Other journals: September 2003

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

Substance-abuse symptoms differ for boys and girls
If you're a parent of a teenager, take note: Your daughter is almost as likely as your son to drink alcohol, smoke and try drugs such as methamphetamines and inhalants.
While the percentage of girls using some drugs reached that of boys more than a decade ago, the perceptions of parents and physicians haven't necessarily caught up, experts say. In general, girls are less likely to get caught using drugs and may have been doing it longer before they receive treatment. They may also become addicted faster and be more susceptible to health consequences.
"Contrary to what some parents might still believe, the gender gap (in substance abuse) pretty much closed in the last 15 years," said Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse (CASA) at Columbia University. "High-school girls are a little less likely to binge drink or smoke marijuana, but otherwise there's not an appreciable difference."
However, the reasons why and how teens use drugs often differ by gender. If parents are watching for typical signs associated with drug use — hanging out with peers more, skipping school — they may miss girls' more subtle signals, experts say.
"Substance abuse in girls tends to be more inward in terms of both symptoms and causes of use, whereas boys tend to be more outward," said Linda Penhallegon, substance-abuse program supervisor for Youth Eastside Services.
Boys generally experiment with drugs for sensation and thrill seeking, while girls often rely on them to relieve stress, cope with depression and lose weight. (Experts note general differences between boys and girls, but individual children may not follow the same patterns.)
"Frequently, girls' use is connected to emotional causes, and they self-medicate," Penhallegon said. "Depression is one of the major symptoms of drug use with girls."
High-school girls who smoke or drink are nearly twice as likely to report feeling sad or depressed as girls who never smoke or drink, according to a CASA report released in February.
Boys, on the other hand, are more likely to draw attention by getting into fights, for example, or smoking pot at school. They're also more likely to buy and sell drugs (girls, at least initially, often have drugs given to them). Thus, more boys end up in drug treatment or the juvenile-justice system than girls (though the number of girls in both is rising).
"Parents whose daughter is depressed might not connect that with substance abuse," Penhallegon noted. "But with a boy caught with alcohol in his car, that's a more obvious connection."

Multiple problems
Indeed, it's often not until girls' use escalates and they start acting out like boys — mouthing off, breaking curfew — that parents realize, "Whoa, something unacceptable is going on here," Penhallegon said.
That means "more boys are referred to treatment early on in the progression of abuse," she said. "Fewer girls are referred to treatment, but those who come in present with multiple problems in addition to substance abuse."
Many of these problems, including self-harm (such as cutting the skin with sharp objects), eating disorders and a history of being raped or sexually abused, are linked to higher uses of alcohol and drugs with girls.
Chris, an Eastside mom of six who asked that her full name not be used, discovered her oldest daughter was using drugs after having her hospitalized for self-inflicted cutting. "It was an inward cry," said Chris, who found out that her daughter, then 17, had been using since age 14.
"She was pretty sneaky about it — she would smoke marijuana in her room before school and sometimes drink," said Chris, a former dot-com manager now studying to become a chemical-dependency counselor. "Girls get away with it because they know how to play up to their parents better."
Even in the worst of her drug dependency, her daughter was never loud and obnoxious; she just wouldn't follow the rules or come home by curfew.
It was more obvious with her son: He drank a fifth of whiskey with friends and collapsed in their home's foyer, ending up in the hospital for alcohol poisoning.
"Alcohol and drugs got him pepped, made him feel tough," she said. Her children are now clean and sober, having been through treatment.
Puberty is a risky time for both sexes in terms of starting to drink and use other drugs, but that's especially true for girls who develop early. This may be because girls who look older hang out with older boys, putting them in a situation where drugs are more available, CASA's Foster said. Girls who go through puberty earlier — developing breasts and wider hips — are also more likely to develop eating disorders.
"The link between eating disorders and drug use is extremely important for parents to know," said Katherine Ketcham, the Walla Walla-based co-author of "Teens Under the Influence: The Truth about Kids, Alcohol and Other Drugs."

The weight-loss trap
Girls trying to lose weight sometimes try stimulants such as amphetamine or methamphetamine, Ketcham said. One girl she spoke with first relied on over-the-counter weight-loss medications she bought at convenience stores. Then another girl told her to try "meth," because she'd lost a lot of weight fast.
"Like most kids, she thought she'd use it until she'd lost the weight and then stop," Ketcham said. "But meth is powerfully addictive."
Girls are also more likely to start smoking as a weight-loss technique. "Girls who smoke to suppress their appetite are the largest group of new nicotine addicts," Ketcham said.
Girls concerned about their weight were twice as likely to smoke and 1-1/2 times more likely to get drunk, according to a study of 10- to 15-year-olds published in a 2002 issue of the Journal of the American Academy of Child and Adolescent Psychiatry.
Issues for boys tend to be more focused on behavior, such as acting out and anger management, Penhallegon said.
Substance use for both sexes is associated with many negative effects — from increased risk for unprotected sex to car accidents to delinquent behavior — but the health impact may be especially harsh for girls.
Studies show girls become addicted to nicotine at lower levels of use, get drunk faster and are more susceptible to developing alcohol-related medical disorders such as liver disease and brain impairment. Youthful smoking and moderate to heavy alcohol consumption are also linked to higher risk for breast cancer.
While drug use is certainly not good for boys, "girls are more likely to get hooked faster and suffer more health consequences," Foster said. "There are still a lot of questions as to why that happens. It might be the drug interaction with estrogen or how the body metabolizes it."

Girls

Are slightly more likely to abuse prescription drugs such as painkillers (9 percent versus 7 percent for boys) and stimulants (4.6 percent versus 3.4 percent for boys).
Are less likely to smoke, drink or use drugs if they frequently attend religious services (which isn't as true for boys).
Are more likely to have been abused in the past. Among adolescents in drug treatment, 57 percent of girls, versus 31 percent of boys, report experiencing sexual or physical abuse in their lifetimes.

Boys

Are much more likely than teen girls to use smokeless tobacco (15 percent versus 2 percent) and smoke cigars (22 percent versus 8.5 percent).
Are more likely to use drugs, drink or smoke on school property.
Are more likely to binge drink. A third of boys report episodic heavy drinking, compared with a fourth of girls. This isn't true for black teens, who are less likely than white and Hispanic teens (boys and girls) to have five or more drinks on one occasion.

Sources: Centers for Disease Control and Prevention, 2001 Youth Risk Behavior Survey; The National Center on Addiction and Substance Abuse at Columbia University.
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Number dyslexia hits one in 20 children
(Tim Radford — The Guardian) Dyscalculia, the arithmetical equivalent of dyslexia, afflicts about one child in 20 in Britain and could make them cases for special treatment, Brian Butterworth of University College London told the British Association science festival at Salford yesterday.
Most people can recognise three or four objects without needing to count. Dyscalculics cannot. They have trouble manipulating numbers at all.
"Our big success this year has been to get the government to recognise dyscalculia," he said. "This could pave the way for funding to support these kids. These kids find it difficult to count. They think that three plus one is five. They might learn it by rote, but they do not understand why it isn't five. They are misdiagnosed by their teachers as stupid, they are misdiagnosed by their parents as stupid, they think of themselves as stupid, other kids think they are stupid and the daily maths lesson is a daily humiliation for them."
The ability to recognise numbers and see that some numbers or quantities are larger than others is widespread across the animal kingdom: laboratory experiments with monkeys and rats have confirmed that at least one region of the brain has evolved to manipulate number. But some children, competent in other ways, are afflicted by number blindness.
"We have done focus group studies with nine-year-old kids with this condition and I found what they said heartbreaking, they feel so bad about it," Prof Butterworth said. "If we can find a simple way of diagnosing this, and alerting teachers and parents and kids themselves to the problem, we can say it is just like colour blindness, it doesn't show you are stupid.
"Maybe — we do not know this yet — they will never be very good at calculating. However, we know dyscalculics who are good at statistics, who are good at algebra, and we have recently been testing a young woman who got a first class degree in philosophy, including first class marks on the formal logic module, and she has severe dyscalculia."
Prof Butterworth told the conference that in an experiment involving 18,000 people, females were slightly quicker at recognising numbers than males - but only up to three. He and Penny Fidler of the explore@bristol science museum used a touch screen to test the numerical grasp of large numbers of people.
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Childhood snoring tied to poor school performance
(By David Douglas —Reuters Health) Habitual snoring, per se, is associated with poor academic performance in primary school children, European researchers report in the August 15th issue of the American Journal of Respiratory and Critical Care Medicine.
Dr. Christian F. Poets of University Hospital Tuebingen, Germany, and colleagues note that habitual snoring accompanies a variety of sleep-disordered breathing manifestations, including those with and without intermittent hypoxia.
To determine whether snoring and hypoxia might impair academic performance, the researchers studied 1144 third-grade school children. Their parents completed questionnaires and all children underwent nocturnal pulse oximetry. Intermittent hypoxia was defined as episodes during which oxygen saturation fell to 90% or less.
Children who "always" snored were significantly more likely than others to show poor academic performance. The associated odds ratios by subject were 3.6 for mathematics, 4.3 for science and 3.5 for spelling.
This was also true of those who snored "frequently." In this group, the odds ratio for poor performance in mathematics was 2.5 and in spelling, 2.0.
Furthermore, snoring had a significant relationship with poor academic performance in children without intermittent hypoxia. However, intermittent hypoxia did not show an independent association with poor academic performance.
The researchers thus conclude that "habitual snoring without intermittent hypoxia, up to now largely considered benign, may impair neurocognitive functioning in children and, thereby, academic success."
Commenting on the findings, Dr. Poets told Reuters Health that "this effect is not primarily related to a lack of oxygen--which may result from snoring--but appears to be due to other mechanisms, such as disturbed--poor, broken sleep resulting from the snoring."
"It sure seems not to be just a harmless nuisance," he added.
Because of this, "parents whose kids snore regularly may want to see their pediatrician or ENT surgeon; often the problem can be solved by removing or reducing the size of the adenoids."

Sweeping changes urged to curb youth drinking
(By Ed Edelson-HealthDayNews) In a report with some explosive recommendations, a government-appointed committee says a basic requirement of a program to combat underage drinking is more responsible behavior by adults and the alcohol industry — and higher taxes on booze, wine and beer.
Parents would have to keep a closer eye on their teenagers, since most youngsters get their alcohol from adults, says the report by a committee appointed by the National Research Council and the Institute of Medicine.
And alcohol advertising, most specifically for beer, would have to be steered away from entertainment aimed at teens, the report recommends.
But the most controversial recommendation is for tax increases. Today's taxes — $2.14 on a bottle of 80-proof whiskey, 33 cents on a six-pack of beer, and 21 cents on a bottle of wine — "represent a long downward slide in the value of these taxes," and increases would help reduce teen drinking, the committee says.
Other recommendations include the creation of a national training and research center on underage drinking along with a federal interagency coordination committee, new industry reporting requirements, and more government money for programs aimed at the problem.
Something has to be done because underage drinking costs the nation $53 billion a year — $19 billion of it from traffic accidents — and is a cause of "violence, suicide, and other dangerous behavior," committee chairman Richard J. Bonnie said at a media briefing Wednesday.
Yet the federal government currently spends 25 times more to fight illicit drug use than it does on underage drinking, said Bonnie, who is director of the University of Virginia Institute of Law, Psychiatry and Public Policy.
"We need a broad, multifaceted effort," Bonnie added. "Adults must be the primary targets, since youths most often get alcohol from adults. We need to change the behavior of well-meaning adults."
Reactions were predictable. The report "gives a new sense of urgency and needed impetus to turn this problem around," said Wendy J. Hamilton, national director of Mothers Against Drunk Driving, in a prepared statement. There have been "months of attempts by the alcohol industry to unduly influence today's report," the statement added.
Who, us?, said Jeff Becker, president of the Beer Institute. "Steady progress" toward less underage drinking has been made over the past two decades, and "brewers have actively encouraged such approaches for many years," Becker said.
Creating a research center and other organizations would be "woefully misguided" right now, "when both federal and state governments are looking for ways to eliminate bureaucracy and balance budgets," he added.
And unsurprisingly, he noted, higher taxes on beer would not make teens drink less but would only lead to "higher unemployment and higher prices for responsible adults."
But there was no industry objection to the advertising recommendation. Both the Beer Institute and the Distilled Spirits Council of the United States say they are willing to limit advertising to media with no more than a 30 percent youth audience, a change from the current 50 percent limit.
Other recommendations of the report are for frequent checks to be sure that sellers and servers of alcoholic beverages are observing rules on underage drinking, and for state-run training for those sellers and servers.
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Spend time, not money on kids to fight drugs
The best thing parents can do to keep their teenagers from using alcohol, tobacco and other drugs is to keep them from getting bored, getting stressed out or getting too much money, according to the 2003 Survey of Teens and Their Parents released Tuesday by the National Center on Addiction and Substance Abuse (CASA) at Columbia University.
CASA President Joseph Califano said the survey should help dispel some of the cultural myths about which teens are most likely to be substance abusers.
"We tend to think that the only kids that are using drugs, or the likeliest to use drugs, are these kids with all these problems, some poor kids in an urban ghetto," Califano said. "The reality is that the average American teenager who's stressed out or who's bored or who has too much money to spend is at enormously high risk of using drugs, and parents have got to recognize that."
Traditional indicators of a higher-than-average likelihood of substance abuse among teens include being physically or sexually abused, having a learning disability or eating disorder, or suffering from serious depression or another mental health condition. In addition to those factors, the CASA found that: More than half of U.S. 12- to 17-year-olds (52 percent) are at greater risk of substance abuse because of high stress, frequent boredom, too much spending money or some combination of these characteristics.
Teens who reported being highly stressed are twice as likely as teens experiencing little stress to smoke, drink, get drunk and use illegal drugs.
"Often bored" teens are 50 percent more likely than "not often bored" teens to use alcohol, tobacco or other drugs.
Teens with $25 a week — or more — spending money are almost twice as likely as teens with less to smoke, drink and use illegal drugs — and more than twice as likely to get drunk.
Teens displaying two or three of these characteristics have more than three times a greater risk of substance abuse than those exhibiting none of the characteristics. Parents' attitudes can shape children's futures. "This survey signals parents that their conduct and attitudes have an enormous impact on their children," Califano stressed. "Parental engagement in their child's life is the best protection Mom and Dad can provide their children against substance abuse."
Kristin Hansen with the Family Research Council said she hopes parents will listen to what their children told the CASA researchers.
"Parents are not realizing the dramatic impact that they can have on their children - or that their teens are looking for a strong message from them and from society," Hansen said. "They want their parents to be involved in their lives, yet parents are throwing up their hands and saying, 'This is a fait accompli; we cannot have any impact on our children.'
"That's just not true," Hansen said, adding that parents can persuade their teens to avoid premarital sex and other high-risk behaviors, just as they can successfully discourage substance abuse.
One manner parents can get involved in their children's lives, which the CASA measured, is participation in religious services. The survey found: "Teens who attend religious services at least once a week (49 percent) are at substantially lower risk (average risk score of 0.81) than those who attend less frequently or not at all (average risk score of 1.21)."
Bob Smithouser — editor of Focus on the Family's Plugged In monthly magazine, which analyzes youth culture and teen entertainment trends — said he's not surprised that "a close relationship with Mom and Dad and a religious affiliation would limit teens' risky behavior. "Here, we've got accountability to not only elders, but to God as well," Smithouser explained.
"When people are faced with those kinds of temptations," Smithouser continued, "they realize that they're part of something bigger than themselves, and it's something worthwhile, either a family or - in a grander, spiritual scheme of things - that there's something there of greater value than that quick fix and the potential risks of drug abuse."
While positive parental influences can greatly reduce teens' risk for substance abuse, negative parental leanings — even slight ones — can have the reverse effect. In fact, "parental pessimism" — as the CASA calls it — can actually increase the chances that a teen will experiment with controlled substances.
While only 11 percent of teens declared themselves "likely" to engage in substance abuse in the future, 41 percent of the parents surveyed said that their teen was "likely" to abuse. [Emphasis in original] The CASA concluded that: "Teens whose parents think future drug use is 'very likely' are more than three times likelier to smoke, drink and use illegal drugs than teens whose parents say future drug use is 'not likely at all."
More teens avoiding peers who engage in risky behaviors The CASA discovered that more teens are steering clear of peers who are substance abusers. But children are still presented with their first opportunity to abuse alcohol, tobacco and other drugs at a very young age, and the exposure and associated risk tends to increase as they grow older. Fewer teens are associating with peers who use substances: 56 percent have no friends who regularly drink, up from 52 percent in 2002; 68 percent have no friends who use marijuana, up from 62 percent in 2002; and 70 percent have no friends who smoke cigarettes, up from 56 percent in 2002.
The average age of first use is 12 years, two months for alcohol, 12 years, six months for cigarettes and 13 years, 11 months for marijuana.
Between 12 and 17 years of age, the likelihood that a teen will smoke, drink or use illegal drugs increases more than seven times, and the percentage of teens with close friends who use marijuana jumps 14 times.
Califano hopes parents of older students will pay particularly close attention to this year's survey and the CASA recommendations because the proportion of students who say that drugs are used, kept or sold at their high schools is up 18 percent over 2002, from 44 to 52 percent.
"Whereas last year, the odds were that your high schooler was going to go to a school where drugs would not be used, kept and sold," Califano noted, "this year, the odds are that you're high schooler is returning to a school where drugs are used, kept and sold."
Teens as worried over social and academic pressures as drugs for first time. The 2003 Survey of Teens and Their Parents included 1,987 teens between 12 and 17 years of age (1,044 boys and 943 girls), along with 504 parents (403 of those were parents of the teens interviewed). This is the first year that the CASA has included questions about boredom, stress and spending money, as well as questions about the abuse of prescription drugs and steroids. Twenty-five percent of the teens surveyed said they know someone who abuses prescription medications, while only 12 percent said they knew of a peer using steroids.
The CASA survey also determined that:
More than 5 million 12- to 17-year-olds (20 percent) can buy marijuana in an hour or less; another 5 million (19 percent) can buy marijuana within a day.
The proportion of teens that consider beer easier to buy than cigarettes or marijuana is up 80 percent from 2000 (18 percent vs. 10 percent).
For the first time in the survey's eight-year history, teens are as concerned about social and academic pressures as they are about drugs.
Teens at schools with more than 1,200 students are twice as likely as teens at schools with less than 800 students to be at high risk of substance abuse (25 percent vs. 12 percent).
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Street proofing your children
The Peel Regional Police want to remind parents that street proofing children prior to the start of school is a safe practice. Here are a few guidelines that may assist you and your child:
General