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| NEWS BRIEFS Below are news releases and briefs on statements appearing in the July issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP). For Release: July 7, 2008, 12:01 am (ET) THE IMPACT OF CHILDHOOD AUTISM ON PARENTAL EMPLOYMENT AND CHILD CARE
A study that appeared in the April issue of Pediatrics estimated households that have a child with autism earn 14 percent less income than comparable households. In this new study, “Child Care Problems and Employment Among Families With Preschool-Aged Children With Autism in the United States,” researchers analyzed the child care arrangements of 16,282 preschool-aged children diagnosed with autism spectrum disorders (ASDs). Ninety-seven percent of children with ASDs were cared for by a community resource such as preschool or Head Start, with only 3 percent in exclusive parental care. Thirty-nine percent of parents of children with ASDs reported that child care issues had greatly impacted their employment decisions by quitting or refusing a job, compared with 9 percent of those with children who were developing typically. Households in poverty were twice as likely to report that child care problems had a significant impact on employment decisions. Authors conclude that community resources available to families with children with ASDs and other special needs should be evaluated to provide the best care possible to minimize the possibility of child care problems affecting parental employment. SHYNESS LINKED TO LOW BIRTH WEIGHT
Research has shown that children who are born with extremely low birth weights have a higher risk of learning difficulties and behavioral and emotional problems. A new study tracked whether personality differences extend into adulthood. The study, “Shyness and Timidity in Young Adults Who Were Born at Extremely Low Birth Weight,” assessed 71 young adults born with extremely low birth weight for temperament, motivation and socialization. Compared to young adults born at normal birth weights, the low-birth weight group reported significantly higher shyness and behavioral inhibition and lower sociability and emotional wellbeing. Editor’s note: The July issue of Pediatrics also includes the study, “Young Adults With Very Low Birth Weight: Leaving the Parental Home and Sexual Relationships - Helsinki Study of Very Low Birth Weight Adults.” OVERWEIGHT IN CHILDREN AND ADOLESCENTS IN RELATION TO ADD/ADHD
Identifying children and adolescents who are at an increased risk of overweight is important. Children diagnosed with attention-deficit disorder/hyperactivity disorder (ADD/ADHD) may be one such risk group. In the study, “Overweight in Children and Adolescents in Relation to Attention-Deficit/Hyperactivity Disorder: Results From a National Sample,” researchers analyzed the weight status of nearly 63,000 children and adolescents ages 5 to 17 years. Children with ADD/ADHD who were not using medication had 1.5 times the odds of being overweight, and those taking medication had 1.6 times the odds of being underweight compared to children without ADD/ADHD. In light of these findings, the authors suggest children and adolescents with ADD/ADHD should be monitored for overweight and underweight to prevent the onset of obesity in relation to ADD/ADHD and medication use. REPEATED TB TESTING IN INTERNATIONALLY ADOPTED CHILDREN
In 2006, nearly 21,000 children were adopted into the United States from countries around the world. While initial health screening of internationally adopted children is recommended and includes a tuberculosis (TB) skin test, testing often varies by provider and the country of origin of the child. Results of the study, “Tuberculosis Screening in Internationally Adopted Children: The Need for Initial and Repeat Testing,” found that out of 527 internationally adopted children who had an initial TB skin test, 111 (21 percent) had evidence of a latent tuberculosis infection. To determine what proportion of internationally adopted children had false-negative TB tests initially, repeat testing was conducted three months later of those whose first test was negative. Twenty percent of these children were found to have a latent TB infection. TB rates in the United States are highest among foreign-born individuals. The study authors suggest initial TB skin testing - and repeat tests for those whose first tests are negative - should be the standard of care for internationally adopted children from high-prevalence countries. A QUICK CHAT AT THE PEDIATRICIAN’S OFFICE CAN HELP PREVENT VIOLENT BEHAVIOR DOWN THE LINE
Parents and caregivers who receive tangible tools and brief counseling on violence prevention behaviors at their pediatricians’ offices may be more likely than those who do not to make positive changes that reduce violent behaviors in children, according to the study, “Is Office-Based Counseling About Media Use, Timeouts, and Firearm Storage Effective?” The research was based on the concept that exposure to media violence, corporal punishment and gun access all contribute to a child’s perception of violence as an acceptable means of resolving conflicts, achieving goals and acquiring status. Researchers worked with 137 pediatric practices who surveyed caregivers of children ages 2 to 11 about their discipline strategies, their children’s use of media, and, if applicable, how they stored their firearms. One group of parents received a specific violence prevention intervention, including timers for media use and time-outs, cable locks for guns, and office referrals for childhood aggression. The other group received only printed literature on literacy promotion and no information related to violence prevention. When asked after one month and again six months later, parents who received the violence prevention intervention were significantly more likely to limit their children’s media time to fewer than two hours per day and to store firearms more safely than parents who did not receive the intervention. Use of time-outs was not significantly affected. IMPLEMENTING BRIGHT FUTURES GUIDELINES IN PRACTICE Evidence-based practice guidelines can support preventive health care services for young children. However, with limitations on pediatricians’ time, resources and training, these guidelines don’t always make it into practice. In “The Bright Futures Training Intervention Project: Implementing Systems to Support Preventive and Developmental Services in Practice,” researchers tested several strategies to encourage pediatric primary care practices to incorporate developmental and preventive health guidelines into their practice. They found that the use of office systems, tailored materials and brief, simple questions increased the implementation of Bright Futures concepts in pediatricians’ offices. The materials used in this project will be published in 2009 to help physicians incorporate Bright Futures guidelines into their practices. =============================================================== The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.
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