Ecological issues related to children's health and safety.

Issues concerning the health and safety of children and youth occur at multiple levels. Bronfenbrenner (1995) proposed an ecological systems approach in which multiple systems interact to enhance or diminish children's development. The same systems are at work in health promotion. The following articles reflect the multiple systems that influence the health of our children. These were jointly reviewed by me and my colleague Maxie Kohler.--JA

CHILD WELL-BEING: The Intersection of Schools and Child Welfare. Wulczyn, F., Smithgall, C., & Chen, L.; Review of Research in Education, 2009, Vol. 33, 35-62. The collaboration between educational institutions and the child welfare system is not as effective as it should be. Due to increased federal accountability and the large number of children simultaneously served by both systems, more collaboration is needed.

This extensive article is divided into three sections, which focus on foster care placement, findings concerning children "who encounter the child welfare system in the first year of life" (p. 37), and the relationship between schools and the child welfare system. Each section contains a wealth of current data accompanied by numerous explanatory charts.

The summary and discussion section provides salient information that has practical value for educators. The authors point out that children who have been maltreated are less motivated and less ready to learn. They also explain the need for children to receive educational support beyond learning issues. Teachers must understand "the social, biological, and behavioral sequelae that affect academic engagement" (p. 56). However, lack of attention in these areas is an increasing problem, due to the academic focus of No Child Left Behind. Wulczyn, Smithgall, and Chen go beyond explaining what teachers can do--they propose policy changes at administrative levels. They call for federal, state, and local agencies to incorporate policies that promote collaboration between education and child welfare systems. This is especially important, since "70% of all children reported for maltreatment are between the ages of 4 and 17" (p. 55).

This article should be required reading for both preservice and inservice teachers. While the article is quite technical at times, it contains suggestions about collaboration between educators and child welfare systems that are needed in order to better serve children who are maltreated. As the authors point out, "Success with at-risk children in a school setting may well depend on how well the child welfare system does its job and vice versa" (p. 58).

CONSEQUENCES OF PHYSICAL HEALTH AND MENTAL ILLNESS RISKS FOR ACADEMIC ACHIEVEMENT IN GRADES K-12. Joe, S., Joe, E., & Rowley, L.; Review of Research in Education, 2009, Vol. 33, 283-309. Joe, Joe, and Rowley focus on the connection between health problems and academic achievement. Some research has examined how educational achievement "determines access to healthcare, general health and well being" (pp. 285-286). However, fewer studies focus on how one's early health could influence educational performance. The authors discuss health behaviors and chronic illness, and how they affect academic achievement. They also report on "lingering issues of physical and mental health in research and practice" (p. 285). Finally, they discuss how academic achievement could improve children's health and how schools could be used as vehicles for improving the health care of children and their families.

Some of the health issues discussed in detail include obesity, nutrition, physical activity, asthma, epilepsy, and sleep disturbances. The authors describe other health concerns, such as ADHD, conduct disorders, and eating disorders. They also focus on preadolescent and adolescent health issues, as well as those of early and middle childhood. Specifically, they consider tobacco use, drug abuse, and teenage pregnancy, emphasizing the salience of considering educational and health issues simultaneously. According to the authors,

it is critical to study educational and health trajectories in tandem (or pathways over time). If child and adolescent health problems threaten students' trajectories through the school system, then the negative long-term association between educational attainment and adult health may be partially attributed to these early health problems among children. (p. 301)

The article does a better job of explaining specific health problems in childhood than it does considering how health and academic success are related. Still, this article would be a good place to start for those interested in how health influences academic performance. The reference section provides an additional 100+ resources for more information.

SCHOOL-BASED CHILD SEXUAL ABUSE PREVENTION PROGRAMS: A Review of Effectiveness. Topping, K., & Barron, L; Review of Educational Research, 2009, Vol. 79(1), 431-463. Topping and Barron review the effectiveness of 22 school-based child sexual abuse prevention programs. The measured outcomes for children included knowledge, skills, emotion, risk perception, touch discrimination, reported response to actual threat or abuse, disclosure, maintenance of gains, and negative effects.

The researchers found a wide range of variation among school-based child sexual prevention programs. Most of them included the following seven themes: 1) how to recognize sexual abuse, 2) types of touching, 3) types of secrets, 4) how to say "no," 5) how to tell an adult that something happened, 6) the issue of blame, and 7) how to report sexual abuse or reduce its likelihood. The authors also describe the data through such measures as knowledge increases, self-protection skills, emotional impact, risk perception, and variation by socioeconomic status. Variations by gender and ethnic origin also are discussed, as are maintenance of gains, negative effects of sexual abuse programs, and parental involvement.

While all of the research and background information can be useful, the most practical section of the article dealt with guidelines for effective programs. Topping and Barron conclude that effective school-based child sexual abuse prevention programs: 1) build in an evaluation system, 2) include discussions and modeling, 3) involve four or five sessions, 4) use a wide range of knowledgeable presenters, and 5) include parent participation. For those who are interested in conducting research in this area, the "guidelines for future research" section would be helpful.

FINDING KIRK'S WORDS: An Infant Mental Health Approach to Preschool Intervention. Marsili A., & Hughes, M.; Young Exceptional Children, 2009, Vol. 12(2), 2-15. Early intervention is known for its family-centered practice, but is less well-known from the infant mental health (IMH) perspective. IMH is "the developing capacity of the child from birth to three to: experience, regulate, and express emotions; form close interpersonal relationships; and explore the environment and learn--all in the context of family, community, and cultural expectations for young children" (Zeanah, Stafford, Nagle, & Rice, 2005, p. 4). This article focuses on the IMH perspective and provides examples of what this encompasses through a case study of Kirk, a preschooler with special needs. The authors focus on the importance of relationships, as opposed to "conventional, behaviorally based interventions" (p. 3).

The authors draw heavily on the early temperament studies of Chess and Thomas (1986, 1996), although that step is implied rather than explicit. Marsili and Hughes focus on the importance of "goodness-of-fit" between the child and his parents, the child and the child care providers, and the child and his peers. The authors also stress the salience of a strengths-based approach over deficit models. They conclude, "In a conventional preschool setting, the primary concern is likely to be how behaviors affect the overall functioning of a regular class day. By comparison, a relationship-based mental health approach accommodates a child's individual needs while also eliciting the strengths of his or her classmates" (p. 14).

This article is a must-read for professionals and paraprofessionals who work in inclusive preschool settings. The authors incorporate ways to develop interpersonal relationships on multiple levels to support the mental health of all children, but especially those with special needs. The article also takes an ecological systems approach to mental health, focusing on positive interactions to promote healthy child care.

ACHIEVING THE PROMISE: The Significant Role of Schools in Transforming Children's Mental Health in America. Lechtenberger, D., Mullins, F., & Greenwood, D.; Teaching Exceptional Children, 2008, Vol. 40(4), 56-64. According to Lechtenberger, Mullins, and Greenwood, "One out of five children and adolescents in the United States experience[s] the signs and symptoms of a diagnosable mental health disorder" (p. 56). Mental health disorders are common among all economic, racial, ethnic, and familial categories.

The authors propose five strategies that schools could employ to improve the mental health of students: 1) focusing on emotional and social well-being as well as academics, 2) incorporating early intervention and prevention programs, 3) utilizing mental health resources for all of the stakeholders, 4) partnering with families and community agencies, and 5) promoting appropriate special education services for children who need it. The authors also describe specific suggestions as to how schools can accomplish these goals. Unfortunately, the authors did a better job of explaining what needs to done than how to go about doing it.

STRESS AND THE STUDENT WITH AUTISM SPECTRUM DISORDERS: Strategies for Stress Reduction and Enhanced Learning. Lytle, R., & Todd, T.; Teaching Exceptional Children, 2009, Vol. 41(4), 36-42. Lytle and Todd provide a thorough explanation of the common stress responses of children with autism spectrum disorder (ASD). The authors describe brain activity and behavioral symptoms, as well as intervention strategies to reduce stress in educational settings.

The authors cover traditional stress-reduction methods that focus on classroom routines, child choices, communication, and exercise. They also promote other strategies that many teachers may not have considered, and some that educators would find unconventional--for example, yoga, tai chi, aromatherapy, lava lamps, and visualization. Lytle and Todd also explain why addressing the stress response is so important with children with autism spectrum disorders: "Understanding the stress response in the typical individual and the irregularities of this response in individuals with ASD can help the teacher better comprehend why stress-reduction strategies are important in planning learning environments for these students" (p. 41).

While this article provides numerous suggestions (both traditional and unconventional) for addressing stress with students who have ASD, an important piece was missing. We believe parents should be actively engaged with the teachers in stress-reduction interventions. Many of the unconventional techniques described here may interfere with or run counter to families" belief systems. Collaboration between teachers and parents should be a prerequisite before using any of the strategies. Then, the home and school should work in concert to promote the best stress-reduction plans for children with ASD.

FALL DOWN, GO BOOM. Clendaniel, M.; Education Digest, 2009, Vol. 74(6), 31-36. According to Clendaniel, "In the last two decades, playgrounds have gotten safer, more streamlined--and progressively worse. Now innovators are taking playgrounds more seriously than ever" (p. 31). This article begins by describing how play and playgrounds have changed. For example, children spend "50% less time outside than kids did 20 years ago" (p. 32). Schools have drastically changed their policies related to physical education and some have eliminated physical education completely. Amazingly, "7% of first graders now get no recess at all, with many more having their minutes drastically cut; the poorer the school, the less time is dedicated to it" (p. 32). The increased emphasis on testing and worries about lawsuits are partly to blame.

A select group of professionals, including landscape designers, architects, and educators, is working to promote better spaces for children's play. They hope to make playgrounds of the type that were in operation a generation ago obsolete. Three examples of the new playground experiments include adventure playgrounds, nature playgrounds, and loose parts playgrounds.

Currently, only a few adventure playgrounds exist throughout the United States. The Adventure Playground in Berkeley, California, has been in operation since 1979. In an adventure playground, "There is no equipment, as such.... Instead, kids are confronted with boards, spare tires, telephone poles, and lots and lots of mud" (p. 34). While parents are skeptical as to the safety of such playgrounds, Clendaniel asserts that adventure playgrounds have turned out to be particularly safe. Kids entering the park receive an explanation that dangerous objects are around. "As a result, the injury rate is something that would be bragged about at a union job site. Over a two-day period last summer, 700 children came through the Adventure Playground. The injury total was two fingers hit by hammers" (p. 34).

Nature playgrounds also are beginning to take root. A catalyst for nature playgrounds was the book Last Child in the Woods by Richard Louv (2005) (reviewed in the Professional Books column in this issue). "A University of Illinois study found that playing in nature increased creativity, improved interactions with adults, and, most important, reduced the symptoms of ADHD" (p. 35). An example of a nature park is Teardrop Park in Manhattan. Areas of that park incorporate water, pebbles, sand, and even a slide that is nestled in a large rock formation. Typically, playgrounds that only have sand, trees, and rocks are difficult to sell to communities. Robin Moore, who helped design Teardrop Park, "incorporates nature with manufactured equipment as best as he can" (p. 35). Nature playgrounds, such as the one being developed by the Natural Learning Institute in Cary, North Carolina, are sprouting up in other areas of the United States.

Finally, loose parts playgrounds, which incorporate some of the traditional playground equipment, such as a water area and a sandbox, are becoming popular. In addition, these parks also include creative play spaces with "loose parts," such as large foam blocks and other equipment that children manipulate using their imaginations.

There is no doubt that opportunities for children to play, as well as playground spaces that support them, have decreased over the years. Hopefully, these new playground innovations will promote children's creativity and mental, as well as physical, health.

GOING GREEN. Witkowsky, K.; Education Digest, 2009, Vol. 74(7), 19-25. Witkowsky reports on an innovative "zero waste" project that has taken hold at the University of Washington. She provides numerous examples of what the school is doing to go green. In order to achieve this, the school has worked to become a leader in the areas promoted by the Sustainable Endowments Institute: "administrative support, commitment, food and recycling, climate change, green building, student involvement, transportation, and investment policies" (p. 22).

The university also is involved in data collection related to going green. The school has developed "a building benchmark program that will allow users to track data related to energy consumption of each building on campus" (p. 23). Data are also collected in food services. The university uses reusable and biodegradable cutlery and packaging, which has saved a lot of money. The result has been a 9% cost drop for packaging. Also, the waste oil used in food services is sold to companies that convert it into biodiesel.

The University of Washington serves as a successful "going green" model for institutions of higher education as well as K-12 schools. Anyone seriously interested in developing environmentally friendly schools or even starting an ecological service learning project would find this article invaluable.

References

Bronfenbrenner, U. (1995). The bioecological model from a life course perspective: Reflections of a participant observer. In P. Moen, G. H. Elder Jr., & K. Luscher (Eds.), Examining lives in context (pp. 599-618). Washington, DC: American Psychological Association.

Chess, S., & Thomas, A. (1986). Temperament in clinical practice. New York: Guilford.

Chess, S., & Thomas, A. (1996). Temperament: Theory and practice (2nd ed.). New York: Psychology Press.

Louv, R. (2005). Last child in the woods: Saving our children from nature deficit disorder. Chapel Hill, NC: Algonquin Books.

Zeanah, P. D., Stafford, B. S., Nagle, G. A., & Rice, T. (2005). Addressing social-emotional development and infant mental health in early childhood systems. National Center for Infant and Early Childhood Health Policy, 12, 1-56.