Search

Little is known about the early childhood indicators of adolescent risk. The link between trajectories of externalizing behavioral problems and early adolescent risk behavior was examined in a longitudinal sample of 875 child participants in the LONGSCAN studies. Five trajectory groups of children defined by externalizing behavior problems were identified: Low, Low-Medium, Moderate, Increasing-High, and High. After controlling for demographics and maltreatment, violent/delinquent behavior was significantly predicted by membership in the Moderate and Increasing-High problem behavior groups. Substance use in early adolescence was significantly predicted by membership in the High behavior problem group. These findings suggest that there is a great deal of continuity between patterns of externalizing behavior in childhood and risk-taking in early adolescence. Understanding the course of externalizing behavior in childhood can help identify children at particular risk for more serious behavioral problems in early adolescence. (Contains 3 tables and 1 figure.)

Objective: To examine whether children with substantiated maltreatment reports between 4 and 8 years of age differ from children with unsubstantiated reports on any of 10 behavioral and developmental outcomes. Method: Longitudinal data from 806 children and their adult caregivers collected in four US study sites were pooled and analyzed using Analysis of Variance (ANOVA) and multivariate linear regression. Results: There were no significant differences between the mean scores of children with unsubstantiated and substantiated maltreatment reports filed between 4 and 8 years of age for any of the 10 behavioral and developmental outcomes. In the multivariate analysis, substantiation status was not significantly associated with any of the 10 outcomes after adjusting for prior functioning, prior maltreatment status, and sociodemographic characteristics. Findings from within-site analyses were generally consistent with the pooled analyses in finding no association between substantiation status and the outcomes examined. Conclusions: In this high-risk sample, the behavioral and developmental outcomes of 8-year-old children with unsubstantiated and substantiated maltreatment reports filed between ages 4 and 8 were indistinguishable. Future research should attempt to replicate these findings on probability samples that represent the full range of childhood maltreatment risk and with models that control for the impact of social services.

Children's exposure to violence is often found to be an important predictor of child outcomes. The measures most frequently used to assess it have not been systematically examined, and there is little consensus about how to use these measures. This study examined a version of the Things I Have Seen and Heard Scale in a sample of 784 children who completed the scale at both age 6 and 8. There was only modest support for the use of the scale as a set of single-item measures or as a simple sum of items. Exploratory factor analyses suggested that the scale consisted of two factors: a global/community violence scale and a home violence scale. The evidence for validity of the scales was stronger at age 8 than at age 6. These findings suggest that there may be some limits to the utility of self-reports of violence exposure in very young children. However, there is initial evidence that the global/community scale is a reliable and valid indicator of young children's exposure to violence. Further use and exploration of the subscales is warranted. Keywords: witnessed violence, measurement, reliability, validity

HOW PREVALENT IS childhood maltreatment, which children are at greatest risk, and what are the health consequences? Despite >40 years of sustained research on child abuse and neglect, we are [...], OBJECTIVES. The purpose of this study was to estimate the prevalence of child maltreatment in the United States and examine its relationship to sociodemographic factors and major adolescent health risks. METHODS. The National Longitudinal Study of Adolescent Health is a prospective cohort study following a national sample of adolescents into adulthood. The wave III interview, completed by 15 197 young adults in 2001-2002 (77.4% response rate), included retrospective measures of child maltreatment. We used these measures to estimate the prevalence of self-reported supervision neglect, physical neglect, physical assault, and contact sexual abuse during childhood. Next, we investigated the relationship between sociodemographic characteristics and maltreatment. Finally, we examined the association between child maltreatment and adolescent self-rated health; overweight status; depression; cigarette, alcohol, marijuana, and inhalant use; and violent behavior. RESULTS. Having been left home alone as a child, indicating possible supervision neglect, was most prevalent (reported by 41.5% of respondents), followed by physical assault (28.4%), physical neglect (11.8%), and contact sexual abuse (4.5%). Each sociodemographic characteristic was associated with ≥ 1 type of maltreatment, and race/ethnicity was associated with all 4. Each type of maltreatment was associated with no fewer than 8 of the 10 adolescent health risks examined. CONCLUSIONS. Self-reported childhood maltreatment was common. The likelihood of maltreatment varied across many sociodemographic characteristics. Each type of maltreatment was associated with multiple adolescent health risks. Key Words abuse, socioeconomic factors, neglect, adolescent health, prevalence Abbreviations Add Health--National Longitudinal Study of Adolescent Health CASI--computer-assisted self-interviewing SES--socioeconomic status OR--odds ratio aOR--adjusted odds ratio NCANDS--National Child Abuse and Neglect Data System CPS--Child Protective Service NIS--National Incidence Study

The rate of births to adolescent parents has declined steadily since 1991, yet the United States continues to have one of the highest adolescent birth rates in the industrialized world. [...], Objective. To investigate whether living in a 3-generation household (grandmother-mother-child) is associated with fewer behavior problems and better cognitive development among preschool children of mothers who gave birth during adolescence and whether it protects children from the behavior and developmental problems associated with maltreatment and maternal depression. Design. Cohort study. Setting. Participants included low-income families recruited from 4 sites: East, Northwest, Midwest, and South, who are part of LONGSCAN, a longitudinal study of children's health, development, and maltreatment. Participants. One hundred ninety-four mothers who were adolescents (less than age 19) at delivery. Data were gathered when children were 4 to 5 years of age. Twenty-six percent of the children lived in 3-generation households, 39% had a history of maltreatment, and 32% of the mothers had depression scores in the clinical range. Main Outcome Measures. Child behavioral problems were measured with the Child Behavior Checklist, completed by the mother, and child developmental status was assessed with the Battelle Developmental Inventory Screening Test, administered by research assistants. Results. Multiple regression analyses revealed that children who had been reported for maltreatment and had mothers with depressive symptoms had more externalizing behavior problems, compared with children who experienced neither risk or only 1 risk. However, when residential status was considered, children with the greatest number of externalizing behavior problems were those who experienced both maltreatment and maternal depressive symptoms and lived in 3-generation households. Children who had been reported for maltreatment or had mothers with depressive symptoms were more likely to have internalizing problems, compared with children with neither risk. Residential status was not related to children's internalizing behavior problems or cognitive development. Conclusions. Living in a 3-generation household did not protect preschool children from the behavior problems associated with maltreatment and depression. In contrast, living in a 3-generation household was associated with more behavior problems among the highest risk group of children--those who had been maltreated and had mothers with symptoms of depression. Although 3-generation families may provide an important source of support and stability for adolescent mothers and their infants early in the parenting process, it may not be advisable to rely on 3-generation households as young mothers enter adulthood, particularly among those with a history of maltreatment or depression. Children with the fewest number of behavior problems were living with their mothers in their own household (often with the father), had not been maltreated, and had mothers with few symptoms of depression. Pediatrics 2002; 109:573-580; adolescent mother, 3-generation, grandmother, maternal depression, maltreatment. ABBREVIATIONS. CPS, Child Protective Services; CBCL, Child Behavior Checklist.

Objectives. There is mounting concern about how mothers' own victimization experiences affect their children. This study examines the effects of mothers' victimization on their own mental health and parenting and on their children's behavior, development, and health. The effects of both timing and type of victimization are assessed. A related objective was to determine if there was a cumulative risk effect produced by victimization during both childhood and adulthood, or both physical and sexual. Setting. Urban families in an eastern state and urban and rural families in a southern state. Participants. A total of 419 mothers and their children 6 to 7 years old were identified from 2 sites. The eastern sample was recruited in the first 2 years of life from 3 pediatric clinics: 1 for children at high risk for human immunodeficiency virus disease, 1 for children with failure to thrive, and a third providing pediatric primary care. The southern sample was derived from a cohort of children at risk for adverse health or developmental outcomes, plus a systematic sampling of controls, recruited from area hospitals. At age 4, a random sample of children from the original cohort who had been maltreated along with a matched comparison group of nonmaltreated children were selected. Results. In general, mothers victimized during both childhood and adulthood had poorer outcomes than mothers victimized during either childhood/adolescence or adulthood who in turn had worse outcomes than mothers with no history of victimization. This manifested as more maternal depressive symptoms, harsher parenting, and more externalizing and internalizing behavior problems in their children. There were no significant differences in maternal functioning or child outcomes between those abused in childhood and those abused in adulthood. These findings were similar for type of victimization. Mothers' depression and harsh parenting were directly associated with their children's internalizing and externalizing behavior problems. Conclusions. Maternal victimization appears to be a highly prevalent problem in high-risk samples and is associated with harmful implications for mental health and parenting, as well as for the offspring. Pediatricians need to consider past and current victimization of mothers. Routine screening for these problems, followed by appropriate evaluation and intervention may reduce maternal depression, improve parenting, and reduce the incidence of behavior problems in children. Pediatrics 2001;107:728-735; maternal victimization, children, witness to violence, domestic violence., ABBREVIATIONS. CPS, Child Protective Services; PTSD, posttraumatic stress disorder. Health care providers play a critical role in identifying abused and neglected children. (1) In recent years, the scope of child [...]

The authors explore the reasons for age misinformation on death certificates of elderly African-Americans. Reasons cited such as literacy, education, and not knowing the decedent's true age are discussed.

Introduction: Although elevated blood glucose is associated with adverse maternal and fetal health outcomes, evidence suggests that women with diabetes may not be receiving comprehensive reproductive health care, including family planning and preconception care. Using a population‐based sample, we evaluated the relationship between contraceptive use and biomarker‐identified diabetes. Methods: This cross‐sectional study used data from 5548 women in the nationally representative National Longitudinal Study of Adolescent to Adult Health (Add Health) from 2007 to 2009. Women were aged 24 to 32 years, sexually active with men, and not pregnant. Hemoglobin A1C identified prediabetes and diabetes from blood specimens. The primary outcome was most effective contraception used in the past year: more effective (sterilization, intrauterine device, implant, combined hormonal methods, or injectable), less effective (condoms, diaphragms, spermicides, natural family planning, or withdrawal), or none. Multinomial regression models were adjusted for race and ethnicity, education, insurance, health care access, and body mass index. Results: Of the women with diabetes, 37.6% used more effective contraception, 33.6% less effective contraception, and 28.8% none. Women with diabetes had higher odds of using no contraception, rather than more effective contraception, than women with normoglycemia (adjusted odds ratio [aOR], 1.90; 95% CI, 1.25‐2.87). Women with diabetes who were undiagnosed had greater odds of using less effective contraception, rather than more effective contraception, compared with those who were diagnosed (aOR 3.39; 95% CI, 1.44‐7.96). Contraceptive use did not differ between women with prediabetes and normoglycemia. Discussion: Less effective contraceptive methods were commonly used by women with diabetes. Midwives and other women's health care providers can support women with diabetes to reach their pregnancy goals by providing preconception care and family planning. [ABSTRACT FROM AUTHOR]