers also filled in questionnaires about their relationship with their parents and grandparents, how well they were supervised after school and whether they were allowed to meet friends at home.
"Both the quality of family relationships and the structure of families appear to be significant influences on youth drug use," McArdle said in a statement.
But he added a strong maternal bond offered the greatest protection against developing drug habits.
The rate of drug abuse among teenagers living with both parents and who had a good relationship with their mother was 16.6%. If either factor was missing the drug abuse rate rose to 32%.
More than 42% of teenagers living in one-parent families who did not have a strong bond with their mother used drugs.
Drug prevention campaigns in British schools and on television warn teenagers about the danger of drugs and alcohol, but McArdle said no one is tackling the issue of parental responsibility.
"This study shows that the quality of family life, or rather the lack of it for many young people, is at the core of the drugs problem in Western society," he added.
Source: Addiction

Street Life Ups Drug, Sex Abuse Risks for Gay Youth
Reuters Health - Homeless gay, lesbian, bisexual and transgender adolescents appear to be at a higher risk for physical and sexual abuse, substance abuse and mental health problems than their heterosexual peers, new study findings show.
"Survival on the streets is a constant struggle for all homeless adolescents," Bryan N. Cochran, a doctoral student at the University of Washington in Seattle, told Reuters Health. "However, for those who identify as gay, lesbian, bisexual or transgender (GLBT), these challenges become even greater in the context of having a stigmatized sexual identity."
Cochran and his colleagues investigated the challenges of being homeless in a 1995-1998 study of 84 gay, lesbian, bisexual and transgender Seattle youth aged 13 to 21. For comparison, the study also included 84 heterosexual youth.
Both groups of adolescents left home for similar reasons, such as family conflict, a desire for freedom and difficulties with a family member, the investigators report in the May issue of the American Journal of Public Health, journal of the American Public Health Association (news - web sites). However, GLBT youth left home almost twice as often as their heterosexual peers and were more likely to cite physical abuse at home as a reason for leaving.
GLBT adolescents also reported experiencing more instances of sexual abuse since they became homeless than did their heterosexual peers, study findings indicate.
Further, these youth reported more frequent use of substances--especially cocaine/crack, crack/crack mixed with amphetamines, and speed/crystal methamphetamines--than did their heterosexual peers, and also used a larger variety of drugs, the researchers report.
What's more, GLBT youth reported a much higher level of mental health symptoms, as well as more withdrawn behavior, social problems and delinquency than did their heterosexual peers.
Finally, although nearly all (94%) of the youth said they had had sex voluntarily at least one time in their life, GLBT youth reported having sex for the first time at much younger ages than their peers. They also reported having almost twice as many sexual partners as their heterosexual peers, and said they engaged in unprotected sex approximately "half of the time," the report indicates.
"GLBT youth are an extremely vulnerable population, even more so when they are homeless," Cochran said. "We believe that more service programs are needed that directly address the needs of GLBT homeless adolescents and protect them from the increased risks that they experience."
SOURCE: American Journal of Public Health 2002;92:773-777.
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