Mothers in poverty need help with depression

New research from the Urban Institute finds that more than half of mothers in poverty show symptoms of depression, posing a serious risk to their children’s well-being and development.

The study is the first took look at depression among mothers in poverty across the nation and also assess parenting approaches for infants living in poverty whose mothers are depressed. The research was based on data from a federal education survey of 14,000 children born in 2001. It was funded by The Doris Duke Charitable Foundation.

Among the surprising results are:

  • Eleven percent of infants living in poverty have a mother suffering from severe depression.
  • Compared with non-depressed mothers, severely depressed mothers are more likely to struggle with domestic violence and substance abuse.
  • Infants of depressed mothers are breastfed for shorter periods of time than those with mothers who are not depressed.
  • Even though depression is treatable, many severely depressed mothers do not receive care.

The evidence suggests that depression interferes with mothers’ parenting abilities.

“A mom who is too sad to get up in the morning won’t be able to take care of all of her child’s practical needs,’’ researcher Olivia Golden, who coauthored the paper, told the Washington Post. “If she is not able to take joy in her child, talk baby talk, play with the child — those are features of parenting that brain development research has told us contribute to babies’ and toddlers’ successful development.’’

But many of these mothers are already connected with programs that could provide help with depression or referrals for mental health services. Ninety-six percent of severely depressed mothers live with some who qualifies for the Special Supplemental Nutrition Program for Women, Infants, and Children. Seventy percent participated in the Supplemental Nutrition Assistance Program, formerly known as Food Stamps. And 90 percent of infants receive Medicaid benefits, giving their mothers’ access to health care providers.

Now researchers need to find an evidence-based approach to reaching these mothers and providing them with mental health services.

Using the evidence: TV-time in our family

We have written about the topic of screen-time for children several times on this blog.  It’s a sign of our society today. As kids have more multimedia options than ever before, researchers are continually trying to assess the long-term effects of technology on children. And many parents, myself included, are trying to assess what all of that means for their own household rules.

In our family, my nearly-two-year-old son loves Sesame Street. He’s happy to watch it quietly for up to an hour at a time, which is a very tempting when I need to accomplish something without any toddler “help.” 

But I worry about what that means for his development. Am I ruining his ability to focus, or creating problems that will surface later in school?

When Rachel Dunifon, associate professor of human development at Cornell, posted a comment in our previous post about TV-watching, I was anxious to read her opinion.

Dunifon shared a study published earlier this year in the journal Child Development, which reexamined more than 1,000 mothers’ reports of television-viewing for 1- to 3-year-olds, and the assessed those children’s attention problems at age 7.

The study found, among other things, that watching TV is only associated with a higher risk of attention problems in children who watch seven or more hours a day.  It also suggested the effect of television may depend on the “quality” of viewing. Children who watch educational television have actually shown higher school readiness and language skills compared with children who viewed general programming.

Those results made me feel a lot better about the TV rules in our house. For now, our son is allowed to watch a half-hour a day of a recorded, educational show. That gives me a little extra time to jump in the shower or get dinner on the table, and it gives him a little down time to relax as well.

–        Sheri Hall

Texting while driving: Clearly dangerous

Multitasking has become a way of life in this digital age, where most people can access their e-mail, their calendars and make phone calls from a mobile device they keep in their pockets or purse. While communication-on-the-go certainly can make us more efficient, it can have dire consequences as well.

Some 200,000 car accidents each year are caused by texting while driving, according to a report from the National Safety Council, a nonprofit group recognized by congressional charter as a leader on safety.

The scientific literature backs up the report.  A 2009 study of long-haul truckers by the Virginia Tech Transportation Institute found drivers were more than 23 times more likely to experience a safety-critical event when texting. The study also found that drivers typically take their eyes off the road for an average of four out of six seconds when texting, during which time he travels the distance of a football field without their eyes on the road.

Another study by psychologists and the University of Utah found that texting while driving is riskier than talking on a cell phone or with another passenger. In the study, people texting in a driving simulator had more crashes, responded more slowly to brake lights on cars in front of them, and showed more impairment in forward and lateral control than did drivers who talked on a cell phone or drove without texting.

The Utah study found that drivers who talked on the phone attempted to divide their attention between the conversation and driving, adjusting the priority of each activity based on what was happening on the road.  But texting required drivers to switch their attention from one task to the other, causing a substantial reduction in reaction times compared to those talking on the phone.

State governments are responding to the evidence. Text messaging is banned for all drivers in 30 states and the District of Columbia. In addition, novice drivers are banned from texting in 8 states.  And President Barack Obama issued a texting-ban while driving for on all federal employees while using a government vehicle or government-issued cell phone.

The take home message: Save your text for non-driving times.

–        Sheri Hall

Video feature: Science education outreach

Researchers and scientists across the country are making new discoveries every day, but continually must find the best ways to share that knowledge with the public.  The Cornell Center for Materials Research sets outstanding example of the best way to accomplish this.

The center’s mission is to advance, explore and exploit the science and engineering of advanced materials. It is part of a  national network of centers for Materials Research encompasses 29 centers funded by the National Science Foundation.

Nev Singhota is the director of the center’s Educational Programs Office, which reaches out to thousands of students, hundreds of parents and teachers, and many undergraduates from across the country. Many Cornell faculty, post-doctoral fellows, graduate and undergraduate students contribute to the center’s outreach efforts by visiting schools, hosting family and teacher workshops and coordinating an “Ask the Scientist” column in the local newspaper.

Singhota describes her role a facilitating interactions between Cornell scientists and all sorts of people in the community. “We create this web,” she said. “We’re like the spider who is trying to connect everyone together .” 

Interested in hearing more about Cornell Center for Materials Research’s outreach efforts?  Check out this conversation with Singhota:

New Evidence: TV time leads to attention problems

There is another piece of evidence that supports a long-standing belief among child development experts: Too much TV time is associated with attention problems in youth. The newest piece of proof comes from a study conducted by researchers at Iowa State University and published this month in the journal Pediatrics

The new research found that children who exceeded the two hours per day of screen time recommended by the American Academy of Pediatrics – either in TV-watching or video games – were 1.5 to 2 times more likely to have attention problems in school.

The study followed third-, fourth- and fifth-grade students as well as college-aged students for more than one year. Over that time, participants’ average time using television and video games was 4.26 hours per day, well below the national average of 7.5 hours per day reported in other studies.

Study author Douglas Gentile, an associate professor of psychology at Iowa State, explained the phenomenon for a report in Science Daily.

“Brain science demonstrates that the brain becomes what the brain does,” he said. “If we train the brain to require constant stimulation and constant flickering lights, changes in sound and camera angle, or immediate feedback, such as video games can provide, then when the child lands in the classroom where the teacher doesn’t have a million-dollar-per-episode budget, it may be hard to get children to sustain their attention.”

This phenomenon again raises the question for professionals who coordinate youth intervention programs:  What can be done to capture the attention of youth who are so captivated by electronic media?   The answer is most likely to meet them somewhere in their world.

– Sheri Hall

Children and Earth Day

Earth Day is just around the corner and, as it does every year, it’s got me thinking about my relationship to the planet. When I was a kid growing up in rural Kentucky, some of my best memories are of the hikes my friends and I used to take through the woods and up to the top of the hill behind our house to have picnics.  It was a pre-tech world (before computers, cell phones, and Ipods) when kids created their own recreation. Our family vacations often consisted of camping trips to state parks with my grandparents, where we’d sleep in tents and I’d spend the days fishing alongside my grandmother. These experiences gave me a deep appreciation for nature. Are they related to my motivation to do what I can to improve the environment? What does research tell us about this topic?

Nancy Wells, an environmental psychologist in the Design and Environmental Analysis Department of the College of Human Ecology, has researched childhood exposure to nature and adult attitudes toward the environment. In her article Nature and the Life Course: Pathways from Childhood Nature Experiences to Adult Environmentalism, she examined the question of what specific activities or events in a child’s life might set them on a path toward later-life commitment to environmental attitudes and behaviors. Wells and her colleague, Kristi Lekies, examined interviews of 2000 adults living in urban environments who were questioned about their childhood exposure to nature. Results from the analysis of their responses provide insight into the origins of commitment to pro-environmental values.

Wells and Lekies found that exposure to “wild” nature (hiking, playing in the woods, hunting, fishing, etc.) and “domesticated” nature (picking flowers, gardening, etc.) both have a positive relationship to adult environmental attitudes. In addition, they found that “wild nature” participation was positively associated with environmental behaviors, while “domesticated nature” participation was marginally related to environmental behaviors.

So, the take away message is that it’s important to encourage children in every way we can to spend time outside in nature.  This is one very concrete thing each of us can do to contribute to the development of healthy children who feel connected to the environment, and, in turn, work to improve it later on in their lives.  I’ll always be grateful to my parents and grandparents for giving me this enduring gift. And now, as an adult, I wouldn’t trade it for anything.

Teen Sex and Pregnancy: Evidence from Systematic Reviews

Having just posted on systematic reviews, let’s take a look at some recent examples on a topic of importance in contemporary society: sexual activity and pregnancy on the part of teenagers. We tend to throw up our hands about this problem, but systematic evidence-based reviews show that some intervention programs actually work, and others don’t. Take a look at these as examples of how systematic reviews work and what they can tell us.

A Cochrane Collaboration review team examined the literature on teen pregnancy prevention. They examined studies of primary pregnancy prevention carried out in a variety of settings. Findings from a total of 41 randomized, controlled trials were synthesized. The review team found that programs that combined educational and contraceptive interventions were effective in preventing teen pregnancy.

A systematic review was conducted of programs to promote condom use among teens. This study is a good example of a review that concluded there was insufficient evidence to be definitive. Although many individual intervention studies showed modest effects, the authors noted that the quality of most of the studies was poor. So in this case, we really can’t be sure interventions to promote condom use really work.

What about abstinence? Our friendly neighborhood Cochrane reviewers have taken this on, too. They conducted a systematic review of abstinence-only HIV prevention programs, and found no evidence that such programs protected against sexually transmitted diseases. They also did not prevent teens from engaging in unprotected intercourse, the frequency of intercourse, the number of sexual partners, age of sexual initiation, or condom use.

Why do you think kids make risky decisions? Bet you’re wrong…

On a trip to Dallas last week, I stayed in a large hotel that was playing host to a convention of high school student members of a service organization. A group of boys was roughhousing on a balcony where only a low railing served as a barrier against a 3-floor drop to the lobby, and it looked like a shove in the wrong direction would send someone over the edge. Down swept a small phalanx of chaperones exclaiming what a bunch of idiots the kids were. The young fellows sauntered off, muttering about “over-reacting,” and “always ruining it when we’re having fun.”

To adults, the reason for this behavior seems obvious: Kids are illogical and don’t understand the risks of their behavior. We assume that they do risky things – like use drugs, drive drunk, or have unprotected sex – because they are irrational beings. Like my grandmother would say: “Those kids just don’t have any sense.”

Enter Cornell professor Valerie Reyna to show us that we’re wrong about this, and our misconceptions have implications for how we try to help kids make less risky decisions. A faculty member in Human Development, Prof. Reyna conducts groundbreaking work on judgment and decision making. And she has taken the additional step of turning her basic research into practical programs to help young people.

In the laboratory under controlled conditions, she has conducted many studies of children and adolescents. Following a translational research model, she and her colleagues wanted to first understand the causal mechanisms that generated risky behavior. What she learned in the lab about the psychology of adolescent risk-taking and about how risky decision making changes with age, she found could then be used to modify unhealthy behavior.

The findings are fascinating. It turns out that adolescents don’t take risks because they are irrational and feel invulnerable and immortal. In fact, it’s because they are too logical. Adults can access informed intuition to avoid risk, whereas adolescents count up and weigh risks versus immediate benefits, and often the risk comes out on top. As Prof. Reyna puts it, “We found that teenagers quite rationally weigh benefits and risks. But when they do that, the equation delivers the message to go ahead and do that, because to the teen the benefits outweigh the risks.”

Existing prevention curricula that had been developed tended to have effects that faded over time and were not as large as they could be.  Prof. Reyna translated her research findings into a curriculum based on both theory and empirical findings.  She has created interventions to teach adolescents to think categorically—to make sweeping, automatic gist-based decisions about life: “unprotected sex bad,” “illegal drugs bad.”

After more than 800 teenagers participated in a randomized controlled trial, the investigators found that the curriculum was more broadly effective, and its effects lasted in many cases for long periods of time.

Prof. Reyna’s web page Resources on Risky Decision-Making in Adolescence is a terrific resource. I recommend starting by watching one of her presentations on the topic, conveniently available on the site. An article in the New York Times provides a quick overview. If you are a professional working with adolescents (or if you have one in your family) you’ll find a whole new way of looking at why kids take risks.

How does the physical environment affect child well-being?

Gary Evans, a Cornell researcher in the Department of Design and Environmental Analysis, has spent much of his career researching this important issue.  Evans, who is an environmental psychologist, has completed a large body of research that examines the relationship of crowding, noise, housing and neighborhood quality on the lives of children.  His research reveals that these factors can have a lot of impact on a child’s academic achievement, as well as cognitive and social development.

Noise is one of the factors that Evans has studied.  Music, conversation and transportation are the most common noises that children are exposed to.  Evans and colleagues have found that noise levels, such as those in homes near airports, can result in children’s reading delays. Children often adapt to exposure to chronic noise by tuning out auditory input, which can also result in delayed language development.

Overcrowding is another factor that can result in biological and cognitive delays for children.  While family size is not a factor in overcrowding, Evans has identified density (the number of people in a room) as a crucial variable to measure when examining the effects of crowding. Children may withdraw as a way of coping with over stimulating environments. Specific effects of crowding on preschoolers are distraction and less constructive play. 

Research has also found that neighborhood environments can have a great impact on child well-being.  Some of the factors that have the most impact are housing quality, toxic exposure, access to natural settings, transportation and health services. Natural settings have a constructive effect by providing children with the opportunities to develop gross mother skills and alleviating the negative effects of children’s exposure to chronic stress.

The good news is that there are many things that can be done to improve the environments children are living in and address negative environmental factors.  These ideas are detailed in a brief that you can read entitled The Effects of the Physical Environment on Children’s Development.

Evidence-based practice with children and adolescents: A great resource

Let’s say you have a long lunch hour (hey, it’s spring, so why not take, say, 90 minutes?). You could put that time to good use reading an excellent publication on evidence-based practice and what it means for kids. This was published a little over a year ago, but only recently came to my attention. I’m sorry I didn’t see it sooner, because it helps answer a lot of questions about what “evidence-based” really means –  whether or not you happen to be interested in children.

It’s the American Psychological Association’s Disseminating Evidence-Based Practice for Children & Adolescents, available here.

The report begins with a wake-up call:

The prevalence of children’s behavioral disorders is well documented, with 10 to 20% of youth (about 15 million children) in the United States meeting diagnostic criteria for a mental health disorder. Many more are at risk for escalating problems with long-term individual, family, community, and societal implications.

 It then moves to a nice summary of the varying contexts in which children’s problems arise and the systems for dealing with them. It also uses an inclusive definition of Evidence-Based Practice (EBP). They look at EBP as way of moving tested practices into real-world settings. However, they also emphasize the importance of integrating these approaches with practice expertise. Evidence-based interventions for children and youth are critically important so that practitoners can draw on programs that have “track records” – that is there is longitudinal data for short-term and long-term outcomes, showing that the program reduces problems or symptoms.

The report highlights four “guiding principles” for evidence-based approaches with children and youth:

 1. Children and adolescents should receive the best available care based on scientific knowledge and integrated with clinical expertise in the context of patient characteristics, culture, and preferences. Quality care should be provided as consistently as possible with children and their caregivers and families across clinicians and settings.

2. Care systems should demonstrate responsiveness to youth and their families through prevention, early intervention, treatment, and continuity of care.

3. Equal access to effective care should cut across age, gender, sexual orientation, and disability, inclusive of all racial, ethnic, and cultural groups.

4. Effectively implemented EBP requires a contextual base, collaborative foundation, and creative partnership among families, practitioners, and researchers.

All points worth thinking about!

If you don’t have time for the entire report, some interesting sections are: a review of the history of the “evidence-based” concept (for all of us who wonder where this came from all of a sudden), a good discussion of definitions, and a review of what the evidence shows about prevention programs.

 Happy reading!

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