Military families need more help with mental health - Pediatrics

A leading pediatricians' group is highlighting the plight of children in military families in a new report.

Tours of duty can last up to 18 months, and studies have shown that one in four children of active-duty service members has symptoms of depression.

One in three children experiences excessive worry, and half of children have trouble sleeping, according to the American Academy of Pediatrics (AAP) report.

These problems can be even worse when there are other psychological issues in the family, according to the report, which was published online May 27 and in the June print issue of the journal Pediatrics.

During deployments, preschoolers could become anxious and withdraw. Children between 5 and 17 years old also are at greater risk for emotional and behavioural problems, the report said.

And the situation can get worse when kids' parents are on extended deployments. Meanwhile, the AAP advised that parents or caregivers who remain at home also are under greater stress.

This could, in turn, affect the mental health and well-being of children.

Because half of all children of active-duty military service members are taken care of by nonmilitary pediatricians before, during and after deployment, the AAP emphasized that all health care providers must recognize the mental-health needs of their patients with deployed parents, and those of other family members.

"By understanding the military family and the stressful experiences of parental wartime deployment, all pediatricians—both active duty and civilian—and other health care providers can be the front line in caring for U.S. military children and their families," report co-author Dr. Benjamin Siegel said.

"In the past 10 years, more than 2 million children in the U.S. have experienced the emotional and stressful event of being separated from a loved one deployed for active duty," report co-author Dr. Beth Ellen Davis said in the release.

"Most children cope and adapt quite well, but all children experience a heightened sense of fear and worry during a parent's deployment. It's important for pediatricians caring for these families to be aware of their family's situation so they can guide them appropriately."

Parent and Teachers Concerns Block Children Playing freely

Prof Anita Bundy

Altering parents' and teachers' notion of risk taking behaviour can significantly increase children's physical activity suggests a study lead by University of Sydney researchers.

The results of the Sydney Playground Project published online in the Preventive Medicine Journal show simple, low cost, additions to a playground can increase physical activity and decreases children's sedentary behaviour during recess times.

However parental and teachers' concerns for safety and being sued remain a concern.

Lead investigator Professor Anita Bundy from the University's Faculty of Health Sciences says the trial may have helped reverse parents and teachers' perception of what constitutes risky play activities by assisting them to understand what can motivate and encourage children to be physically active and socialise with their peers.

Twelve Australian primary schools participated in the project which simultaneously focused on the school children aged between five-to-seven years, their parents and their teachers.

The initial phase of the three-year project involved a 13-week intervention program. The program that introduced new objects such as cardboard boxes, old car tyres, colourful fabrics, and Styrofoam and milk crates into schoolyards, thereby giving children opportunities for creative, outdoor play.

Workshops were also conducted with parents and teachers to discuss play and perceptions around risk taking related to play.

"We wanted to capture children's intrinsic motivations to play, increase their physical activity during break times, while simultaneously helping adults reconsider their views on risky play behaviour," says Professor Bundy.

"What we found was these simple objects coupled with an education program for parents and teachers significantly increased the children's activity levels."

Whether the increases measured can be maintained remains to be seen says Professor Bundy but evidence in one school suggests they can.

"We retested children in one intervention school after two years and they had maintained their gains," she states.

Trial project manager Lina Engelen says schools and preschools are ideal sites for interventions to promote physical activity either within the school's Physical Education curriculum or via breaks such as recess and lunchtime.

"If break times are to promote physical activity in a sustained manner then available activities must be highly motivating, such as active play and have adults' support," Dr Engelen says.

Children of all sizes and shapes were delighted by the playground initiative she adds.

Stepfathers: Three Factors Contribute to Closeness

Although one-third of American children live in a step-family during part of their childhood, little is known about the development of the relationship between stepfathers and stepchildren.

New research from Brigham Young University fills that gap with a study that identified three factors that significantly contribute to closeness in stepfamilies:

• The couple keeps arguments to a minimum
• Mothers help children feel comfortable sharing their frustrations. 
• The stepfather and mother agree on how to parent

Kevin Shafer

BYU professor Kevin Shafer's research on step-families appears in the academic journal Social Work.

"Family roles can be negotiated and there is going to be some bumpiness," said Shafer, who teaches and researches in BYU's School of Social Work.

"The notion that couples should put the couple first and everything else will fall into place is false."

Shafer and BYU grad student Todd Jensen analyzed data from a nationally representative sample of 1,088 children in step-families.

From the children's perspective, frustrations occur when the new dad assumes too much parental authority or when he disrupts the family's normal way of doing things.

"Moms need to let their children know that it's ok to talk if they have a problem with their stepfather because everybody is still trying to figure out this new family dynamic," Shafer said.

And the lack of history between step-fathers and children amplifies the detrimental effects of parental conflict. "Full-blown arguments set up step-families for failure," Shafer said.

Couples typically make one of two mistakes in the transition.

• The first type involves the couple acting as though nothing major has changed. that the new father is a replacement instead of an addition. 
• The second type of mistake is for mom to take upon herself all of the parenting.

The common thread in both scenarios is that the children's voices are missing.

"If you have teenagers, they should be a pretty active participant in discussions of what the family is going to look like and how the family is going to function," Shafer said.

The study contains one pleasant surprise:

Communicating openly and avoiding arguments contributes to closeness regardless of family income or education level.

"It really is the interpersonal dynamic that predicts family closeness," Shafer said. "You can build these bonds in spite of financial challenges."