Children's Voice May/June 2009

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End Notes

Research Report

In March, Pediatrics published a national survey of medical providers that assessed their child abuse training and knowledge. Researchers from Virginia sought to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. They surveyed program directors and third-year residents at 67 programs; their methods included a 24-question quiz.

They found that of the three groups, pediatric programs were much more likely to have a medical provider who specialized in child abuse cases. Pediatric programs were also more likely to have faculty responsible for child abuse training, use a written curriculum for that training, and offer an elective rotation in child abuse medical response. Pediatric residents did much better on the quiz than others. Exposure to child abuse cases and comfort with managing those cases was lowest among family medicine residents.

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A longitudinal study of 339 foster youth transitioning out of care in Missouri found that having a sustained relationship with an adult mentor was associated with better outcomes, such as lower life stress, higher life satis-faction, and fewer depressive symptoms in the youth. Mentoring that lasted more than one year was linked to less likelihood of being arrested.

The study, "Natural Mentoring and Psychosocial Outcomes Among Older Youth Transitioning from Foster Care," appears in the January issue of Children and Youth Services Review. To access an abstract, visit www.sciencedirect.com.


Health Beat

The second-stage results of a continuing federal study into the effectiveness of medication for attention-deficit hyperactivity disorder (ADHD) have researchers giving mixed messages. The Multi-modal Treatment Study of Children with ADHD (MTA) compares four treatment options: routine care, talk therapy, medication, or talk therapy and medication, according to an article in The Washington Post.

While outcomes in 1999, when the children in the study had been receiving treatment for two years, showed drug treatment was successful, the long-term effects are in dispute. Some children who continued taking the drugs experienced stunted growth. As for how the drugs influenced ADHD behavior, the subgroup analysis showed variations: children in socially and economically stable homes did the same with or without medication; children from what the Post called "troubled or deprived backgrounds" worsened when their treatment stopped; and children with the least impairment at the beginning continued to improve.

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Dr. Robert Wilder, an anesthesiologist at the Mayo Clinic, was curious about the effects of pediatric anesthesia after seeing research that exposure to anesthesia can kill brain cells in very young rats and other animals, according to a National Public Radio report. Wilder studied the records of about 600 children treated at the Mayo Clinic and in surrounding Olmstead County, Minnesota, with general anesthesia, which puts a patient into a state of unconsciousness. He found that children who'd had one operation with general anesthesia before their 4th birthday were no different than other children. However, children who'd had two anesthetic surgeries by age 4 were one-and-a-half times more at risk of developing a learning disability, and those with a third surgery were two-and-a-half times more at risk. In Wilder's study, half of the children who'd gone under general anesthesia by age 4 later developed a learning disability.

The results of this single study, published recently in Anesthesiology, is not enough for cause-and-effect conclusions. Researchers point out that the illness that necessitated the surgery may be the culprit. The FDA is partnering with the Mayo Clinic and others to run further studies. Doctors also say parents should not be discouraged from getting surgery for children if they need it; just be aware of the possible connection, and consider postponing surgery until the child is a little older.


Tech Trends

Girls Scouts of America and Windows have partnered to create LMK, an interactive website to help teen girls navigate the Web safely. With an editorial board of two dozen Girl Scouts from around the country, LMK (an acronym for "let me know") seeks to empower girls and make them conscious of their own online safety. So far the site features explanations of cyber bullying, online sexual predators, and social networking, with more topics to be added in the future. There are quizzes, videos, articles, and personal stories for each topic. For more information, visit http://lmk.girlscouts.org.

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SchoolTipline is a new tool for anonymous feedback and information sharing in school communities. The Web-based service lets administrators send and receive information and manage feedback from students, parents, and staff. Services on the website include SafeTalk, a proprietary anonymous communication system that allows administrators, counselors, and/or safety officers to keep communication channels open with anonymous tipsters. This system serves as an early warning system for bullying, hazing, drugs, violence, or vandalism. The site also administers surveys and notifications for schools. For more information, visit www.schooltipline.com.


Dispatch From Abroad


Photo courtesy of AFP

One story from Thailand brought smiles to faces worldwide as media outlets around the globe picked it up: firefighter Somchai Yoosabai donned a Spiderman costume to coax a young boy off of a third-floor window ledge.

The boy, 8, who is autistic, was upset on his first day at a special-needs school in Bangkok. He started crying and climbed out of a classroom window. Teachers and the boy's mother were unable to convince him to come back inside, and then called the police.

When the mother mentioned her son's love of superheroes, Somchai immediately went back to the fire station to retrieve his Spiderman costume. The little boy couldn't turn down Spiderman's request to come inside. Somchai keeps the costumes of Spiderman and Japanese television character Ultraman to entertain children during school fire drills.

Australia's New South Wales (NSW) government has proposed a number of changes to its child welfare system, responding to a November report with 111 recommendations for reform. The Special Commission of Inquiry into Child Protection Services in New South Wales was established in late 2007 after two unrelated child deaths.

NSW Community Services Minister Linda Burney said the government accepted 106 of the recommendations, The Australian reported in early March. Most of the recommendations focus on bolstering "front-end" early intervention programs that support families before children are removed.

At the same time, one major planned change would bring only the more urgent cases of children at risk of "significant harm" to the Department of Community Services. Six new Child Wellbeing Units in the Departments of Health, Education, Police, Housing, Juvenile Justice, and Disabilities would respond to less severe cases with services for parents and families.

Two of the five recommendations the government did not accept were to privatize the Brighter Futures early intervention program and to professionalize foster care by paying those who quit other jobs to become foster parents.

To comment on this story, e-mail voice@cwla.org.


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