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SMS benefits stuttering children
Mobile phone technology is helping
children in rural areas overcome stuttering, a new study shows.
Sydney-based speech pathologist Elisabeth Harrison said today the
Macquarie University study involved the use of SMS (short messaging
service) texting to gather information about the severity of stuttering
preschool-aged children.
Ms Harrison said after parents participating in the study monitored
their children, a daily rating of the extent of stuttering was text
messaged to the researcher to ultimately determine if speech pathology
was required.
Ms Harrison said the study suggested SMS texting was much more
convenient for parents in remote areas than “paper, pen and clinic
visits”.
At least 5 per cent of Australian children under five years of age
stuttered, but up to 80 per cent of these children overcome the problem
without speech pathology, she said.
“SMS technology could make the monitoring
more effective and less costly ... it is an extremely effective and
efficient data collection method in overcoming distance boundaries for
early stuttering management of rural children,” Ms Harrison said.
“Our findings suggest further trials would be beneficial to both
clinical practice and clinical research for stuttering management.”
Ms Harrison will discuss the pilot study, which involved parents based
in city and regional areas of New South Wales, and its implications at
the annual National Conference for Speech Pathology Australia in
Canberra this week.
30 May 2005
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Oily fish hope in fight against child
autism
Eating more oily fish could help manage
autism in children, according to a study involving Edinburgh's Sick Kids
Hospital.
A possible link between fatty acid deficiency and childhood autism has
been discovered by scientists at the universities of Edinburgh and
Stirling.
The researchers are now to investigate whether eating more fatty acids,
which are contained in oily fish, could actually help reduce the effects
of childhood autism. The study is being carried out in conjunction with
the Royal Hospital for Sick Kids in Edinburgh and South Glasgow
University Hospitals NHS Trust.
Early results have suggested that the behaviour of fatty acids in the
blood of children diagnosed with autism may differ from that of other
youngsters.
The team now want to discover whether autistic children break down the
vital acids too quickly.
The study is looking specifically at highly unsaturated fatty acids such
as arachidonic (ARA) or docosahexaenoic (DHA), which are needed to boost
vital brain functions, as well as helping the body to fight off disease.
They are found in oily cold-water fish, such as mackerel, salmon,
herring, sardines, black cod, anchovies, and tuna.
Dr Anne O'Hare of the University of Edinburgh said: “The number of
children diagnosed with autism has increased dramatically over the past
ten years, both in Scotland, and in the developed world as a whole.
“We hope that this new research will lead to the development of
treatments for managing autism in children.”
But she added: “We are a long way from
that at the moment.”
31 May 2005
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Violence may be a 'socially infectious
disease'
Witnessing gun violence can double the likelihood of a teenager
committing serious violence in the following two years, suggests a new
study by US researchers.
Although a connection between exposure to violence and violent behaviour
has been previously suggested, it is difficult to show a direct causal
link. But this study claims to have isolated the independent
contribution made by actually witnessing gun violence by comparing over
1500 teenagers with a similar likelihood of being exposed to violence.
“Based on this study’s results, showing the importance of personal
contact with violence, the best model for violence may be that of a
socially infectious disease,” says Felton Earls, at Harvard Medical
School, US, who led the study. “Preventing one violent crime may prevent
a downstream cascade of ‘infections’.”
Previous studies have shown a link between child abuse or violence in
the home and violent behaviour outside the home. “But it’s not been so
clear that community violence carries the same implications,” he told
New Scientist. “Our study clarifies doubt that exposure to community
violence is indeed part of the contagion process.”
Walking away
“It suggests that the classic public health approaches to the
control of infectious disease — such as vaccination — might have useful
analogues in violence prevention,” adds Jeffrey Bingenheimer, also on
the team.
“For every specific act of violence (that violence prevention)
programmes prevent, they may also prevent a chain reaction of violence
among those who would have been exposed to that violent act,” he told
New Scientist.
Earls suggests that school-based programmes which teach children how to
deal with conflict without resorting to fighting may help. “In some
cases it means just walking away from somebody you just want to smack —
and showing that can be done with dignity.”
The five-year study, which started in the early 1990s spurred by an
“epidemic” of violent crime in the US, tracked adolescents aged 12 or 15
from 78 Chicago neighbourhoods. To tease out the effects of witnessing
violence on subsequent violent behaviour the team controlled for 153
potentially influential variables, such as family structure and
neighbourhood.
This allowed the sample to be split into two groups, Earls explains,
with just one major difference between them — one group had witnessed
gun violence but the other group had not.
Hyper-vigilance
The children and their parents or primary carers were interviewed on
three occasions over a five-year period. In the two years after
witnessing gun violence, “the exposure group were two to three times
more likely to engage in violent behaviour themselves”, he says.
“When individuals have such traumatic experiences — witnessing or being
exposed to gun violence — it makes them hyper-vigilant,” says Daniel
Webster, co-director of the Center for Gun Policy and Research at the
Johns Hopkins Bloomberg School of Public Health in Baltimore, US.
“There are often social stimuli that are ambiguous — like at a crowded
party, someone bumps into you. How do you interpret those stimuli?” he
asks. Webster suggests that people exposed to violence may be more prone
to assume a hostile intent — as a self-defence mechanism — which could
in itself lead to violence.
Journal reference: Science (Vol 308, p
1323)
27 May 2005
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90% of children 'set to be couch potatoes'
Nine out of 10 schoolchildren are not
doing enough exercise to ensure that they grow into healthy adults,
according to a major new study. Only 10 per cent of young people get the
one hour a day of physical activity that ministers, health experts and
scientists say is necessary.
The findings have sparked new fears that many young Britons are turning
into 'couch potatoes' whose sedentary lifestyles mean they are much more
likely to become obese in later life and suffer a whole range of
diseases. They underline how age-old habits such as playing football in
the street have been replaced by indoor pursuits involving computers and
televisions.
When researchers monitored activity levels among 4,500 11-year-old
pupils in the Bristol area using sophisticated motion sensors called
'accelerometers', they found that some did no exercise at all, only a
few did the recommended daily hour, and most did some but not enough.
“Kids should be doing 60 minutes a day of moderate to vigorous exercise
to be truly healthy and ensure their bones and cardio-vascular systems
develop properly. But this study shows that most are not doing that”,
said Professor Chris Riddoch, head of the London Sports Institute at
Middlesex University, who led the research. Riddoch is a government
adviser on children's health and international expert on physical
activity.
“Children are doing a lot of exercise
such as walking, but just not enough vigorous stuff like running around
and playing football. The fact that more and more of them are getting
fatter shows that they aren't balancing the energy they take in from
food by burning off calories through exercise”, he added.
Recent Office of National Statistics figures showed that 22 per cent of
boys and 28 per cent of girls aged two to 15 in England were overweight
or obese, while a study last month said British children were the third
fattest in the world after the US and Malta.
Experts in obesity said Riddoch's research, part of the Avon
Longitudinal Study of Parents and Children, was alarming but inevitable.
“We live in a society where parents are too frightened to let their kids
out to play, school playing fields have been sold off and streets are so
packed with parked cars that youngsters have nowhere to kick a ball
around even if they feel like it”, said Neville Rigby of the
International Obesity Task Force.
“We need to do nothing less than change the world they are growing up
in. We have to create safer spaces for them to play in so they have an
incentive to leave their keyboard behind and go outside, and reduce the
amount of fatty and sugary foods they consume”, added Rigby.
Dr Ian Campbell, chairman of the National
Obesity Forum, said: “If we want these trends to change we need to
redesign our built environment to encourage walking and cycling, make it
safe for children to be outdoors, and learn to eat together as families
again in a non-rushed way.”
Campbell urged ministers to put money into promoting physical activity
as a normal part of everyday life, and not just into sport.
Boys were much more likely than girls to do an hour a day, while
children from lower socio-economic groups do more than peers from
better-off backgrounds, according to Riddoch's survey.
The Department of Health declined to comment on Riddoch's findings,
which he will present at next week's American College of Sports Medicine
annual conference in Nashville, Tennessee. But a spokeswoman confirmed
that the Chief Medical Officer's advice is that “children and young
people should achieve a total of at least 60 minutes of
moderate-intensity physical activity each day.”
The Government's Physical Education School Sport and Club Links strategy
was increasing the amount of PE and sport which pupils did in and out of
school, she said.
Denis Campbell
29 May 2005
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Canadian children get Fs in phys-ed
A new evaluation of children's
fitness gives Canada a failing grade, the head of a national charity
devoted to boosting healthy living said Thursday.
The report by Active Healthy Kids Canada gave Canada a D average on its
report card and found that less than half of the country's children are
active enough for good health.
“When it comes to keeping kids physically active, Canada is dropping the
ball,” said Dr. Mark Tremblay, chairman of Active Healthy Kids Canada.
It's not the first study of youth activity, but its look at how family,
school, and government policies impact on children's fitness is novel,
said Tremblay, who is professor of exercise physiology and pediatric
exercise science at the University of Saskatchewan.
The report also gave Canada two Fs, one
for lack of daily physical education due to just 14 per cent of
elementary schools and four per cent of high schools offering daily
phys-ed classes in 2000.
The second F came from childhood obesity rates, which ballooned from two
per cent in 1981 to 10 per cent in 2001.
Tremblay said it wasn't intense sport training that was lacking, but
just facets of everyday life that need to be restored or expanded.
“It is unorganized sport – pickup games in the neighbourhood,
unstructured activity, games like tag, an activity that is part of
day-to-day living, such as walking to school or to the store, or doing
chores around the house – that have been shown to have a health benefit
and a protective effect on overweight and obesity prevalence among
children and youth,” he said.
27 May 2005
Source
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Witnessing Violence Can Trigger Violent
Behavior
Teens exposed to gun violence more likely
to commit violence
Can exposure to gun violence make you
more likely to participate in violence? The answer is yes, according to
new research that found teens who had witnessed gun violence or been
victims of it were twice as likely to then commit violence.
“This study makes us more confident that there is a substantial
cause-and-effect relationship between being exposed to violence and
perpetrating violence,” said study author Jeffrey Bingenheimer, a
doctoral candidate at the University of Michigan in Ann Arbor. “Violence
can be socially transmitted from person to person in a community through
exposure.”
The study, published in the May 27 issue of Science, is believed to be
the first one to show a cause-and-effect relationship between exposure
to violence and committing violence.
To reach that conclusion, Bingenheimer and his colleagues analyzed data
from the large, longitudinal Chicago Neighborhoods study, which includes
about 6,000 children from 78 different Chicago neighborhoods.
The researchers began with a group of
about 1,500 children who were either 12 or 15 at the start of the study.
The researchers took a comprehensive assessment of family history, home
and community environment, health, social support, peer influences,
school proficiency, previous exposure to violence and more. Both the
adolescents and their primary caregiver — usually their mother —
provided information for the initial assessment.
A second assessment, which took place about two years later, included
1,239 youngsters from the original group. Study volunteers were asked
about their exposure to gun violence: 942 said they hadn't been exposed
to gun violence; 283 said they had.
There were many differences between the exposed and unexposed groups,
according to the study. Teens exposed to gun violence were more likely
to be male, from single-parent households, nonwhite and to be on public
assistance. According to the researchers, those teens were also more
likely to use drugs or alcohol, to be truant from school, to commit
property crimes, to have family members with criminal problems and to
have witnessed domestic violence in their homes.
The third and final assessment took place
almost three years after the second, and the researchers were able to
get 984 of the original study volunteers to participate.
They found that most — 856 — hadn't become perpetrators of violent
crime. But, 122 (12 percent) had become perpetrators. That meant they
had carried a hidden weapon, attacked someone with a weapon, shot at
someone, or been in a gang fight.
Before controlling for background characteristics, the researchers found
a fourfold increase in the chance that someone exposed to violence would
become violent themselves.
But, the researchers wanted to control for background factors, such as
home and community environment, to see if there truly was a
cause-and-effect relationship between exposure to violence and
committing violent acts.
Using a special statistical technique called propensity stratification,
the researchers used the information on more than 150 characteristics
gathered in the first assessment to determine the probability of gun
violence exposure, which allowed them to compare those with a high
probability of exposure to those who were actually exposed.
After adjusting for these factors, the researchers found that those
actually exposed to gun violence were two times more likely to become
perpetrators of violence.
While this study wasn't designed to look
at the reasons why someone exposed to violence might later become
violent in turn, Bingenheimer said that those who have been exposed to
violence may be more likely to assume that someone is going to hostile,
which “may lead to more preemptive aggressive behaviors.”
“When individuals have such traumatic experiences — witnessing or being
exposed to gun violence — it makes you hypervigilant,” added Daniel W.
Webster, co-director of the Center for Gun Policy and Research at the
Johns Hopkins Bloomberg School of Public Health in Baltimore.
“There are often social stimuli that are ambiguous — like at a crowded
party, someone bumps into you. How do you interpret those stimuli? Most
people think, 'It's crowded, it was an accident.' But, youth [who have
been exposed to violence] may immediately assume a hostile intent and
think someone is trying to challenge them, which can lead to violence,
including gun violence,” Webster said.
“Guns add a unique dimension to violence, because it's difficult to
defend oneself against a gun,” Webster added. “Young people, perhaps
rightly, perceive that guns are ubiquitous in our society and there's
this constant risk of being shot. That has enormous psychological
costs.”
The study, he said, points to the need for mental health services for those who witness gun violence, as well as additional social support services to help counteract chaotic family lives and problems in school.
Serena Gordon
26 May 2005
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The origins of antisocial behaviour, twin study
New research on the origins of antisocial behaviour, published in the
Journal of Child Psychology and Psychiatry, suggests that early-onset
antisocial behaviour in children with psychopathic tendencies is largely
inherited.
The findings are the result of extensive research funded by the Medical
Research Council, the Department of Health and the Home Office, and
carried out by Dr. Essi Viding of the MRC Social, Genetic and
Developmental Psychiatry Centre, within the Institute of Psychiatry,
King's College London.
Past research has shown that children with early-onset antisocial
behaviour show problem behaviours for a variety of different reasons.
One warning sign of vulnerability for antisocial behaviour is
psychopathic tendencies, i.e. lack of empathy and remorse. Dr Viding's
research looked into the factors that contribute to antisocial behaviour
in children with and without psychopathic tendencies. By studying sets
of 7-year-old twins, Dr. Viding and her colleagues were able to pinpoint
to what extent antisocial behaviour in these two groups was caused by
genetic and/or environmental risk factors.
A sample of 3687 twin pairs formed the
starting point for this research. Teacher ratings for antisocial
behaviour and psychopathic tendencies (i.e. lack of empathy and remorse)
were used to classify the twins.
Those who were in the top 10% of the sample for antisocial behaviour
were separated into two groups — those with and without psychopathic
tendencies.
Following analysis, the results showed that, in children with
psychopathic tendencies, antisocial behaviour was strongly inherited. In
contrast, the antisocial behaviour of children who did not have
psychopathic tendencies was mainly influenced by environmental factors.
These findings are in line with previous research showing that children
with psychopathic tendencies are at risk to continue their antisocial
behaviour and are often resistant to traditional forms of intervention.
Dr Essi Viding says: “Our research has important implications. The
discovery that psychopathic tendencies are strongly heritable suggests
that we need to get help for these youngsters early on. Any behaviour is
influenced by multiple genes and an unlucky combination of genes may
increase vulnerability to a disorder.
“However, strong heritability does not mean that nothing can be done.
Children are open to protective environmental influences early in life
and these influences can buffer the effect of genetic vulnerability. By
combining cognitive neuroscience and molecular genetic research, we are
hoping to uncover how genetic vulnerability might influence early brain
development. This can in turn help us to develop methods of prevention
and intervention to suit each particular child. It means that we might
be able to treat antisocial behaviour with psychopathic tendencies as
successfully as other emotional disorders.”
25 May 2005
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Mind-reading key to children's development
A MOTHER'S ability to “read” her baby's
emotions or state of mind can be more important for the child's
development than her social background, according to research published
yesterday.
While the family background of a newborn baby will have some effect on
its progress, it is not the best means to anticipate its later language
and play skills, the study suggests.
Half of all the 200 women who were involved in the study had no
education beyond 16 and were unemployed or in unskilled or semi-skilled
jobs.
The study, sponsored by the Economic and Social Research Council, found
that judging how well a mother understood her baby provided a better
indication as to the child's development than her financial and social
status.
Mothers who are good at “reading” their children's emotions and state of
mind are described as being more “mind-minded”.
Researchers found a definite link between mind-minded mothers and
children's development by the age of two.
John Innes
26 May 2005
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Treating children for bipolar disorder
Child psychiatry, roiled last year by
revelations that antidepressants could increase children's risk of
suicidal behavior, now is embroiled in another controversy: How to treat
troubled children who have explosive rages and dramatic mood swings that
defy conventional diagnosis.
Doctors increasingly agree that some of these children have bipolar
disorder. Once thought to be exceedingly rare among children, the
problem is being diagnosed more frequently and at younger ages than ever
before. A small but growing group of psychiatrists say they are treating
children as young as four for bipolar disorder, prescribing
mood-stabilizing drugs and antipsychotics that have rarely if ever been
used on patients so young.
The number of children diagnosed as bipolar rose 26 percent from 2002 to
2004, to 19,776 cases in a database of 113 million anonymous patient
records kept by health-care information company NDCHealth Corp.
Increased use of antipsychotic medicines, such as Seroquel and Risperdal,
was a big driver of pediatric drug costs last year, according to
pharmacy-benefit manager Medco Health Solutions Inc.
A debate is brewing over how to diagnose
and treat these children. In its classic form, bipolar disorder causes
people to cycle between manic, euphoric highs and crushing, depressive
lows that last a week or more. The picture in children often is muddier.
A bipolar child can flip between a high and low several times a day.
There also is disagreement over what constitutes the highs, with some
doctors saying the manic phase in children often reveals itself as
extreme rages, violence and emotional outbursts, rather than the
traditional euphoria.
Making diagnosis even harder is the great overlap between the symptoms
of bipolar and attention deficit hyperactivity disorder. Research has
shown that 50 percent to 80 percent of children with bipolar also have
ADHD.
“We all agree that kids with classic symptoms definitely have bipolar,”
says Boris Birmaher, professor of psychiatry and director of a pediatric
bipolar clinic at the University of Pittsburgh. “The controversy is over
the kids with vaguer symptoms.”
The debate is a key topic at the annual
meeting of the American Psychiatric Association this week in Atlanta,
where two camps are airing theories about which children are actually
bipolar and how to treat them. One group, led by Joseph Biederman and
Janet Wozniak of Massachusetts General Hospital in Boston, argues that a
child displaying violent outbursts and rages is likely bipolar even
without classic weeklong manic symptoms that help define the disorder in
adults. The opposing group is led by Barbara Geller, at Washington
University in St. Louis, who believes children should display the
textbook grandiose feelings or elated moods. In their practices, many
pediatric doctors who treat bipolar disorder fall somewhere in between
and follow the treatment guidelines for adults.
The difference between the two positions isn't just academic. Children
incorrectly diagnosed with bipolar would be given powerful
mood-stabilizing medications they may not need, such as lithium or
Depakote, or a so-called atypical antipsychotic such as Zyprexa or
Risperdal — few of which have been tested in children and all of which
carry serious side effects. Lithium can cause thyroid problems and
increased thirst, while the atypical antipsychotics can cause serious
weight gain.
If a bipolar diagnosis is missed, children are likely to be put on
antidepressants such as Zoloft, or ADHD drugs such as Adderall, both of
which can actually push bipolar children into a manic mode. Indeed, some
psychiatrists believe the whole flap linking antidepressants with a
heightened risk of suicide in children may be explained by the fact that
these children really were bipolar and not depressed.
A number of studies are exploring the diagnosis and treatment of bipolar
children. Among the research is a large, six-year study at the
Washington University School of Medicine and five other sites, funded by
the National Institutes of Health, that is trying to determine which
medications work best in bipolar patients who are six to 15 years old.
The NIH is conducting another trial that will follow 700 children ages 6
to 17 to try to map what bipolar looks like in children.
Dr. Biederman's group at Massachusetts
General recently presented a small study of 39 children ages 4 to 6,
which showed that those with bipolar benefited from treatment with
antipsychotic drugs, though with significant side effects including
increased appetite and sedation. The study was funded by the nonprofit
Stanley Medical Research Institute, the NIH and the hospital itself. Dr.
Biederman's group has received research funds from makers of atypical
antipsychotics. He and Dr. Wozniak also consult for some drug makers.
Ann Elliott's daughter, Chloe, was given Prozac for depression when she
was six years old, after a two-year history of rages, giddy spells and
self-destructive behavior, including bashing her head against a bathroom
sink. Within a month of starting on the drug, she became mean and manic,
says Ms. Elliott, a computer programmer from Northern California. Prozac
was stopped. Chloe later was diagnosed as bipolar. Now eight, she is
doing well on Trileptal, a mood stabilizer, and Abilify, an
antipsychotic.
Such extreme behavioral problems fall under an umbrella of symptoms
called “irritability” that Dr. Biederman and Dr. Wozniak think is
central to bipolar in kids. These children can have three-hour rages
touched off by something as routine as being told to brush their teeth.
The rest of their families walk on eggshells, never knowing what could
set the children off. Dr. Wozniak says these children are bipolar, even
though their symptoms differ from those seen in adults.
Dr. Geller and other psychiatrists,
however, point out that “irritability” can be found in many illnesses,
like depression, autism and retardation. The scientific data aren't yet
convincing, she says, to show that children who have rages, but not the
conventional manic symptoms, actually have bipolar disorder.
In a study funded by the NIH, Dr. Geller for four years followed 86
children whom she identified as bipolar. She identified grandiosity and
elated mood as two key symptoms. Since the two symptoms aren't present
in ADHD, Dr. Geller says, grandiosity and elation can distinguish the
children with bipolar from those with ADHD. She concedes that current
science can't give clear answers. “We need biological tests or markers,”
she says. However, genetic tests or brain scans are probably decades
away.
Doctors say parents with such troubled children should consult with a
child psychiatrist who specializes in bipolar disorder at a large
academic medical center, where much of the research on bipolar children
is done. The Child and Adolescent Bipolar Foundation Web site at
www.bpkids.org also may be a helpful source.
Making a diagnosis can take months. It
can involve interviews with the child, parents, teachers and siblings,
and even observation of the child at school or at home.
It took more than eight years for doctors to diagnose Sue Cahalan's
daughter with bipolar disorder. The girl had tantrums and violent fits
going back to age 4. At age 8, she stole from family and neighbors. At
10, she tried to choke her mother in an argument over the telephone. At
12, Ms. Cahalan came home to find her daughter holding a butcher knife
outside the upstairs bathroom in which she had locked her two younger
siblings. “The psychiatrist said he was finally ready to call it
bipolar,” says Ms. Cahalan, a lawyer from the Chicago area.
Her daughter was put on lithium and her condition improved. For the next
few years, doctors had to tinker with her medication, but Ms. Cahalan
says her daughter slowly stabilized and was able to attend high school
at a residential facility and will head to college next year. “I do
wonder whether things would have been different had she been diagnosed
earlier,” she says.
By Leila Abboud
25 May 2005
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Study: Bipolar disorders worse in
children
A University of Pittsburgh study suggests
children with bipolar disorders experience the disease more severely
than do adults.
Researchers said children with the disease experienced serious symptoms
about two-thirds of the time, USA Today reported Monday. Children aged
7-18 averaged 16 cycles of bipolar mood shifts a year; whereas adults
average 3.5 changes.
“They spend more time ill than adults with the same disease,” said lead
author Boris Birmaher of the University of Pittsburgh Medical School.
“Some kids do well nonetheless, but it's a difficult disease to treat.”
The National Institute of Mental Health estimates about 1 percent of
adults, or about 2 million Americans, suffer with the disease. Birmaher
said, however, there are no solid figures on how many children and
teenagers suffer from the ailment.
The findings were presented during the American Psychiatric Association
meeting in Atlanta.
25 May 2005
Source
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Study says foreign children adopt well
A surprising new study disputes
the notion that children adopted from other countries tend to be badly
damaged emotionally because of the hardships they had to endure.
The analysis of more than 50 years of international data found that
these youngsters are only slightly more likely than nonadopted children
to have behavioral problems such as aggressiveness and anxiety. And they
actually seem to have fewer problems than children adopted within their
own countries.
“Our findings may help them fight the stereotype that is often
associated with international adoption,” said researchers Femmie Juffer
and Marinus H. van IJzendoorn of Leiden University in the Netherlands.
They pooled results from 137 studies on adoptions by parents living in
the United States, Canada, Europe, Australia, New Zealand and Israel.
In the study, adopted children in general had more behavior problems
than nonadopted youngsters, regardless of where the adoption took place
— a result that is not surprising, since both groups often suffer
deprivation and come from broken families.
But with backgrounds that often include
abandonment, orphanages and civil strife, foreign adoptees are sometimes
thought of as difficult, disruptive children — an image that the study
does not support, the researchers said.
The results are generally reassuring for international adoption — an
increasing phenomenon involving more than 40,000 children a year moving
among more than 100 countries, the researchers said.
“Before adoption, most international adoptees experience insufficient
medical care, malnutrition, maternal separation, and neglect and abuse
in orphanages,” the researchers said. But to their surprise, they found
that these children do well and are largely able to catch up with their
nonadopted counterparts.
The study appears in Wednesday's Journal of the American Medical
Association.
A JAMA editorial said sensationalized stories about severely disturbed
children adopted from abroad have been widespread in the media, and that
may have skewed perceptions of these children.
The analysis involved studies on adoption between 1950 and 2005,
involving more than 30,000 adoptees and more than 100,000 nonadopted
children.
During that time, adoption has evolved
from being a “shameful secret” to being celebrated and often very
visible, especially with the relatively recent phenomenon of white
parents adopting Chinese children, according to editorial author Dr.
Laurie C. Miller of Tufts-New England Medical Center. In the United
States alone, parents have adopted more than 230,000 children from other
countries since 1989, she said.
Behavior problems were relatively uncommon among all children studied,
but internationally adopted children had a 20 percent higher chance of
being disruptive than nonadopted children, and a 10 percent higher
chance of being anxious or withdrawn. They also were twice as likely as
nonadopted children to receive mental health services.
Children adopted within their own countries were four times more likely
than nonadopted children and twice as likely as internationally adopted
children to receive mental health services. Also, domestically adopted
youngsters had a 60 percent higher chance of having behavior problems
than nonadopted children.
Some of the results probably reflect the parents who adopt foreign
children, said Dr. Gregory Plemmons of Vanderbilt University's clinic
for international adoptees. These parents often are high-achieving and
financially well-off, and tend to seek out services like counseling for
their children, Plemmons said.
Also, children adopted domestically may suffer from the instability of living with different foster families before getting adopted, Plemmons said.
Lindsey Tanner
24 May 2005
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Mental health and juvenile justice: Promising practices in Texas
Nationwide, an estimated 20 percent of
the young people involved in state juvenile justice systems suffer from
severe mental health disorders, according to research cited in Youth and
Mental Health Disorders: Issues and Emerging Responses, published in
2000 in the Office of Juvenile Justice and Delinquency Journal. Yet
until recently, most juvenile justice systems have paid little attention
to the mental health needs of the children and youth with whom they come
in contact.
However, there have been some steps towards a more coherent approach.
One state that has begun to make progress is Texas.
The scope of the problem
According to the results of a federal investigation, as recently as 2003
detention centers in a majority of states reported routinely holding
young people with diagnosed mental illnesses, not because they had
committed or been charged with a crime, but simply because no
appropriate treatment facility could be found.
Whether in Louisiana or the state of Washington, the Special
Investigations Division of the U.S. House Committee on Government Reform
found basically the same circumstances – that juvenile detention
facilities were being used to house young people in need of treatment
for a range of mental health disorders. In July 2004 Special
Investigations issued its report, Incarceration of Youth Who are Waiting
for Community Mental Health Services in the United States, (http://www.democrats.reform.house.gov/Documents/20040817121901-25170.pdf)
conducted at the request of Congressman Henry Waxman (D-CA) and Senator
Susan Collins (R-Maine).
The report also noted concerns of state
administrators on how ill-prepared juvenile detention center employees
are to provide proper care for young people who are severely depressed,
suffering from separation anxiety or suicidal.
Taking a Holistic Approach In its report entitled Mental Health
Treatment for Youth in the Juvenile Justice System, the National Mental
Health Association recognized two Texas initiatives that “incorporate
promising practices to address the mental health, substance abuse and
co-occurring needs of youth involved in the juvenile justice system.”
Both programs address the needs of the family, rather than just the
individual.
The Texas First Time Offender program, available in 43 of the 254
counties in the state, provides services that range from screening and
assessment, substance abuse counseling, case management and connecting
the family to community support systems. This program works to keep
young people from criminal behavior by addressing their mental health
needs and by working to increase the stability of the family.
Tarrant County’s Family Matters works
with youth deemed at risk for delinquency by the county’s Juvenile
Probation Department. This program arranges and coordinates such
treatment services as individual and family counseling and family
stabilization.
Special Needs Diversionary Program Erin Espinosa is a program specialist
in the federal programs division of the Texas Juvenile Probation
Commission. She says that mental health issues were not addressed by the
juvenile justice system in Texas until 2000. “We realized that we had no
data on mental illness among young people in our system,” she said.
“Thanks to a small surplus in the state budget, we were able to address
this.”
The Texas state legislature provided funding for the Special Needs
Diversionary Program (SNDP) in 2001. It’s an alternative to
incarceration for juveniles with mental health needs, seeking to prevent
their removal from their homes and to keep them from further involvement
with the juvenile justice system. At the same time legislation was
enacted that requires that every juvenile formally referred to juvenile
probation departments be given a standard mental health screening.
These screenings can result in the
juvenile being referred for further mental health assessment. In 2004,
18 percent of juveniles screened were referred for further mental health
assessment. However, fewer than half of those referred actually received
a subsequent assessment, due to limited access, especially in smaller
localities.
SNDP applies a team approach, in which a juvenile probation officer who
receives special training is paired with a licensed mental health
practitioner. Each team manages a caseload of 12 to 15 youth and their
families. Bexar, Dallas, El Paso, Tarrant, Travis, Hidalgo and Cameron
counties, representing half of the state’s juvenile justice population,
were selected for SNDP’s first round of funding (2002). In its first
year, 764 youth were enrolled in 19 sites, served by 38 teams. More than
fifty-two percent of these juveniles finished the program.
Dr. Jeannie von Stultz is the director of Mental Health Services for the
Bexar County Juvenile Probation Department. She says that SNDP brought a
welcome change in that treatment is now geared toward addressing a
diagnosis based on screening and assessment, rather than controlling
behavior. “We use MAYSI (the Massachusetts Youth Screening Instrument)
which allows us to prescribe more specific treatment,” von Stultz said.
The diversionary program is designed for
juveniles who meet certain criteria: They must be at risk of removal
from their families because of their psychiatric symptoms, or they must
have been identified by their school system as needing special education
due to their emotional difficulties. And it is mandatory that a family
member or other adult in the young person’s life agree to participate in
the program. Otherwise the juvenile is not eligible.
Juveniles and their families who qualify can receive a wide range of
support services. Von Stultz says that system of care is especially
critical for the success of the program. “We provide skills training and
therapy for the child and the family. Many of our families have had bad
experiences with various parts of the system and get overwhelmed,” she
said. “Our program includes a family advocate, and that aspect works
very well.”
The SNDP approach provides intensive intervention and is family-based.
The team works with the juvenile and the family to create an
individualized case plan, incorporating such services as individual and
family therapy, rehabilitation services, skills training and chemical
dependency education. SNDP guidelines require that the team meet with
the family three to five times a week. Two of these visits must occur in
the home. The family is encouraged to play an active role so that, over
time, they become less dependent upon the SNDP team and more reliant on
supports available to them in the community.
One of the positive outcomes reported by
the Bexar County program in its first year was that the majority of
family and youth who participated in the program were successful in
identifying resources within themselves that helped them manage
stressful situations.
Mental Health 101
The best treatment programs, according to the National Mental Health
Association, use well-qualified and well-trained staff. Erin Espinosa
handles the special training that juvenile probation officers undergo in
order to participate on the SNDP teams. “I call it Mental Health 101,”
says Espinosa. “It’s structured on the definition of normal versus
abnormal behavior, and how adolescents develop.”
This training is critical, given the mental health diagnoses of the
juveniles enrolled in the program’s first year. Major depression was the
single most reported mental disorder. According to a 2002 study
conducted by Columbia University’s Center for the Promotion of Mental
Health in Juvenile Justice in collaboration with the Texas Juvenile
Probation Commission, separation anxiety also ranked high among the
reported disorders. Fourteen percent of the sample (drawn from youth
referred to juvenile probation departments in the eight largest counties
in Texas) reported that they had made a suicide attempt during their
lifetimes.
Next Steps' Erin Espinosa is concerned about continuity of care for
youth who come through the state’s SNDP, which provides services to
enrolled juveniles and their families for four to six months. “What
we’ve seen so far is a gap in the availability of services after young
people leave our programs,” she said. “Of the 75 percent of kids who are
tied back into follow-up care, less than 25 percent actually receive
it.” This is especially true in the rural areas. “Urban areas have more
opportunities to provide continuity of care and community for these
kids,” Espinosa said. “In the rural areas, there’s not much available
for them after the programs.”
While the major goal of the SNDP program is to provide an alternative to incarceration for juveniles in need of mental health services, ultimately its success depends upon the local availability of these services once the youth completes the program. The Texas Juvenile Probation Commission is working on a plan to address this gap through the use of telemedicine. The Telemental Health Pilot Initiative would utilize the latest advances in telecommunications to connect communities in need with the mental health expertise of a major regional medical center specializing in psychiatric services.
Cecilia Garcia
23 May 2005
Source
___
Teen's ability to multi-task develops late in adolescence
Parents of teenagers frustrated by their
children's inability to focus on more than one thing at a time can take
hope: a new study from researchers at the University of Minnesota in
Minneapolis finds behavioral evidence that the part of the brain
responsible for the ability to multi-task continues to develop until
late adolescence.
The research, published in the May/June issue of the journal Child
Development, explored the development of the frontal cortex, the area of
the brain that lies just behind the eyes and extends to just in front of
the ears. This part of the brain controls the ability to think flexibly,
control behavior when confronted with challenging situations, and juggle
multiple pieces of information at the same time, or multi-task.
To better understand the association between the brain and behavioral
development, the researchers had adolescents between ages 9 and 20
complete several behavioral tests designed to measure the functioning of
their frontal cortex. One task involved recognizing previously presented
faces while a second involved looking at the location of a dot on a
computer screen, then, after a delay, indicating where the dot had been.
These two tasks assessed “working memory,” the ability to use
recognition or recall to guide future actions.
A third task required that the youth
remember multiple pieces of information in the correct sequence, and
sometimes re-order the information in their memory before responding to
a question. Finally, the researchers included a task in which
participants had to search for hidden items in a manner requiring a high
level of multi-tasking and strategic thinking.
The researchers found that the ability to use recall-guided action to
remember single pieces of spatial information developed until ages 11 to
12, while the ability to remember multiple units of information
developed until ages 13 to 15. However, strategic self-organized
thinking, the type that demands a high level of multi-tasking skill,
continues to develop until ages 16 to 17.
“When the frontal lobe reaches maturity has been debated among
researchers, although it has been speculated that it matures after
puberty based on recent imaging data,” said lead researcher Monica
Luciana, PhD, associate professor of psychology. “Our findings lend
behavioral support to that work and indicate that the frontal lobe is
continuing to develop until late adolescence in a manner that depends
upon the complexity of the task that is being demanded.” Put another
way, she says, “when we use tasks that would be challenging even for a
healthy adult, it becomes apparent that teenagers are still developing
the cognitive skills necessary to efficiently manage multiple pieces of
information simultaneously.”
Those skills improve over time, she says,
as the connections between brain cells become more refined, enabling
more information to be simultaneously managed.
“These findings have important implications for parents and teachers who
might expect too much in the way of strategic or self-organized
thinking, especially from older teenagers,” she said. “We need to keep
their cognitive limitations in mind, especially when adolescents are
confronted with demanding situations in the classroom, at home, or in
social gatherings.”
Summarized from Child Development, Vol. 76, Issue 3, The development of nonverbal working memory and executive control processes in adolescents by Luciana M, Conklin, HM, Hooper, CJ, Yarger, RS ( all University of Minnesota ).
i-Newswire
23 May 2005
Source
___
More sleep, less TV fends off child obesity
— study
Scientists have drawn up a check-list of early warning signs of child
obesity, among them too much television and not enough sleep.
More than eight hours' TV a week or less than 10-1/2 hours' sleep a
night for a three-year-old increase the risk of piling on the pounds,
they say.
“Eight factors in early life are associated with an increased risk of
obesity in childhood,” said Dr John Reilly, an expert on child obesity
at the University of Glasgow. “There are certain factors, very early on,
which can set you on a particular path in life to becoming obese,” he
added in an interview.
The others are: high birth weight; early size; rapid weight gain; quick
growth in years one and two; early body fat; and having obese parents.
A propensity to gain weight begins early,
even in the womb.
“If you are big early on and you grow rapidly, it seems to predict risk
of obesity later on,” said Reilly. “There is something about size and
growth, even in the womb, that seems to have an effect.”
By the tender age of three, children are developing habits that will
mean they are more likely to be overweight or obese.
“We shouldn't be complacent about the lifestyles of our children,”
Reilly said. “What our study is showing is that although there are early
growth risk factors, there are also a number of risk factors that relate
to lifestyle, of three-year-olds and probably earlier, that seem to make
a difference.”
He and his colleagues, whose findings were reported online by the
British Medical Journal, studied more than 9,000 children aged seven
whose growth had been followed since birth.
Health experts estimate that about 10 percent of children, or at least
155 million youngsters worldwide, are overweight or obese.
Overweight and obese children have a higher risk of suffering from type
2 diabetes and, later in life, of developing heart disease, stroke and
certain types of cancer.
Reilly stressed that efforts to prevent obesity should begin very early
in life.
“We are missing an opportunity to prevent obesity if we do not modify
lifestyle and environment early in life. We need to be looking more at
improving long-term outcomes by changing lifestyle,” he added.
Source: BMJ Online First.
Patricia Reaney
20 May 2005
___
Being well-liked in school a double-edged sword
The most well-liked seventh- and eight-graders are more likely to be
well-adjusted — and to adopt risky behaviors such as drinking, smoking
marijuana, and shoplifting, new study findings suggest.
The study also suggests, however, that well-liked students who are
surrounded by friends who stay away from drinking and other dangerous
behaviors are not more likely to engage in them, suggesting that a
popular kid's crowd has a big influence, the study's lead author told
Reuters Health.
Parents of popular kids should “relax and enjoy it for about 10
seconds,” Dr. Joseph P. Allen of the University of Virginia in
Charlottesville said in an interview. “Then get to work and try to
understand, 'okay, who is my kid popular with?' Because that's very
important.”
Well-liked kids are leaders, Allen
explained, but they're also “mini-politicians,” who often feel they need
to follow the norms and opinions of their peers to stay on top. And for
many kids, drinking, smoking marijuana and committing crimes are deemed
adult behaviors, which make them feel grown-up, Allen said.
To study the effects of popularity, Allen and his colleagues asked kids
which students they liked most spending time with at school. The
investigators then followed 185 of these well-liked 13- to 14-year-olds
for one year.
Allen and his team found that well-liked kids were more likely to be
well-adjusted than their less popular peers, and have better
relationships with their parents.
Both groups of students were equally likely to try alcohol and marijuana
at age 13. However, by one year later, 26 percent of popular students
had experimented with alcohol and marijuana, relative to only 9 percent
of less popular teens. Popular students were also more likely to report
shoplifting and vandalism.
However, students who were popular among a group of teenagers who did not support drinking and smoking marijuana were not at greater risk of those behaviors, the authors report in the journal Child Development.
Source: Child Development, May/June 2005.
Alison McCook
18 May 2005
Source
___
Child sex abuse affects both genders long term
Men and women may suffer nearly equally
from the long-term effects of childhood sexual abuse.
Although most research on the consequences of childhood sexual abuse has
focused on female survivors, a new study suggests that men who were the
victims of sexual abuse as children may suffer from similar issues.
Researchers found the impact of childhood sexual abuse on the risk later
in life of health and social problems was similar for both men and
women. These problems include drug and alcohol abuse, mental illness,
and marital difficulties.
The results of the study appear in the June issue of the American
Journal of Preventive Medicine.
Results of survey on childhood sexual
abuse
In the study, researchers surveyed more
than 17,000 adults who belonged to an HMO in California. The
participants were asked about their history of childhood sexual abuse as
well as current health and social problems.
In the survey, 25 percent of females and 16 percent of males reported
experiencing childhood sexual abuse.
When asked about the gender of the perpetrators, women reported that men
committed the abuse 94 percent of the time. But men reported that the
abusers were nearly equally divided among men and women, with women
accounting for 40 percent of the perpetrators.
The survey also asked the participants if the childhood sexual abuse
involved intercourse or inappropriate touching only. Researchers found
that the risk of lasting negative effects was slightly higher for both
men and women if the abuse included attempted or completed intercourse.
Lasting impact of sexual abuse
Previous studies in women have shown that
childhood sexual abuse increases the risk of mental health problems as
well as social problems, and this study confirmed that men share that
risk.
The study showed that a history of attempted suicide was more than twice
as likely among both male and female victims of childhood sexual abuse
compared with others.
In addition, sexually abused adults of both genders had a 40% greater
risk of marrying an alcoholic and they were 40-50 percent more likely to
report current problems in their marriage.
Sources: Dube, S. American Journal of Preventive Medicine. June
2005; Vol. 28: pp 430-438.
News release, Health Behavior News Service.
Jennifer Warner
19 May 2005
___
Treating teen drug problem alone may not be
enough
Teenagers being treated for alcohol and drug problems may fare better
when they also receive therapy for other mental health conditions they
may have, according to a new study.
In a study of more than 400 12- to 18-year-olds being treated for
substance abuse, researchers found that 55 percent had at least one
other psychiatric condition such as depression, anxiety, eating
disorders or some type of behavioral disorder.
Those who received additional treatment for these co-existing conditions
were 57 percent more likely than their untreated peers to be abstinent
from drugs and alcohol 6 months after entering their substance abuse
program.
The findings are published in the journal Alcoholism: Clinical & Experimental Research.
It seems intuitive that addressing
teenagers' overall mental health would improve their outcomes after
substance abuse treatment, said lead study author Stacy Sterling, a
researcher with Kaiser Permanente Northern California, the large managed
care plan to which study participants belonged.
However, Sterling told Reuters Health, much of the research on the issue
has focused on adults. And, she said, the whole notion of integrating
substance abuse treatment and other psychiatric services is relatively
new.
Also, integrated services are not widely available. The various
substance abuse programs nationwide differ greatly in their capacity to
screen for and treat other mental health conditions, Sterling said,
particularly when clinics are small or based in rural areas.
“I think programs try as hard as they can,” she noted.
Her study looked at teenage patients in
four different Kaiser Permanente chemical-dependency treatment programs
in Northern California. Overall, 54 percent of patients with a
co-existing mental health disorder were referred for a psychiatric
evaluation.
Exactly why more of these teenagers did not receive psychiatric
treatment is unclear, Sterling and colleague Constance Weisner note in
the report. One possibility is that some teenagers and their parents may
not want additional treatment while they're in a substance abuse
program.
Another, the researchers write, is that there may be a lack of
communication between providers in substance abuse programs and those in
psychiatric services.
At two of the sites included in the study, substance abuse and
psychiatry services were located in the same building or across the
street from each other, while the other two sites had these services in
separate locations.
Teenagers at sites where services were in
close proximity, the study found, were more likely than those at the
other two sites to be off drugs and alcohol 6 months after starting
treatment.
This was the case whether patients had psychiatric symptoms or not. The
reasons for the greater success at these sites is unclear, according to
the researchers, but it may have to do with better communication among
providers — even if the actual number of referrals to psychiatric care
aren't higher.
Overall, teenagers in the study had rates of mental health problems many
times higher than the norm. More than one-third had depression, while 16
percent and 17 percent, respectively, had an anxiety disorder or
attention deficit-hyperactivity disorder (ADHD). Many had conduct
disorder, which is marked by behavioral and emotional problems such as
aggressiveness, stealing and serious rule violations.
“The point is that many of these kids have multiple problems,” Sterling
said.
This is far from the first study to show as much, she noted. The body of
evidence, Sterling said, points to a need to screen kids for substance
abuse further “downstream” — such as during routine doctor visits or
even in school — before the problem and its associated disorders become
severe.
Source: Alcoholism: Clinical & Experimental Research, May 2005.
Amy Norton
18 May 18, 2005
___
Autism may be linked to difficult births —
study
A difficult birth or a history of mental illness in a parent may put a
baby at greater risk for autism, according to a study that may provide
clues to the causes of the devastating neurological disability.
The Centers for Disease Control and Prevention said on Monday that in a
study of 698 Danish children with the developmental disorder,
researchers found a disproportionately high number had been born before
the 35th week of pregnancy, had suffered from low birth weights and were
in a breech position at birth.
The children, all of whom were born after 1972 and diagnosed with autism
before 2000, also were more likely to have a parent who had been
diagnosed with schizophrenia-like psychosis before the autism was
discovered.
The study was partly funded by the CDC and published in the most recent
issue of the American Journal of Epidemiology.
Previous research had suggested that
perinatal factors, parental psychiatric history and socioeconomic status
might represent or include risk factors for autism. The CDC, however,
noted that the latest findings did not indicate a definitive link
between autism and troubled births or other possible risk factors.
“At this point we don't know for sure if these events are causes, but it
certainly points us to look more closely at what happens during
pregnancy as a possible opportunity for future prevention,” said Diana
Schendel, a CDC epidemiologist and one of the authors.
The study came amid growing debate in the United States over the causes
of autism, which permanently impairs development of those areas of the
brain that control verbal and nonverbal communication as well as social
interaction.
About one out of every 250 babies in the nation is born with the
disability, which usually appears in the first three years of childhood,
according to the Autism Society of America.
Some parents have claimed that their
children developed autism due to exposure to childhood vaccines
containing the preservative thimerosal, an organic compound that is 49
percent mercury.
Thimerosal was used routinely in the United States between the 1930s and
the 1990s to prevent bacterial and fungal contamination of a wide range
of infant vaccines, including those for hepatitis B.
Thimerosal is no longer used in childhood vaccines in the United States,
but remains in the influenza vaccine and in vaccines in other countries.
The CDC, which launched a campaign earlier this year to make doctors and
parents more aware of the need for early diagnosis of autism and other
developmental disorders, said it had found no proof of a link between
autism and vaccines.
Paul Simao
16 May 2005
___
Lonely students show weaker immunity: study
First-year college students who
consider themselves to be very lonely on campus and cut off from their
friends and family back home may receive less benefit from flu
vaccinations than their peers, new study findings suggest.
“The loneliness and social isolation that university freshman experience
in their first semester is powerful enough to have a very real impact on
immune function, with potentially health relevant implications,” study
author Sarah D. Pressman, a doctoral candidate at Pittsburgh's Carnegie
Melon University, told Reuters Health.
In light of this, it is important for
students to “form social connections to protect themselves against
illness, and against poorer immune response to vaccination,” she said.
Pressman and her team looked at the influence of loneliness and social
isolation on the immune response of 83 healthy men and women in their
first semester of college.
At the start of the study, the college freshmen completed questionnaires
about their psychological status, including their degree of loneliness.
Then they began recording information about loneliness, stress and mood
in their palm computer. Two days after the students began this online
diary, they were vaccinated against influenza.
Chronically lonely students mounted a
weaker immune response — as measured by their production of antibodies
to the influenza virus — at both one and four months after vaccination
than did those who reported less loneliness, the researchers report.
The association was true for students who consistently reported
loneliness throughout the four-month study period, but not for those who
only reported a high degree of loneliness at the start of the semester,
Pressman noted.
A poorer immune response was also seen in those who reported having a
small social network — that is few friends or family members with whom
they were in regular contact — at the start of the study as well as for
those who remained socially isolated throughout the study period, the
researcher report in Health Psychology, a journal published by the
American Psychological Association.
Students who consistently experienced a high degree of loneliness also
reported more psychological stress. Stress is known to be bad for a
person's health so it may be a “good pathway,” by which the immune
system is affected, according to Pressman. “Loneliness and stress are
obviously closely intertwined,” she said.
In light of the findings, “parents shouldn't worry about the transient
loneliness that their children may experience upon their transition to a
new school and a new city,” according to Pressman. “But if their
children seem to be experiencing social isolation many months into their
new program, it might be best to advise them to try to get out there and
meet people,” she suggested.
“Even participating in a club or society might be beneficial because of
the social contact that it offers.”
Pressman also stressed that while the lonely, socially isolated students
did not have the strongest immune response, that doesn't mean they
received no benefit from their vaccination.
“It was not the case that these students were not protected by the flu
vaccination, only that there immune response was less robust than their
non-lonely and less isolated counterparts,” she noted. “It is still very
important that university students get vaccinated against the flu.”
SOURCE: Health Psychology
17 May 2005.
___
Practical approach may cut teenage girls' STD
rate
In a study of sexually active
black and Hispanic teenage girls, researchers found that a
“skills-based” safer sex program offered at an adolescent health clinic
helped cut the rate of sexually transmitted diseases (STDs) among girls
who participated.
The program, given as a single 4-hour class, provided girls with
information on HIV and other STDs, and on how to reduce their risk of
infection. It also gave them practical training; girls practiced correct
condom use on an anatomical model, and they role-played to practice
“negotiating” condom use with their partners.
In the long term, the study found, the program was more effective in
cutting risky sexual behavior and STD rates than two other approaches
that gave girls information only.
Dr. John B. Jemmott III of the University of Pennsylvania in
Philadelphia led the study, which is published in the Archives of
Pediatrics & Adolescent Medicine.
The study included 682 sexually active
African American and Latina teenage girls who attended an inner-city
Philadelphia adolescent health clinic. The girls were randomly assigned
to participate in either the skills-based STD-prevention class, or one
of two comparison classes: an information-based class on STDs, or a
class on general health.
Over the next year, the girls were periodically surveyed about their
sexual behavior and screened for gonorrhea, chlamydia and trichomoniasis.
At the start of the study, more than half of the girls said they'd had
unprotected sex during the previous 3 months, and 22 percent tested
positive for one of the three STDs.
One year later, girls in the skills-based program were less likely than
their peers to have an STD; about 10 percent tested positive, versus 18
percent in the general-health program and 15 percent in the
STD-information program.
They also reported fewer instances of unprotected sex than girls in
either of the other groups, and were less likely to say they'd had
multiple sexual partners in the past 3 months.
There were, however, no clear differences
between the groups at an earlier time point, 3 and 6 months after the
classes. The apparent “delayed effect” of the skills-based program,
Jemmott and his colleagues note, may indicate that it's hard for girls
to start safer-sex practices in their existing relationships. Instead,
they may be better able to use what they've learned at the beginning of
a new relationship.
Though past studies have found that teenagers in STD-prevention programs
report changes in their sexual behavior afterward, this study — by
actually screening for STDs — helps confirm that the changes are real,
according to the researchers.
“HIV/STD interventions for adolescents can, indeed, influence a health
outcome, not only self-reported behavior,” they write.
And if the current findings are an indication, programs that focus on
practical skills — by “empowering” teenagers to protect themselves from
STDs — may be especially effective, according to the researchers.
“This is particularly important for African American and Latino
adolescents,” they write, “whose rate of STDs is considerably higher
than the rate among other adolescents.”
SOURCE: Archives of Pediatrics &
Adolescent Medicine
17 May 2005.
___
Study: at-risk children not lead tested
A University of Michigan study suggests children at the greatest risk
for lead poisoning are the least likely to undergo necessary testing.
The study by the university's Health System's Child Health Evaluation
and Research Unit said 53.9 percent of children in Medicaid with
elevated blood lead levels identified through screening received
necessary follow-up testing to prevent lead poisoning. Of those
children, nearly half undergoing follow-up testing still had elevated
blood lead levels.
“Screening children for lead is so important because its symptoms are
not physical. But it's only effective with appropriate follow-up
testing,” said lead author Alex Kemper, an assistant professor of
pediatrics at the U-M Medical School. “Follow-up testing is the
cornerstone of lead poisoning management and an essential component of
secondary prevention, and kids aren't making it to that necessary next
step.”
He said more research is needed to understand the specific barriers to
optimal care for children with elevated blood lead levels and to define
the responsibilities of public and private health care providers.
The study appears in the May 11 issue of the Journal of the American Medical Association.
Source
___
Measure would crack down on teen drinking
The old saying of “My house, my rules,”
may soon be a thing of the past when it comes to providing minors a
place to drink alcohol.
A proposed state House bill would make it illegal for parents or legal
guardians to allow minors to possess and consume alcohol on their
property. It would also make it illegal for minors to possess alcohol on
private property.
The proposed bill unanimously passed the Judiciary Committee and
successfully passed the General Law Committee with an 11-3 vote.
“This bill intends to close an existing loophole in current law,” said
Craig Turner, the vice chairman of the Connecticut Coalition to Stop
Underage Drinking and the director of Wallingford's Youth and Social
Services Department. “The current law states that minors cannot drink on
public property. We're trying to take that ruling and extend it to
private property as well.”
It is not illegal for property owners to allow minors to drink on their
private property as long as they do not provide the alcohol to the
minors, Turner said. It is also not illegal for a minor to drink in
their own home with or without their parent or legal guardian's
permission.
Under the proposed bill, an adult would
be cited with an infraction and fined if minors were found drinking on
their private property. The minors would also be issued an infraction
and fined for possession of alcohol. The fine for possession of alcohol
by a minor in a public place is now between $200 to $500 under state
law.
Turner added the bill might be amended to bump the infraction up to a
misdemeanor for a second offense, but that would not be proposed until
after the bill passed and was in place for about a year.
The proposed bill would not make it illegal for a parent or guardian to
allow their own child to consume alcohol in their home, have alcohol at
religious observances or deny the use of alcohol by a minor for medical
purposes. It would also not prohibit the employment of an 18-year old in
a licensed establishment that sells or serves alcohol.
“We're not going after a parent's right to decide what they want to do
with their kid,” Turner said. “It was never about that. It's not a moral
issue and it's not really a legal issue. It's a public health issue and
a community safety issue.”
“The governor certainly shows concern regarding underage drinking and is
open to any steps we can take to address that issue,” said Dennis Schain,
spokesman for Gov. M. Jodi Rell.
Turner said he believes parents who allow
minors to drink on their property do so because they figure it's a safe
place for the minors to drink or because they are trying to be more of a
friend than a parent.
“I'm a prime example of the baby boomers who are now parents and, when
we were that age in high school, we had the highest alcohol and drug
rates of any group,” said Turner, noting that he was a high school
senior in 1973. “Now we're adults and we came out of a heavy alcohol and
drug culture as kids, so it's very difficult to persuade parents that
this behavior is really dangerous because they did it and they survived.
Jess Morales, a junior at Sheehan High School in Wallingford and the
school's public relations officer for SADD, estimated at least 50
percent of students at her school know a parent who would allow them to
drink in their home on a regular basis.
“I definitely hear about it a lot,” Morales said. “I think it's teaching
kids the wrong behavior. I think this bill is coming at the perfect time
because it's just getting out of control.”
“I think they have good intentions because their intent is to protect
those kids from drinking and driving and that's not a bad thing to do,”
Turner added. “But no parent should be extending their parental
authority or decision-making power beyond the realm of their own kids.”
Turner was interviewed by Time magazine for an article that appeared in
the April 18 issue regarding the subject of parents hosting drinking
parties for minors. That interview led Turner to several radio
interviews, including one with Mitch Albom, author of “Tuesdays with
Morrie” and “The Five People You Meet in Heaven.”
One of the main issues regarding the proposed bill is how will police
enforce it and what warrants probable cause for them to enter private
property.
State Sen. Len Fasano, R-North Haven, said he supports the proposed
bill, but wants to clear up the language regarding probable cause.
“I know several police chiefs who are against the bill just because of
the probable cause issue,” Fasano said.
“Our position is that it's the exact same threshold that the officer
would have to be able to go into the house if he had gotten a call over
domestic violence or excessive noise,” Turner said.
Turner gave the example of a neighbor who
calls the police to report underage drinking at a neighboring home. A
minor opens the door and the homeowner is not present. The officer sees
minors in the house, but does not see any of them holding a container of
alcohol. They may smell it and they can presume the minors are drinking,
but they have no reasonable cause to go in the house, Turner said.
“The cops aren't going to do nothing,” Turner said. “If that's all that
cop has, they shouldn't be doing anything. They would have to have
evidence beyond a shadow of a doubt that that kid's been drinking. If
that kid has slurred speech and the cop can smell alcohol on her breath,
that might be considered probable cause.”
Forty-four of the state's 169 municipalities — including Meriden,
Cheshire and Southington — have already passed the “Social Host
Ordinance,” which makes it illegal for parents or guardians to allow
underage drinking parties on their property and for minors to possess
alcohol on private property. Wallingford has proposed the ordinance.
Turner said a state bill is needed to create uniformity and because
minors have already found ways around the local ordinances by heading to
parties in towns that haven't adopted the ordinance.
“What kids are doing now is identifying where the safe harbor is and
going to those communities,” he said.
Cheshire was the state's first municipality to pass the ordinance in
1986.
Det. Bill Fountain, the youth officer for the Cheshire Police Department
and a member of the Cheshire Coalition to Stop Underage Drinking, said
there are several options officers have when they suspect underage
drinking on private property.
“For the most part, we get consent to
enter the house,” Fountain said. “If we don't, we can hang around
outside and wait for people to walk out or we can find out information
about the homeowner and investigate. We would investigate the situation
the same as we would any other time we get a call.”
Sgt. Lowell DePalma, spokesman for the Southington Police Department,
said the violation of the town ordinance brings with it a $90 fine, but
the parent or legal guardian could face other charges, including
reckless endangerment, risk of injury to a minor and impairing the
morals of children based on the situation.
Another issue Fasano had with the proposed bill was what happens once
the officer is inside the private property in regards to other illegal
activity.
“Once that officer is inside the home for whatever reason, is everything
else in plain sight fair game?” Fasano asked.
Fountain said any time an officer goes into a home, the officer can,
“serve and act upon” anything in plain view.
Turner said a local legislature questioned him about what would happen
if an officer went into a home with probable cause for underage drinking
and found marijuana on the table.
“That's already against the law so they can definitely do something
about that,” Turner said. “I posed the question, if that's your daughter
at the door, would you want her in that house to begin with? Don't you
want the cops to protect your daughter from that kind of environment?”
“If somebody was in the neighborhood
pushing drugs, you would want the police to come in and deal with it,”
said State Rep. Mary Mushinsky, D-Wallingford. “It's the same thing if
someone is pushing underage drinking. It's a risk to that neighborhood
and to the young people.”
The risks that come along with underage drinking have been well
documented, Turner said adding that minors consume 33 percent of the
country's alcohol.
Forty percent of minors who begin to drink before the age of 15 become
alcoholics or develop an alcohol dependency as adults, he said. That
number drops to 20 percent for those who start drinking at the age of 17
and drops again to 10 percent at the age of 21.
Turner said those numbers alarm him as a parent of two sons, ages 16 and
13. What alarms him even more are parents who would allow his children
to drink in their home without his knowledge.
“If you want to do that with your own kid, I've got no problem with
that,” Turner said. “If you know your kid is going to drink and drive
then I want you to have your kid in your home so you can keep an eye on
them. I do have a problem if one of those kids you're talking about is
my kid. You don't have the right to make that decision.”
And it may soon be against the law.
Dan Champagne
10 May 2005
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Pressure driving young to steroids
Pressure to succeed on the sports field
or simply to look “better” is driving a growing number of US children to
abuse steroids.
Latest estimates suggest more than a million high school students in the
country have tried the body-altering drugs — nearly six times the number
just 10 years ago.
Among the users are an increasing number of girls — some as young as
nine — who are taking steroids to emulate the toned looks of movie stars
and pop idols.
Experts say the phenomenon is due in part to children being pushed
harder and younger than ever before.
| POSSIBLE
SIDE-EFFECTS insomnia jumpiness and short temper indigestion high blood pressure acne bad breath shrinking testicles liver, kidney, heart and prostate problems (less common) increased sex drive |
'Cracking under strain'
Dr Marianne Engle, a psychologist with
the New York-based Child Studies Centre, told the BBC: “There is
tremendous pressure for kids to be successful in any accomplishment, to
make their parents proud, to aim for a better life.
“Steroid abuse is an example of how our
children are cracking under that strain.”
Children are playing team sports in the US by the age of four. By the
time they reach 10-years-old they may already be in elite competitions.
At top high school level, many are practically semi-professional sports
stars facing huge pressure to perform, both for their communities and to
win college scholarships.
“Today, sports figures are more revered than they have ever been,” said
Dr Engle.
“Some kids — and their parents — will do whatever it takes to get
there.”
'Winning at all costs'
Concern over steroid abuse among the
young comes at a time when some of the biggest names in US sport are
involved in a major drugs controversy.
An investigation into a steroid distribution ring at the Bay Area
Laboratory Co-Operative has put a number of elite athletes under
suspicion of using banned drugs.
Meanwhile, a US congressional committee is looking into steroid abuse in
sports.
Its chairman says his “primary focus” is on the message being sent to
children who idolise and emulate professional athletes.
Congressman Tom Davis said: “I can only wonder how we've arrived at a
place where the drive to win is more important to some than not
cheating, or not risking permanent harm to your health.”
Vanity drugs
Research suggests that young people are
less likely to see steroids as harmful than they were 10 years ago,
while getting hold of the drugs is becoming easier.
A black market exists in illegal anabolic steroids obtained from the gym
or over the internet. One study suggests some parents and coaches may
supply steroids to teenage athletes.
Equally alarming is research that suggests young girls may be using
steroids as vanity drugs.
Dr Julian Bailes, a neurosurgeon at West Virginia University, says some
7.5% of ninth grade girls (aged 14 or 15) are using steroids.
He says they are taking low doses of the drugs, and do light workouts in
a bid to lose fat and increase muscle tone.
Meanwhile, the sports medicine division at Oregon Health and Science
University surveyed more than 4,000 students and found 2.6% of girls
admitted using steroids.
Two-thirds of those girls were not athletes but young women looking for
ways to get thin.
'Fair play'
Another indication of the growing
pressure on young people came in January 2005, when doctors announced an
“alarming increase” in the numbers of child sports injuries.
The American Academy of Orthopaedic Surgeons said doctors treated more
than 3.5 million children for sports injuries in 2003 and warned against
treating young athletes as “merely small adults”.
Former NFL player Steve Courson — a Superbowl winner who confessed to
using steroids — says the whole mentality of youth sports needs to
change.
“How can coaches teach valuable lessons about preparing youth for life
when their value is based only on wins and losses?” he told a
Congressional hearing last week.
Parents are also being urged to take responsibility.
Dr Bailes told the BBC: “What we are seeing is an explosion in the
acceptance that steroids are necessary to succeed.
“We as parents need to redirect today's youth to what should be gained
from sport — fair play, team spirit and success without cheating.”
Matthew Davis
3 May 2005
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Study shows dramatic effect of fish oil supplement
Children's diet link to disorders
British children are suffering
behavioural and learning disorders because their diets are deficient in
vital nutrients needed for their brains to function normally, a study
reveals today. Rigorous scientific research shows that the performance
of underachieving children, some of whom were also disruptive, improved
dramatically when their diets were supplemented with fish oils. The fish
oils contain omega-3 fatty acids that are essential for brain
development and function but are largely missing from modern processed
diets.
The study, published in this month's issue of the American journal
Pediatrics and conducted by researchers from Oxford University's
department of physiology, found that some 40% of the children made
dramatic improvements in reading and spelling when given supplements
high in omega-3 essential fats. The data also shows a significant
improvement in concentration and behaviour. Symptoms of the sort
associated with attention deficit and hyperactivity disorder (ADHD) were
reduced by an order of magnitude usually achieved with stimulants such
as Ritalin. Parents reported that other health problems, such as eczema
and asthma, also improved, although no specific data on these other
conditions has been published in the study.
The research looked at 117 children aged
five to 12 in 12 schools in Co Durham who were of normal ability but
were underachieving and were suspected of having problems with
coordination or motor skills, a condition known as dyspraxia. Dyspraxia
is thought to affect at least 5% of British children to varying degrees
— they may struggle to tie shoelaces or balance, for example.
The disorder frequently overlaps with dyslexia and ADHD, and is part of
a range of conditions that include autistic spectrum disorders.
Researchers have been trying to establish why there has been a fourfold
rise in these types of disorders in the past 15 to 20 years.
The Durham study followed a rigorous scientific method called a
randomised double blind placebo-controlled trial.
Children were assessed for their motor skills, IQ, reading, spelling and
behaviour. Testing confirmed they had dyspraxia.
Half were given supplements of essential
fats, over three months, and half were given placebos of olive oil.
Neither the children nor the assessors knew which was receiving which.
After three months, the placebo group were also given the supplements.
Children on the supplements of omega-3 fatty acids made nine to 10
months' progress in their reading in three months, compared with the
control group, who made the normal progress of three months. When the
group on placebos was switched to active supplements, it too made
similar leaps in progress.
None of the children had been diagnosed as suffering from ADHD, although
a third were found to have sufficient problems to put them in this
category. After three months of fish oils, half of them showed so much
improvement that they no longer fell into this category.
The early results of the research, which began in 2002, were so dramatic
that they attracted considerable publicity before the codes to establish
which group had been on the fish oils and which had been on placebos had
been broken. Now that the full data is available it proves what has been
increasingly feared by parents and teachers — that children's diets
today are inadequate for their basic needs.
Dr Alexandra Richardson, who led the research, said: “Food affects
behaviour. If you paid attention to diet, you could really make a
difference.”
Felicity Lawrence
2 May 2005
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