Behavior Problems Index Research Articles

Behavioral and Social Outcomes in Adolescent Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Adolescents, regardless of medical history, may face behavioral and social challenges. Cancer and related treatments represent additional challenges for teens navigating the transition from childhood to adulthood. This study was conducted to evaluate behavioral and social outcomes of adolescent childhood cancer survivors using data from the Childhood Cancer Survivor Study. We evaluated 2,979 survivors and 649 siblings of cancer survivors to determine the incidence of difficulty in six behavioral and social domains (depression/anxiety, headstrong, attention deficit, peer conflict/social withdrawal, antisocial behaviors, and social competence). Outcomes were determined by calculating parent-reported scores to questions from the behavior problem index. Survivors and siblings were similar in age at the time of interview (mean: 14.8, survivors; 14.9, siblings; range, 12 to 17 years). Overall, multivariate analyses showed that survivors were 1.5 times (99% CI, 1.1 to 2.1) more likely than siblings to have symptoms of depression/anxiety and 1.7 times (99% CI, 1.3 to 2.2) more likely to have antisocial behaviors. Scores in the depression/anxiety, attention deficit, and antisocial domains were significantly elevated in adolescents treated for leukemia or CNS tumors when compared with siblings. In addition, survivors of neuroblastoma had difficulty in the depression/anxiety and antisocial domains. Treatments with cranial radiation and/or intrathecal methotrexate were specific risk factors. Adolescent survivors of childhood cancer, especially those with a history of leukemia, CNS tumors, or neuroblastoma, may be at increased risk for adverse behavioral and social outcomes. Increased surveillance of this population, in combination with development of interventional strategies, should be a priority.

Predictors of Early Alcohol Drinking Onset

ABSTRACT Early alcohol drinking onset (ADO) has been implicated as a cause of adult alcohol disorder inviting interventions that target the causes of ADO. This study explores the precursors of early ADO using variables measured before drinking onset, reaching back to the mothers of the respondents. The sample consists of children of the women respondents in the National Longitudinal Survey of Youth (79) who were 11 or 12 and still not drinking in the baseline interviews and who were re-interviewed two years later (n = 1951). The risk of drinking onset by age 13 or 14 was higher for three distal predictors: if mothers began drinking at age 14 or younger, if the respondent is female, and if the respondent was high on the Headstrong dimension of the Behavior Problems Index measured before age 6. More proximal predictors (measured at baseline) included loneliness (negatively), living with mother only, older, multiple problem behaviors, and no adult home after school. Implications for research and prevention are discussed.

Do Parenting and the Home Environment, Maternal Depression, Neighborhood, and Chronic Poverty Affect Child Behavioral Problems Differently in Different Racial-Ethnic Groups?

To determine whether the processes through which parenting practices, maternal depression, neighborhood, and chronic poverty affect child behavioral problems are similar or different in minority and nonminority children in the United States. Data from 884 white, 538 black, and 404 Latino families with children who were 6 to 9 years of age in the National Longitudinal Survey of Youth were analyzed. The outcome, child behavioral problems, was measured using the Behavior Problems Index externalizing and internalizing subscales. The effects of chronic poverty, neighborhood, maternal depression, and parenting on the outcome were analyzed using multigroup structural equation modeling. Chronic poverty affected child behavioral problems indirectly through the other variables, and parenting practices had direct effects in each racial/ethnic group. The effects of maternal depression were partially mediated through parenting in the white and Latino samples but were direct and unmediated through parenting practices in the black sample. Neighborhood effects were present in the white and black samples but were not significant for the Latino sample. Chronic poverty, neighborhood, maternal depression, and parenting practices have effects on child behavioral problems in white, black, and Latino children, but the processes and mechanisms through which they exert their effects differ among the groups. The differences may be related to social stratification mechanisms as well as sociocultural differences in family and childrearing practices.

Early Intervention in Low Birth Weight Premature Infants: Results at 18 Years of Age for the Infant Health and Development Program

To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age. This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; < or = 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status. We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2). The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.

The Equivalence of the Behavior Problem Index Across U.S. Ethnic Groups

In this study, the authors examine the equivalence of the factor structure of a commonly used symptom checklist of behavioral and emotional problems—the Behavior Problem Index (BPI)—across African American, Hispanic, and White children in the United States. The sample is drawn from the 1998 data file of the Children of the National Longitudinal Survey of Youth, a U.S. data set. The results of the study suggest that the BPI is not equivalent across the three ethnic groups. These findings are consistent when equivalence is tested for a one-factor model, a two-factor model using the internalizing and externalizing dimensions of the BPI, and a six-factor model using the subscales of the BPI. Item-level analyses identify the statistically significant items that are associated with nonequivalence across ethnic groups. The implications of nonequivalent measures for cross-cultural research and practice with families and children are discussed.

Leveling the Home Advantage: Assessing the Effectiveness of Parental Involvement in Elementary School

In the past two decades, a great deal of energy has been dedicated to improving children's education by increasing parents' involvement in school. However, the evidence on the effectiveness of parental involvement is uneven. Whereas policy makers and theorists have assumed that parental involvement has wide-ranging positive consequences, many studies have shown that it is negatively associated with some children's outcomes. This article uses data from the children of the National Longitudinal Survey of Youth 1979 to estimate time-lagged growth models of the effect of several types of parental involvement on scores on elementary school achievement tests and the Behavioral Problems Index. The findings suggest that parental involvement does not independently improve children's learning, but some involvement activities do prevent behavioral problems. Interaction analyses suggest that the involvement of parents with low socioeconomic status may be more effective than that of parents with high socioeconomic status.

Intergenerational Health Disparities: Socioeconomic Status, Women's Health Conditions, and Child Behavior Problems

Relatively little is known about the intergenerational mechanisms that lead to social disparities in child health. We examined whether the association between low socioeconomic status (SES) and child behavior problems is mediated by maternal health conditions and behavior. Prospective cohort data (1979-1998) on 2,677 children and their mothers were obtained from the National Longitudinal Survey of Youth. SES, the Child Behavior Problems Index (BPI), and maternal smoking, depressive symptoms, and alcohol use before, during, and after pregnancy were examined. Lower income and lower maternal education were associated with increased child BPI scores. Adjustment for maternal smoking, depressive symptoms, and alcohol use attenuated the associations between SES and child BPI by 26% to 49%. These maternal health conditions often occurred together, persisted over time, and were associated with the mother's own childhood SES and pre-pregnancy health. Social disparities in women's health conditions may help shape the likelihood of behavior problems in the subsequent generation. Improved public health programs and services for disadvantaged women across the lifecourse may not only address their own urgent health needs, but reduce social disparities in the health and well-being of their children.

Black-White Differences in Occupational Prestige

This article examines whether differences in parental occupational prestige mediate or moderate race differences in four indicators of child development—reading scores, math scores, Behavior Problems Index, and health status—using data from the Panel Study of Income Dynamics Child Development Supplement. The authors find that although for behavioral problems there is no impact of parental occupational prestige, for reading, math, and health there are significant academic returns to parental occupational prestige, but only for White families. The authors hypothesize that this racially distinct dynamic may be a result of ongoing discrimination in the labor market, thereby reducing the association between ability (job and parenting) and prestige; or it may be a result of the difficulty of Blacks to translate occupational prestige gains into other benefits as a result of discrimination outside the labor market; or finally, it may be the result of a generational lag between occupational status and parenting practices.

Protease Inhibitor Combination Therapy, Severity of Illness, and Quality of Life Among Children With Perinatally Acquired HIV-1 Infection

This study examines quality of life (QOL) among school-aged children with perinatally acquired HIV infection and compares QOL outcomes between treatment groups that differ according to the use of protease inhibitor (PI) combination therapy (PI therapy). To gain insights into how PI therapy might influence QOL, associations between severity of illness and QOL were also investigated. Cross-sectional data for 940 children, 5 to 18 years of age, who were enrolled in Pediatric AIDS Clinical Trials Group Late Outcomes Protocol 219 were used to examine domains of caregiver-reported QOL, as assessed with the General Health Assessment for Children, during 1999. The General Health Assessment for Children is an age-specific, modular, QOL assessment that was developed for the study with previously validated measures. QOL differences between treatment groups were estimated with linear and logistic regressions that controlled for sociodemographic characteristics (age, gender, race/ethnicity, maternal/caregiver education, and respondent) and severity-of-illness indicators related to receipt of PI therapy (AIDS status, log(10) CD4+ cell counts, and height-for-age z scores). The mean age of participants was 9.7 years. Most children were non-Hispanic black (54%) or Hispanic (31%), and 49% of the participants were female. At the 1999 study visit, approximately 14% of children had severe immune suppression (<15% CD4+ cells), whereas 62% of children had > or =25% CD4+ cells, ie, no immune suppression. Participants did exhibit some lag in growth, with mean height and weight z scores of -0.70 and -0.20, respectively. Twenty-eight percent of the children were reported to have met criteria for AIDS at study entry (1993-1999). When treatment groups were compared, children receiving PI therapy (72%) were older, had lower CD4+ cell percentages, and had lower height and weight z scores than did those receiving non-PI therapies. They were also more likely to have met criteria for AIDS at study entry. The most commonly used PIs were ritonavir (46%) and nelfinavir (63%). Health perceptions ratings for most children were at the upper end of the scale, whereas ratings for 25% of the children ranged over the lower 70% of scale scores. Almost one half of the children had at least some limitations in physical functioning, with more frequent limitations in energy-demanding activities (46%) than in basic activities of daily living (32%). The Behavior Problems Index was used to assess psychologic functioning. The mean total Behavior Problems Index score (9.34) and the proportion of children with extreme scores (23%) were consistent with values reported for chronically ill children and those at social and economic risk. One or more limitations in social/school functioning were reported for 58% of children. More than one third of the children (38%) experienced > or =1 physical symptoms that were at least moderately distressing. Health perceptions, physical functioning, psychologic functioning, social/school functioning, and overall HIV symptom scores did not differ between treatment groups. However, receipt of PI therapy was associated with an increased rate of diarrhea (28 vs 13%; adjusted odds ratio: 2.59; 95% confidence interval: 1.74-3.85). Severity of illness was associated with QOL in all domains except psychologic functioning. Higher log(10) CD4+ cell counts, higher height-for-age z scores, and absence of AIDS at study entry were independently associated with fewer social/school limitations and better HIV symptom scores. Health perceptions and physical functioning scores were associated with log(10) CD4+ cell counts and height z scores, respectively. QOL among children receiving PI therapy differed little from that among children receiving non-PI therapy, despite clinical indications of more advanced disease. Importantly, the study found no evidence of direct negative effects of PI therapy on QOL outcomes, other than an increased rate of diarrhea. Findings suggest that the effects of PI combination therapies to slow or to prevent disease progression and to increase CD4+ cell counts and height growth have the potential to improve QOL among children with HIV infection. However, many children do experience a constellation of functional impairments indicated by behavioral problems and clinical symptoms, with limitations in activities and in school performance. Comprehensive health services will continue to be required to minimize long-term illness and disability and to maximize children's potential as they move into adolescence and adulthood.

Preschool child care and risk of overweight in 6- to 12-year-old children

To determine if there is a relationship between center-based child care attendance from ages 3 to 5 y and future overweight at ages 6-12 y. Longitudinal, observational study of child experience and future body mass index. A total of 1244 US children aged 6-12 y included in the 1997 Panel Study of Income Dynamics Child Development Supplement. Parent-reported child care attendance from ages 3 to 5 y, trichotomized as 'none', 'limited' (>0 but <15 h/week), and 'extensive' (> or =15 h/week). Overweight defined as a body mass index > or =95th percentile for age and gender. Candidate covariates (selected a priori): gender, race, age, poverty status, birth weight, hours of television per day, Behavior Problems Index score >90th percentile, and Home Observation for Measurement of the Environment-Short Form (HOME-SF) cognitive stimulation score. Of the potential confounding variables, race, HOME-SF cognitive stimulation score, and age significantly altered the relationship between child care attendance and overweight in the multiple logistic regression model. With these covariates in the final model, limited center-based child care attendance from ages 3 to 5 y was independently associated with a decreased risk of overweight at ages 6-12 y (adjusted odds ratio=0.56, 95% confidence interval 0.34, 0.93) relative to no child care attendance. Extensive center-based child care attendance was not associated with future overweight. Limited center-based child care attendance during the preschool years was independently associated with a decreased risk of future overweight relative to no child care attendance. Additional studies are needed to clarify these findings.

Early television exposure and subsequent attentional problems in children.

Cross-sectional research has suggested that television viewing may be associated with decreased attention spans in children. However, longitudinal data of early television exposure and subsequent attentional problems have been lacking. The objective of this study was to test the hypothesis that early television exposure (at ages 1 and 3) is associated with attentional problems at age 7. We used the National Longitudinal Survey of Youth, a representative longitudinal data set. Our main outcome was the hyperactivity subscale of the Behavioral Problems Index determined on all participants at age 7. Children who were > or = 1.2 standard deviations above the mean were classified as having attentional problems. Our main predictor was hours of television watched daily at ages 1 and 3 years. Data were available for 1278 children at age 1 and 1345 children at age 3. Ten percent of children had attentional problems at age 7. In a logistic regression model, hours of television viewed per day at both ages 1 and 3 was associated with attentional problems at age 7 (1.09 [1.03-1.15] and 1.09 [1.02-1.16]), respectively. Early television exposure is associated with attentional problems at age 7. Efforts to limit television viewing in early childhood may be warranted, and additional research is needed.

A Comparative Study of Child Welfare Adoptions with Other Types of Adopted Children and Birth Children

ABSTRACTThrough parent surveys, the level of adjustment in home, school, health, mental health, and community of children from three types of adoptive and from birth families was compared. The sample groups include: child welfare adoptions (1340), domestic infant adoptions (481), international adoptions (89), and birth families (175). On most measures, particularly in relation to school functioning, adopted children were rated by their parents as having more problems than children from birth families. Children adopted from the child welfare system had significantly higher rates of problems than other types of adopted children. Using the Behavior Problem Index (BPI) as a measure of behavior problems, child welfare adopted children were rated as having a mean of 11.9 problems as compared to 6.2 for birth children and 9.1 and 9.4 respectively for domestic infant and internationally adopted children. Logistic regression analysis demonstrates the odds ratio present for an elevated BPI score for children from each family form. Children adopted from the child welfare system are 3.4 times as likely and internationally adopted children are 2.4 times as likely to be in the upper quartile of the BPI as children in birth families.

Association between clinically meaningful behavior problems and overweight in children.

To determine whether there is a relationship between clinically meaningful behavior problems and concurrent and future overweight in 8- to 11-year-old children. 1998 National Longitudinal Survey of Youth interview data for 8- to 11-year-old children and their mothers were analyzed. A Behavior Problems Index score >90th percentile was considered clinically meaningful. Child overweight was defined as a body mass index (BMI) >or=95th percentile for age and sex. Multiple logistic regression was used to control for potential confounders (selected a priori): child's sex, race, use of behavior-modifying medication, history of academic retention, and hours of television per day; maternal obesity, smoking status, marital status, education, and depressive symptoms; family poverty status; and Home Observation for Measurement of the Environment-Short Form (HOME-SF) cognitive stimulation score. In an attempt to elucidate temporal sequence, a second analysis was conducted with a subsample of normal-weight children who became overweight between 1996 and 1998 while controlling for BMI z score in 1996. The sample included 755 mother-child pairs. Of the potential confounding variables, race, maternal obesity, academic grade retention, maternal education, poverty status, and HOME-SF cognitive stimulation score acted as joint confounders, altering the relationship between behavior problems and overweight in the multiple logistic regression model. With these covariates in the final model, behavior problems were independently associated with concurrent child overweight (adjusted odds ratio: 2.95; 95% confidence interval: 1.34-6.49). The relationship was strengthened in the subsample of previously normal-weight children, with race, maternal obesity, HOME-SF cognitive stimulation score, and 1996 BMI z score acting as confounders (adjusted odds ratio: 5.23; 95% confidence interval: 1.37-19.9). Clinically meaningful behavior problems in 8- to 11-year-old children were independently associated with an increased risk of concurrent overweight and becoming overweight in previously normal-weight children.

The Roles of Birth Inputs and Outputs in Predicting Health, Behavior, and Test Scores in Early Childhood

The goal of this study is to address directly the predictive value of birth inputs and outputs, particularly birth weight, for measures of early childhood development in a simultaneous equations modeling framework. Strikingly, birth outputs have virtually no structural/casual effects on early childhood developmental outcomes, and only maternal smoking and drinking during pregnancy have some effects on child height. Not surprisingly, family child-rearing environment has sizeable negative and positive effects on a behavioral problems index and a math/reading test score, respectively, and a mildly surprising negative effect on child height. Despite little evidence of a structural/causal effect of birth weight on early childhood developmental outcomes, our results demonstrate that birth weight nonetheless has strong predictive effects on early childhood outcomes. Furthermore, these effects are largely invariant to whether family child-rearing environment is taken into account. Family child-rearing environment has both structural and predictive effects on early childhood outcomes, but they are largely orthogonal and in addition to the effects of birth weight.

Relationship between Maternal Behavior During Pregnancy, Birth Outcome, and Early Childhood Development: An Exploratory Study

This study examines the relationship between maternal behavior during pregnancy, birth outcomes, and early childhood development. Specifically, in the context of four measures of maternal behavior during pregnancy (maternal smoking, drinking, prenatal care, and maternal weight gain), three measures of birth outcome (gestational age, birth length, and birth weight), and 32 exogenous covariates observed during pregnancy, we investigate the importance of maternal choices during pregnancy and birth outcomes in forecasting child health (as indicated by height and weight), child behavioral problems, and a child math/reading test score at age five or six. Strikingly, birth outcomes have virtually no structural/causal effects on early childhood developmental outcomes, and only maternal smoking and drinking during pregnancy have some effects on child height. Not surprisingly, family child-rearing environment has sizeable negative and positive effects on behavioral problems index and math/reading test score, respectively, and a mildly surprising negative effect on child height.

How money matters for young children's development: parental investment and family processes.

This study used data from the Panel Study of Income Dynamics and its 1997 Child Development Supplement to examine how family income matters for young children's development. The sample included 753 children who were between ages 3 and 5 years in 1997. Two sets of mediating factors were examined that reflect two dominating views in the literature: (1) the investment perspective, and (2) the family process perspective. The study examined how two measures of income (stability and level) were associated with preschool children's developmental outcomes (Woodcock-Johnson [W-J] Achievement Test scores and the Behavior Problem Index [BPI]) through investment and family process pathways. Results supported the hypothesis that distinct mediating mechanisms operate on the association between income and different child outcomes. Much of the association between income and children's W-J scores was mediated by the family's ability to invest in providing a stimulating learning environment. In contrast, family income was associated with children's BPI scores primarily through maternal emotional distress and parenting practices. Level of income was associated with W-J letter-word scores and income stability was associated with W-J applied problem scores and BPI, even after all controls were included in the models.

Scaling Back Survey Scales

To understand children's development, one must examine an array of constructs. Yet the time and budget constraints of large-scale survey research create a dilemma: how to cut scales to the fewest possible items while still retaining their predictive properties. In this article, the authors compare the predictive validity of several shortened versions of the Behavior Problems Index and the Home Observation for Measurement of the Environment-Short Form with their full scales within the National Longitudinal Survey of Youth-1979 cohort. They use the scales to predict delinquency, reading recognition scores, parent-child activities, and smoking behavior of children at ages 13 or 14 from data gathered 2, 4, and 6 years prior. Analyses leave the authors cautiously optimistic that short scales, especially scales composed of items gathered at different time points and repeated regularly, may enjoy substantial predictive power. However, two-item scales may be too short, and psychometric study on additional scales is warranted.

Early Childbearing and Children's Achievement and Behavior over Time

Compared with children of older women, children of women who had their first birth during their teens have long been believed to be at higher risk for a host of poor health, social and economic outcomes. Recent studies have failed to confirm this belief, but none have taken into account whether children's outcomes or the effects of early childbearing on those outcomes have changed over time. Data from the National Longitudinal Survey of the Labor Market Experience of Youth and the Panel Study of Income Dynamics are used to separate the influence of changes from the 1960s through the 1990s in children's experiences from the effect of mother's age at first birth. Multivariate analyses controlling for social and demographic characteristics show that among children born to women from a particular birth cohort, those whose mothers first gave birth in their teens have significantly lower scores on a set of four achievement tests and significantly higher scores on a behavior-problem index than do children whose mothers delayed childbearing. However, when changes over time in children's outcomes and in the effect of early childbearing on those outcomes are taken into account, children born to women who began childbearing early score significantly worse than those whose mothers delayed their first birth on the behavior-problem index, but on only one achievement test. Comparisons by age at first birth among women born in the same period may misestimate the effects of early motherhood. Whether early childbearing's effects on children are overestimated or underestimated depends on whether test scores are rising or falling. Policymakers should be cautious in making decisions based on studies that do not take time trends into account.

School Involvement and the Working Poor

IN THE May Research column, I described some ways in which rich schools and poor schools differ in the literacy experiences they offer young children. In the winter 2000 issue of the American Educational Research Journal, S. Jody Heymann and Alison Earle of the Harvard School of Public Health report on how poverty influences another aspect of school life: parent involvement. Heymann and Earle point out that comes in a number of forms. It can occur from parents' developing and using skills to support effective learning; engaging in home-to-school communication about student progress; volunteering at school; assisting their children with homework; becoming involved in school governance issues and decisions; and coordinating and integrating community services that will enhance the learning experience. . . . Numerous studies have shown that, regardless of how it is defined, parental involvement is important to children's success at school. The researchers began by examining the working conditions of substantially employed mothers. Substantially employed is a term taken from the National Longitudinal Survey of Youth (NLSY) and means that the mother was not self-employed, had held at least one job within 30 days of the 1994 survey, and worked at least 20 hours a week. (When the researchers used cutoffs of 30, 35, and 40 hours a week, the results were unchanged. The NLSY did not collect employment data on fathers.) Twelve hundred and eighty of the mothers completed the Behavior Problems Index (BPI), a 28-item questionnaire about peer conflict, antisocial behavior, anxiety or depression, and dependency - behaviors that a child might have exhibited in the 30 days before the mother completed the BPI. The NLSY had also administered the Peabody Individual Achievement Test (PIAT) in reading and math. Of the 1,280 mothers, 582 had a child in the top quartile of the BPI. Two hundred and eighty had a child in the bottom quartile of the PIAT reading test, and 334 had a child in the bottom quartile of the PIAT math test. One analysis the researchers conducted looked at the working conditions of mothers who had a child in the lowest quartile in PIAT reading. When divided into families living in poverty and families above the poverty line, substantial differences appeared in the amount of time a parent had available to become involved with the school - or even with the child. Forty percent of the families above the poverty line had no paid sick leave, while 67% of those below the poverty line had no paid sick leave. Smaller differences appeared between the two groups for paid vacation leave and for the ability to leave the job site. Similar findings existed for mothers with children in the lowest quartile on the PIAT math. The largest differences in the availability of mothers appeared for the mothers below the poverty line whose children also acted out often enough to land them in the highest quartile on the BPI: 71% of these mothers had no paid sick leave (compared to 36% of mothers not in poverty whose children were also in the top quartile on the BPI), 46% had no paid vacation, and 67% could not leave their job sites. The researchers offer a number of suggestions as to how to ameliorate the problem. Holding meetings outside of school hours is one possibility, but this imposes an added burden on teachers, many of whom are mothers, too. The Family Medical Leave Act could be expanded. It currently covers only 50% of families, and the leave is for up to 24 hours, but since it is unpaid, it would be of less help to poor families. The researchers are most enthusiastic about two other possibilities: Alternatively, paid family leave could be provided through an insurance program. National survey data have shown that the majority of Americans would be in favor of family leave insurance. An insurance program could be modeled after current public insurance programs, such as workman's compensation, or private insurance programs that are typically offered through workplaces, such as disability insurance. …

How American Children Spend Their Time

The purpose of this article is to examine how American children under age 13 spend their time, sources of variation in time use, and associations with achievement and behavior. Data come from the 1997 Child Development Supplement to the Panel Study of Income Dynamics. The results suggest that parents' characteristics and decisions regarding marriage, family size, and employment affect the time children spend in educational, structured, and family activities, which may affect their school achievement. Learning activities such as reading for pleasure are associated with higher achievement, as is structured time spent playing sports and in social activities. Family time spent at meals and time spent sleeping are linked to fewer behavior problems, as measured by the child's score on the Behavior Problems Index. The results support common language and myth about the optimal use of time for child development.