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November 09, 2004 Volume 40 Issue 42
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CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
CACAP: Combating youth crime
By Susannah Benady
MONTREAL â “ If we as a society seriously intend to prevent youth crime, we need to start investing at a much earlier age than previously thought, says Canada's leading researcher in children's psychosocial maladjustment.
If we want to prevent that aggressive kindergartner from turning into a young offender by the time he is 15, we have to start taking preventive steps very earlyâ â€before kindergarten and even before that child's mother is pregnant, probably while she is still a child or adolescent herself.
"A mother having a conduct disorder is one of the major predictors of a child being highly aggressive," Dr. Richard Tremblay told more than 200 child psychiatrists attending the conference here of the Canadian Academy of Child and Adolescent Psychiatry.
A mother who has had a conduct disorder or who has failed at school is likely to have less control over her own aggression and be less skilled at teaching her infant not to be physically aggressive. Such a mother is also more likely to have a poor diet, to drink alcohol and to smoke.
Surprisingly, whether or not the father has a conduct disorder is almost irrelevant, said Dr. Tremblay, a Université de Montréal professor of pediatrics, psychiatry and psychology, who holds a Canada research chair in child development.
"It is the mother who provides the environment that determines the baby's brain development in the womb, by what she eats and drinks, and whether she smokes or suffers stress."
Dr. Tremblay has spent 20 years conducting a program of longitudinal and experimental research focusing on the physical, cognitive, social and emotional development of children from conception onward.
He has been hoping to understand the development of antisocial and violent behaviour and what can be done to prevent it.
He is probably best known for the Montreal longitudinal experimental study in which he and his colleagues showed that intensive interventions at the time children enter school can make a difference in the long-term trajectory of aggressive kindergarten boys.
More recently, he has been looking at when children develop aggressive behaviour and has found that it is much earlier than anyone thought.
The results of his studies are overthrowing many of the widely held beliefs about what makes some children and adolescents aggressive, violent and hard to control.
In fact, Dr. Tremblay told the conference, the traditional viewâ â€that most acts of aggression are committed by 14- to 18-year-olds and result from their higher testosterone levelsâ â€is a misconception. The seeds of aggressive behaviour are sown not just during pregnancy, but also before.
If we want to prevent antisocial behaviour before it even starts, the best places to invest are in high-risk girls, particularly during pregnancy, where interventions have been shown to reduce antisocial behaviour in their children up to mid-adolescence.
This, said Dr. Tremblay, is the conclusion he has drawn as a result of the 15-year longitudinal study of 1,000 boys from socioeconomically disadvantaged groups in Montreal.
The study made two significant findings. First, that all childrenâ â€even the most aggressiveâ â€are at their worst in kindergarten. Second, there was no late onset physical aggression. If an adolescent was highly aggressive, the trait had been there all along.
"We were surprised to find first of all that all the children were at their most aggressive in kindergarten and second that no significant group of children started to show physical aggression as they got older," said Dr. Tremblay.
The 1,000 children studied were divided into four subgroups, from those showing the least aggression over the period from kindergarten to age 15 (about 14%) to those showing the most (4%). Those in between (about 80%) showed physical aggression in kindergarten but their aggression decreased with age. The majority (53%) fell into the group showing physical aggression in kindergarten but decreasing with age. Twenty-eight per cent were relatively highly aggressive in kindergarten but did get better over time.
Most aggressive children became less aggressive with age. But a small subgroupâ â€the hard core 4%â â€started off highly aggressive in kindergarten and remained at a high level right up to adolescence.
The researchers have replicated these findings in two samples in New Zealand, two samples in the U.S., one random sample of Quebec children and a random sample of Canadian children.
But while the longitudinal study has provided valuable new insights, it did not answer the question it set out to explore: What makes youth violent?
"We had begun by asking how children learn to use physical aggression and become violent adolescents.
"What this study showed us was that humans do not learn (to be aggressive). They learn not to be aggressive). At least, most of them do."
To try and trace the roots back even further, Dr. Tremblay's team began a birth cohort study that showed even though aggression is a basicâ â€and necessaryâ â€human trait, some children are "genetically" more aggressive and are therefore at risk from socioeconomic and environmental factors.
Factors include a mother being age 19 years or younger at the time she has her first child, smoking, poverty and school failure.
Children's natural aggression can be seen by about 17 months, said Dr. Tremblay, but if their environment does not teach them not to use physical aggression, they are in for a lifetime at the losing end.
"Those who are slow in learning not to use physical aggression are in for a life of misery."
Governments need to invest more and earlier to defuse problems among high-risk mothers, he warned. Nurse home-visiting programs for children up to age five years and enriched daycare environments have shown success, he said.
"I have managed to convince the Quebec government to invest about $30 million a year in this. The problem at the moment is that those who are going there (government-sponsored day care) are the children from well-off families, while the children who need it most are at home with their mothers, where they should not be."
In future, he said, interventions would be better tailored to each individual's circumstance through the use of psychosocio- genomics, the study of how an individual's genetic inheritance affects his response to psychosocial interventions.
"Understanding an individual's genetic makeup is thought to be the key to devising personalized interventions with greater efficacy and safety."
sidebar
By Susannah Benady
Play-fighting is one of the best interventions for an aggressive child, and is one of the few areas where fathers can have an impact on decreasing children's aggression, says Dr. Richard Tremblay.
"It is something that children do with their fathers, that helps them learn limits about where you have to stop in order for it to still be fun," he said. "All kinds of play-fighting are valuableâ â€even including toy guns."
Play-fighting is probably one of the best interventions parents can do with children, he added.
"We ought to be encouraging people to play-fight with their children, rather than preventing them from play- fighting, as most people tend to think. The children who do not play-fight, who live alone with their aggressive mothers, are much more at risk of not learning alternatives to physical aggression."
Doctors, teachers and parents are making a mistake in preventing children from play-fighting if they think it is going to reduce aggression. In fact the reverse is true, he said. "It's a silly idea that children shouldn't play at fighting. There is less and less physical aggression in our societies and yet people are going more and more to see violent movies. We were built to (be aggressive), and need an outlet," said Dr. Tremblay, professor of pediatrics, psychiatry and psychology at the University of Montreal.
Dr. Tremblay said a father can be an influence in this way (play fighting) because while so many risk factors for youth aggression stem from the mother, no father characteristics emerge as independent predictors of aggressive behaviour. If the father's history of aggression or antisocial behaviour is relevant, it is only because the mother also has these characteristics and like is attracting like.
"Mothers who have problem behaviour tend to mate with men who have problem behaviour."
During pregnancy, the baby is living mainly what the mother is living, not what the father is living. Also, in the studies of children from poor socioeconomic backgrounds, many of the fathers were no longer on the scene, so the child is raised by the mother, determining the whole environment from preconception onwards.The father only becomes important much later.
-------------------------------------------------------------------------------------------------------------------------------------------------
Here is the link.
http://www.medicalpost.com/mpcontent/article.jsp?content=20041108_181415_5924
Tom
November 09, 2004 Volume 40 Issue 42
--------------------------------------------------------------------------------
CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY
CACAP: Combating youth crime
By Susannah Benady
MONTREAL â “ If we as a society seriously intend to prevent youth crime, we need to start investing at a much earlier age than previously thought, says Canada's leading researcher in children's psychosocial maladjustment.
If we want to prevent that aggressive kindergartner from turning into a young offender by the time he is 15, we have to start taking preventive steps very earlyâ â€before kindergarten and even before that child's mother is pregnant, probably while she is still a child or adolescent herself.
"A mother having a conduct disorder is one of the major predictors of a child being highly aggressive," Dr. Richard Tremblay told more than 200 child psychiatrists attending the conference here of the Canadian Academy of Child and Adolescent Psychiatry.
A mother who has had a conduct disorder or who has failed at school is likely to have less control over her own aggression and be less skilled at teaching her infant not to be physically aggressive. Such a mother is also more likely to have a poor diet, to drink alcohol and to smoke.
Surprisingly, whether or not the father has a conduct disorder is almost irrelevant, said Dr. Tremblay, a Université de Montréal professor of pediatrics, psychiatry and psychology, who holds a Canada research chair in child development.
"It is the mother who provides the environment that determines the baby's brain development in the womb, by what she eats and drinks, and whether she smokes or suffers stress."
Dr. Tremblay has spent 20 years conducting a program of longitudinal and experimental research focusing on the physical, cognitive, social and emotional development of children from conception onward.
He has been hoping to understand the development of antisocial and violent behaviour and what can be done to prevent it.
He is probably best known for the Montreal longitudinal experimental study in which he and his colleagues showed that intensive interventions at the time children enter school can make a difference in the long-term trajectory of aggressive kindergarten boys.
More recently, he has been looking at when children develop aggressive behaviour and has found that it is much earlier than anyone thought.
The results of his studies are overthrowing many of the widely held beliefs about what makes some children and adolescents aggressive, violent and hard to control.
In fact, Dr. Tremblay told the conference, the traditional viewâ â€that most acts of aggression are committed by 14- to 18-year-olds and result from their higher testosterone levelsâ â€is a misconception. The seeds of aggressive behaviour are sown not just during pregnancy, but also before.
If we want to prevent antisocial behaviour before it even starts, the best places to invest are in high-risk girls, particularly during pregnancy, where interventions have been shown to reduce antisocial behaviour in their children up to mid-adolescence.
This, said Dr. Tremblay, is the conclusion he has drawn as a result of the 15-year longitudinal study of 1,000 boys from socioeconomically disadvantaged groups in Montreal.
The study made two significant findings. First, that all childrenâ â€even the most aggressiveâ â€are at their worst in kindergarten. Second, there was no late onset physical aggression. If an adolescent was highly aggressive, the trait had been there all along.
"We were surprised to find first of all that all the children were at their most aggressive in kindergarten and second that no significant group of children started to show physical aggression as they got older," said Dr. Tremblay.
The 1,000 children studied were divided into four subgroups, from those showing the least aggression over the period from kindergarten to age 15 (about 14%) to those showing the most (4%). Those in between (about 80%) showed physical aggression in kindergarten but their aggression decreased with age. The majority (53%) fell into the group showing physical aggression in kindergarten but decreasing with age. Twenty-eight per cent were relatively highly aggressive in kindergarten but did get better over time.
Most aggressive children became less aggressive with age. But a small subgroupâ â€the hard core 4%â â€started off highly aggressive in kindergarten and remained at a high level right up to adolescence.
The researchers have replicated these findings in two samples in New Zealand, two samples in the U.S., one random sample of Quebec children and a random sample of Canadian children.
But while the longitudinal study has provided valuable new insights, it did not answer the question it set out to explore: What makes youth violent?
"We had begun by asking how children learn to use physical aggression and become violent adolescents.
"What this study showed us was that humans do not learn (to be aggressive). They learn not to be aggressive). At least, most of them do."
To try and trace the roots back even further, Dr. Tremblay's team began a birth cohort study that showed even though aggression is a basicâ â€and necessaryâ â€human trait, some children are "genetically" more aggressive and are therefore at risk from socioeconomic and environmental factors.
Factors include a mother being age 19 years or younger at the time she has her first child, smoking, poverty and school failure.
Children's natural aggression can be seen by about 17 months, said Dr. Tremblay, but if their environment does not teach them not to use physical aggression, they are in for a lifetime at the losing end.
"Those who are slow in learning not to use physical aggression are in for a life of misery."
Governments need to invest more and earlier to defuse problems among high-risk mothers, he warned. Nurse home-visiting programs for children up to age five years and enriched daycare environments have shown success, he said.
"I have managed to convince the Quebec government to invest about $30 million a year in this. The problem at the moment is that those who are going there (government-sponsored day care) are the children from well-off families, while the children who need it most are at home with their mothers, where they should not be."
In future, he said, interventions would be better tailored to each individual's circumstance through the use of psychosocio- genomics, the study of how an individual's genetic inheritance affects his response to psychosocial interventions.
"Understanding an individual's genetic makeup is thought to be the key to devising personalized interventions with greater efficacy and safety."
sidebar
By Susannah Benady
Play-fighting is one of the best interventions for an aggressive child, and is one of the few areas where fathers can have an impact on decreasing children's aggression, says Dr. Richard Tremblay.
"It is something that children do with their fathers, that helps them learn limits about where you have to stop in order for it to still be fun," he said. "All kinds of play-fighting are valuableâ â€even including toy guns."
Play-fighting is probably one of the best interventions parents can do with children, he added.
"We ought to be encouraging people to play-fight with their children, rather than preventing them from play- fighting, as most people tend to think. The children who do not play-fight, who live alone with their aggressive mothers, are much more at risk of not learning alternatives to physical aggression."
Doctors, teachers and parents are making a mistake in preventing children from play-fighting if they think it is going to reduce aggression. In fact the reverse is true, he said. "It's a silly idea that children shouldn't play at fighting. There is less and less physical aggression in our societies and yet people are going more and more to see violent movies. We were built to (be aggressive), and need an outlet," said Dr. Tremblay, professor of pediatrics, psychiatry and psychology at the University of Montreal.
Dr. Tremblay said a father can be an influence in this way (play fighting) because while so many risk factors for youth aggression stem from the mother, no father characteristics emerge as independent predictors of aggressive behaviour. If the father's history of aggression or antisocial behaviour is relevant, it is only because the mother also has these characteristics and like is attracting like.
"Mothers who have problem behaviour tend to mate with men who have problem behaviour."
During pregnancy, the baby is living mainly what the mother is living, not what the father is living. Also, in the studies of children from poor socioeconomic backgrounds, many of the fathers were no longer on the scene, so the child is raised by the mother, determining the whole environment from preconception onwards.The father only becomes important much later.
-------------------------------------------------------------------------------------------------------------------------------------------------
Here is the link.
http://www.medicalpost.com/mpcontent/article.jsp?content=20041108_181415_5924
Tom
