Bridging the gaps: children in a changing society.

At the 1985 Annual ACEI Conference in San Antonio, I discussed societal gaps in the care and education of children. Children and youth were rebelling against traditional norms of social behavior, becoming increasingly alienated from parents and teachers; too many were failing in school. Politicians concluded that teachers and teachers of teachers were at fault; the schools were "failing our young," they said. Parents questioned our commitment; governors and legislators questioned our competence; popular media depicted us as absent-minded, bungling, comical, and incompetent (Frost, 1986). This article continues the discussion about the gaps, but also describes ways to bridge the gaps to reach children's hearts and minds.

Let us examine one example of why schools are "failing the young." An amusing yet telling Internet story making the rounds describes a purported message on a school answering machine. The school and teachers are being sued by parents who want their children's failing grades changed to passing grades even though the children had excessive absences during the school year and did not complete their work.

"Hello. You have reached the automated answering service of your school. In order to assist you in connecting to the right staff member, please listen to all your options before making a selection: To lie about why your child is absent--Press 1. To make excuses for why your child did not do his work--Press 2. To complain about what we do--Press 3. To swear at staff members--Press 4. To ask why you didn't get information that was already enclosed in your newsletter and in several flyers mailed to you--Press 5. If you want us to raise your child--Press 6. If you want to reach out and touch, slap, or hit someone--Press 7. To request another teacher for the third time this year--Press 9. To complain about school lunches Press (). If you realize this is the real world and your child must be responsible for his or her behavior, class work, and homework, and that your children's lack of effort is not the teacher's fault, hang up and have a nice day!"

I contended in 1985 that the problems affecting children and their education go beyond teachers and schools. The child rearing gaps widely documented in the 1980s actually began in the 1950s and 1960s as Americans struggled with the relative values of traditionalism-merit, competition, self-restraint, self-discipline, family stability, and moral universals--and those of modernism--sensual gratification, self-expression, multiple family forms, and ethical relativism. Parents and teachers were making demands that reflected the virtues of traditionalism while their own actions modeled the vices of modernism. These profound trends in society have been remaking the world.

GAPS IN CHILD REARING

In the 1980s, the rapidly growing gaps in the lives of children included family disruption due to divorce, teen pregnancy, single-parent families, extended parent absence, child abuse, lack of quality child care outside the home, excessive television watching, changing sexual mores, violence, and illicit drug use. Two decades later, these societal gaps are still evident. While some have leveled off or even narrowed, others have continued to grow (Federal Interagency Forum on Child and Family Statistics, 2002). Then and now, the bridges needed to close these gaps are as much matters of the heart as they are matters of the mind. What are the gaps of hearts and minds that continue to broaden? What bridges are still needed?

The Child Obesity Gap

An insidious disease has crept up on Americans, now claiming more than 300,000 lives each year (more than doubling its victims over the past decade), and is rapidly overtaking smoking as the leading preventable cause of death. This disease is readily recognizable and easily diagnosed, even by children. For most, it can be prevented without drugs, surgery, or skilled therapy. When this disease originates during childhood, it almost invariably gets worse with age. In most cases it can be reversed, but tends to become permanent over time. It is caused by conditions at home and at school that are understood and recognized but widely ignored by parents, teachers, school boards, and politicians. This disease tends to run in families. Only rarely is a child the only victim within a family; at least one parent usually has the same condition.

This disease is obesity. In almost all cases it can be prevented or may be cured merely by choosing healthful foods and improving exercise habits. Obesity is closely linked to growing patterns of sedentary activity (e.g., watching television and playing video games at home), deletion of recess and physical education at school, and a growing reliance on junk food, fast food, and "eat all you can hold" restaurants.

About 65 percent of American adults and 20 to 30 percent of children are overweight or obese. As this is being written, a full-page article appears in my local newspaper about a war epic, The Alamo, being filmed in Texas. Five hundred lean, mean men were needed to fill costumes based on military uniforms from 1836; despite three months of publicity, cash offers, and hundreds of applications and auditions, however, not enough men have been found. They cannot fit into the uniforms of that era or look and perform like soldiers.

Overweight children are at risk for type 2 diabetes, liver disease, cancer, and later heart disease. They frequently develop low self-esteem and social withdrawal because of teasing by their peers and their inability to perform physical skills easily accomplished by other children. Our recent research into motor skill development on playgrounds indicates that the only 3-, 4-, and 5-year-old children who could not traverse the overhead ladder, hanging by their arms, after three weeks of practice were the obese ones (Frost, Brown, Thornton, Sutterby, & Therrell, 2001; Frost & Kim, 2000). Obese elementary schoolchildren tend to be isolated on playgrounds, shunned by their thinner agemates, and not welcomed into competitive games; thus, they are increasingly deprived of physical activity.

At home after school, children waiting for parents to come home from work raid the refrigerator for junk food and settle down for an afternoon of television and video games, having been warned against going out in the neighborhood without their parents. Schools, facing growing demands for standardized testing and accountability, eliminate recess and reduce physical education, and they augment limited funds with revenue from sugar water (soda) machines. Florida's creative solution to the fitness problem is to allow high school students to substitute online nutrition and fitness classes for gym classes--perhaps while eating a Big Mac ("Getting virtually fit," 2003).

The Standardized Testing Gap

The high-stakes (win or lose, pass or fail) testing chasm also must be bridged. This illogical and harmful gap is remodeling the nation's schools into academic factories--factories that sort both children and teachers into "winners" and "losers" and grade children like chickens on the assembly line going to market. On January 25, 2003, Texas teachers, professors, and parents marched on the state capitol building, protesting the pandemonium in children's, parents', and teachers" lives brought about by testing. More than a decade ago, Texas began requiring competency testing for both teachers and students. Blaming public schools and universities for failing to properly educate children and teachers, Texas politicians in 1987 outlawed all education degrees in the state; in 2001, Texas mandated even more stringent tests and even more punishing results for failure.

Now high-stakes testing has gone national. The re-authorized Elementary and Secondary Education Act was signed into law in December 2001. This Act proposes that every student in grades 3 through 8 will be proficient in reading and math. High-stakes tests are considered a way to hold schools accountable and ensure that 100 percent of the nation's students will become proficient (as measured by the tests) in 12 years.

In response to the federal plan to test every child in grades 3 through 8, five education associations convened the Commission on Instructionally Supportive Assessment. The Commission's chairman stated, "There is no doubt that the kinds of tests being used in today's state accountability programs--mandated standardized achievement tests--are causing educational harm, perhaps irreparable harm, to thousands of American children" (Popham, 2002, p. 21).

Texas is now implementing even tougher tests (Martinez, 2002). The new high-stakes tests will determine who will be promoted to the next grade and who will fail. School officials predict that one-third of Texas' 3rd-grade children will fail the first test and risk retention and failure, even if they have earned As in their classes. Those who fail will be subjected to the additional anxiety of special drill classes and required to take the test again. If they fail the test three times, they will be retained in grade to begin the process all over again.

Even kindergartners are feeling the testing heat. Five-year-olds from California to Florida wet their pants, put their heads on their desks in exhaustion, and act out as they prepare for and take standardized tests (Brandon, 2002). Now in 2003 ("Head Start resists efforts," 2003), the most successful program from the Johnson era is under threat from high-stakes testing initiated by the White House as the Administration moves to shift the responsibility of Head Start to cash-strapped states. The President has proposed using a national skills test of 4-year-olds to identify low-performing programs. Test-driven reforms set the unrealistic expectations that all child ten will learn to read by the end of kindergarten and will pass tests of questionable validity. Professional objection to high-stakes testing has prevailed for more than a quarter century. In 1976, the Association for Childhood Education International (ACEI) and the National Association of Elementary School Principals (NAESP) issued a position paper calling for a moratorium on standardized testing in the early years of schooling (ACEI & NAESP/Perrone, 1976). The National Association for the Education of Young Children (NAEYC, 1988) and other organizations also developed position papers outlining the negative consequences of high-stakes testing.

The publication of A Nation at Risk in 1983 (National Commission on Excellence in Education, 1983) led to rapid expansion of testing in kindergarten and the early grades, leading to further deleterious results, particularly for poor and minority children (ACEI/ Perrone, 1991). By 1990, 16 states and districts in 21 other states required passing scores on a standardized test for graduation from kindergarten (National Commission on Testing and Public Policy, 1990), Two decades later, a follow-up study, "Our Schools and Our Future: Are We Still at Risk?" (2003), concludes that students are still failing in school. Standards-based reform has not achieved its potential, yet the authors of the report propose even tougher standards, tougher accountability, and more testing.

The writers of the 1991 ACEI position paper on standardized testing concluded: "To continue such testing in the face of so much evidence of its deleterious effects, in opposition to most of what we know about the developmental needs of young children, is the height of irresponsibility" (ACEI, 1991, p. 9). Standardized testing results in increased pressure, lowered self-esteem, and devastating failure for many. The testing does not provide useful information about individual children, and it leads to harmful tracking and labeling. Testing wastes precious teacher and child time preparing for tests, and limits the attention given to educational and developmental needs such as the arts, physical education, play, and recess. The testing limits higher order thinking skills and reading for meaning through focus on worksheets and skills.

Two studies by Arizona State University researchers (Amrein & Berliner, 2002a, 2002b) have confirmed the drawbacks of such testing. Data from 28 states already using high-stakes testing show that the recent national No Child Left Behind legislation and the planned massive testing programs may be counterproductive. In states implementing high-stakes testing, academic achievement, ACT scores, SAT scores, and AP scores all declined. The researchers found higher rates of retention and suspension, more teachers teaching to the tests, increased flight of teachers, increased cheating by teachers and other school employees, and reduced offerings in art, music science, social studies, and physical education.

The tests have become the stimulus for practices examined and discarded as detrimental years ago: homogeneous grouping; tracking; extensive drill; workbooks; teaching to the test; narrowing the curriculum to the three Rs; restriction of cooperative learning; reduction of the arts, play, and physical education; and predetermined expectations. Cash-strapped Texas is proposing purchasing only those textbooks that correlate with the mandated tests and some cities are proposing cutting teachers in fine arts and physical education and making classes larger (Martinez, 2003).

The advocates of high-stakes testing point to Japan's schools as models of efficiency, pointing to their students' high respect for teachers and outstanding test scores. But Tina Cross (2002), a Fulbright scholar studying in Japan, revealed the downside of pursuing test scores at the expense of other important areas, such as creativity and originality. The children who bow so politely as class begins routinely fall asleep during class and ignore the teacher. Long hours in after-hours "cram schools" leave children exhausted and bored. Japanese principals, teachers, board members, and parents express deep concern about the stresses of testing, lack of creativity, and mediocrity outside of test performance. Realizing their high-stakes testing is not working, the Japanese are modifying their system to emphasize creativity and originality as well as test scores. Meanwhile, American schools are catapulting themselves into the disastrous practices the Japanese are abandoning.

High-stakes testing defies everything we know about child development. How can we believe, much less accept, that one standard test can adequately measure a child's potential? That one test can grade and classify all children? That one test can determine who passes and who is retained, who succeeds and who fails? That one test can tap the resources, the creativity, the motivation, the persistence, the potential of any child? To those who believe tests are the answer to the growing gaps in children's lives, I have this warning: Don't walk slowly through the woods, the squirrels will eat you--you're nuts!

The Pill Generation Gap

A third pressing gap that must be bridged is the pill gap. The number of children using psychiatric drugs prescribed by physicians has skyrocketed over the past 15 years, a rate that has more than tripled since 1987 (Mowbray, 2003; Zito et al., 2003). Mind-altering drugs such as Ritalin and anti-depressants are increasingly sought by teachers and parents as a quick-fix for problem children with some suspected affliction--attention deficit disorder is in vogue. While some children do need and benefit from prescription drugs, doctors commonly diagnose and prescribe with little or no diagnostic data to distinguish between children with genuine behavior disorders and those who simply fidget too much or misbehave in class.

Many medicated children have no disease. Tough love; consistent discipline; clear expectations; reasonable schedules; a balanced schedule of play, rest, and work; and adult attention and counseling may be all that is needed. Not having the time or support to employ such methods, overworked parents and pressured teachers turn to the quick-fix of highly addictive drugs. Schools all over the country monitor drug use by students, not to limit unnecessary medication, but rather to ensure that misbehaving or rowdy children are doped. This pattern is so common that lawmakers in Vermont last year introduced legislation to prevent schools from requiring children to take medication (Mowbray, 2003). Now, prescription drug use by children equals that by adults, and medicated children tend to become medicated adults. How will the next generation of doped adults deal with their children?

The Child Crime and Violence Gap

We also must commit to bridging the child violence gap. Distressed by the absence of one or both parents; jaded by daily hours of violent television and video games; stressed out and throwing up over tests and threats of failure in school; exhausted from extended academic drills; worried about war, terrorism, and evil adults--children arrive at school in no mood to sit and listen.

Two national violence commissions and an overwhelming number of social scientists, having conducted 50 studies of 10,000 children, have arrived at one conclusion: Violence on television breeds aggression in children. A long-term study by researchers at the University of Michigan's Institute for Social Research concludes that boys and girls who watch a lot of violence on television are more aggressive as adults, no matter how they acted in childhood ("Research links adult aggression," 2003).

In Philadelphia during the first four months of 2001, one kindergartner was suspended from school. During the first four months of 2002, with the goal of getting parents involved, 33 kindergartners were suspended for such infractions as hitting a pregnant teacher, indecent exposure, and stabbing a classmate with a pencil. In Connecticut, during the 1999-2000 school year, 311 kindergartners were suspended: 79 percent boys, three-quarters of them from the lowest socio-economic class (Dale, 2002). In California from 1995 to 2001, school crimes such as assault against persons nearly doubled. Elementary school principals and safety experts are seeing more violence and aggression than ever before among their youngest children. Some of the most violent offenders are in kindergarten, 1st, and 2nd grade (Toppo, 2003).

The Morals/Ethics Gap

Following the publication of my 1985 San Antonio ACEI address in Childhood Education (Frost, 1986), I received a letter from Professor Selma Wassermann of Simon Fraser University in British Columbia. She stated that she found the article "one of the most stunning ... and heart-breaking pieces she had ever read." She suggested another issue of concern: the cheating, lying, and stealing by elected representatives and leaders of industry. Some are charged and go to jail; some are charged and get "excused"; some are never charged. Are these appropriate "models" for our children?

Almost two decades later, Wassermann's concerns are even more critical. We see almost daily charges against CEOs and elected officials for graft, deceit, and theft. These trends send a disturbing message to our children and youth. The Josephson Institute of Ethics' 2002 Report Card on the Ethics of American Youth (2003) is a nationwide study of the ethical behavior of 12,000 high school youth. The number admitting to cheating on one or more exams during the past year increased from 61 percent in 1992 to 74 percent in 2002; the number who stole from a store rose from 31 percent in 1992 to 38 percent in 2002. Lying to parents increased from 83 percent to 93 percent, and 37 percent said they would lie to get a good job. A willingness to cheat has become the norm for children who will become future executive, politicians, parents, teachers, and nuclear inspectors.

The International Gaps

Finally, we must commit ourselves to bridging the gaps between the haves and the have-nots. Chasms of a staggering scope exist in developing countries for which we have obligations. These include war, homelessness, HIV/AIDS, poverty, illiteracy, infanticide, the sale of children, child prostitution, child pornography, and starvation--all gaps that overshadow in their magnitude and severity those faced by children of the industrialized world.

There is good news and bad news on the international scene. Since 1990, 28 million fewer children under 5 have died each year, due largely to immunizations and family and community efforts. In developing countries, 28 million fewer children suffer from malnutrition. Despite these gains, more than 10 million children died from preventable diseases, 600 million still live in poverty, and 100 million, mostly girls, do not go to school (United Nations Children's Fund, 2002, p. 6).

BRIDGING THE GAPS

When one carefully studies the problems that beset American children, some striking relationships appear. Given the pressures on teachers, parents, and children, it is no wonder that teachers are leaving the profession in unprecedented numbers and parents are turning to psychiatric drugs to get their children through school. Teachers can't stand the kids anymore and kids can't stand the stress. Along with the growing epidemic of obesity and related diabetes and heart disease, we see almost 3 million children and teens struggling with acute depression (Wingert & Kantrowitz, 2002). Until recently, these diseases were considered by doctors t be strictly adult problems. What has changed?

Consider the everyday stresses of disintegrating families; disappearing time for free, creative play and relaxation; self-monitoring of diet; children and teachers alike stressed over the threats of test failure. A picture begins to develop of an adult society that is out of touch with their children, dedicated to the simplistic and unfounded belief that one size fits all in the education and assessment of children, and looking for easy fixes through the miracle of chemistry. Now, we must attend to bridging these gaps.

Adults Taking Responsibility

Adults, not children, control the prevention and the cure for obesity. The cure is a "no-brainer'--a healthful diet and regular physical activity--yet evasive because the disease is addictive. The more junk food the body gets, the more junk food the brain wants. Prevention and cure also require that parents and teachers be good models and teach children about nutrition and the effects of obesity. Basic nutrition instruction and practice at home and in school cafeterias means reading and heeding labels, avoiding certain areas of supermarkets, placing fast food venues off limits, replacing bad foods with good foods, cutting down portion sizes, and increasing consumption of fruits and vegetables while decreasing that of sugar and fat. These are matters of the mind--children can be taught that a balanced diet does not mean having a cookie in each hand.

The second part of the solution is also very simple--get children active. Break up the school day with periods of aerobic activity--with free play on well-equipped playgrounds every day and physical education with well-trained instructors every day. Parents can encourage children to play outside every day at home (skating, shooting hoops, dancing, jumping rope, riding bicycles, playing tennis, swimming, playing ball games in the neighborhood); involve children in active organized sports; and participate in physical activities as a family. And, yes, we can even introduce children to responsible physical work: assisting with house and yard tasks, cleaning up their own messes, planting gardens, and assisting with charitable work. Parents and teachers must play an active role in combating the obesity epidemic. Adults--parents and teachers--must bridge this gap.

Politicians also must do their part in reshaping the dietary and exercise patterns of American children. Currently, Washington proposes conflicting programs that cost millions yet place children and schools in a no-win dilemma. The President and Congress initiated a national "No Child Left Behind" program of high-stakes testing and academic rigor. Such programs result in reduction of time and loss of teachers for recess, physical education, art, music, and special education. The nation's cash-strapped schools choose passing t the tests over the so-called "frills." Simultaneously, the U.S. Department of Health and Human Services (Roser, 2003) rolls out a conflicting $125 million plan by the President for a new "healthy cities" initiative focusing on diet and exercise.

Sharing Responsibility

Teachers cannot teach children unless parents are raising them. Parents cannot raise their children unless schools are teaching them. Schools cannot develop creative, individualized, fun yet profound, challenging curricula unless school boards and politicians stop using them as pawns and as their agents for implementing misinformed school reforms, siphoning growing millions of dollars from already meager budgets.

Fifteen years ago (Frost, 1988), I wrote the following:

At the present time, American schooling, according to various national reports, is involved in an "education crisis." Children, the reports say, are unruly and failing in school. Essentially, they believe that teachers and those [who] train teachers are to blame. Consequently, politicians, education agencies and administrators are jumping through hoops to establish "educational reforms."

A fundamental issue in this context is cause. It is assumed If that because children are failing, the teachers and teachers of teachers are at fault. The research, supporting a radically different conclusion, is far more compelling, children are in trouble primarily because the American family base and, consequently, the moral and ethical foundations of education have eroded. This family base includes variables of divorce, poverty, television, drugs, etc. and is extensively documented. The current dominant emphasis on reforming the school, without equivalent attention to reforming the family, will be one of our greatest historical disappointments. The simple, unalterable fact is that children who arrive at school from disrupted families will continue to have trouble in school--despite the reforms. High-stakes testing has already failed [inserted 2-13-03]. History will judge us harshly for failing to recognize this. (pp. 36-37)

Caring for Others

Let us commit ourselves and teach our children to strive for a healthier and more peaceful world. It is ironic indeed that one of the major gaps in child health in America is gluttony, while a critical gap for many developing nations is starvation. The bridge that must be built here is one of the heart--giving" sharing, caring, working for others, devoting larger portions of our energy and abundance to those who are struggling to exist.

Reexamining Political Responsibilities

One vote in the hands of a politician--a school board member or a state or national legislator--can exert greater power over the welfare of children than most professional educators can exert in a lifetime. This is not to deny the power of teachers to influence positively many lives over a teaching career or to deny the influence of parents on their own children, but rather to admit and bring into question the power of politics, good and bad, in our chosen profession. My message to politicians is clear: Ensure that all children have nutritious food and good housing and that their parents have jobs. Protect our neighborhoods from crime. See that all children have proper health care. Keep peace with our world neighbors. Give us good school buildings and equipment. Keep classes to manageable sizes. Support our teacher education institutions. Pay teachers fair and equitable salaries--and delegate teaching and testing to the professionals. In short, your plates are full. Tend to your houses, hold your colleagues and leaders of industry accountable for their crimes, do your jobs, and support us as we do ours.

Rediscovering Ethics and Morals

Ethics is doing what one should do because it is right. Morals refers to one's character and knowing, and respecting, the difference between right and wrong. The impressionable young look to adults with whom they are close and to superheroes for their models of right and wrong, and they learn from the media bombardment that surrounds them (since the 1950s and 1960s, moral and ethical relativism have held sway). It is time for adults to come right out and say to children that immoral and unethical behavior is bad and unacceptable; time for them to impose and enforce consequences; time for them to admit that guilt is an acceptable and useful human emotion. The conscience should hurt even if all the other parts feel good. Mind bridges will never be built without the heart bridges. Mind bridges are taught, heart bridges are lived. Morals, ethics, and character are matters of the heart. Children learn not only what they live, but also what their significant adults live. It is time we begin to live responsibly.

References

Am rein, A. L., & Berliner, D. C. (2002a). An analysis of some unintended and negative consequences of high-stakes testing. Research report. Tempe, AZ: Arizona State University Education Policy Studies Laboratory.

Amrein, A. L., & Berliner, D. C. (2002b). The impact of high-stakes tests on student academic performance. Research report. Tempe, AZ: Arizona State University Education Policy Studies Laboratory. www.asu.edu/educ/epsl/EPRU/epru_Research_Writing.him

Association for Childhood Education International/Perrone, V. (1991). On standardized testing. A position paper. Childhood Education, 67, 132-142.

Association for Childhood Education International & National Association of Elementary School Principals/Perrone, V. (1976). On standardized testing and evaluation. A position paper. Childhood Education, 53, 9-16.

Brandon, K. (2002, Oct. 28). Pressure, stress and evaluations--all at age 5. From the Chicago Tribune. Reprinted in The Austin American-Statesman, pp. A1, A7.

Cross, T. (2002, December 3). Standardized testing wanes in Japan as it rises in USA. USA Today, p. 23A.

Dale, M. (2002, December 14). Kicked out of kindergarten: School suspensions are rising. The Austin American-Statesman, p. A-1.

Federal Interagency Forum on Child and Family Statistics. (2002). America's children: Key national indicators of well-being 2002. Washington, DC: U.S. Government Printing Office. http:// childstats.gov.

Frost, J. L. (1986). Children in a changing society: Frontiers of challenge. Childhood Education, 62, 242-249.

Frost, J. L. (1988). In G. F. Roberson & M. A. Johnson (Eds.), Leaders in education: Their views on controversial issues (pp. 30-42). Lanham, MD: University Press of America.

Frost, J. L., & Kim, S. (2000). Developmental progress in preschool-age children's using an overhead ladder. Unpublished research, University of Texas, Austin.

Frost, J. L., Brown, P., Thornton, C. D., Sutterby, J. A., & Therrell, J. A. (2001). The developmental benefits and use patterns of overhead equipment on playgrounds. Unpublished research report, University of Texas, Austin.

Getting virtually fit in Florida schools. (2003, February 11). In The Austin American-Statesman. Reprinted from The Los Angeles Times.

Head start resists efforts to give pupils a real boost. (2003, February 10). USA Today, p. 14A.

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Martinez, M. M. (2002, Sept. 6). Austin maps out school lessons. The Austin American-Statesman, p. B1.

Martinez, M. M. (2003, January 22). Forgione: Cut 450 teaching positions. The Austin American-Statesman, p. A1.

Mowbray, J. (2003, January 16). Doped-up kids. Knight Ridder/ Tribune News Service. In Las Vegas Review-Journal, p. 7B.

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Our schools and our future: Are we still at risk? (2003, February 7). Arkansas Democrat Gazette, p. 4A.

Popham, W. J. (2002). Today's standardized tests are not the best way to evaluate schools or students: Right task--wrong tool. American School Board Journal, Feb., 21.

Research links adult aggression and TV violence. (2003, March 10). The Austin American-Statesman, p. A8.

Roser, M. A. (2003, January 24). Americans need to get fit, U.S. Health Secretary says. The Austin American-Statesman, p. B3.

Toppo, G. (2003, January 13). School violence hits lower grades. USA Today, pp. 1A 2A.

United Nations Children's Fund. (2002). The state of the world's children 2002. New York: UNICEF.

Wingert, P., & Kantrowitz, B. (2002, October 7). Young and depressed. Newsweek, 53-61.

Zito, J. M., Safer, D. J., dosReis, S., Gardner, J. F., Magder, L., Soeken, K., Boles, M., Lynch, F., & Riddle, M.A. (2003). Psychotropic practice patterns for youth: A 10-year perspective. Archives of Pediatric Adolescent Medicine,157(1), 17-25. www.archpediatrics.com

Note: This article is based on a general session address at the ACEI Annual Conference in Phoenix, Arizona, April 2003.