Below are releases on studies appearing in the October issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: Monday, September 28, 2009, 12:01 am (ET)

ACTIVE PARENTING MAKES TEEN DRIVERS SAFER

According to the Insurance Institute for Highway Safety, motor vehicle crashes are the leading cause of teen deaths. In the study, “Associations Between Parenting Styles and Teen Driving Safety-Related Behaviors and Attitudes,” researchers analyzed results from the 2006 National Young Driver Survey, which gathered data on the association between parenting style and driving behaviors of 5,665 ninth-, tenth-, and eleventh-graders. Parents were separated into four groups based on how teens described them: authoritative (high support and high rules/monitoring), authoritarian (low support/high rules), permissive (high support/low rules), and uninvolved (low support/low rules). Teens with authoritative parents reported half the crash risk and were 71 percent less likely to drive while intoxicated compared to teens with uninvolved parents. They were also 30 percent less likely to use a cell phone while driving. Teens with authoritative or authoritarian parents used seat belts twice as often and reported speeding half as often as teens with uninvolved parents. The authors determined that while teens are ultimately responsible for their own behavior, parental involvement that includes both rules and support can effectively foster safer driving practices.

Editor’s Note: A related study, “Primary Versus Shared Access to Vehicles and Assocations With Risky Teen Driving Behaviors and Crashes: National Perspective,” also will be published online on September 28.

GROWTH CHARTS STUMP PARENTS

While physicians routinely use growth charts as a visual aid for parents when discussing growth rates, do parents understand them? Several organizations, including the Centers for Disease Control and Prevention and the World Health Organization, encourage parents to partner with pediatricians in using the charts to track their children’s growth patterns. To determine whether parents really understood growth chart data, authors of the study, “Do Parents Understand Growth Charts? National, Internet-Based Survey,” conducted an online survey of 1,000 parents. Researchers at the Nemours Center for Children’s Health Media and KidsHealth.org asked parents to identify a child’s weight by looking at plotted points on a growth chart. Only 64 percent of respondents could correctly determine the child’s weight. When looking at a combined height/weight measurement chart, up to 77 percent incorrectly interpreted the data. Although parents do want a method to help them understand how their child is growing, few parents understand the growth chart in its current form. Rather than teaching parents the complicated mathematical concepts of the current growth charts, the study authors suggest clinicians and health educators would do better by inviting parents to help redesign growth charts or develop other techniques for helping parents understand complex health concepts such as growth. 

Editors Note: A commentary, “Where All The Children Are Above Average,” accompanies this article in the September 28 issue. 

UNIVERSAL SCREENING LOWERS RISK OF SEVERE HYPERBILIRUBINEMIA

Screening all newborns for hyperbilirubinemia (which causes jaundice) resulted in a significantly lower incidence of severe cases in the study, “Impact of Universal Bilirubin Screening on Severe Hyperbilirubinemia and Phototherapy Use in a Managed Care Organization.” Hyperbilirubinemia is an excess of the substance bilirubin in the blood, which can cause jaundice and, in severe cases, may cause seizures and brain damage. A large health system in California implemented the 2004 American Academy of Pediatrics (AAP) guidelines recommending that every newborn be assessed for the risk of developing a severe case of this condition. The researchers found that after implementation of screening, there was a 62 percent decrease in the number of newborns with very high bilirubin levels. There also was an increase in the use of phototherapy to treat infants with elevated bilirubin levels, sometimes even when the AAP guidelines did not call for it. The authors concluded that with additional education, the reduction in serious hyperbilirubinemia with universal screening can be achieved without excessive use of phototherapy.

Editor’s Note: Five additional articles on bilirubin and hyperbilirubinemia will be published online September 28.

ETHNICITY AND LANGUAGE LINKED TO MEDICATION USE

There are significant health care disparities among children, especially Hispanic children, living in the United States. In the study, “Cross-Sectional Analysis of the Association Between Parental Acculturation and Children’s Medication Use in the United States,” researchers used data from the 2004 Medical Expenditure Panel Survey linked to the National Health Interview Survey to determine how acculturation affects prescription medication use in Hispanic children. Results indicate that older children, children from big families, and children with a non-citizen mother were least likely to use any medication. Children without a usual source of care or medical home had a lower prevalence of any medication use, 24.3 percent, compared to 51.6 percent of children with a medical home. The study also found that Hispanic, Spanish-interviewed subjects were less likely to have a medical home than were Hispanic, English-interviewed subjects, but both groups had lower odds of using any prescription medication compared to white children. In addition, Hispanic children from acculturated backgrounds are more likely to use psychiatric medications than less-acculturated children, but their use of antibiotics or respiratory medications remain the same.

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The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.