Association of early childbearing and low cognitive ability.During 1998, U.S. women aged 15-19 had an estimated one million pregnancies and nearly a half million live births. (1) Despite some success in reducing the incidence of adolescent pregnancy adolescent pregnancy See Teenage pregnancy. and childbearing child·bear·ing
Pregnancy and parturition.
childbearing adj. in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , early childbearing remains a pressing social concern and public health problem. Teenage mothers are more likely than older mothers to experience low educational and occupational achievement; (2) to live in poverty; (3) and to have children with behavioral problems, academic difficulties and developmental delays developmental delay
A chronological delay in the appearance of normal developmental milestones achieved during infancy and early childhood, caused by organic, psychological, or environmental factors. , including mild mental retardation mental retardation, below average level of intellectual functioning, usually defined by an IQ of below 70 to 75, combined with limitations in the skills necessary for daily living. . (4) In addition, many young Americans have a second pregnancy while still in their teens, exacerbating ex·ac·er·bate
tr.v. ex·ac·er·bat·ed, ex·ac·er·bat·ing, ex·ac·er·bates
To increase the severity, violence, or bitterness of; aggravate: the problems associated with early childbearing. (5)
A substantial body of research describes the individual, familial and social factors associated with early childbearing. In particular, poverty, living in a single-parent household, having sexually active peers and being a member of certain racial or ethnic groups predispose pre·dis·pose
To make susceptible, as to a disease. adolescents to having at least one child before their 18th birthday. (6) These factors are also associated with the timing and pattern of adolescent sexual behavior
or coitus or copulation
Act in which the male reproductive organ enters the female reproductive tract (see reproductive system). . (7) However, the potential influence of cognitive ability on early sexual activity and births has been studied less often. Studies of programs for pregnant teenagers have found that participants were overrepresented o·ver·rep·re·sent·ed
Represented in excessive or disproportionately large numbers: "Some groups, and most notably some races, may be overrepresented and others may be underrepresented" in special education classes and had high rates of mild mental retardation. This suggests that adolescents with cognitive deficiencies are more likely to experience pregnancy than are their peers with higher ability. (8)
Having a higher cognitive ability is associated with delayed initiation of sexual activity. (9) On the other hand, adolescents with borderline borderline /bor·der·line/ (-lin) of a phenomenon, straddling the dividing line between two categories.
borderline mental retardation * have the highest probability of having sex, according to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. findings from the National Longitudinal Study of Adolescent Health The National Longitudinal Study of Adolescent Health (also called Add Health) is the first and only nationally-representative study of adolescent sexuality, which has spawned over one thousand peer-reviewed publications on many issues related to adolescent health and . (10) Although low academic performance is associated with early sexual initiation and pregnancy, it may be the result primarily of poor-quality schooling or low motivation, rather than of low cognitive ability. (11)
The exclusion of cognitive ability in studies of antecedents of teenage childbearing and sexual risk-taking stands in sharp contrast to its common inclusion in investigations of other adolescent problem behaviors, such as truancy and delinquency. One study showed that the peak crime rate occurred among individuals with borderline mental retardation. (12) In other studies, mildly retarded adolescent men were more likely than others to binge-drink, carry a weapon, initiate sexual activity early and be involved in a pregnancy. (13)
To our knowledge, no population-based study has directly examined the effect of cognitive functioning cognitive function Neurology Any mental process that involves symbolic operations–eg, perception, memory, creation of imagery, and thinking; CFs encompasses awareness and capacity for judgment on sexual activity and early childbearing. The purpose of the study presented in this article is to examine relationships between cognitive ability, early childbearing and other factors known to be associated with teenage pregnancy teenage pregnancy Adolescent pregnancy, teen pregnancy Social medicine Pregnancy by a ♀, age 13 to 19; TP is usually understood to occur in a ♀ who has not completed her core education–secondary school, has few or no marketable skills, is in a population-based sample of young women. The primary questions are whether teenage women with below-average cognitive functioning have an elevated risk of bearing a child before the age of 18 and having a second birth before the age of 20. We also assess the potential influence of cognitive ability on selected reproductive and social factors.
Given the relationship between cognitive ability and adolescent risk behaviors, it would not be surprising to discover that early sexual activity is associated with below-average cognitive ability. Low intelligence might lead to a limited ability to understand the relationship between sexual activity and pregnancy and childbirth, or the function and proper use of contraceptive methods Noun 1. contraceptive method - birth control by the use of devices (diaphragm or intrauterine device or condom) or drugs or surgery
birth control, birth prevention, family planning - limiting the number of children born . Having low cognitive ability would make it difficult to link one's current actions (e.g., sexual activity) to future results (e.g., pregnancy and childbirth). This is a cognitive process that requires being able to think abstractly, an ability that normally develops during midadolescence. Teenagers with cognitive limitation may experience significant delays in developing this ability, or they may never develop it.
Low cognitive ability might also increase a young woman's need for peer acceptance and, therefore, make it difficult for her to resist male pressure for sex. Resisting sex would be especially difficult when age differences between partners compound developmental differences. For example, teenagers with borderline mental retardation experience a developmental delay of 2-4 years, and mildly retarded teenagers have a mental age that is roughly 5-8 years younger than their chronological age chron·o·log·i·cal age
n. Abbr. CA
The number of years a person has lived, used especially in psychometrics as a standard against which certain variables, such as behavior and intelligence, are measured. . Furthermore, it is not unusual for teenage females to have male sexual partners who are two or more years older than themselves. (14) Therefore, a cognitively impaired teenage female could be sexually involved with someone with a mental maturity four or more years her senior. This would make saying no or even resisting coercive sex very difficult.
In addition, low cognitive ability influences school success. Limited academic success reduces motivation to complete high school and further limits educational aspirations. Mildly retarded adolescents face significant barriers to meeting the requirements for graduation from high school with a standard diploma. Faced with such obstacles, and knowing that employment opportunities are limited, an adolescent female may see little, if any, advantage to remaining in school or postponing a pregnancy.
For these reasons, adolescent females with limited cognitive ability may willingly, or as a result of coercion, initiate sexual activity early, and they may not use contraceptives effectively or at all. Among women who do not have fertility problems, the result could be pregnancy and, in the absence of miscarriage miscarriage: see abortion.
or spontaneous abortion
Spontaneous expulsion of an embryo or fetus from the uterus before it can live outside the mother. or abortion, childbearing.
Directly testing this theoretical framework would require a study that included an assessment not only of cognitive ability, but also of the variables described above, such as understanding of the relationship between sexual activity and pregnancy or ability to resist male pressure. Such a study has not been conducted, but the National Longitudinal Survey of Youth (NLSY NLSY National Longitudinal Survey of Youth (USA) ) provides a unique and valuable opportunity to examine these issues. It is one of the few youth-based data sets that includes a measure of cognition cognition
Act or process of knowing. Cognition includes every mental process that may be described as an experience of knowing (including perceiving, recognizing, conceiving, and reasoning), as distinguished from an experience of feeling or of willing. , and it contains information on initiation of sexual activity and childbearing, as well as on relevant social and economic factors. While the NLSY data cannot address all the mechanisms by which low cognitive ability may influence early childbearing, they can be used to establish the existence of a relationship between cognitive ability and early childbearing.
DATA AND METHODS
The NLSY sample is a nationally representative cohort of 12,686 men and women who were aged 14-22 in 1979; participants were followed annually for 16 years. Our analyses are based on two NLSY components: a cross-sectional sample of more than 6,100 youth designed to represent the noninstitutionalized civilian segment of young people and a supplemental oversample of almost 5,300 civilian Hispanic, black and economically disadvantaged white youth.
We focused on data collected between 1979 and 1990 from the entire female sample of the NLSY cohort (N=6,283), and used a case-control design to study the 706 women who reported bearing a first child before their 18th birthday. We matched each of these women according to age, race and ethnicity, geographic region and urban-rural status to two women who did not have a child before age 18 (controls); * the resulting sample included 2,094 women aged 14-22 in 1979. A second, nested case-control study A nested case-control study is a type of study design where new case controls are applied into cohorts which were defined before the study begins.
Compared with case-control study, nested case-control study can reduce 'recall bias' and temporal ambiguity, and compared with design compared 333 early childbearers from the first study who had a second birth before their 20th birthday with 373 women who had only one birth during their teens.
Forty-three percent of women in the sample were black, 41% were white and 16% were Hispanic. Fourteen-year-olds and 22-year-olds each made up 5% of the sample; the remainder were evenly divided between ages 15-21. Nearly half (46%) of the women lived in the southern United States The Southern United States—commonly referred to as the American South, Dixie, or simply the South—constitutes a large distinctive region in the southeastern and south-central United States. , one-quarter lived in the North Central states and the rest were evenly divided between the West and the Northeast. The great majority (80%) lived in urban areas. Early childbearers and repeat early childbearers were similar with regard to age, race and ethnicity, and geographic location.
* Early childbearing. We considered women who had their first live birth before age 18 to have engaged in early childbearing. The rate of early childbearing was determined by dividing the sample by age at first birth: either before age 18 or afterward. We extracted the data related to this question from the NLSY data set for 1982-1990. Women who had their second birth before age 20 were considered to have engaged in repeat early childbearing.
* Cognitive ability. Between June and October of 1980, when the respondents were aged 15-23, more than 94% of the NLSY cohort completed the Armed Services Vocational Aptitude Battery The Armed Services Vocational Aptitude Battery (ASVAB) is a multiple choice test, administered by the United States Military Entrance Processing Command, used to determine qualification for enlistment in the United States armed forces. , a test designed by the U.S. military to measure 10 areas of knowledge and skill. As in previous studies using the NLSY data, (15) we based cognitive ability on a composite score derived from the sum of four of the 10 subtests: arithmetic reasoning, math knowledge, word knowledge and paragraph comprehension. Norms for the composite measure--the Armed Forces Qualifications Test (AFQT AFQT Armed Forces Qualification Test
AFQT Air Force Officers Qualifying Test ) score--are based on persons who are at least 17 years old; scores for younger respondents may not be psychometrically correct. However, a ranking of cognitive ability will be correct among respondents with the same birth year, even if they are younger than 17. To assure comparability of AFQT scores, the study design included matching respondents by age. *
We followed procedures developed by the Department of Defense to compute the composite AFQT standard scores and the resulting percentile percentile,
n the number in a frequency distribution below which a certain percentage of fees will fall. E.g., the ninetieth percentile is the number that divides the distribution of fees into the lower 90% and the upper 10%, or that fee level rankings in the NLSY data. Exploratory analysis of the cognitive ability percentile rankings revealed a large right-skewed distribution associated with oversampling Creating a more accurate digital representation of an analog signal. In order to work with real-world signals in the computer, analog signals are sampled some number of times per second (frequency) and converted into digital code. techniques in the NLSY study design. Hence, we used the percentile rankings only for descriptive analysis. For inferential in·fer·en·tial
1. Of, relating to, or involving inference.
2. Derived or capable of being derived by inference.
in analysis, we divided our study sample into quartiles that reflected the range of cognitive scores: The first quartile Quartile
A statistical term describing a division of observations into four defined intervals based upon the values of the data and how they compare to the entire set of observations.
Each quartile contains 25% of the total observations. includes the one-fourth of respondents corresponding to the first to 10th percentiles of cognitive scores for the NLSY sample (lowest cognitive ability); the second and third quartiles include the one-fourth corresponding to percentiles 11-24 and 25-48 for the overall sample, respectively; and the fourth quartile includes the one-fourth corresponding to percentiles 50-99 (highest cognitive ability).
* Reproductive and social variables. We examined the following reproductive and social variables associated with early childbearing: age at first sexual intercourse, participation in a sexuality education course, ability to correctly identify when pregnancy is most likely during the menstrual cycle menstrual cycle
The recurring cycle of physiological changes in the uterus, ovaries, and other sexual structures that occur from the beginning of one menstrual period through the beginning of the next. , educational expectations (as measured by the number of years of school respondents expected to attend), ([dagger]) poverty status and self-esteem. Poverty status was a dichotomous di·chot·o·mous
1. Divided or dividing into two parts or classifications.
2. Characterized by dichotomy.
di·chot measure based on a single item--family poverty status in 1978, when most respondents still resided in the parental home. Self-esteem was based on scores from the 10-item Rosenberg Self-Esteem Scale, administered to respondents in 1979. (16)
We examined the relationship between each explanatory variable and the two outcome variables to determine the strength of each and to identify variables to include in the multivariate analysis multivariate analysis,
n a statistical approach used to evaluate multiple variables.
n a set of techniques used when variation in several variables has to be studied simultaneously. . To examine the distributions of risk factors among women with and without teenage births, we used chi-square analysis for nominal and categorical That which is unqualified or unconditional.
A categorical imperative is a rule, command, or moral obligation that is absolutely and universally binding.
Categorical is also used to describe programs limited to or designed for certain classes of people. variables; continuous and ordinal (mathematics) ordinal - An isomorphism class of well-ordered sets. measures were examined with two sample t-tests. We conducted bivariate bi·var·i·ate
Mathematics Having two variables: bivariate binomial distribution.
Adj. 1. analyses using simple logistic models logistic models,
n.pl statistical models that describe the relationship between a qualitative dependent variable (that is, one that can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. for identified risk factors for early childbearing and for second birth before the age of 20; variables that were significant at p<.10 were included in the multivariate The use of multiple variables in a forecasting model. analyses. (17)
To examine the risk of early childbearing and to determine which factors, in the presence of the others, place a woman at highest risk for having a birth before age 18, we created multiple logistic regression In statistics, logistic regression is a regression model for binomially distributed response/dependent variables. It is useful for modeling the probability of an event occurring as a function of other factors. models using a backward elimination process; the final model included only variables that were significant at p<.10. Results are expressed as odds ratios and 95% confidence intervals confidence interval,
n a statistical device used to determine the range within which an acceptable datum would fall. Confidence intervals are usually expressed in percentages, typically 95% or 99%. . (18) We used the same procedures to examine the risk of having a second birth before the age of 20. After accounting for the main effects, we examined interactions between cognitive ability and each of the remaining explanatory variables. The statistical software package used for these analyses was SAS System (1) Originally called the "Statistical Analysis System," it is an integrated set of data management and decision support tools from SAS that runs on platforms from PCs to mainframes. for Windows, version 6.11. (19)
Early childbearers had significantly lower cognitive scores than controls: They ranked in the 22nd percentile for the NLSY sample overall, whereas controls ranked in the 37th percentile (Table 1). Two-thirds of early childbearers were in the two lowest quartiles of cognitive ability, but only 11% were in the highest quartile. The distribution of scores is even more disproportionate for repeat early childbearers: More than 70% of these women were in the two lowest quartiles, while only 7% of mothers with second early births were in the highest quartile.
Women who bore children early had consistently lower cognitive scores than women who delayed first birth, regardless of their age, race and ethnicity, and geographic location (not shown). Differences in percentile rankings ranged from about 10 to 20 points.
Early childbearers differed from controls on all reproductive factors (Table 1). Compared with women who did not have a birth before age 18, those with an early birth initiated sex at a younger age (15.2 vs. 17.5 years, on average), were less likely to report having had a sexuality education course (47% vs. 65%) and were less likely to correctly identify when during the menstrual cycle women are most fertile (25% vs. 36%).
The two groups of women also differed with respect to social factors. On average, women with early births expected to attend about two fewer years of school than their late-childbearing counterparts. Furthermore, a greater proportion of women with teenage births than of controls grew up in homes below the federal poverty level. Significant differences in age at first sex and educational expectations persisted when repeat early childbearers were compared with early childbearers who did not have a second birth during adolescence (Table 1).
Cognitive ability was significantly associated with all of the reproductive variables studied (Table 2). On average, women in the lowest quartile of cognitive ability initiated sex 1.4 years earlier than those in the highest quartile. Among those who had had a sexuality education course, a smaller proportion of women were in the first quartile than in the fourth quartile (20% vs. 28%); among women who correctly answered a question about pregnancy risk, the gap was even larger (14% vs. 43%).
Cognitive ability was also significantly associated with all of the social variables studied. More than two-thirds (68%) of the women living in poverty had cognitive scores in the first and second quartiles. On average, women in the highest quartile expected to have nearly three more years of schooling than those in the lowest quartile. Women in the highest quartile of cognitive ability also had slightly, but significantly, greater self-esteem scores than those in the lowest quartile (24.0 vs. 23.4).
The multivariate logistic regression model for predicting childbearing before age 18 included first, second and third quartile of cognitive ability; age at sexual initiation; having had a sexuality education course; being able to correctly answer a question about pregnancy risk; educational expectation; self-esteem score; and poverty status. Second and third quartiles of cognitive ability were included in the model as dummy variables This article is not about "dummy variables" as that term is usually understood in mathematics. See free variables and bound variables.
In regression analysis, a dummy variable to restrict the comparison to the reference group (fourth quartile) and the first quartile. Table 3 shows significant results of these analyses.
Women with low cognitive ability (as represented by the lowest quartile) and those living in poverty had increased odds of giving birth before age 18 (odds ratios, 2.0 and 1.8, respectively). Delaying initiation of sex, having had a sexuality education course and having relatively high educational expectations reduced the odds of early childbearing (0.4-0.8). Women with low cognitive ability had nearly three times the odds of those with high cognitive ability of having two births before age 20; postponement of sex and having higher educational expectations both reduced a woman's odds of having a second teenage pregnancy (0.7-0.9).
None of the possible interactions of the significant variables from the final logistic regression models were statistically significant. Poverty was the variable that most closely approached significance (p=.16) and was considered a possible effect modifier (programming) modifier - An operation that alters the state of an object. Modifiers often have names that begin with "set" and corresponding selector functions whose names begin with "get". . To examine this possibility, we stratified stratified /strat·i·fied/ (strat´i-fid) formed or arranged in layers.
Arranged in the form of layers or strata. the sample by poverty status. Being in the lowest quartile of cognitive ability remained a strong predictor of early childbearing among nonpoor women (odds ratio, 3.0), but not for women in poverty (Table 4).
Our results convincingly show that low cognitive ability increases an adolescent's odds of having an early birth. Two-thirds of women who had their first birth before age 18 had cognitive scores below the median of the entire NLSY sample. After we controlled for age, race and ethnicity, and geography, the percentile ranking The percentile rank of a score is the percentage of scores in its frequency distribution which are lower. For example, a test score which is greater than 85% of the scores of people taking the test is said to be at the 85th percentile. of cognitive scores of adolescent women with and without early births still differed by 10-20 points; these data support the findings of other studies. (20) Although these results suggest a relationship between low cognitive ability and early childbearing, clearly, further research is needed to determine who is at greatest risk: women with mild, moderate or severe cognitive deficits Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to cognitive performance. The term may describe deficits in global intellectual performance, such as mental retardation, or it may describe specific deficits in cognitive abilities .
We also found that women with low cognitive ability who have a first birth before age 18 have an increased risk of having a second before the age of 20. Nearly half of women with two teenage births had cognitive scores in the lowest quartile suggesting that low cognition is an even greater risk factor for second early births than for first births. The reason for the increased risk is not clear.
Most second teenage pregnancies occur among sexually active young women who do not use contraceptives even though they do not want to become pregnant. (21) Experiencing an unplanned pregnancy does not improve subsequent contraceptive behavior. (22) Cognitive ability may influence many critical aspects of decision-making that influence young women's sexual activity and contraceptive use. What many experts view as an unplanned action or consequence may, in fact, be caused by a young woman's inability to make an informed, reasoned decision after weighing personal risk. Further research is necessary to illuminate this potential pathway to second pregnancies among teenagers.
In addition to examining the effects of low cognitive ability on first and second teenage births, we looked at the relationship between cognitive ability and other, well-documented antecedents of early childbearing. Low cognitive ability was associated with several reproductive risk factors (early age at sexual initiation, lack of sexuality education and lack of knowledge about when during the menstrual cycle a women is most fertile) and social factors (educational aspiration, poverty and low self-esteem). These findings suggest that women with lower intellect are at increased risk of negative sexual outcomes. Consistent with these results, one study has indicated that as many as 68% of women with cognitive limitations will be sexually abused before the age of 18. (23) Other experts suggest that such women are more vulnerable to sexual exploitation because of their need for attention and acceptance. (24)
It is not clear from the data whether women with low cognition actually had less exposure to sexuality education or they were less likely to remember or effectively use the information they received. However, other research supports an association between low cognition and lack of sexuality education. Findings from a study of the information needs of people with cognitive limitations found that more than half wanted more information about contraception, dating and intimacy; one-third expressed a desire to know more about AIDS and pregnancy. (25) Although health education programs are rarely designed to take into account adolescents with cognitive limitations, (26) ensuring comprehensive sexuality education for such teenagers could help decrease sexual abuse among this population. (27)
Furthermore, our data show that as cognitive ability increased, so did young women's aspirations. Previous studies have shown a relationship between school experiences and adolescent pregnancy. (28) Having low educational aspirations and experiencing a pregnancy as an adolescent are among the most commonly observed markers of deviant behavior For the scholarly journal, see .
“Deviant” redirects here. For other uses, see Deviant (disambiguation).
Deviant behavior is behavior that is a recognized violation of social norms. Formal and informal social controls attempt to prevent or minimize deviance. associated with low intelligence and disadvantaged social status. (29) Clearly, cognitive ability influences school success, and success in school raises educational aspirations. If young women with low cognitive ability have minimal success in school, they may feel bad about themselves and about their futures. In this light, early childbearing may appear to them to be an appropriate and positive life choice.
This investigation had several limitations that warrant mention. Longitudinal data sets such as the NLSY have numerous inherent problems: For instance, a large amount of data is missing for some variables; our study excluded any variables that missed data for more than 10% of respondents. In addition, the respondents were adolescents in the late 1970s and early 1980s; different findings might be observed in a sample of today's adolescents. Another limitation is the difficulty of measuring cognitive ability and of interpreting or classifying an individual's level of cognition. It is not possible with any single measure to determine if an individual has a diagnosed cognitive limitation, such as mental retardation. Such determinations require assessment by a qualified professional and the use of adaptive behavior Adaptive behavior is a type of behavior that is used to adapt to another type of behavior or situation. This is often characterized by a kind of behavior that allows an individual to substitute an unconstructive or disruptive behavior to something more constructive. measures. Sample size limitations did not allow for analysis of race-specific or age-specific populations, further limiting the generalizability of the findings.
Interpretation of the effect of cognitive ability on poverty in the study population was problematic because of the degree of correlation between the two. It was not our intent to tease out the underlying causal relationship between low cognition and poverty; however, these characteristics were significantly associated with one another, as well as with early childbearing. More than two-thirds of women in the NLSY sample who lived in impoverished environments were also in the two lowest quartiles of cognitive ability. This finding supports studies showing that environments lacking in resources are positively associated with mild cognitive limitations and mental retardation. (30)
When the analysis was restricted to women not in poverty, the effect of low cognitive function increased. It is difficult to interpret the nonsignificance of the association between cognitive ability and teenage childbearing among poor women. One possible explanation is the degree of collinearity collinearity
very high correlation between variables. between age at sexual initiation and other variables. Another possibility is that other adverse factors that exist in low-income populations may overwhelm o·ver·whelm
tr.v. o·ver·whelmed, o·ver·whelm·ing, o·ver·whelms
1. To surge over and submerge; engulf: waves overwhelming the rocky shoreline.
a. the influence of cognitive ability.
Among women living above the poverty line, there may have been some residual confounding confounding
when the effects of two, or more, processes on results cannot be separated, the results are said to be confounded, a cause of bias in disease studies.
confounding factor as a result of income differences that could not be determined with the dichotomous measure of poverty used in this study. This was an unfortunate limitation of the data, which reduced our ability to measure variation in poverty status. In future studies, poverty might need to be measured differently, to address the natural variations that occur in this population. Nonetheless, the tripling of the risk between the first and fourth quartiles of cognitive ability hint at a dose-response relationship The Dose-response relationship describes the change in effect on an organism caused by differing levels of exposure (or doses) to a stressor (usually a chemical). This may apply to individuals (eg: a small amount has no observable effect, a large amount is fatal), or to populations , and suggest again that unknown factors within impoverished environments may mask the effects of low cognitive ability. This ambiguity may partially explain why the contribution of cognitive ability has been widely ignored in studies of adolescent pregnancy.
Yet another explanation may be that society has higher expectations of nonpoor women than of their poor counterparts. When these women cannot meet such expectations because of low cognitive function, they react negatively and, perhaps, seek recognition for something they can do (e.g., have a child at a young age). In any case, cognition and poverty are undoubtedly interrelated in·ter·re·late
tr. & intr.v. in·ter·re·lat·ed, in·ter·re·lat·ing, in·ter·re·lates
To place in or come into mutual relationship.
in . State-level studies reveal that 30-54% of adult recipients of Temporary Assistance for Needy Families Temporary Assistance for Needy Families (TANF, often pronounced "TAN-if") is the July 1, 1997, successor to the Aid to Families with Dependent Children program, providing cash assistance to indigent American families with dependent children through the United States Department of , including some with documented IQs in the slow learner and mild mental retardation range, have special learning needs. (31)
Significance of Findings for Practitioners
Our results have implications for practitioners who work with vulnerable adolescent populations. Individuals with mild cognitive limitations are expected to manage typical social roles with few or no specialized supports, and for the most part they succeed. However, if their learning needs go unrecognized, these individuals are at risk for outcomes that directly and negatively affect them and their children. Without appropriate support, they are unlikely to function appropriately in complex situations, such as when planning for and making major decisions, providing consent, accepting responsibility for their actions, protecting themselves from harm and finding themselves in roles that require complex learning skills and judgment. Adolescents with intellectual limitations have the same right as others to make choices about sexual activity, but they may not have the same capacity to comprehend the implications of sexual behavior sexual behavior A person's sexual practices–ie, whether he/she engages in heterosexual or homosexual activity. See Sex life, Sexual life. or the skills to fend off unwanted or coercive sex.
Teenage pregnancy prevention and educational programs are often based on social learning theories, which postulate postulate: see axiom. that behavior is based on the merging of internal perceptions with actual external events. Such programs are effective in helping adolescents to avoid problems and to promote their health. (32) Generally, teenagers respond best to instructional approaches that present peers as positive role models, or that use familiar vehicles such as rap songs or dance clubs to introduce information. (33) One study suggests, however, that this is not true for adolescents with mild cognitive limitations enrolled in special education classes: When peers were the instructors, these adolescents did not show gains in their posttest post·test
A test given after a lesson or a period of instruction to determine what the students have learned. scores, and in some instances, the posttest scores were lower than the pretest pre·test
a. A preliminary test administered to determine a student's baseline knowledge or preparedness for an educational experience or course of study.
b. A test taken for practice.
2. scores. (34) Specialized, individualized in·di·vid·u·al·ize
tr.v. in·di·vid·u·al·ized, in·di·vid·u·al·iz·ing, in·di·vid·u·al·iz·es
1. To give individuality to.
2. To consider or treat individually; particularize.
3. and concrete instruction is extremely important for students with cognitive limitations. These teenagers often exhibit problems with attention, perception, memory, problem-solving and logical thinking. They also are slower to learn than other youngsters and experience difficulty in applying previously learned information to new situations and problems. (35)
Many researchers have concluded that younger teenagers are at a disadvantage in assessing their personal risk of pregnancy because of their cognitive immaturity and limited ability to think abstractly. (36) Low cognitive ability may produce a similar, but more lasting disadvantage. Difficulties in seeing or recognizing consequences may result in the acquisition of a sexually transmitted disease sexually transmitted disease (STD) or venereal disease, term for infections acquired mainly through sexual contact. Five diseases were traditionally known as venereal diseases: gonorrhea, syphilis, and the less common granuloma inguinale, , including HIV HIV (Human Immunodeficiency Virus), either of two closely related retroviruses that invade T-helper lymphocytes and are responsible for AIDS. There are two types of HIV: HIV-1 and HIV-2. HIV-1 is responsible for the vast majority of AIDS in the United States. , or in unplanneckpregnancy. In addition, teenagers with low cognitive ability may engage in high-risk behaviors high-risk behavior Public health A lifestyle activity that places a person at ↑ risk of suffering a particular condition. See Safe sex practices. out of a desire to be like everyone else. (37)
The findings of this study are in accord with expert assertions that decreased developmental maturity in adolescence influences the amount of forethought fore·thought
1. Deliberation, consideration, or planning beforehand.
2. Preparation or thought for the future. See Synonyms at prudence. teenagers give to contraceptive use and educational accomplishments. (38) Low cognitive ability influences many of the critical aspects of decision-making and risk calculation that ultimately affect the choices that young women make about sex and contraception. Additional research is needed to examine the role of cognitive ability in adolescents' decision-making process regarding initiation of sexual activity and contraceptive use.
TABLE 1. Means (and standard deviations) and percentages reflecting cognitive, reproductive and social characteristics of women in case-control studies of early and repeat early childbearing, National Longitudinal Survey of Youth (NLSY), 1979-1990 Characteristic Early Cases Controls [chi square] (N=706) (N=1,383) or t Cognitive Mean score as NLSY percentile rank 21.6 (25.5) 37.0 (26.9) 15.0 *** % in first quartile 38.0 17.0 na % in second quartile 28.0 26.0 na % in third quartile 23.0 25.0 na % in fourth quartile 11.0 32.0 163.9 *** Reproductive Mean age at first sex (range, 9-26 yrs.) 15.2 (1.2) 17.5 (1.9) 32.2 *** % who had sexuality education 47.0 65.0 13.2 *** % with right answer to pregnancy question 25.2 36.4 26.6 *** Social Mean yrs. of expected schooling (range, 1-18) 12.1 (2.3) 14.1 (2.2) 18.8 *** Mean self-esteem score (range, 15-32) 23.7 (2.3) 23.8 (2.2) ns % in poverty 48.0 30.8 105.6 *** Characteristic Repeat Cases Controls [chi square] (N=336) (N=379) or t Cognitive Mean score as NLSY percentile rank 18.2 (16.8) 24.6 (20.0) 4.6 *** % in first quartile 46.0 32.0 na % in second quartile 26.0 29.0 na % in third quartile 21.0 25.0 na % in fourth quartile 7.0 15.0 21.6 *** Reproductive Mean age at first sex (range, 9-26 yrs.) 14.9 (1.2) 15.5 (1.1) 6.5 *** % who had sexuality education 43.9 49.9 ns % with right answer to pregnancy question 22.2 27.9 ns Social Mean yrs. of expected schooling (range, 1-18) 11.6 (2.3) 12.5 (2.2) 4.9 *** Mean self-esteem score (range, 15-32) 23.6 (2.4) 23.8 (2.3) ns % in poverty 57.4 51.8 ns *** p<.001. Notes: Early childbearing is defined as having a first birth before age 18; repeat early childbearing is defined as having a first birth before age 18 and a second birth before age 20. Percentages were compared through chi-square analyses, means through t-tests. na=not applicable. ns=not significant. TABLE 2. Means and percentage distributions reflecting women's reproductive and social characteristics, by quartile of cognitive score Characteristic First Second quartile quartile Reproductive Mean age at first sex (range, 9-26 yrs.) 16.0 16.6 % who had sexuality education 20.0 27.0 % with right answer to pregnancy question 14.0 19.0 Social Mean yrs. of expected schooling (range, 1-18) 12.1 13.0 Mean self-esteem score (range, 15-32) 23.4 23.7 % in poverty 39.0 29.0 Characteristic Third Fourth quartile quartile Reproductive Mean age at first sex (range, 9-26 yrs.) 16.7 17.4 % who had sexuality education 25.0 28.0 % with right answer to pregnancy question 24.0 43.0 Social Mean yrs. of expected schooling (range, 1-18) 13.7 14.9 Mean self-esteem score (range, 15-32) 23.9 24.0 % in poverty 20.0 12.0 Characteristic [chi square] or [r.sub.s] Reproductive Mean age at first sex (range, 9-26 yrs.) 0.24 *** % who had sexuality education 36.96 *** % with right answer to pregnancy question 191.4 *** Social Mean yrs. of expected schooling (range, 1-18) 0.41 *** Mean self-esteem score (range, 15-32) 0.09 *** % in poverty 201.6 *** *** p<.001. Note: Percentages were compared through chi-square analyses, means through Spearman rank correlation. TABLE 3. Odds ratios (and 95% confidence intervals) from logistic regression analyses reflecting the risk of early childbearing and of repeat early childbearing, by selected characteristics Characteristic Early Repeat Cognitive ability Fourth quartile (ref) 1.00 1.00 Third quartile 1.20 (1.10-1.40) * 1.20 (1.00-1.50) * Second quartile 1.20 (1.10-1.60) 1.30 (0.98-1.70) First quartile 2.00 (1.70-3.70) *** 2.90 (1.70-4.90) *** Age at first sex 0.38 (0.33-0.41) *** 0.67 (0.58-0.76) *** Sexuality education Yes 0.63 (0.48-0.79) *** ns No (ref) 1.00 ns Highest grade expected 0.80 (0.80-0.85) *** 0.88 (0.82-0.94) *** Lived in poverty Yes 1.80 (1.40-2.40) *** ns No (ref) 1.00 ns [R.sup.2] 0.39 0.10 * p<.05. *** p<.001. Notes: Early childbearing is defined as having a first birth before age 18; repeat early childbearing is defined as having a first birth before age 18 and a second birth before age 20. ns=not significant. ref=reference group. TABLE 4. Odds ratios (and 95% confidence intervals) from logistic regression analyses reflecting the risk of early childbearing, by selected characteristics, according to poverty status Characteristic Nonpoor Poor (N=1,216) (N=775) Cognitive ability Fourth quartile (ref) 1.00 1.00 Third quartile 1.30 (1.10-1.60) *** 1.00 (0.78-1.20) Second quartile 1.40 (1.10-1.80) ** 1.00 (0.70-1.30) First quartile 3.00 (1.70-5.10) *** 1.10 (0.60-2.10) Age at first sex 0.41 (0.36-0.47) *** 0.32 (0.27-0.39) *** Sexuality education Yes 0.66 (0.46-0.93) ** 0.61 (0.41-0.89) ** No (ref) 1.00 1.00 Highest grade expected 0.79 (0.73-0.86) *** 0.82 (0.75-0.90) *** [R.sup.2] 0.33 0.40 ** p<.01. *** p<.0001. Notes: Early childbearing is defined as having a first birth before age 18. na=not applicable. ref=reference group.
The authors would like to thank Carl Brezausek, Frank Mulvihill and Steve McClaskie for their assistance in conducting analyses and interpreting findings.
* Teenagers with IQs of 70-85 are considered borderline mentally retarded Noun 1. mentally retarded - people collectively who are mentally retarded; "he started a school for the retarded"
developmentally challenged, retarded , and those with IQs of 50-70 are defined as being mildly retarded.
* Poverty was not used as a case-control match variable, because it was an important predictor of both the independent and the dependent variables.
* The psychometric psy·cho·met·rics
n. (used with a sing. verb)
The branch of psychology that deals with the design, administration, and interpretation of quantitative tests for the measurement of psychological variables such as intelligence, aptitude, and properties of both the complete test and the AFQT are well documented, and the research suggests that differences in these scores predict performance in military and in civilian life (source: Bock Noun 1. bock - a very strong lager traditionally brewed in the fall and aged through the winter for consumption in the spring
lager beer, lager - a general term for beer made with bottom fermenting yeast (usually by decoction mashing); originally RD and Mislevy RJ, Data Quality Analysis of the Armed Services Vocational Aptitude Battery, Chicago: National Opinion Research Center, 1981; and Bock RD and Moore EGJ EGJ Esophagogastric junction, see there , Advantage and Disadvantage: A Profile of American Youth, Hillsdale, NJ: Lawrence Erlbaum Associates, 1986). The AFQT is highly correlated with a range of other cognitive tests Cognitive tests are assessments of the cognitive capabilities of humans and animals. Tests administered to humans include various forms of IQ tests; those administered to animals include the mirror test (a test of self-awareness) and the T maze test (which tests learning ability). , including the Wechsler, revised Wechsler and Stanford Binet. The magnitude of correlation between the AFQT and classic IQ tests is as high as or higher than the observed correlation of these traditional IQ tests with each other (source: Herrnstein RJ and Murray C, 1994, reference 15).
([dagger]) The NLSY collected little information on respondents' perceptions of and expectations for the future. The questions related to respondents' expectations for their educational future were asked in 1979. Given that educational expectations were measured at a different time than when birth of a first child was reported, we assume that this variable was differentially distributed in the sample. Independent of cognitive or childbearing status, responses may have differed, but not in a significant way.
(1.) Ventura SJ, Mathews TJ and Curtin SC, Declines in teenage birth rates, 1991-98: update of national and state trends, National Vital Statistics Reports, 1999, 47(26): 1-9.
(2.) Ahn N, Teenage childbearing and high school completion: accounting for individual heterogeneity het·er·o·ge·ne·i·ty
The quality or state of being heterogeneous.
the state of being heterogeneous. , Family Planning family planning
Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. Perspectives, 1994, 26(1):17-21; Baldwin W and Cain VS, The children of teenage parents, Family Planning Perspectives, 1980, 12(1):34-43; Grogger J and Bronars S, The socioeconomic consequences of teenage childbearing: findings from a natural experiment, Family Planning Perspectives, 1993, 25(4): 156-174; Mott FL and Marsiglio W, Early childbearing and completion of high school, Family Planning Perspectives, 1985, 17(5):234-237; and Nord CW et al., Consequences of teen-age parenting, Journal of School Health, 1992, 62(7):310-317.
(3.) Furstenberg FF, Jr., The social consequences of teenage parenthood, Family Planning Perspectives, 1976, 8(4): 155-164; Geronimus A and Korenman S, The socioeconomic consequences of teen childbearing reconsidered, Quarterly Journal of Economics The Quarterly Journal of Economics, or QJE, is an economics journal published by the Massachusetts Institute of Technology and edited at Harvard University's Department of Economics. Its current editors are Robert J. Barro, Edward L. Glaeser and Lawrence F. Katz. , 1993, 107(4):1187-1214; Moore KA et al., Age at first childbirth and later poverty, Journal of Research on Adolescence, 1993, 3(4):393-422; and Stevens-Simon C and Lowy R, Teenage childbearing: an adaptive strategy for the socioeconomically disadvantaged or a strategy for adapting to socioeconomic disadvantage? Archives of Pediatric pediatric /pe·di·at·ric/ (pe?de-at´rik) pertaining to the health of children.
Of or relating to pediatrics. and Adolescent Medicine adolescent medicine
The branch of medicine concerned with the treatment of youth between 13 and 21 years of age. Also called ephebiatrics, hebiatrics. , 1995, 149(8):912-915.
(4.) Baldwin W and Cain VS, 1980, op. cit. (see reference 2); Furstenberg FF, Jr., Brooks-Gunn J and Morgan SP, Adolescent mothers and their children in later life, Family Planning Perspectives, 1987, 19(4): 142-151; and Hardy JB et al., Long-range outcome of adolescent pregnancy, Clinical Obstetrics and Gynecology obstetrics and gynecology
Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. , 1978, 21(4):1215-1232.
(5.) Nord CW et al., 1992, op. cit. (see reference 2); Kalmuss DS and Namerow PB, The mediators of educational attainment Educational attainment is a term commonly used by statisticans to refer to the highest degree of education an individual has completed.
The US Census Bureau Glossary defines educational attainment as "the highest level of education completed in terms of the among early childbearers, paper presented at the Outcomes of Early Childbearing Conference, New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , 1992; and Polit DF and Kahn JR, Early subsequent pregnancy among economically disadvantaged teenage mothers, American Journal of Public Health The American Journal of Public Health (AJPH) is a peer reviewed monthly journal of the American Public Health Association (APHA). The Journal also regularly publishes authoritative editorials and commentaries and serves as a forum for the analysis of health policy. , 1986, 76(2):167-171.
(6.) Moore KA et al., Adolescent Sex, Contraception and Childbearing: A Review of Recent Research, Washington, DC: Child Trends, 1995; Forrest JD and Singh S For the fictional global crime syndicate, see .
Singh is a Sanskrit word meaning "lion". It is used as a common surname and middle name in North India by many communities, especially by the Sikhs and the Rajputs. , The sexual and reproductive behavior Reproductive behavior
Behavior related to the production of offspring; it includes such patterns as the establishment of mating systems, courtship, sexual behavior, parturition, and the care of young. of American women, 1982-1986, Family Planning Perspectives, 1990, 22(5):206-214; Furstenberg FF, Jr., et al., Race differences in the time of adolescent intercourse, American Sociological Review The American Sociological Review is the flagship journal of the American Sociological Association (ASA). The ASA founded this journal (often referred to simply as ASR) in 1936 with the mission to publish original works of interest to the sociology discipline in general, new , 1987, 52(4):511-518; Leigh BC et al., Sexual behavior of American adolescents: results from a U.S. national survey, Journal of Adolescent Health, 1994, 15(4):117-125; and Miller BC and Bingham CR, Family configuration in relation to the sexual behavior of female adolescents,Journal of Marriage and the Family 1989, 51(2):499-506.
(7.) Hogan DP and Kitagawa EM, The impact of social status, family structure, and neighborhood on the fertility of black adolescents, American Journal of Sociology Established in 1895, the American Journal of Sociology (AJS) is the oldest scholarly journal of sociology in the United States. It is published bimonthly by The University of Chicago Press.
AJS is edited by Andrew Abbott of the University of Chicago. , 1985, 90(4):825-855; Mott FL and Marsiglio W, 1985, op. cit. (see reference 2); Singh S and Darroch JE, Trends in sexual activity among adolescent American women: 1982-1995, Family Planning Perspectives, 1999, 31(5):212-219; and Upchurch DM et al. Gender and ethnic differences in the timing of first sexual intercourse, Family Planning Perspectives, 1998, 30(3):121-127.
(8.) Kleinfeld LA and Young RL, Risk of pregnancy and dropping out of school among special education students,Journal of School Health, 1989, 59(8):359-361; and Levy SR et al., Reducing the risks of pregnant teens who are very young and those with mild mental retardation, Mental Retardation, 1992, 30(4):195-203.
(9.) Halpern CT et al., Smart teens don't have sex (or kiss much either), Journal of Adolescent Health, 2000, 26(3):213-225.
(11.) Kasen S, Cohen cohen
(Hebrew: “priest”) Jewish priest descended from Zadok (a descendant of Aaron), priest at the First Temple of Jerusalem. The biblical priesthood was hereditary and male. P and Brook JS, Adolescent school experiences and dropout (1) On magnetic media, a bit that has lost its strength due to a surface defect or recording malfunction. If the bit is in an audio or video file, it might be detected by the error correction circuitry and either corrected or not, but if not, it is often not noticed by the human , adolescent pregnancy, and young adult deviant behavior, Journal of Adolescent Research, 1998, 13(1):49-72.
(12.) Jenson AR, The g Factor: The Science of Mental Ability, Westport, CT: Praeger, 1998.
(13.) Pack RP, Wallander JL and Browne D, Health risk behaviors of African American African American Multiculture A person having origins in any of the black racial groups of Africa. See Race. adolescents with mild mental retardation: prevalence depends on measurement method, American Journal on Mental Retardation, 1998, 102(4):409-420; Shearer DL and Wallander JL, unpublished data, Civitan International Research Center, University of Alabama at Birmingham UAB began in 1936 as the Birmingham Extension Center of the University of Alabama. Because of the rapid growth of the Birmingham area, it was decided that an extension program for students who had difficulties which prevented them from studying in Tuscaloosa was needed. : Birmingham, AL, 2000.
(14.) Leigh BC et al., Sexual behavior of American adolescents, 1994, op. cit. (see reference 6).
(15.) Moore KA and Snyder NO, Cognitive attainment among firstborn first·born
First in order of birth; born first.
The child in a family who is born first.
Noun 1. firstborn - the offspring who came first in the order of birth
eldest children of adolescent mothers, American Sociologic Review, 1991, 56(5):612-624; Herrnstein RJ and Murray C, The Bell Curve: Intelligence and Class Structure in American Life, New York: Free Press, 1994; and Rodgers WM and Spriggs WE, What does the AFQT really measure: race, wages, schooling and the AFQT score, Review of Black Political Economy, 1996, 24(Spring): 13-46.
(16.) Rosenberg M, Society and Adolescent Self-Image, Princeton, NJ: Princeton University Princeton University, at Princeton, N.J.; coeducational; chartered 1746, opened 1747, rechartered 1748, called the College of New Jersey until 1896. Schools and Research Facilities
(17.) Hosmer DW and Lemeshow S, Applied Logistic Regression, New York: John Wiley John Wiley may refer to:
(19.) SAS Institute SAS Institute Inc., headquartered in Cary, North Carolina, USA, has been a major producer of software since it was founded in 1976 by Anthony Barr, James Goodnight, John Sall and Jane Helwig. , SAS (1) (SAS Institute Inc., Cary, NC, www.sas.com) A software company that specializes in data warehousing and decision support software based on the SAS System. Founded in 1976, SAS is one of the world's largest privately held software companies. See SAS System. Procedures Guide, Release 6.03 Edition, Cary, NC: SAS Institute, 1988.
(20.) Kleinfeld LA and Young RL, 1989, op. cit. (see reference 8); and Levy SR et al., 1992, op. cit. (see reference 8).
(21.) Seitz V and Apfel NH, Adolescent roothers and repeated childbearing: Effects of a school-based intervention program, American Journal of Orthopsychiatry or·tho·psy·chi·a·try
The psychiatric study, treatment, and prevention of emotional and behavioral problems, especially of those that arise during early development. , 1993, 63(4):572-581.
(22.) Orcutt HK and Cooper ML, The effects of pregnancy experience on contraceptive practice, Journal of Youth and Adolescence, 1997, 26(6):763-778; and Rigsby DC, Macones GA and Driscoll DA, Risk factors for rapid repeat pregnancy among adolescent mothers: a review of the literature,Journal of Pediatric and Adolescent Gynecology, 1998, 11(3):115-126.
(23.) Senn CY, Vulnerable: Sexual Abuse and People with an Intellectual Handicap, North York, Ontario North York forms the central part of the northern half of Toronto, Ontario, Canada. As of the 2006 Census, it has a population of 624,610. The official 2001 census count was 608,288. , Canada: G. Allan Roeher Institute, 1988.
(24.) Krents E, Schulman V and Brenner S Brenner might refer to:
(25.) Whitehouse MA and McCabe MP, Sex education programs for people with intellectual disability: how effective are they? Education and Training in Mental Retardation and Developmental Disabilities developmental disabilities (DD),
n.pl the pathologic conditions that have their origin in the embryology and growth and development of an individual. DDs usually appear clinically before 18 years of age. , 1997, 32(3): 229-240.
(26.) Pack RP, WallanderJL and Browne D, 1998, op. cit. (see reference 13).
(27.) Corbett K, Klein SS and Bregante JL, The role of sexuality and sex equity in the education of disabled women, Peabody Journal of Education, 1987, 64(4):198-212; and Krents E, Schulman V and Brenner S, 1987, op. cit. (see reference 24).
(28.) Kasen S, Cohen P and BrookJS, 1998, op. cit. (see reference 11).
(29.) Cairns Cairns, city (1991 pop. 64,463), Queensland, NE Australia, on Trinity Bay. It is a principal sugar port of Australia; lumber and other agricultural products are also exported. The city's proximity to the Great Barrier Reef has made it a tourist center. RB, Cairns BD and Neckerman HJ, Early school dropout: configurations and determinants, Child Development, 1989, 60(6): 1437-1452.
(30.) Martin SL, Ramey CT and Ramey $L, The prevention of intellectual impairment in children of impoverished families: findings ora randomized ran·dom·ize
tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es
To make random in arrangement, especially in order to control the variables in an experiment. trial of educational day care, American Journal of Public Health, 1990, 80(7):844-847; and Stoneman Z, Conceptual relationships between family research in mental retardation, in: Bray NW, ed., International Review of Research in Mental Retardation, Volume 16, New York: Academic Press, 1990, pp. 161-202.
(31.) Spitalnik DM and White-Scott S, Access to health services health services Managed care The benefits covered under a health contract : improving the availability and quality of health services for people with mild cognitive limitations, in: Tymchuk AJ, Lakin KC and Luckasson R, eds., The Forgotten Generation, Baltimore: Paul H. Rookes Publishing, 2001, pp. 203-220.
(32.) Johnson G, Johnson RL and Jefferson-Aker CR, HIV/AIDS HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome prevention: effective instructional strategies for adolescents with mild mental retardation, Teaching Exceptional Children, 2001, 33(6):28-32.
(33.) Schinke SA et al., African-American and Hispanic-American adolescents, HIV infection and preventive intervention, AIDS Education and Prevention, 1990, 2(4):305-311.
(34.) Johnson GF and Johnson RL, Peer initiated materials and activities to educate adolescents about HIV and AIDS prevention, The Researcher, 1997, 15:35-43.
(35.) Johnson G, Johnson RL and Jefferson-Aker CR, 2001, op. cit. (see reference 32).
(36.) Cobliner WG, Prevention of adolescent pregnancy: a developmental perspective, in: McAnarney ER and Stickle stick·le
intr.v. stick·led, stick·ling, stick·les
1. To argue or contend stubbornly, especially about trivial or petty points.
2. To have or raise objections; scruple. G, eds., Pregnancy and Childbearing During Adolescence: Research Priorities for the 1980s, New York: Alan R. Liss, 1981; Hayes CD, ed., Risking the Future: Adolescent Sexuality, Pregnancy and Childbearing, Volume 1, Washington, DC: National Academy Press, 1987; and McAnarney ER and Schreider C, eds., Identifying Social and Psychological Antecedents of Adolescent Pregnancy: The Contribution of Research to Concepts of Prevention, New York: William T. Grant Foundation, 1984.
(37.) Spitalnik DM and White-Scott S, 2001, op. cit. (see reference 31).
(38.) Cobliner WG, Pregnancy in the single adolescent girl: the role of cognitive functions,Journal of Youth and Adolescence, 1974, 3(1):17-29; Gordon DE, Formal operational thinking: the role of cognitivedevelopmental processes in adolescent decision-making about pregnancy and contraception, American Journal of Orthopsychiatry, 1990, 60(3):346-536; and Moore KA et al., 1995, op. cit. (see reference 6).
Author contact: firstname.lastname@example.org
At the time the research presented in this article was completed, Darlene L. Shearer was associate director and adjunct professor, Civitan International Research Center, University of Alabama at Birmingham. Beverly A. Mulvihill is assistant professor of maternal and child health, School of Public Health; Jan L. Wallander is professor, Civitan International Research Center; Mary E. Hovinga is associate professor of epidemiology, School of Public Health; and David T. Redden red·den
v. red·dened, red·den·ing, red·dens
To make red.
1. To become red.
2. To blush. is assistant professor of biostatistics biostatistics /bio·sta·tis·tics/ (-stah-tis´tiks) biometry.
The science of statistics applied to the analysis of biological or medical data. , School of Public Health--all with the University of Alabama at Birmingham. Lorraine V. Klerman is professor at the Heller School for Social Policy and Management The Heller School for Social Policy and Management is one of the three graduate schools of Brandeis University.
The School was founded in 1959 as the University's first professional school. The Heller school offers the degrees of M.A. , Brandeis University Brandeis University, at Waltham, Mass.; coeducational; chartered and opened 1948. Although Brandeis was founded by members of the American Jewish community, the university operates as an independent, nonsectarian institution. , Waltham, MA.