Environmental stressors and emotional status of adolescents who have been in special education classes

Psychopathology and special education enrollment in children with prenatal cocaine exposure

OBJECTIVE

This study evaluated how enrollment in special education services in 11-year-old children relates to prenatal cocaine exposure (PCE), psychopathology, and other risk factors.

METHODS

Participants were 498 children enrolled in The Maternal Lifestyle Study, a prospective, longitudinal, multisite study examining outcomes of children with PCE. Logistic regression was used to examine the effect of PCE and psychopathology on enrollment in an individualized education plan (IEP; a designation specific to children with special education needs), with environmental, maternal, and infant medical variables as covariates.

RESULTS

PCE, an interaction of PCE and oppositional defiant disorder, child attention-deficit hyperactivity disorder, parent-reported internalizing behaviors, and teacher-reported externalizing behaviors, predicted enrollment in an IEP. Other statistically significant variables in the model were male gender, low birth weight, being small for gestational age, white race, caregiver change, low socioeconomic status, low child intelligence quotient, caregiver depression, and prenatal marijuana exposure.

CONCLUSIONS

PCE increased the likelihood of receiving an IEP with adjustment for covariates. Psychopathology also predicted this special education outcome, in combination with and independent of prenatal cocaine exposure.

Associations among sleep problems, learning difficulties and substance use in adolescence

This study investigated the relationships among sleep problems, learning difficulties and substance use in adolescence. Previous research suggests that these variables share an association with executive functioning deficits, and are intertwined. The sample comprised 427 adolescents (M age = 16 years) attending remedial schools and 276 adolescents (M age = 15 years) attending a mainstream school in Cape Town, South Africa. Participants completed anonymous self-report questionnaires. Results indicated that adolescents without learning difficulties were more likely to use tobacco, methamphetamine and cannabis, whereas those with learning difficulties engaged in more inhalant use. Adolescents who had more sleep problems were more likely to use tobacco, alcohol, methamphetamine, cannabis, inhalants, cocaine, ecstasy and any other illegal drug. Adolescents with learning difficulties had more sleep problems than those without learning difficulties. However, sleep problems remained independently associated with tobacco, cannabis and inhalant use when learning difficulties were taken into account.

Sexually transmitted infection among adolescents receiving special education services

BACKGROUND

To estimate the relative risk of sexually transmitted infections (STIs) among children identified as having learning disabilities through the special education system.

METHODS

This cross-sectional study used special education data and Medicaid data from Philadelphia, Pennsylvania, for calendar year 2002. The sample comprised 51,234 Medicaid-eligible children, aged 12-17 years, 8015 of whom were receiving special education services. Claims associated with diagnoses of STIs were abstracted, and logistic regression was used to estimate the odds of STI among children in different special education categories.

RESULTS

There were 3% of males and 5% of females who were treated for an STI through the Medicaid system in 2002. Among females, those in the mental retardation (MR) category were at greatest risk (6.9%) and those in the emotionally disturbed or "no special education" category at lowest risk (4.9% each). Among males, STIs were most prevalent among those classified as mentally gifted (6.7%) and lowest among those in the MR category (3.0%). In adjusted analyses, males with specific learning disabilities and females with MR or who were academically gifted were at excess risk for STIs.

CONCLUSIONS

The finding that children with learning disabilities are at similar or greater risk for contracting STIs as other youth suggests the need to further understand their risk behaviors and the potential need to develop prevention programs specific to their learning needs.

Predictors of internalizing symptoms among very low birth weight young women

As part of a longitudinal study of the outcomes of very low birth weight children (<1.5 kg), we sought to examine the perinatal, childhood, and young adult predictors of internalizing symptoms among very low birth weight young women and their normal birth weight controls. The cohort included 125 very low birth weight and 124 normal birth weight 20-year-old subjects. Perinatal, childhood, and young adult predictors were examined via stepwise multivariate analyses. Results revealed very low birth weight to be a significant predictor of parent-reported internalizing symptoms of their daughters but only among white subjects who had mothers with high levels of psychological distress. Additional significant predictors of 20-year internalizing symptoms included child I.Q. and internalizing symptoms at age 8 years and family expressiveness. When the results were analyzed according to the young adult self-report, additional predictors of internalizing symptoms included a history of asthma and exposure to violence. Perinatal risk factors were not found to be predictive of internalizing symptoms at age 20 years. Future studies should prospectively examine social and environmental factors associated with the neonatal intensive care experience that might explain the effect of very low birth weight on later psychopathology.

Adolescents with learning disabilities: risk and protective factors associated with emotional well-being: findings from the National Longitudinal Study of Adolescent Health

PURPOSE

To identify differences in emotional well-being among adolescents with and without learning disabilities and to identify risk and protective factors associated with emotional distress.

METHODS

Cross-sectional analysis of adolescent in-home interview data of the National Longitudinal Study of Adolescent Health. A total of 20,780 adolescents were included in this study of whom 1,301 were identified as having a learning disability. Initially, emotional distress, suicidal behaviors, and violence involvement were compared among those adolescents with and without learning disabilities using Student's t-test for the continuous or semicontinuous variables and Chi-square for the dichotomous variables. Subsequently, logistic regression analyses were conducted to identify which variables were most strongly associated with risk and protective factors for emotional distress.

RESULTS

Adolescents with learning disabilities had twice the risk of emotional distress, and females were at twice the risk of attempting suicide and for violence involvement than their peers. While educational achievement is below that of peers, connectedness to school is comparable. So, too, is connectedness to parents. Connectedness to parents and school was identified as most strongly associated with diminished emotional distress, suicide attempts, and violence involvement among adolescents with learning disabilities.

CONCLUSIONS

Given the increased association with emotional distress, suicidal attempts, and violence involvement, clinicians need to assess social and emotional as well as educational and physical functioning of these young people. We also need to be aware of the role protective factors play in the lives of young people with learning disabilities.