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Whats New in Research

What makes a good childhood: results of a UK national survey

What makes a good life for children and adolescents? A national survey carried out in the United Kingdom sought to answer this question by polling thousands of young people living in England. The survey was launched amid growing concern that pressures of modern life may be contributing to increased mental health problems among children in the UK. Writing in the Daily Telegraph, one group of teachers and psychiatrists believe that computers, advertising, and overly academic test driven primary schools might be responsible for the increasing incidence of behavioral problems and depression among children. There is clearly a mood in the UK that as a society we have got some important things wrong about childhood, says Bob Reitemeier, chief executive of The Childrens Society, which carried out the survey in partnership with the University of York. Some of the themes that emerged from the participants responses were the quality of their interpersonal relationships, particularly with the family; worries about school exams or school work; personal safety at home, school and in the community; and being allowed freedom in what they think, speak and do. Some themes were conspicuous by their absence such as technology, which might reflect the fact that young people take technology for granted or, at a more fundamental level, that technology does not have an impact on the quality of their everyday life. Other topics which were scarcely mentioned by the respondents were those of a national or global political nature, as well as issues which had a spiritual dimension. The survey, polled over 11,000 adolescents, 14 to 16 years of age, in a representative sample of 16 areas of England during 2005. There were two open-ended questions on the final page of the survey questionnaire: What do you think are the most important things that make a good life for young people? and What things do you think stop young people from having a good life? The research team carried out a

detailed qualitative thematic analysis of a random 50% sample of the survey data set, as well as a content analysis of word frequencies found in the responses. The following summary represents an overview of some of the participantscomments. Family was considered the most important and most commonly mentioned topic. Approximately 93% of the respondents felt their parents or caregivers cared about them, while a smaller proportion (63%) indicated that their parents or caregivers understood them. Having friends was the second most important topic, mentioned mostly in a positive sense such as providing support through friendship.

There is clearly a mood in the UK that as a society we have got some important things wrong about childhood.
Bob Reitemeier, chief executive of The Childrens Society
Leisure was the third most important quality of life ingredient, mentioned in a number of different contexts (e.g., having something to do, having nothing to do, something that is relaxing, sports-related, having sex, belonging to clubs, having hobbies, listening to music, going to the cinema, shopping, socializing, and being bored). Approximately 60% of the respondents agreed with the statement I often hang about with my friends doing nothing in particular. Safety was also considered important to young people in terms of having places to go which are not dangerous. Having a good quality education was considered to be one of the key factors in having a good childhood. Although education was often mentioned in a positive context, school was sometimes considered a hindrance to having a good life through the negative impact of stress from exams or having too much homework. Many respondents recognized that their own behavior contributed greatly to

how they experienced their childhood. Substance use was often mentioned as an aspect of behavior that prevented young people from having a good life, particularly with regard to use of drugs and alcohol. However, a minority of respondents, identified substance use as a contributor to a good life (e.g., having a good smoke). Another broad category of comment regarding negative behavior preventing a good life was involvement in crime. Sub-themes that emerged during the analysis were love (particularly its importance in terms of family life); support (most notably from family, friends, and school); fairness (perceived as a key relationship issue with regard to being treated fairly by others as well as its negative aspects involving prejudice, discrimination, bullying); respect (closely related to the issue of fairness; importance of mutual respect); and safety, security and protection (e.g., fear of crime and the impact of drugs were 2 key themes that emerged as well as gangs and adults who were perceived as a threat). To extend the scope of the current survey, The Childrens Society has called for a national inquiry panel to provide evidence from children, adolescents, professionals working with young people, and the general public, on what they think makes for a good childhood today in the UK. !!!
Cole A: Inquiry opens into state of childhood in the UK. BMJ 2006; DOI:10.1136/bmj.333.7569.619 333(7569):619. The full report may be downloaded from The Childrens Society website at www.goodchildhood.org.uk.

National survey examines impact of child abuse in the U.S.

Child maltreatment is a commonly self-reported phenomenon in the United States, according to new data from the National Longitudinal Study of Adolescent Health. Supervisory neglect, physical neglect, physical abuse and sexual abuse are the 4 most commonly reported types of maltreatment among children, and all are associated with multiple adolescent health risks.
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The Brown University Child and Adolescent Behavior Letter November 2006

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The survey was carried out in 3 waves. Based on a representative sample of children in grades 7-12 during the 1994-1995 school year, wave I was carried out from April to December 1995, using in-home interviews with children who had previously completed an in-school questionnaire. Wave II in-home follow-up interviews were carried out during 1996. Wave III took place during 2001-2002 with inhome interviews of young adults (18-26 years of age). The current study is based on 10,828 respondents who were interviewed in all 3 waves. During wave III interviews, participants were asked how often the following had taken place by the time they had started 6th grade: 1) how often their parents or adult caregivers had left them alone when an adult should have been present; 2) how often parents or adult caregivers had not taken care of their basic needs (e.g., keeping them clean or providing food or clothing); 3) how often they had been slapped, hit or kicked by a parent or adult caregiver; and 4) how often they had been touched in a sexual way by a parent or adult caregiver, or had had been forced to touch or forced to take part in sexual relations with a parent or adult caregiver. Prevalence estimates were based on answers recorded as never, once, twice, or 3 or more times. The 10 adolescent health-risks were: self-reported general health status, overweight, depression, cigarette use during the last 30 days, regular alcohol use, binge drinking, marijuana use within last 30 days, any inhalant use, serious fighting, or physically hurting someone. Associations were also measured between the 4 types of child maltreatment and sociodemographic variables (gender, race/ethnicity, parents education, family income, immigrant status, and region of residence in the U.S.)

Supervisory neglect was the most commonly reported type of maltreatment experienced during childhood, with nearly 42% of respondents indicating they had been left alone at least once when they should have been under adult supervision, and 19% reporting they had been left alone 3 or more times. Approximately 28% reported having been physically assaulted by a parent or adult caregiver. Among respondents who reported any physical assault, 14% indicated this had occurred 3

Supervisory neglect was the most commonly reported type of maltreatment experienced during childhood, reported by 42% of respondents.
or more times. Among respondents who reported physical neglect, nearly 12% indicated that at least once during early childhood their basic needs had not been met; 5% reported episodes of physical neglect 3 or more times. By the time they had reached 6th grade, more than one in 25 respondents (4.5%) reported having been a victim of contact sexual abuse by a parent or adult caregiver. Each of the 4 types of maltreatment was associated with 8 or more adolescent health risks. After adjusting for demographic variables, there were significant associations between self-rated fair or poor health and being a victim of supervisory neglect and physical neglect, and physical assault and contact sexual abuse. Being overweight was significantly associated with physical assault. Depression was also significantly associated with supervisory neglect, physical neglect and physical assault. All 4 types of mal-

treatment increased the likelihood of 30day cigarette use,, regular alcohol use and binge drinking, marijuana use, illicit inhalant use and violent behavior. Race/ethnicity was associated with all 4 types of abuse, with the strength of the associations varying by type of abuse. Supervisory neglect, physical neglect and physical assault were more likely to be reported by Hispanic and Asian adolescents than non-Hispanic whites. Black adolescents were more likely to report physical neglect and sexual abuse, and Native Americans more like to report physical neglect. Adolescent youth in the other racial/ethnicity category (predominantly multiracial) were more likely to report all 4 types of abuse. Children in families with less than $15,000 annual income were at increased risk of supervisory neglect, physical neglect and contact sexual abuse. Immigrant status was significantly associated with respondents who reported supervisory neglect, physical neglect and physical assault, with greater risk of maltreatment among children of foreign-born parents. First-generation adolescents were 1.55 times more likely to report having been left alone as a child than third-plus-generation youth. The study limitations include measuring only preadolescent maltreatment, neglect measured only by subjective judgments, use of an all-inclusive measure of physical abuse (hitting, slapping, kicking) which could range from a slap on the wrist to life-threatening assaults, and a definition of supervisory neglect that would not meet official Child Protective Service criteria for this type of abuse. !!!

Hussey JM, Chang JJ, Kotch JB: Child maltreatment in the United States: prevalence, risk factors, and adolescent health consequences. Pediatrics 2006; 118(3):933-942. E-mail: jon_hussey@unc.edu.

Childrens Mental Health

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in 2000. In 2000, there were 6,300 and no promises of a new flood of trainees, according to the report. The Federal Bureau of Health Professions projects

that by 2020 the nation will need 12,624 child and adolescent psychiatrists but is expected to have only 8,312. While there have been increases in the total number of child and adolescent psychiatrists, we still face a shortage and estimates of population growth project that we will fall even further behind over the coming decade based on the report of

the Federal Bureau of Health Professions, Christopher Thomas, Ph.D., professor of Psychiatry & Behavioral Sciences at the University of Texas Medical Branch at Galveston, told CABL. There is no quick solution to the issue that we face, said Thomas, an AACAP member. The uneven distribution of child and adolescent psychiatrists further complicates the

The Brown University Child and Adolescent Behavior Letter November 2006