Military Dependent Children Research Articles

Biracial Identity in Adult Military Children

ABSTRACT This study sought to explore adult biracial individuals and their perceived racial identities and their own military dependent identities in military communities. Utilizing a social constructivist grounded theory methodology, the study participants consisted of 21 Black/White self-identifying biracial former military dependent children. Results show a core category, and two key categories were discovered from the analysis. The core category indicated that biopsychosocial and ecological factors across time influence biracial military identity development. These individuals have an intersecting and outsider identity that influences their community identity. The participants used different coping behaviors to ecological stressors they experienced that shaped their identity. The implications and recommendations for practice, training, and future research are discussed for this study.

Trends in Well-Child Visits and Routine Vaccination among Children of U.S. Military Members: An Evaluation of the COVID-19 Pandemic Effects.

The COVID-19 pandemic has drastically impacted administration of healthcare including well-child visits and routine vaccinations. The purpose of this study was to determine the impact of COVID-19 pandemic disruption on childhood health maintenance: well-child visits and scheduled vaccinations. We queried the TRICARE Management Activity's Military Health System (MHS) database for outpatient well-child visits and vaccinations for all children 0 to 23 months of age eligible for TRICARE healthcare. The median rate of well-child visits, during the COVID-19 period (March 2020-July 2021), was significantly declined for all demographic groups: all ages, parental military ranks, sex, and regions as compared to the pre-COVID-19 period (February 2019-February 2020). Similar to rates of well-child visits, the rate of vaccinations declined during the COVID-19 period as compared to the pre-COVID-19 period for all demographic groups, except children 12-23 months. Rates of well-child visits for military dependent children under 2 years of age were decreased during the 16 month COVID-19 period, with large increases seen in the first 2 months of the pandemic; the consequences of missed well-child visits and vaccination are unknown.

Prescriptions of Psychotropic Medications by Providers Treating Children of Military Service Members.

There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System. A between-subjects, cross-sectional study was performed on children aged 5-18 years old in fiscal years 2011-2015 and enrolled in TRICARE Prime. Study analyses examined specialty ("talk therapy") mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care. Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n = 131,393) were diagnosed with a psychological disorder during FY 2011-2015. Most were attention-related (5.2%, n = 79,770), followed by mood (1.7%, n = 25,314), anxiety (1.1%, n = 16,155), and conduct-related diagnoses (0.7%, n = 10,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR) = 1.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR = 2.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health ("talk therapy") follow-up (ps < 0.0001). For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes.

The Impact of Parental Injury on Children's Mental Health Diagnoses and Classes of Psychotropic Medication by Child Age.

Civilian and military research has linked parental illness and injury with increased overall mental health care and psychiatric medication use in children. Care for specific mental health conditions and medications by child age have not been reported. We sought to quantify the effect of parental illness and injury on child mental health care and psychiatric medication use in children overall and stratified by age. A self-controlled case series analyzed the impact of parental illness/injury on mental health and psychiatric medication use of military dependent children. Children were aged 2-16 years (51% male) when their parents were injured and received care in the Military Health System for 2 years before and 2 years after their parent's illness/injury. We used International Classification of Diseases 9th edition codes to identify outpatient mental healthcare visits. Outpatient care for 14 specific mental health diagnoses was classified using the Agency for Healthcare Research and Quality clinical classification system. Outpatient pharmacy records identified psychiatric medication prescriptions by therapeutic class. Parental illness/injury was identified by inclusion in the Military Health System Ill, Injured, and Wounded Warrior database. Adjusted negative binomial regression analysis compared rates of outpatient visits and medication days in the 2 years following parental illness/injury to the 2 years before the parent's illness/injury overall. Secondary analyses were stratified by age groups of 2-5 years (n = 158,620), 6-12 years (n = 239,614), and 13-16 years n = 86,768) and adjusted for parental pre-injury/illness deployment and child sex. Additional secondary analysis compared post-parental injury/illness care of children whose parents had post-traumatic stress disorder or traumatic brain injury to children of parents with physical/mental health injury/illness. There were 485,002 children of 272,211 parents injured during the study period. After adjustment for child sex, years of pre-injury/illness parental deployment, and child age, parental illness/injury was associated with increased mental visits across all categories of care except developmental diagnoses. Post-parental injury visits for suicidal ideation, alcohol abuse, mood, and anxiety disorders were all doubled. For children aged 2-5 years at parental illness/injury, the largest increases in care were in psychotic, anxiety, attention deficit, and mood disorders. In children aged 6-12 years, the largest increases were in psychotic conditions, suicidal ideation, and personality disorders. In adolescents aged 13-16 years, the largest increases were for alcohol and substance abuse disorders, with visits increasing by 4-5 times. For children of all ages, parental injury was associated with increased use of all therapeutic classes of psychiatric medications; use of stimulant medications was increased in younger children and decreased in older children following parental injury (P < .001). Parental illness/injury is associated with increased mental health care and days of psychiatric medication use in dependent children. Practitioners who care for families impacted by parental illness/injury should be cognizant of children's mental health risk. Early identification and treatment of child-related mental health issues can improve family functioning and increase military family readiness.

Childhood Vaccination Coverage Rates Among Military Dependents in the United States

The Military Health System provides universal coverage of all recommended childhood vaccinations. Few studies have examined the effect that being insured by the Military Health System has on childhood vaccination coverage. The purpose of this study was to compare the coverage of the universally recommended vaccines among military dependents versus other insured and uninsured children using a nationwide sample of children. The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children aged 19 to 35 months old. Data from 2007 through 2012 were combined to permit comparison of vaccination coverage among military dependent and all other children. Among military dependents, 28.0% of children aged 19 to 35 months were not up to date on the 4:3:1:3:3:1 vaccination series excluding Haemophilus influenzae type b vaccine compared with 21.1% of all other children (odds ratio: 1.4; 95% confidence interval: 1.2-1.6). After controlling for sociodemographic characteristics, compared with all other US children, military dependent children were more likely to be incompletely vaccinated (odds ratio: 1.3; 95% confidence interval: 1.1-1.5). Lower vaccination coverage rates among US military dependent children might be due to this population being highly mobile. However, the lack of a military-wide childhood immunization registry and incomplete documentation of vaccinations could contribute to the lower vaccination coverage rates seen in this study. These results suggest the need for further investigation to evaluate vaccination coverage of children with complete ascertainment of vaccination history, and if lower immunization rates are verified, assessment of reasons for lower vaccination coverage rates among military dependent children.

How Early Childhood Teachers Perceive the Educational Needs of Military Dependent Children

Military dependent children remain a largely unexplored subject, particularly in early childhood education. In an effort to fill the gap in the current literature, this research study focuses on how early childhood teachers perceive the educational needs of military dependent children. Previous research in the areas of geographic mobility, parental separation, and socioemotional needs are reviewed and used as a platform for this study. The study includes a survey developed by the researcher used in conjunction with Teacher Observation of Classroom Adaptation—Checklist to further examine the needs of these children from the perceptions of their teachers. The results of the study demonstrate that while early childhood teachers do not perceive a significant difference between military and nonmilitary dependent children in the socioemotional domains of prosocial behavior, concentration, and disruptive behavior, they do believe there is a difference related to stability. Additionally, early childhood teachers noted a negative socioemotional and academic impact related to parental separation and a negative academic impact related to geographic mobility. Teachers’ responses indicated mixed beliefs about the social impact of frequent relocations.

Advocating for America's Military Children: Considering the Impact of Parental Combat Deployment to Iraq and Afghanistan

Military dependent children and adolescents have faced remarkable adversity during the last 12 years of war. Although we know most military children and families are resilient, research addressing military child and family strengths and challenges in peace and war has shown that military youth fared better than their civilian counterparts in areas such as self‐regulation, academic performance, and emotional well‐being. However, many of these studies occurred prior to current combat activities of the past 10‐plus years with families experiencing repeated military parental deployments to war. It is important for family court professionals to understand that being resilient does not mean that these important families are invulnerable. In this article, the journey of a military family is described through the eyes of its teenage son, Ben. Key Points for the Family Court Community The story of a significantly affected military family The effect of relationship restructuring in military families (separation, divorce, changed family members) Unique military child and adolescent culture Advocacy efforts on behalf military children Relevance of the issues to family court professionals

Recurrent Headache in Military-Dependent Children and the Impact of Parent Deployment

Our objective is to determine the prevalence of recurrent headaches in military-dependent children and to study the changes in headache frequency, severity, and duration during a parental deployment. Recurrent headaches are common in children and are often intensified by stressful life events. Military-dependent children are subjected to unique stressors, most significantly parental wartime deployment. No studies have evaluated the effect of deployment on somatic complaints, to include headaches. We conducted a parental, cross-sectional questionnaire-based study in patients aged 5 to 17 years who were seen in the pediatric or adolescent clinics at a regional military medical center. The overall prevalence of recurrent headaches in the preceding 12 months was 30%. Almost half reported headache worsening in frequency, severity, or duration over the previous 12 months, whether a parent was deployed or not. For children who had experienced parental deployment, younger children and females were affected more often. Younger females had the highest rates of headache worsening. This trend may indicate a more detrimental effect of parental deployment on childhood headache in certain populations.

Children's action-control beliefs and emotional regulation in the social domain.

In a short-term longitudinal study of 314 U.S. military-dependent children (Grades 2-6 ) in Berlin, Germany, we examined whether children's coping strategies mediate the relations between their action-control beliefs and anxiety. The results provided only limited support for a mediational hypothesis. At both times of measurement, self-related agency beliefs related to ( a ) increased prosocial coping, (b) reduced antisocial coping, and (c) reduced anxiety. Prosocial coping was not uniquely related to anxiety. However, antisocial coping did partially mediate the relations between children's action-control beliefs and anxiety over time. Consistent with previous literature, boys reported using antisocial coping more than did girls, and younger children reported using primary control coping strategies more than did older children. Results are discussed in terms of lifespan differences in the development of coping strategies.

Demographics of Military Dependent Children and Adolescents: Projected Patient Population Shift

The United States government provides health care for one of the largest beneficiary populations in the world. Approximately 796,500 (35%) of the 2.27 million dependent children of uniformed services personnel are adolescents (13 to 19 years old). Although the majority of dependent children are dependents of active duty personnel (74.7%), close to half of the adolescents (47.7%) are dependents of retired personnel. Recent geopolitical world changes and a perceived decreased threat to national security have led to a planned 25% reduction of the active duty force by 1996. The mean age of children beneficiaries will rise as a result. Pediatricians in the military and civilian contract physicians need to prepare for increased health care of older pediatric patients, particularly adolescents.

Pharyngeal beta-Hemolytic Streptococci: A Study in American Military Dependent Children Stationed in West Germany

Pharyngeal beta-Hemolytic Streptococci: A Study in American Military Dependent Children Stationed in West Germany

Prevalence of psychiatric disorder in a pediatric clinic for military dependent children

The prevalence of psychiatric disorders was determined among dependents of military personnel by means of a semistructured parent interview, a behavior questionnaire completed by the child's teacher, and a diagnostic play interview with the child. Among 100 consecutive children ranging in age from 8 to 11 years, there were 35 with a psychiatric disorder. Conduct disorders were more common in boys: neurotic disorders were found more frequently in girls. In general, mothers of children diagnosed as having a psychiatric disorder differed little from those of children without an apparent psychiatric disorder in regard to their assessments of their children's behavior or emotional state.

Relationship between Transgression and Locus of Control in Military Dependent Children

It was hypothesized that externally controlled children (as defined operationally by scores on the Bialer-Cromwell Children's Locus of Control Scale) would exhibit a higher frequency of transgression than internally controlled children. Ss were a random selection of 60 fourth and fifth grade boys and 60 first and second grade boys randomly assigned to one of three groups: (a) punishment at initiation, (b) punishment at completion, (c) control. As the child reached for the attractive member of a pair of toys, he was verbally admonished (punishment). Having been conditioned with punishment for nine trials, the child was left alone on Trial 10, to determine if he would transgress (move the preferred toy). The hypothesis was not confirmed. Children who transgressed were significantly higher in internality than those who did not. Analysis of variance showed no statistically significant differences. Data was examined in terms of the military situation, individual differences, and item analysis of the locus of control scale.