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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2002;156:207.
Psychosocial Intervention for Postdisaster Trauma Symptoms in Elementary
School Children
There is increasing evidence that natural disasters have multiple negative
effects on children's emotional and behavioral adjustment. Although a substantial
proportion of children can develop posttraumatic stress disorder if left untreated,
there is little research on effective postdisaster interventions. Chemtob
and colleagues conducted a community-wide screening after Hurricane Iniki
in Hawaii and assigned those with the worst symptoms to either individual
or group therapy. Both types of treatment were effective in reducing symptoms
and facilitating psychological recovery. The study provides a model for community
response to large-scale disasters.
(SEE ARTICLE)
Day Care Attendance, Respiratory Tract Illnesses, Wheezing, Asthma,
and Total Serum IgE Level in Early Childhood
Prior studies have demonstrated that day care attendance in early life
is associated with a lower risk of atopy, wheezing, and asthma later in childhood.
This prospective birth cohort study followed up 498 children who had a family
history of allergy or asthma. The risk of wheezing associated with attendance
of day care in the first year of life decreased with age; early day care seemed
to be protective against wheezing by age 4 years. However, diagnosis of a
lower respiratory tract infection during the first year of life doubled the
risk of later recurrent wheezing. These results suggest that the long-term
protective effect of early day care attendance may be manifest by age 2 or
3 years.
(SEE ARTICLE)
How Common Is Attention-Deficit/Hyperactivity Disorder? Incidence in
a Population-Based Birth Cohort in Rochester, Minn
This population-based study examined the cumulative incidence of attention-deficit/hyperactivity
disorder (AD/HD) in children born in Rochester, Minn, between 1976 and 1982.
By age 19 years, 7.4% of the population had met criteria for definitely having
AD/HD, while an additional 8.6% had probable or questionable AD/HD. Stimulant
medication had been used in 86.5% of children with a definite diagnosis of
AD/HD. The study demonstrates that the incidence of AD/HD depends strongly
on the stringency of the criteria used for diagnosis.
(SEE ARTICLE)
Violence Exposure, Trauma, and IQ and/or Reading Deficits Among Urban
Children
Exposure to violence, both as witnesses and victims, is common among
young urban children. The long-term effects of such violence are still unclear.
Delaney-Black and colleagues studied 299 urban first-grade children and their
caregivers. Exposure to violence in the community was significantly associated
with child IQ. Children scoring at or above the 90th percentile on both community
violence exposure and distress reactions to this violence had a decrement
of 7.5 IQ points and a substantially lower reading ability compared with children
with the least amount of exposure. The potential effect of violence exposure
on children emphasizes the need for interventions that address domestic and
community violence.
(SEE ARTICLE)
Effect of Growth Hormone Therapy on Height in Children With Idiopathic
Short Stature
The use of growth hormone therapy to treat the 1 million children in
the United States with idiopathic short stature is controversial at least
in part because of the lack of clear data on treatment effectiveness. This
systematic review of the literature reports on 10 controlled trials and 28
uncontrolled trials of growth hormone treatment of idiopathic short stature.
The controlled studies report a mean growth of 2.86 cm per year in the treated
compared with the untreated group in the first year after treatment, and a
5- to 6-cm effect on final adult height. Similar results were found in the
uncontrolled trials. The cost was approximately $35 000 per inch gained
in final adult height.
(SEE ARTICLE)
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