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This Month in Archives of Pediatrics & Adolescent Medicine
Arch Pediatr Adolesc Med. 2007;161(10):929.
A Tertiary-Primary Care Partnership Model for Medically Fragile Children
As many as 1 in 6 children in the United States has a need for special health care treatment, which is difficult for families to access and primary care physicians to provide. Gordon and colleagues describe a special needs program established by Children's Hospital of Wisconsin and the Medical College of Wisconsin to partner with families and primary care physicians to serve these children. The program reduced the rate of hospitalization, number of inpatient days, and charges and increased use of outpatient services for medically fragile children and children with special health care needs. The return on investment indicates that such programs should be further explored.
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Block Play and Language Acquisition, Attention Span, and Television Viewing in Toddlers
Early childhood is a critical time in development, but few randomized trials have been conducted on ways to enhance development, promote language acquisition, and improve attention. In this randomized trial, in which the intervention children aged 18 to 30 months were given plastic blocks to use at home, after 6 months of play significantly higher language scores were found in low- and middle-income children who were given blocks than in children not given blocks. Similar to the Reach Out and Read program, this study suggests that a "reach out and play" program to distribute blocks may also promote development.
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Homelessness and Health Care After Emancipation From Foster Care
There are more than half a million children in foster care in the United States, and approximately 20 000 adolescents "age out" or are "emancipated" from foster care each year without being reunited with their families. These youth are often without health benefits and must function in the world without adult guidance. This study interviewed 345 such emancipated foster care youth. One in 7 experienced homelessness after leaving foster care and 39% were unstably housed. Youth who were homeless were less likely to have health insurance and more likely to have unmet health care needs. Strategies to improve health outcomes among emancipated youth should address both their lack of health insurance and their risk of housing instability and homelessness.
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Dietary Supplement Use in the United States, 1999-2002
Data from the National Health and Nutrition Examination Survey from 1999 to 2002 indicate that nearly one-third of children aged 18 years and younger used a dietary supplement in the last month. Use was highest in children aged 1 to 8 years, children who were underweight or at risk of being underweight, and children from higher income families and families in which there was no tobacco use. Multivitamins and multiminerals were the most common supplements used. Only 3% of children used supplemental fluoride.
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Figure. Prevalence and SE (error bars) of dietary supplement use among infants, children, adolescents, and adults in the past 30 days.
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