Nonminority Children Research Articles

The Effects of Self Harming Behaviours of Youth in Child Welfare Care

This paper considers the clinical issue of self-harming behaviours, defined as intentional self-injury that results in tissue damage. It is distinct from a suicide attempt, as self-harm does not occur within the context of a conscious wish to die. Self-harming behaviours among children and youth is a recent area of research. To date, studies indicate that in community samples, self-harming behaviours occur in as many as 35% of youth who are sampled (Gratz, 2001). Alarmingly, very little is known about self-harming behaviours among children and youth within the child protection system. This study, drawing from data gathered through a government-mandated reporting procedure of all children and youth in care,attempted to explore self-harming behaviours of children and youth in welfare care. While analyses did not focus explicitly on Aboriginal children and youth, it does consider differences in self-harming behaviours among minority and non-minority children and youth in care of the Children’s Aid Society of Toronto. Approximately half of all child welfare cases that go through the child protection system in Toronto fall under the responsibility of the Children’s Aid Society of Toronto. Although minority status was not significantly related to the number of self-harming attempts or threats, results suggested that minority children and youth in care were less likely to use puncture-type behaviour (cutting, scratching, stabbing) as a means of serious self harm. Results suggest that although self- harm may be a universal phenomenon, culture may affect how children and youth in care engage in self-harming behaviours. Direction of future research should consider between-cultural effects and more importantly, how these culture-specific differences may impact on children and youth’s self-harming behaviours.

Differences in Febrile and Respiratory Illnesses in Minority Children: The Sociodemographic Context of Restrictive Parenting

ObjectiveTo examine the moderating role of restrictive parenting on the relation of socioeconomic status (SES) to febrile illnesses (FIs) and upper respiratory illnesses (URIs) among ethnic minority and non-minority children. MethodsChildren from diverse ethnic backgrounds (Caucasian, African American, Asian, Latino, other, or multiethnic) were followed across the course of the kindergarten year. Parents reported on SES and parenting. A nurse completed 13 physical exams per child over the year to assess FIs and URIs. ResultsDuring the school year, 28% of children (n = 199, 56% ethnic minority) exhibited one or more FIs (range, 0–6) and 90% exhibited one or more URIs (range, 0–10). No main or moderating effects of SES or restrictive parenting on FIs or URIs were found among Caucasian children; however, among ethnic minority children, the relation of SES to FIs was conditional upon restrictive parenting (β = .66; P = .02), as the fewest FIs were found for lower SES minority children whose parents reported more restrictive practices. Additionally, among minority children, more restrictive parenting was marginally associated with fewer URIs (β = –.21; P = .05). ConclusionsUnexpectedly, among minority children the fewest illnesses occurred among lower SES children whose parents endorsed more restrictive parenting. This may be due to unique appraisals of this rearing style among minority children in lower SES environments and its potential to influence immune functioning. Results suggest variability in the effects of parenting on offspring health and support context-specific evaluations of parenting in efforts to ameliorate early health disparities.

Using Bayesian Imputation to Assess Racial and Ethnic Disparities in Pediatric Performance Measures.

To analyze health care disparities in pediatric quality of care measures and determine the impact of data imputation. Five HEDIS measures are calculated based on 2012 administrative data for 145,652 children in two public insurance programs in Florida. The Bayesian Improved Surname and Geocoding (BISG) imputation method is used to impute missing race and ethnicity data for 42 percent of the sample (61,954 children). Models are estimated with and without the imputed race and ethnicity data. Dropping individuals with missing race and ethnicity data biases quality of care measures for minorities downward relative to nonminority children for several measures. These results provide further support for the importance of appropriately accounting for missing race and ethnicity data through imputation methods.

Tell-Me-A-Story (TEMAS) Assessment for Culturally Diverse Children and Adolescents

The Tell-Me-A-Story (TEMAS) narrative test is a multicultural measure developed for both minority and nonminority children and adolescents. As the off-spring of the Thematic Apperception Test (TAT), it enhances several narrative features, including the use of chromatic cards, diminished ambiguity and structured pictorial stimuli of the cards, familiar and contemporary themes, problem-solving situations, and an objective scoring system. This article describes the standardization of the TEMAS in the US, the validation of the Orthodox Jewish version of the TEMAS, and the internal reliability of the Argentinian version of the TEMAS. In the US, the test was normed on a sample of 642 children (281 boys and 361 girls) from public schools in the New York City area, ages 5–13 years, with a mean age of 8.9 years (SD = 1.9). The total sample represented four ethnic/racial groups: Puerto Rican and other Hispanic, Black, and White children. The TEMAS measures 10 personality functions, 18 cognitive functions, and seven affective functions. This paper presents two studies. The first study describes the reliability of the TEMAS measurement, using the Argentinian version of the TEMAS. The second study provides the rationale as well as the procedures for developing culturally suitable pictures, and also presents novel data for the cultural validity of the Orthodox Jewish version of the TEMAS. Overall, these results provide support for TEMAS as a reliable and culturally valid tool for the measurement of cognitive, personality, and affective functioning.

Socioeconomic disparities in indoor air, breath, and blood perchloroethylene level among adult and child residents of buildings with or without a dry cleaner

In many cities, dry cleaners using perchloroethylene are frequently located in multifamily residential buildings and often cause elevated indoor air levels of perchloroethylene throughout the building. To assess individual perchloroethylene exposures associated with co-located dry cleaners, we measured perchloroethylene in residential indoor air, and in blood and breath of adults and children residing in buildings with a dry cleaner as part of the New York City (NYC) Perc Project. We also measured perchloroethylene in indoor air, and in blood and breath of residents of buildings without a dry cleaner for comparison. Here, we evaluate whether an environmental disparity in perchloroethylene exposures is present. Study participants are stratified by residential building type (dry cleaner or reference) and socioeconomic characteristics (race/ethnicity and income); measures of perchloroethylene exposure are examined; and, the influence of stratified variables and other factors on perchloroethylene exposure is assessed using multivariate regression. All measures of perchloroethylene exposure for residents of buildings with a dry cleaner indicated a socioeconomic disparity. Mean indoor air perchloroethylene levels were about five times higher in minority (82.5ug/m3) than in non-minority (16.5ug/m3) households, and about six times higher in low-income (105.5ug/m3) than in high income (17.8ug/m3) households. Mean blood perchloroethylene levels in minority children (0.27ng/mL) and adults (0.46ng/mL) were about two and three times higher than in non-minority children (0.12ng/mL) and adults (0.15ng/mL), respectively. Mean blood perchloroethylene levels in low income children (0.34ng/mL) and adults (0.62ng/mL) were about three and four times higher than in high income children (0.11ng/mL) and adults (0.14ng/mL), respectively. A less marked socioeconomic disparity was observed in perchloroethylene breath levels with minority and low income residents having slightly higher levels than non-minority and high income residents. Multivariate regression affirmed that indoor air perchloroethylene level in dry cleaner buildings was the single most important factor determining perchloroethylene in blood and breath. Neither age, gender, nor socioeconomic status significantly influenced perchloroethylene levels in breath or blood. We previously reported that increased indoor air, breath, and blood perchloroethylene levels among NYC Perc Project child participants were associated with an increased risk for slightly altered vision. Thus, the disproportionately elevated perchloroethylene exposures of minority and low-income child residents of buildings with a dry cleaner shown here constitutes an environmental exposure disparity with potential public health consequences. Among residents of buildings without a dry cleaner, we observed some small increases in perchloroethylene breath and blood levels among non-minority or high income residents compared to minority or low income residents. These differences were not attributable to differences in indoor air levels of perchloroethylene which did not differ across socioeconomic categories, but appear to be associated with more frequent exposures dry cleaned garments.

Acculturation, Cultural Values, and Latino Parental Beliefs About the Etiology of ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent mental health disorders of childhood. Despite the availability of several evidence-based interventions, Latino children are more likely than non-minority children to have an unmet need for services related to ADHD. Given that parental beliefs about the etiology of ADHD likely influence service utilization, research needs to focus on cultural factors that may influence parental beliefs about the etiology of child behavior problems. Thus, the goal of the current study was to investigate the role of acculturation and cultural values of familism, respect, spirituality, and traditional gender roles in explaining parental etiological beliefs about ADHD in a sample of Latino parents. Findings suggest that behavioral acculturation was not significantly correlated with biopsychosocial or sociological/spiritual etiological beliefs; however, the cultural values of familism and traditional gender roles were positively correlated with sociological/spiritual beliefs. Further, exploratory analyses suggested that after controlling for SES, familism and traditional gender roles accounted for 30.5% of the total variance in sociological/spiritual beliefs about ADHD. Finally, post hoc analyses revealed that cultural values were associated with several individual belief categories within the sociological/spiritual domain, including beliefs about friends, spirituality, and nature disharmony. The current study supports the inclusion of etiological beliefs and cultural factors in research examining help-seeking and access to mental health services among Latino families and suggests that the incorporation of alternative etiological beliefs about child behavior may be an important factor in culturally-appropriate mental health services.

Differences in Autism Symptoms Between Minority and Non-Minority Toddlers

Little is known about whether early symptom presentation differs in toddlers with ASD from ethnic minority versus non-minority backgrounds. Within a treatment study for toddlers with ASD, we compared 19 minority to 65 Caucasian children and their parents on variables obtained from the Mullen Scales of Early Learning, Autism Diagnostic Observation Schedule, and Communication and Symbolic Behavior Scales Caregiver Questionnaire. The majority of parents were from the upper classes irrespective of ethnic membership. Minority children had lower scores in language, communication, and gross motor than non-minority children. Findings indicate that subtle communication delays may be undetected or presumed unremarkable by parents of minority toddlers, and that more significant delays are needed to prompt the search for intervention services.

Parent Medication Concerns Predict Underutilization of Mental Health Services for Minority Children With ADHD

OBJECTIVE. Disparities in attention deficit hyperactivity disorder (ADHD) treatment are recognized with minority children using services less than nonminority children. The authors examine minority parents' knowledge and perceptions of ADHD as they relate to service utilization. METHODS. Using a longitudinal cohort design, parents of children with untreated ADHD were surveyed regarding their knowledge and perceptions of ADHD and then followed for 3 to 6 months to determine whether they used services. RESULTS. Seventy parents of 5- to 18-year-old children with untreated ADHD were enrolled. Of the 70 children, 33 (47.1%) had not attended any mental health appointments and 51 (72.9%) had not used any treatments by 3- to 6-month follow-up. Logistic regression indicated that increasing age and medication concerns were associated with less follow-up at mental health appointments (P < .05) and less utilization of treatments (P < .05). CONCLUSIONS. The results of this study highlight the importance of addressing medication concerns, when referring minority children to mental health services or offering treatments.

Racial and Ethnic Differences in the Use of Environmental Control Practices Among Children With Asthma

Objective. Minority children with asthma suffer a disproportionate burden of asthma morbidity. National asthma guidelines recommend use of environmental control practices (ECPs) as part of a comprehensive approach to asthma management. The purpose of this study was to examine use of ECPs among minority and nonminority children with asthma. Methods. The authors used data from the four state sample of the National Asthma Survey, a telephone survey conducted in 2003. The sample included Alabama, California, Illinois, and Texas. Parents provided responses for 2003 children ≤17 years of age with a diagnosis of asthma. The outcomes of interest were use of mattress covers, use of pillow covers, smoke avoidance, pet avoidance, and carpet removal. Univariate and multiple regression analyses were conducted to examine the rates of use of these ECPs among minority and nonminority children. Results. Black and Hispanic children with asthma were less likely to use mattress covers and pillow covers compared to white children in these four states. Smoking avoidance was less likely among black children but more likely among Hispanic children compared to white children. Both black and Hispanic children were more likely to live in a home without pets and without carpets compared to white children. Conclusions. These data illustrate that there are differences in the patterns of ECP use among minority and nonminority children with asthma in these four states. This information can help target physician counseling regarding ECP use in asthmatic children and should inform interventions to improve asthma management among minority children.

Giving Literacy a Shot in the Arm

In the U.S., fewer than half of young children (aged birth to 5 years) are read to daily. Low-income and minority children are significantly less likely to be read to daily than non-minority children and children who live in higher-income households.1 This gap is associ ated with gaps in school readiness and achievement. Reach Out and Read is a model that promotes early development and literacy through pediatric primary care so that children enter school ready to learn. Doctors implementing Reach Out and Read give new books to very young children aged 6 months through 5 years. During well-child checkups, they also incorpo rate advice to parents about the importance and joy of reading aloud to children. Focusing on children growing up in low-income households, Reach Out and Read builds on the unique relationship between pediatricians and parents to encourage daily book sharing activities. Reach Out and Read has been shown to increase parent/child book-sharing activities and has a posi tive effect on child-centered literacy orientation in the home.2-4 Similar results have also been found in

Factors Contributing to Blood Lead Levels of U.S. Children

While elemental lead has been removed from a variety of products over the past 30 years, it is still a widely distributed metal in the environment and can be found in old electronics, children's toys, and ceramics resulting in the exposure of young children. To determine what factors contribute to blood lead levels in children, and therefore, help determine possible exposure routes, we assessed the effect of housing and general demographic factors and determined which characteristics had the greatest influence on lead levels for children. Blood lead levels (BLLs), demographic data, and housing data from the third National Health and Nutrition Examination Survey (NHANES) (1988–1994) and the three continuous NHANES cycles (1999–2000, 2001–2002, 2003–2004) were used in these analyses. Using SAS software, potential correlations between BLLs and various characteristics were determined using simple linear regression while multivariate regression was utilized to assess the significance of several factors while controlling for known predictors of blood lead levels in children 1–5 years of age. Age of housing, being non-Hispanic black, and age of child had the greatest effect on lead levels in children. Non-Hispanic black children had significantly higher BLLs than non-minority children even after adjusting for age of child and age of housing; however, significant differences in BLLs among the different races were not observed for children living in housing built prior to 1950. More notably, mean ln[BLL] was significantly associated with lead dust levels, which is consistent with the result that children who attend daycare/preschool have significantly lower BLLs than children who do not. These results demonstrate a complex interaction between several demographic, sociodemographic and housing characteristics in predicting BLLs of U.S. children.

Comparing Patients Seen in Pediatric Resident Continuity Clinics and National Ambulatory Medical Care Survey Practices: A Study From the Continuity Research Network

The goal was to compare visit data from Continuity Research Network practices with data for a nationally representative sample of pediatric visits in practice settings from the National Ambulatory Medical Care Survey. A cross-sectional study comparing data for Continuity Research Network practice visits during a 1-week period in 2002 with data from the 2000 National Ambulatory Medical Care Survey was performed. Continuity Research Network and National Ambulatory Medical Care Survey data were derived from 30 patient visits per practice site for patients < 22 years of age, with the primary care providers being residents and practicing pediatricians, respectively. Eighteen Continuity Research Network practices reported on 540 visits, compared with 32 National Ambulatory Medical Care Survey physicians reporting on 792 visits. Continuity Research Network patients were more likely to be black non-Hispanic or Hispanic/Latino and to have public insurance. The top 5 reasons for visits were the same for Continuity Research Network and National Ambulatory Medical Care Survey visits, although the orders varied slightly. These 5 reasons accounted for 58% of Continuity Research Network visits and 49% of National Ambulatory Medical Care Survey visits. Continuity Research Network visits were more likely to result in patient instructions to return at a specific time (78% vs 52%). Residents in Continuity Research Network practices provide care to more underserved patients but evaluate problems that are similar to those observed in office practices; the Continuity Research Network practices thus provide important training experiences for residents who will serve both minority and nonminority children.

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.

Addressing the Achievement Gap between Minority and Nonminority Children

Addressing the Achievement Gap between Minority and Nonminority Children

Addressing the Achievement Gap between Minority and Nonminority Children by Increasing Access to Gifted Programs

Project EXCITE is a collaborative program of a university-based gifted center and local school districts designed to prepare gifted minority elementary and middle school students for advanced tracks in math and science in high school. This paper describes the characteristics and components of the EXCITE program and gives data regarding the academic and school achievement of participating students over the past 3 years. Results showed that most of the students were retained in the program, earned high grades in math and science in school and performed well on state criterion-referenced tests in math and science. There was a 300% increase of minority children qualifying for an advanced math class in grade 6 after 2 years of involvement in the program.

National Examination of Compliance Predictors and the Immunization Status of Children: Precursor to a Developmental Model for Health Systems

The gap between children's immunization requirements and actual compliance is staggering. Using a national survey instrument, the purpose of this study was to analyze the relationship between select predictors and immunization status in children between 19 months and 6 years of age. From the 1998 Medical Expenditure Panel Survey, 1575 children were included in a multivariate logistical model. Outcomes were measured as compliance with approved vaccination regimens. Only 67% of children between 19 months and 6 years old were compliant with all recommended vaccines. However, nonminority children with health insurance from families with income above the federal poverty line or living outside a metropolitan statistical area were more likely to be vaccinated. Children of older or educated parents likewise tended to have complete immunization. Analyzing childhood immunization via parental characteristics identifies prevalent predictors of compliance. Outcomes suggest potential strategies for health systems to focus on children's health issues--specifically immunizations.

Do We Change Gifted Children to Fit Gifted Programs, or Do We Change Gifted Programs to Fit Gifted Children?

In this article, I present a framework that can be used in our work with special groups of gifted students—one that recognizes the effects of socioeconomic status (SES), racism, and other limiting factors on educational achievement and provides a blueprint for interventions. This framework stems from Urie Bronfrenbrenner's ecological theory of development and emphasizes the role of social support systems in the development of talent. I then argue that two important reasons to retain a strong focus on programs that serve minority students include the fact that the gap in achievement between minority and nonminority children is pervasive and exists even at high socioeconomic levels and that minority students' underachievement is largely attributable to cultural factors within our society.

A Longitudinal Study of the Effects of the Birth of a Sibling during Preschool and Early Grade School Years

This study investigates the changes in socioemotional development, achievement, and self-concept after the birth of a sibling in a cohort of preschool-aged children over a 2-year period and a 4-year period. We test whether the birth of a sibling is associated with changes in the family environment and in children's developmental trajectories. We use data from nonminority children of the National Longitudinal Survey of Youth. The birth of a sibling is associated with a significant increase in the behavior problems of the children, but these increases are temporary. The birth of a sibling also is associated with lower reading recognition scores among economically disadvantaged children. The impact of the birth of a sibling on self-perception is large and negative, and this effect is stronger among the children of economically disadvantaged families.

A Longitudinal Study of the Effects of the Birth of a Sibling during the First 6 Years of Life

We investigate links among the birth of a new infant, changes in the family environment, changes in the relationship between the mother and an older child, and changes in an older child's cognitive and socioemotional development. We hypothesize that the effects of sibling birth are mediated by the associated changes in the family environment and changes in the interaction patterns of the family members. Data from the National Longitudinal Survey of Youth are used on a cohort of nonminority children between 6 and 23 months old. The birth of a sibling results in significant changes in the family environment. At the same time, positive interactions with the older child diminish, especially if the birth interval is short, and the mother increasingly adopts controlling parenting styles. These changes result in lower levels of verbal development. About 2.5 years after the sibling birth, negative effects are detected on achievement and on socioemotional adjustment. Some positive effects of sibling birth also are noted on verbal ability and peer relations. Key Words: achievement, preschool children, sibling, socioemotional problems. JEANNE BROOKS-GUNN Columbia University* This study investigates the changes in the level of cognitive and socioemotional development after the birth of a sibling in a national cohort of infants and toddlers over a 4-year period. Previous studies relied on detailed data obtained from interviews and observations of small samples. These studies examined the prenatal and postnatal patterns of interaction among family members (Dunn & Kendrick, 1980; Dunn, Kendrick, & MacNamee, 1981; Dunn & Munn, 1985; Kendrick & Dunn, 1982; Stewart, 1990; Stewart, Mobley, Van Tuyl, & Salvador, 1987). They contribute to our understanding of the birth of a sibling as a process of adjustment in the family system that leads to some positive and some negative, outcomes for the older sibling. Generally, the quality and intensity of maternal interactions with the firstborn decrease after the birth of a sibling, and some specific behavioral and emotional problems-such as regression, anxiety, and aggression-in the older child are observed (Dunn & Kendrick, 1980; Stewart, 1990; Stewart et al., 1987). Sibling rivalry and the resulting behavior problems also have been studied (DelGiudice, 1986; Dunn & Munn, 1986; Jalongo & Renck, 1985; Pietropinto, 1985; Stewart et al., 1987). Most of these studies point to the importance of positive parenting styles in attenuating the sibling rivalry (Dunn & Munn, 1986; Gottlieb & Mendelson, 1990). They also show that the effects of sibling birth depend on age (Gibbs, Teti, & Bond, 1987; Stewart et al., 1987) and the sex of both siblings (Austin, Summers, & Leffler, 1987; Kendrick & Dunn, 1982). These studies of family processes after the birth of the second child are difficult to generalize for two reasons. First, the small samples of fewer than 100 families, often of middle-class origin and with two biological parents, may not be representative of the general population. Second, some of these study samples do not include families who did not experience the birth of a new baby. Hence, maturational changes cannot be distinguished from the changes attributed to the sibling birth (Stewart et al., 1987). Sociological studies that use large and diverse samples generally focus on the correlates of sibling group size, birth order, and birth spacing, rather than family changes after the birth of a sibling. These studies have three major shortcomings. First, sibling group size effects, holding constant the birth order, are equivalent to a study of aggregate outcomes of experiencing a number of births of siblings. This is a problem because the effects of the birth of a sibling cannot be distinguished from the effects of family size. Second, due to the limitations of cross-sectional data, neither the processes that account for sibling group size differentials, nor the factors that account for the differences in sibling group size effects (such as the age of the child at the time of sibling birth) can be fully studied. …

DSM-IV: Implications for Hispanic Children and Adolescents

Hispanic children and adolescents are a rapidly growing segment of the general population. The mental health needs of this group of youth are thought to be at least equal to the needs of nonminority children. Culturally appropriate diagnostic, treatment, and evaluation servicesfor this group of Hispanic youth are much needed so that ethical and appropriate mental health and educational services can be provided. This article provides an overview of the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV. Highlighted in this article is a discussion of the validity and reliability of the diagnostic categories included in the DSM-IV. An extensive review of the literature reveals few empirical studies related to the validity and reliability of the DSM when used with Hispanic children and adolescents. This review of the existing literature, as well as the clinical experiences of the authors, provide the basis for some general guidelines in the use of the DSM-IV such that diagnostic errors with Hispanic children and adolescents can be minimized.