School-based violence prevention programs have become increasingly popular in the United States and have been adopted as an important strategy to decrease aggressive behavior. This systematic review of randomized controlled trials found consistent evidence that these programs can reduce aggressive behavior, and that the effect seems to be greater in older students and in boys. This information can be useful to school districts and school physicians in planning and implementing violence prevention programs.
With increasing emphasis on safe storage of handguns in homes (especially homes with children), methods to improve access to information on safe storage are important. In this study of 96 gun dealers, less than 10% of dealers offered advice about safe storage of handguns. Only 8% had any on-site educational materials available on safe storage, and the information given was often inconsistent with the American Academy of Pediatrics' recommendations. Dealers are currently an unsolicited but potentially important source of information on safe storage of handguns.
Many pediatricians care for children who have been physically abused, but unfortunately, few have the opportunity to learn the outcomes of these children years later. In this study of 585 children, Lansford and colleagues examined the outcomes in adolescence of the 11.8% of patients who had been abused before entering kindergarten, compared with those who were not abused. Early physical maltreatment resulted in greater school absenteeism; lower expectations for college attendance; and more emotional, behavioral, cognitive, and social problems in adolescence. Early intervention to both detect these children and to treat the consequences of abuse are needed to improve later health and social functioning.>
Many crimes committed by delinquents are not reported. In a subgroup of 805 adolescents who participated in the National Gang Survey, 11% of males and 10% of females reported that they had sexually assaulted someone. A third of the male perpetrators and 44% of the female perpetrators had themselves been sexually victimized. There have been no systematic studies of large programs aiming to reduce the risk of abused children becoming future perpetrators.
There is increasing evidence that posttraumatic stress disorder (PTSD) greatly influences functional outcome after injury. Fein and colleagues followed youths who sustained injuries from youth violence and found that 25% reported clinically significant distress. Five months later, 15% of these youth reported significant PTSD symptoms, with more symptoms among those with greater acute stress at the time of the initial injury. Treatment of the physical injuries is not enough; attention must also be paid to the potential for PTSD and its long-term effect.
This Month in Archives of Pediatrics & Adolescent Medicine. Arch Pediatr Adolesc Med. 2002;156(8):745. doi:10.1001/archpedi.156.8.745