Audrey Kubetin

Nearly four out of five Americans planning to vote in the upcoming presidential election are concerned with issues related to children's health care, a nationwide telephone survey of 800 registered voters shows.

The survey found that 79% of voters favor increasing federal spending to provide health care to uninsured children. Support for this increased funding crossed party lines, finding approval among 93% of voters supporting Sen. Barack Obama (D-Ill.), 60% of voters supporting Sen. John McCain (R-Ariz.), and 77% of swing voters.

“I take away from this information that, whatever their political persuasion, Americans want more investments in their children and grandchildren,” said Michael R. Petit, president of the Every Child Matters Education Fund (ECMEF), said at a July 17 teleconference. ECMEF is the nonprofit organization that commissioned the poll.

The survey was conducted July 7–10, 2008, by Third Eye Strategies, a national public opinion research organization. Respondents were randomly selected from a cluster sample provided by Survey Sampling International.

Voters were asked whether they would increase or decrease federal spending on several programs and initiatives, including Social Security, Medicare, and the Iraq war. The issue of children's health care was the only one that earned support from a majority of Sen. McCain's supporters, Sen. Obama's supporters, and undecided voters.

Overall, 60% of voters would support increased spending on child abuse prevention, while increased funding for prekindergarten education and after-school programs found approval among 58% and 57% of respondents, respectively. The prospect of increasing funding for child-related programs garnered more support than that of heightened spending on Social Security (58%), Medicare (53%), farm programs (46%), homeland security (37%), and the Iraq war (20%).

Voters were also asked how the next president should prioritize efforts to address several contemporary issues, including children, tax cuts, and the federal budget. A majority of all voters (57%) said that investing in children's health, education, and safety should be a greater priority than making tax cuts permanent, while 49% of respondents said that investing in children is more important than balancing the budget. An additional 21% said that both should be a priority.

For Mr. Petit, the results of the survey highlight the importance of children's health care in the 2008 presidential campaign, especially considering the current closeness of the contest. The ECMEF poll found that 14% of voters are undecided, while 40% said that there is a small to fair chance that they might shift their support to another candidate.

The survey also found that voters are largely uninformed about the presumptive nominees' plans to address children's health issues. When asked to describe Sen. Obama's strong points on issues involving children and families, 34% of all voters could not respond or declined to do so. When asked the same question of Sen. McCain, 48% of all voters could not or did not respond.

“Senators McCain and Obama have a long way to go in satisfying voters with specific information about how their agendas will benefit children and families,” Mr. Petit said.

“Most voters have little idea where Senators McCain and Obama stand on children's issues. That lack of clarity needs to clear up because the stakes for America's children are huge.”

The poll has an overall margin of error of plus or minus 3.5 percentage points.

Nearly four out of five Americans planning to vote in the upcoming presidential election are concerned with issues related to children's health care, a nationwide telephone survey of 800 registered voters shows.

The survey found that 79% of voters favor increasing federal spending to provide health care to uninsured children. Support for this increased funding crossed party lines, finding approval among 93% of voters supporting Sen. Barack Obama (D-Ill.), 60% of voters supporting Sen. John McCain (R-Ariz.), and 77% of swing voters.

“I take away from this information that, whatever their political persuasion, Americans want more investments in their children and grandchildren,” said Michael R. Petit, president of the Every Child Matters Education Fund (ECMEF), said at a July 17 teleconference. ECMEF is the nonprofit organization that commissioned the poll.

The survey was conducted July 7–10, 2008, by Third Eye Strategies, a national public opinion research organization. Respondents were randomly selected from a cluster sample provided by Survey Sampling International.

Voters were asked whether they would increase or decrease federal spending on several programs and initiatives, including Social Security, Medicare, and the Iraq war. The issue of children's health care was the only one that earned support from a majority of Sen. McCain's supporters, Sen. Obama's supporters, and undecided voters.

Overall, 60% of voters would support increased spending on child abuse prevention, while increased funding for prekindergarten education and after-school programs found approval among 58% and 57% of respondents, respectively. The prospect of increasing funding for child-related programs garnered more support than that of heightened spending on Social Security (58%), Medicare (53%), farm programs (46%), homeland security (37%), and the Iraq war (20%).

Voters were also asked how the next president should prioritize efforts to address several contemporary issues, including children, tax cuts, and the federal budget. A majority of all voters (57%) said that investing in children's health, education, and safety should be a greater priority than making tax cuts permanent, while 49% of respondents said that investing in children is more important than balancing the budget. An additional 21% said that both should be a priority.

For Mr. Petit, the results of the survey highlight the importance of children's health care in the 2008 presidential campaign, especially considering the current closeness of the contest. The ECMEF poll found that 14% of voters are undecided, while 40% said that there is a small to fair chance that they might shift their support to another candidate.

The survey also found that voters are largely uninformed about the presumptive nominees' plans to address children's health issues. When asked to describe Sen. Obama's strong points on issues involving children and families, 34% of all voters could not respond or declined to do so. When asked the same question of Sen. McCain, 48% of all voters could not or did not respond.

“Senators McCain and Obama have a long way to go in satisfying voters with specific information about how their agendas will benefit children and families,” Mr. Petit said.

“Most voters have little idea where Senators McCain and Obama stand on children's issues. That lack of clarity needs to clear up because the stakes for America's children are huge.”

The poll has an overall margin of error of plus or minus 3.5 percentage points.

Nearly four out of five Americans planning to vote in the upcoming presidential election are concerned with issues related to children's health care, a nationwide telephone survey of 800 registered voters shows.

The survey found that 79% of voters favor increasing federal spending to provide health care to uninsured children. Support for this increased funding crossed party lines, finding approval among 93% of voters supporting Sen. Barack Obama (D-Ill.), 60% of voters supporting Sen. John McCain (R-Ariz.), and 77% of swing voters.

“I take away from this information that, whatever their political persuasion, Americans want more investments in their children and grandchildren,” said Michael R. Petit, president of the Every Child Matters Education Fund (ECMEF), said at a July 17 teleconference. ECMEF is the nonprofit organization that commissioned the poll.

The survey was conducted July 7–10, 2008, by Third Eye Strategies, a national public opinion research organization. Respondents were randomly selected from a cluster sample provided by Survey Sampling International.

Voters were asked whether they would increase or decrease federal spending on several programs and initiatives, including Social Security, Medicare, and the Iraq war. The issue of children's health care was the only one that earned support from a majority of Sen. McCain's supporters, Sen. Obama's supporters, and undecided voters.

Overall, 60% of voters would support increased spending on child abuse prevention, while increased funding for prekindergarten education and after-school programs found approval among 58% and 57% of respondents, respectively. The prospect of increasing funding for child-related programs garnered more support than that of heightened spending on Social Security (58%), Medicare (53%), farm programs (46%), homeland security (37%), and the Iraq war (20%).

Voters were also asked how the next president should prioritize efforts to address several contemporary issues, including children, tax cuts, and the federal budget. A majority of all voters (57%) said that investing in children's health, education, and safety should be a greater priority than making tax cuts permanent, while 49% of respondents said that investing in children is more important than balancing the budget. An additional 21% said that both should be a priority.

For Mr. Petit, the results of the survey highlight the importance of children's health care in the 2008 presidential campaign, especially considering the current closeness of the contest. The ECMEF poll found that 14% of voters are undecided, while 40% said that there is a small to fair chance that they might shift their support to another candidate.

The survey also found that voters are largely uninformed about the presumptive nominees' plans to address children's health issues. When asked to describe Sen. Obama's strong points on issues involving children and families, 34% of all voters could not respond or declined to do so. When asked the same question of Sen. McCain, 48% of all voters could not or did not respond.

“Senators McCain and Obama have a long way to go in satisfying voters with specific information about how their agendas will benefit children and families,” Mr. Petit said.

“Most voters have little idea where Senators McCain and Obama stand on children's issues. That lack of clarity needs to clear up because the stakes for America's children are huge.”

The poll has an overall margin of error of plus or minus 3.5 percentage points.

A lone soldier, bandaged up to his elbow, stood amid a crowd of clinicians, parents, and teachers, telling the story of a bad day in Iraq.

His audience had gathered at Boston Medical Center to discuss the impact of war and terrorism on children, Kenneth I. Reich, Ed.D., recalled in an interview. The soldier was citing himself as a testament to how easily the war zone can overlap with the home front.

He remembered returning from a difficult mission to find that it was his turn to talk to his family via videophone. What would he tell them? They would be able to tell by looking at him that something was wrong. He didn't want them to worry, but he didn't want to lie about what had happened.

The soldier decided to speak with careful candor. “I just got back from the field,” he told his family. “I'm a little upset right now, but I'll be fine. How are all of you?”

“He found a way to be honest but reassuring at the same time,” said Dr. Reich, who had organized the conference. “That was a very powerful message. We all thought that he knew more about psychology at that moment than any of us in the room.”

Dr. Reich wanted to offer that kind of honest but reassuring support to people feeling the effects of the war on the home front. After meeting many families who were trying to cope with the same sort of stresses as the soldier at the conference, Dr. Reich founded a free counseling group called SOFAR, or Strategic Outreach to Families of All Reservists. A nonprofit program, SOFAR connects military families with clinicians who provide free mental health services, including psychotherapy for children, adolescents, adults, couples, and families.

By focusing on the families of soldiers, SOFAR is rethinking what it means to support the troops. “We see ourselves as supporting the network of people who can then support the soldier,” Jaine L. Darwin, Psy.D., who codirects SOFAR with Dr. Reich, said in an interview.

That network is substantial. A recent study by the Rand Corp. puts the number of U.S. soldiers who have served in Iraq and Afghanistan at 1.64 million. Figuring that these soldiers each have a circle of relatives, friends, and coworkers who care about them, Dr. Reich estimated that 73 million to 95 million people have been affected by the war.

Dr. Reich and Dr. Darwin are seeking to support this population with mental health services tailored to military culture. By helping the families of soldiers cope with the challenges of their loved ones' deployment and return, SOFAR seeks to ease the traumatic impact of the war and prevent the intergenerational transmission of that trauma.

“Trauma has a very long tail,” Dr. Darwin said. “If we don't help these families now, we're going to see the sequelae down the road, as we have with the kids of Vietnam War vets.”

The program focuses its efforts on the extended families of Army Reserve and National Guard soldiers. Unlike military families who live on or around bases, families of Army Reserve and National Guard soldiers often lack the support of a predominantly military community. “If you're active-duty military, you usually either live on the base or live in a town where there is a base, so everybody around you understands the stresses and strains. If you're in a reserve or guard family, you can be the only person in your community with a deployed solider,” said Dr. Darwin, a past president of Division 39 of the American Psychological Association.

When Dr. Reich began hatching the idea for SOFAR, families of soldiers in the National Guard and Army Reserve were being offered one free mental health session as long as their loved one was deployed. “I remember thinking, 'That's not even enough time to say hello,'” he said.

SOFAR views the process of addressing secondary trauma and building resilience among military families as one that demands time and volunteers from a variety of mental health specialties. Since SOFAR was founded in 2003, the program has attracted 90 volunteers in its hometown of Boston. Another chapter has been set up in Michigan, and two more will be launched in New York and Florida before the end of the year. Dr. Reich hopes to expand the program nationwide.

Some of SOFAR's volunteers meet with families in their offices. Some speak at predeployment and prereturn briefings for military families, lecturing them on what to expect during their soldier's deployment and after their soldier's return. Other volunteers visit family readiness groups to meet families and guide discussions about the issues they face.

“First and foremost, we listen. The biggest thing that we do is to help normalize a lot of the feelings that people have and to help put them in perspective,” said Dr. Reich, who is head of the Psychoanalytic Couple and Family Institute of New England, SOFAR's umbrella organization.

SOFAR talks with families about the concept of the “new normal,” a term that Dr. Darwin uses to describe the postdeployment life of a military family. Deployment changes soldier and family alike, hampering a return to predeployment routines. SOFAR encourages families to pursue a “new normal” marked by the renegotiation of roles and relationships.

In advocating this new normal, SOFAR seeks to help military families develop realistic expectations about the process of rehabilitation and reintegration that soldiers undergo when they return from war.

“It's going to take a while for people to become reacquainted. There's going to be some renegotiation about what roles people have picked up in the absence of the soldier, which roles they want to continue to carry, and which they don't,” Dr. Darwin said. “Different families have different ways of coming back together again.”

The Rand study, published in April 2008, found that nearly 20% of returning soldiers report symptoms of posttraumatic stress disorder (PTSD) or major depression. About 19% report sustaining a possible traumatic brain injury during their deployment, while 7% report experiencing both brain injury and PTSD or depression.

According to Dr. Darwin, 50% of Army Reserve and National Guard soldiers will return from service with a diagnosable mental health condition, such as anxiety or depression. Symptoms of PTSD might not manifest until 6-24 months after a soldier has returned from service, making it difficult for veterans and their families to gauge their progress in the reintegration process.

“A soldier's body comes home. The nervous system often doesn't arrive for quite a while,” Dr. Darwin said.

SOFAR educates families about what to expect during the reintegration process and what to flag as a warning sign, “so they can seek help both for themselves and for their soldier,” Dr. Darwin said.

The program offers military families the tools to address secondary trauma, but getting soldiers and these families to take advantage of these has proved difficult.

The Rand study showed that only half of the veterans who report experiencing PTSD or major depression have sought treatment. SOFAR is faced with combating the stigma that often marks popular perceptions of psychotherapy, psychopharmacology, and mental health problems in general.

“The hardest thing for us to do is to destigmatize mental health and to get the families to understand that there are services available and get them to make use of them,” Dr. Darwin said.

The biggest thing that we do is to help normalize the feelings that people have and to help put them in perspective. DR. REICH

A lone soldier, bandaged up to his elbow, stood amid a crowd of clinicians, parents, and teachers, telling the story of a bad day in Iraq.

His audience had gathered at Boston Medical Center to discuss the impact of war and terrorism on children, Kenneth I. Reich, Ed.D., recalled in an interview. The soldier was citing himself as a testament to how easily the war zone can overlap with the home front.

He remembered returning from a difficult mission to find that it was his turn to talk to his family via videophone. What would he tell them? They would be able to tell by looking at him that something was wrong. He didn't want them to worry, but he didn't want to lie about what had happened.

The soldier decided to speak with careful candor. “I just got back from the field,” he told his family. “I'm a little upset right now, but I'll be fine. How are all of you?”

“He found a way to be honest but reassuring at the same time,” said Dr. Reich, who had organized the conference. “That was a very powerful message. We all thought that he knew more about psychology at that moment than any of us in the room.”

Dr. Reich wanted to offer that kind of honest but reassuring support to people feeling the effects of the war on the home front. After meeting many families who were trying to cope with the same sort of stresses as the soldier at the conference, Dr. Reich founded a free counseling group called SOFAR, or Strategic Outreach to Families of All Reservists. A nonprofit program, SOFAR connects military families with clinicians who provide free mental health services, including psychotherapy for children, adolescents, adults, couples, and families.

By focusing on the families of soldiers, SOFAR is rethinking what it means to support the troops. “We see ourselves as supporting the network of people who can then support the soldier,” Jaine L. Darwin, Psy.D., who codirects SOFAR with Dr. Reich, said in an interview.

That network is substantial. A recent study by the Rand Corp. puts the number of U.S. soldiers who have served in Iraq and Afghanistan at 1.64 million. Figuring that these soldiers each have a circle of relatives, friends, and coworkers who care about them, Dr. Reich estimated that 73 million to 95 million people have been affected by the war.

Dr. Reich and Dr. Darwin are seeking to support this population with mental health services tailored to military culture. By helping the families of soldiers cope with the challenges of their loved ones' deployment and return, SOFAR seeks to ease the traumatic impact of the war and prevent the intergenerational transmission of that trauma.

“Trauma has a very long tail,” Dr. Darwin said. “If we don't help these families now, we're going to see the sequelae down the road, as we have with the kids of Vietnam War vets.”

The program focuses its efforts on the extended families of Army Reserve and National Guard soldiers. Unlike military families who live on or around bases, families of Army Reserve and National Guard soldiers often lack the support of a predominantly military community. “If you're active-duty military, you usually either live on the base or live in a town where there is a base, so everybody around you understands the stresses and strains. If you're in a reserve or guard family, you can be the only person in your community with a deployed solider,” said Dr. Darwin, a past president of Division 39 of the American Psychological Association.

When Dr. Reich began hatching the idea for SOFAR, families of soldiers in the National Guard and Army Reserve were being offered one free mental health session as long as their loved one was deployed. “I remember thinking, 'That's not even enough time to say hello,'” he said.

SOFAR views the process of addressing secondary trauma and building resilience among military families as one that demands time and volunteers from a variety of mental health specialties. Since SOFAR was founded in 2003, the program has attracted 90 volunteers in its hometown of Boston. Another chapter has been set up in Michigan, and two more will be launched in New York and Florida before the end of the year. Dr. Reich hopes to expand the program nationwide.

Some of SOFAR's volunteers meet with families in their offices. Some speak at predeployment and prereturn briefings for military families, lecturing them on what to expect during their soldier's deployment and after their soldier's return. Other volunteers visit family readiness groups to meet families and guide discussions about the issues they face.

“First and foremost, we listen. The biggest thing that we do is to help normalize a lot of the feelings that people have and to help put them in perspective,” said Dr. Reich, who is head of the Psychoanalytic Couple and Family Institute of New England, SOFAR's umbrella organization.

SOFAR talks with families about the concept of the “new normal,” a term that Dr. Darwin uses to describe the postdeployment life of a military family. Deployment changes soldier and family alike, hampering a return to predeployment routines. SOFAR encourages families to pursue a “new normal” marked by the renegotiation of roles and relationships.

In advocating this new normal, SOFAR seeks to help military families develop realistic expectations about the process of rehabilitation and reintegration that soldiers undergo when they return from war.

“It's going to take a while for people to become reacquainted. There's going to be some renegotiation about what roles people have picked up in the absence of the soldier, which roles they want to continue to carry, and which they don't,” Dr. Darwin said. “Different families have different ways of coming back together again.”

The Rand study, published in April 2008, found that nearly 20% of returning soldiers report symptoms of posttraumatic stress disorder (PTSD) or major depression. About 19% report sustaining a possible traumatic brain injury during their deployment, while 7% report experiencing both brain injury and PTSD or depression.

According to Dr. Darwin, 50% of Army Reserve and National Guard soldiers will return from service with a diagnosable mental health condition, such as anxiety or depression. Symptoms of PTSD might not manifest until 6-24 months after a soldier has returned from service, making it difficult for veterans and their families to gauge their progress in the reintegration process.

“A soldier's body comes home. The nervous system often doesn't arrive for quite a while,” Dr. Darwin said.

SOFAR educates families about what to expect during the reintegration process and what to flag as a warning sign, “so they can seek help both for themselves and for their soldier,” Dr. Darwin said.

The program offers military families the tools to address secondary trauma, but getting soldiers and these families to take advantage of these has proved difficult.

The Rand study showed that only half of the veterans who report experiencing PTSD or major depression have sought treatment. SOFAR is faced with combating the stigma that often marks popular perceptions of psychotherapy, psychopharmacology, and mental health problems in general.

“The hardest thing for us to do is to destigmatize mental health and to get the families to understand that there are services available and get them to make use of them,” Dr. Darwin said.

The biggest thing that we do is to help normalize the feelings that people have and to help put them in perspective. DR. REICH

A lone soldier, bandaged up to his elbow, stood amid a crowd of clinicians, parents, and teachers, telling the story of a bad day in Iraq.

His audience had gathered at Boston Medical Center to discuss the impact of war and terrorism on children, Kenneth I. Reich, Ed.D., recalled in an interview. The soldier was citing himself as a testament to how easily the war zone can overlap with the home front.

He remembered returning from a difficult mission to find that it was his turn to talk to his family via videophone. What would he tell them? They would be able to tell by looking at him that something was wrong. He didn't want them to worry, but he didn't want to lie about what had happened.

The soldier decided to speak with careful candor. “I just got back from the field,” he told his family. “I'm a little upset right now, but I'll be fine. How are all of you?”

“He found a way to be honest but reassuring at the same time,” said Dr. Reich, who had organized the conference. “That was a very powerful message. We all thought that he knew more about psychology at that moment than any of us in the room.”

Dr. Reich wanted to offer that kind of honest but reassuring support to people feeling the effects of the war on the home front. After meeting many families who were trying to cope with the same sort of stresses as the soldier at the conference, Dr. Reich founded a free counseling group called SOFAR, or Strategic Outreach to Families of All Reservists. A nonprofit program, SOFAR connects military families with clinicians who provide free mental health services, including psychotherapy for children, adolescents, adults, couples, and families.

By focusing on the families of soldiers, SOFAR is rethinking what it means to support the troops. “We see ourselves as supporting the network of people who can then support the soldier,” Jaine L. Darwin, Psy.D., who codirects SOFAR with Dr. Reich, said in an interview.

That network is substantial. A recent study by the Rand Corp. puts the number of U.S. soldiers who have served in Iraq and Afghanistan at 1.64 million. Figuring that these soldiers each have a circle of relatives, friends, and coworkers who care about them, Dr. Reich estimated that 73 million to 95 million people have been affected by the war.

Dr. Reich and Dr. Darwin are seeking to support this population with mental health services tailored to military culture. By helping the families of soldiers cope with the challenges of their loved ones' deployment and return, SOFAR seeks to ease the traumatic impact of the war and prevent the intergenerational transmission of that trauma.

“Trauma has a very long tail,” Dr. Darwin said. “If we don't help these families now, we're going to see the sequelae down the road, as we have with the kids of Vietnam War vets.”

The program focuses its efforts on the extended families of Army Reserve and National Guard soldiers. Unlike military families who live on or around bases, families of Army Reserve and National Guard soldiers often lack the support of a predominantly military community. “If you're active-duty military, you usually either live on the base or live in a town where there is a base, so everybody around you understands the stresses and strains. If you're in a reserve or guard family, you can be the only person in your community with a deployed solider,” said Dr. Darwin, a past president of Division 39 of the American Psychological Association.

When Dr. Reich began hatching the idea for SOFAR, families of soldiers in the National Guard and Army Reserve were being offered one free mental health session as long as their loved one was deployed. “I remember thinking, 'That's not even enough time to say hello,'” he said.

SOFAR views the process of addressing secondary trauma and building resilience among military families as one that demands time and volunteers from a variety of mental health specialties. Since SOFAR was founded in 2003, the program has attracted 90 volunteers in its hometown of Boston. Another chapter has been set up in Michigan, and two more will be launched in New York and Florida before the end of the year. Dr. Reich hopes to expand the program nationwide.

Some of SOFAR's volunteers meet with families in their offices. Some speak at predeployment and prereturn briefings for military families, lecturing them on what to expect during their soldier's deployment and after their soldier's return. Other volunteers visit family readiness groups to meet families and guide discussions about the issues they face.

“First and foremost, we listen. The biggest thing that we do is to help normalize a lot of the feelings that people have and to help put them in perspective,” said Dr. Reich, who is head of the Psychoanalytic Couple and Family Institute of New England, SOFAR's umbrella organization.

SOFAR talks with families about the concept of the “new normal,” a term that Dr. Darwin uses to describe the postdeployment life of a military family. Deployment changes soldier and family alike, hampering a return to predeployment routines. SOFAR encourages families to pursue a “new normal” marked by the renegotiation of roles and relationships.

In advocating this new normal, SOFAR seeks to help military families develop realistic expectations about the process of rehabilitation and reintegration that soldiers undergo when they return from war.

“It's going to take a while for people to become reacquainted. There's going to be some renegotiation about what roles people have picked up in the absence of the soldier, which roles they want to continue to carry, and which they don't,” Dr. Darwin said. “Different families have different ways of coming back together again.”

The Rand study, published in April 2008, found that nearly 20% of returning soldiers report symptoms of posttraumatic stress disorder (PTSD) or major depression. About 19% report sustaining a possible traumatic brain injury during their deployment, while 7% report experiencing both brain injury and PTSD or depression.

According to Dr. Darwin, 50% of Army Reserve and National Guard soldiers will return from service with a diagnosable mental health condition, such as anxiety or depression. Symptoms of PTSD might not manifest until 6-24 months after a soldier has returned from service, making it difficult for veterans and their families to gauge their progress in the reintegration process.

“A soldier's body comes home. The nervous system often doesn't arrive for quite a while,” Dr. Darwin said.

SOFAR educates families about what to expect during the reintegration process and what to flag as a warning sign, “so they can seek help both for themselves and for their soldier,” Dr. Darwin said.

The program offers military families the tools to address secondary trauma, but getting soldiers and these families to take advantage of these has proved difficult.

The Rand study showed that only half of the veterans who report experiencing PTSD or major depression have sought treatment. SOFAR is faced with combating the stigma that often marks popular perceptions of psychotherapy, psychopharmacology, and mental health problems in general.

“The hardest thing for us to do is to destigmatize mental health and to get the families to understand that there are services available and get them to make use of them,” Dr. Darwin said.

The biggest thing that we do is to help normalize the feelings that people have and to help put them in perspective. DR. REICH

The percentage of adolescents being diagnosed with attention-deficit/hyperactivity disorder is on the rise, but prevalence rates remain constant among younger children, a new study shows.

In children aged 12–17 years, the prevalence of attention-deficit/hyperactivity disorder (ADHD) increased by an average of 4% annually from 1997 to 2006. No significant increase was observed in those aged 6–11 years.

Dr. James M. Perrin, cochair of the American Academy of Pediatrics committee that developed practice guidelines for ADHD, suggested in an interview that this apparent increase in prevalence might stem from increased awareness among physicians that ADHD continues into adolescence and adulthood, rather than resolving in childhood.

The study was conducted by Patricia N. Pastor, Ph.D., and Cynthia A. Reuben of the National Center for Health Statistics. Their results are drawn from the National Health Interview Survey (NHIS), an ongoing, annual household survey conducted by the NCHS (Vital Health Stat. 10 2008;237:1–22).

Between 1997 and 2006, NHIS researchers gathered interviews from about 40,000 households a year. In each household with children, interviewers randomly selected one child and asked an adult family member whether that child had ever been diagnosed with ADHD, a learning disability, or other chronic health conditions.

Average annual percentage changes in ADHD prevalence were modeled using logistic regression. The researchers found that the percentage of children diagnosed with ADHD grew slowly from 1997 to 2006, increasing by an average of 3% a year.

To estimate the prevalence of ADHD, NHIS data from 2004, 2005, and 2006 were pooled to create a single sample of about 23,000 children. About 5% of these had ADHD without an accompanying learning disability, 5% had a learning disability without ADHD, and 4% had both.

Children aged 12–17 years were more likely than children aged 6–11 years to have each of the three diagnoses.

Dr. Pastor and Ms. Reuben suggested this apparent age-related difference might result from improved access to health care services, as well as from increased knowledge about ADHD. “Although a number of factors may contribute to differences between younger and older children, a higher 'lifetime' prevalence rate among older children would be expected because of their longer exposure to the possibility of evaluation and diagnosis,” they wrote.

They also reported that health insurance coverage might play a role in whether a child is diagnosed with ADHD.

“The prevalence of diagnosed ADHD was similar among children with private insurance coverage and Medicaid. Although many factors may contribute to the differences between insured and uninsured children, access to health care may make it more likely that a child will be diagnosed,” they said.

Dr. Pastor and Ms. Reuben acknowledged the risks and limitations of relying on parents and adult family members for information on a child's medical history.

“Neither school nor health records were obtained to determine accuracy of parent reports” of either diagnosed ADHD or learning disabilities, they wrote. “The results do not describe the prevalence of children who have the conditions but who have never been diagnosed.”

Nevertheless, they emphasized the importance of following changes in the prevalence of ADHD.

“Given the economic and social costs associated with ADHD and [learning disabilities], monitoring the number and characteristics of children who have been diagnosed with these conditions is critical,” they wrote.

The percentage of adolescents being diagnosed with attention-deficit/hyperactivity disorder is on the rise, but prevalence rates remain constant among younger children, a new study shows.

In children aged 12–17 years, the prevalence of attention-deficit/hyperactivity disorder (ADHD) increased by an average of 4% annually from 1997 to 2006. No significant increase was observed in those aged 6–11 years.

Dr. James M. Perrin, cochair of the American Academy of Pediatrics committee that developed practice guidelines for ADHD, suggested in an interview that this apparent increase in prevalence might stem from increased awareness among physicians that ADHD continues into adolescence and adulthood, rather than resolving in childhood.

The study was conducted by Patricia N. Pastor, Ph.D., and Cynthia A. Reuben of the National Center for Health Statistics. Their results are drawn from the National Health Interview Survey (NHIS), an ongoing, annual household survey conducted by the NCHS (Vital Health Stat. 10 2008;237:1–22).

Between 1997 and 2006, NHIS researchers gathered interviews from about 40,000 households a year. In each household with children, interviewers randomly selected one child and asked an adult family member whether that child had ever been diagnosed with ADHD, a learning disability, or other chronic health conditions.

Average annual percentage changes in ADHD prevalence were modeled using logistic regression. The researchers found that the percentage of children diagnosed with ADHD grew slowly from 1997 to 2006, increasing by an average of 3% a year.

To estimate the prevalence of ADHD, NHIS data from 2004, 2005, and 2006 were pooled to create a single sample of about 23,000 children. About 5% of these had ADHD without an accompanying learning disability, 5% had a learning disability without ADHD, and 4% had both.

Children aged 12–17 years were more likely than children aged 6–11 years to have each of the three diagnoses.

Dr. Pastor and Ms. Reuben suggested this apparent age-related difference might result from improved access to health care services, as well as from increased knowledge about ADHD. “Although a number of factors may contribute to differences between younger and older children, a higher 'lifetime' prevalence rate among older children would be expected because of their longer exposure to the possibility of evaluation and diagnosis,” they wrote.

They also reported that health insurance coverage might play a role in whether a child is diagnosed with ADHD.

“The prevalence of diagnosed ADHD was similar among children with private insurance coverage and Medicaid. Although many factors may contribute to the differences between insured and uninsured children, access to health care may make it more likely that a child will be diagnosed,” they said.

Dr. Pastor and Ms. Reuben acknowledged the risks and limitations of relying on parents and adult family members for information on a child's medical history.

“Neither school nor health records were obtained to determine accuracy of parent reports” of either diagnosed ADHD or learning disabilities, they wrote. “The results do not describe the prevalence of children who have the conditions but who have never been diagnosed.”

Nevertheless, they emphasized the importance of following changes in the prevalence of ADHD.

“Given the economic and social costs associated with ADHD and [learning disabilities], monitoring the number and characteristics of children who have been diagnosed with these conditions is critical,” they wrote.

The percentage of adolescents being diagnosed with attention-deficit/hyperactivity disorder is on the rise, but prevalence rates remain constant among younger children, a new study shows.

In children aged 12–17 years, the prevalence of attention-deficit/hyperactivity disorder (ADHD) increased by an average of 4% annually from 1997 to 2006. No significant increase was observed in those aged 6–11 years.

Dr. James M. Perrin, cochair of the American Academy of Pediatrics committee that developed practice guidelines for ADHD, suggested in an interview that this apparent increase in prevalence might stem from increased awareness among physicians that ADHD continues into adolescence and adulthood, rather than resolving in childhood.

The study was conducted by Patricia N. Pastor, Ph.D., and Cynthia A. Reuben of the National Center for Health Statistics. Their results are drawn from the National Health Interview Survey (NHIS), an ongoing, annual household survey conducted by the NCHS (Vital Health Stat. 10 2008;237:1–22).

Between 1997 and 2006, NHIS researchers gathered interviews from about 40,000 households a year. In each household with children, interviewers randomly selected one child and asked an adult family member whether that child had ever been diagnosed with ADHD, a learning disability, or other chronic health conditions.

Average annual percentage changes in ADHD prevalence were modeled using logistic regression. The researchers found that the percentage of children diagnosed with ADHD grew slowly from 1997 to 2006, increasing by an average of 3% a year.

To estimate the prevalence of ADHD, NHIS data from 2004, 2005, and 2006 were pooled to create a single sample of about 23,000 children. About 5% of these had ADHD without an accompanying learning disability, 5% had a learning disability without ADHD, and 4% had both.

Children aged 12–17 years were more likely than children aged 6–11 years to have each of the three diagnoses.

Dr. Pastor and Ms. Reuben suggested this apparent age-related difference might result from improved access to health care services, as well as from increased knowledge about ADHD. “Although a number of factors may contribute to differences between younger and older children, a higher 'lifetime' prevalence rate among older children would be expected because of their longer exposure to the possibility of evaluation and diagnosis,” they wrote.

They also reported that health insurance coverage might play a role in whether a child is diagnosed with ADHD.

“The prevalence of diagnosed ADHD was similar among children with private insurance coverage and Medicaid. Although many factors may contribute to the differences between insured and uninsured children, access to health care may make it more likely that a child will be diagnosed,” they said.

Dr. Pastor and Ms. Reuben acknowledged the risks and limitations of relying on parents and adult family members for information on a child's medical history.

“Neither school nor health records were obtained to determine accuracy of parent reports” of either diagnosed ADHD or learning disabilities, they wrote. “The results do not describe the prevalence of children who have the conditions but who have never been diagnosed.”

Nevertheless, they emphasized the importance of following changes in the prevalence of ADHD.

“Given the economic and social costs associated with ADHD and [learning disabilities], monitoring the number and characteristics of children who have been diagnosed with these conditions is critical,” they wrote.

The apparent leveling off in the prevalence of being overweight among U.S. children and adolescents is cause for celebration, but it might not necessarily be a trend, experts say.

A study published by the National Center for Health Statistics (NCHS) found no significant trend in the incidence of high body mass index (BMI) among children and adolescents between 1999 and 2006, suggesting that rates of pediatric obesity might be stabilizing after tripling in the 1980s and ′90s.

“It's difficult to know whether or not we are seeing a true halt to the rise in the prevalence of childhood obesity and overweight based on just a few years of data. I think that we were pleasantly surprised by the data, but we can only speculate as to the reasons behind [them],” Dr. Gilbert P. August, chair of the Endocrine Society panel that developed guidelines for the prevention and treatment of pediatric obesity, said in an interview.

The study was conducted by Cynthia L. Ogden, Ph.D., and her associates at the NCHS. Working with data from the National Health and Nutrition Examination Survey, the researchers used logistic regression to model trends in high BMI for age over four time periods: 1999–2000, 2001–2002, 2003–2004, and 2005–2006. No significant trends were identified (JAMA 2008;299:2401-5).

The study also sought to identify recent changes in the prevalence of high BMI for age. To this end, the investigators analyzed height and weight measurements collected from 3,958 children and adolescents (aged 2–19 years) from 2003–2004 and 4,207 children and adolescents from 2005–2006.

The subjects′ BMIs were calculated and compared with the Centers for Disease Control and Prevention's BMI-for-age growth charts with attention to three measures of high BMI: at or above the 97th percentile, at or above the 95th percentile, and at or above 85th percentile. For each of these cutoffs, no statistically significant difference was found between the two 2-year periods.

Dr. Ogden and her associates pooled data from 2003–2004 and 2005–2006 to create population estimates for the prevalence of overweight among children and adolescents between 2003 and 2006. The data showed that within that period, 11.3% of children and adolescents had a body mass index at or above the 97th percentile of the 2000 CDC growth charts, 16.6% had a BMI at or above the 95th percentile, and 31.9% had a BMI at or above the 85th percentile.

In an accompanying editorial, Cara B. Ebbeling, Ph.D., and Dr. David S. Ludwig of Children's Hospital Boston described the study by Dr. Ogden and her associates as a contrast to “years of unremitting bad news about increasing rates of pediatric obesity.”

Dr. Ebbeling and Dr. Ludwig said that more data will be needed to determine whether the study's findings indicate a true plateau in the obesity epidemic. However, they speculated that the findings might indicate the beneficial effects of public health campaigns aimed at raising obesity awareness and improving the quality of school lunches (JAMA 2008; 299:2442-3).

“The optimistic hypothesis is that increased awareness and some programs have made a difference, but we really don't know,” Dr. Ogden said in an interview. She emphasized that the prevalence of pediatric obesity remains a critical issue. “We need to remember that it's still too high.”

Dr. August, a pediatric endocrinologist and professor emeritus of pediatrics at George Washington University, Washington, stressed that it was important to continue to work at decreasing the prevalence of high BMI among children and teens even if the findings from the study reflect a true leveling off in the obesity epidemic.

The authors of the study reported no disclosures.

The apparent leveling off in the prevalence of being overweight among U.S. children and adolescents is cause for celebration, but it might not necessarily be a trend, experts say.

A study published by the National Center for Health Statistics (NCHS) found no significant trend in the incidence of high body mass index (BMI) among children and adolescents between 1999 and 2006, suggesting that rates of pediatric obesity might be stabilizing after tripling in the 1980s and ′90s.

“It's difficult to know whether or not we are seeing a true halt to the rise in the prevalence of childhood obesity and overweight based on just a few years of data. I think that we were pleasantly surprised by the data, but we can only speculate as to the reasons behind [them],” Dr. Gilbert P. August, chair of the Endocrine Society panel that developed guidelines for the prevention and treatment of pediatric obesity, said in an interview.

The study was conducted by Cynthia L. Ogden, Ph.D., and her associates at the NCHS. Working with data from the National Health and Nutrition Examination Survey, the researchers used logistic regression to model trends in high BMI for age over four time periods: 1999–2000, 2001–2002, 2003–2004, and 2005–2006. No significant trends were identified (JAMA 2008;299:2401-5).

The study also sought to identify recent changes in the prevalence of high BMI for age. To this end, the investigators analyzed height and weight measurements collected from 3,958 children and adolescents (aged 2–19 years) from 2003–2004 and 4,207 children and adolescents from 2005–2006.

The subjects′ BMIs were calculated and compared with the Centers for Disease Control and Prevention's BMI-for-age growth charts with attention to three measures of high BMI: at or above the 97th percentile, at or above the 95th percentile, and at or above 85th percentile. For each of these cutoffs, no statistically significant difference was found between the two 2-year periods.

Dr. Ogden and her associates pooled data from 2003–2004 and 2005–2006 to create population estimates for the prevalence of overweight among children and adolescents between 2003 and 2006. The data showed that within that period, 11.3% of children and adolescents had a body mass index at or above the 97th percentile of the 2000 CDC growth charts, 16.6% had a BMI at or above the 95th percentile, and 31.9% had a BMI at or above the 85th percentile.

In an accompanying editorial, Cara B. Ebbeling, Ph.D., and Dr. David S. Ludwig of Children's Hospital Boston described the study by Dr. Ogden and her associates as a contrast to “years of unremitting bad news about increasing rates of pediatric obesity.”

Dr. Ebbeling and Dr. Ludwig said that more data will be needed to determine whether the study's findings indicate a true plateau in the obesity epidemic. However, they speculated that the findings might indicate the beneficial effects of public health campaigns aimed at raising obesity awareness and improving the quality of school lunches (JAMA 2008; 299:2442-3).

“The optimistic hypothesis is that increased awareness and some programs have made a difference, but we really don't know,” Dr. Ogden said in an interview. She emphasized that the prevalence of pediatric obesity remains a critical issue. “We need to remember that it's still too high.”

Dr. August, a pediatric endocrinologist and professor emeritus of pediatrics at George Washington University, Washington, stressed that it was important to continue to work at decreasing the prevalence of high BMI among children and teens even if the findings from the study reflect a true leveling off in the obesity epidemic.

The authors of the study reported no disclosures.

The apparent leveling off in the prevalence of being overweight among U.S. children and adolescents is cause for celebration, but it might not necessarily be a trend, experts say.

A study published by the National Center for Health Statistics (NCHS) found no significant trend in the incidence of high body mass index (BMI) among children and adolescents between 1999 and 2006, suggesting that rates of pediatric obesity might be stabilizing after tripling in the 1980s and ′90s.

“It's difficult to know whether or not we are seeing a true halt to the rise in the prevalence of childhood obesity and overweight based on just a few years of data. I think that we were pleasantly surprised by the data, but we can only speculate as to the reasons behind [them],” Dr. Gilbert P. August, chair of the Endocrine Society panel that developed guidelines for the prevention and treatment of pediatric obesity, said in an interview.

The study was conducted by Cynthia L. Ogden, Ph.D., and her associates at the NCHS. Working with data from the National Health and Nutrition Examination Survey, the researchers used logistic regression to model trends in high BMI for age over four time periods: 1999–2000, 2001–2002, 2003–2004, and 2005–2006. No significant trends were identified (JAMA 2008;299:2401-5).

The study also sought to identify recent changes in the prevalence of high BMI for age. To this end, the investigators analyzed height and weight measurements collected from 3,958 children and adolescents (aged 2–19 years) from 2003–2004 and 4,207 children and adolescents from 2005–2006.

The subjects′ BMIs were calculated and compared with the Centers for Disease Control and Prevention's BMI-for-age growth charts with attention to three measures of high BMI: at or above the 97th percentile, at or above the 95th percentile, and at or above 85th percentile. For each of these cutoffs, no statistically significant difference was found between the two 2-year periods.

Dr. Ogden and her associates pooled data from 2003–2004 and 2005–2006 to create population estimates for the prevalence of overweight among children and adolescents between 2003 and 2006. The data showed that within that period, 11.3% of children and adolescents had a body mass index at or above the 97th percentile of the 2000 CDC growth charts, 16.6% had a BMI at or above the 95th percentile, and 31.9% had a BMI at or above the 85th percentile.

In an accompanying editorial, Cara B. Ebbeling, Ph.D., and Dr. David S. Ludwig of Children's Hospital Boston described the study by Dr. Ogden and her associates as a contrast to “years of unremitting bad news about increasing rates of pediatric obesity.”

Dr. Ebbeling and Dr. Ludwig said that more data will be needed to determine whether the study's findings indicate a true plateau in the obesity epidemic. However, they speculated that the findings might indicate the beneficial effects of public health campaigns aimed at raising obesity awareness and improving the quality of school lunches (JAMA 2008; 299:2442-3).

“The optimistic hypothesis is that increased awareness and some programs have made a difference, but we really don't know,” Dr. Ogden said in an interview. She emphasized that the prevalence of pediatric obesity remains a critical issue. “We need to remember that it's still too high.”

Dr. August, a pediatric endocrinologist and professor emeritus of pediatrics at George Washington University, Washington, stressed that it was important to continue to work at decreasing the prevalence of high BMI among children and teens even if the findings from the study reflect a true leveling off in the obesity epidemic.

The authors of the study reported no disclosures.