Denise Bothe

The effects of a stress management intervention in elementary school children.

Objective: This preliminary study tests the effectiveness of an elementary school-based stress management technique on anxiety symptoms and heart rate variability (HRV) in children. Methods: In this controlled prospective longitudinal study, children in third-grade classroom participated in a teacher-led daily 10-minute stress management intervention for 4 months. The control class teacher read from a childrens book for 10 minutes daily. A standardized anxiety scale and HRV (using computer biofeedback program) were measured before the 4-month intervention, immediately after, and 1 year later. Results: The intervention class showed significant improvement from baseline to the immediate postintervention period in total anxiety (N = 14, F = 12.95, p = .002), with 1-year follow-up scores maintaining improvement (N = 13, F = 5.88, p = .025). The intervention class had small improvement in HRV using the biofeedback program in the immediate postintervention period, with significant improvement at 1-year follow-up (N = 13, F = 10.61, p = .005). The control class showed no improvements. Qualitatively, children reported that the intervention was helpful during stressful times at school and at home, even after the study period. Conclusion: An elementary school-based short daily stress management intervention can decrease symptoms of anxiety, and improve HRV, a measure of relaxation. Ultimately, these children found this skill continued to help them cope better with everyday stressors.

The Impact of Nutritional Status and Longitudinal Recovery of Motor and Cognitive Milestones in Internationally Adopted Children

Internationally adopted children often arrive from institutional settings where they have experienced medical, nutritional and psychosocial deprivation. This study uses a validated research assessment tool to prospectively assess the impact of baseline (immediately post adoption) nutritional status on fifty-eight children as measured by weight-for-age, height-for-age, weight-for-height and head circumference-for-age z scores, as a determinant of cognitive (MDI) and psychomotor development (PDI) scores longitudinally. A statistical model was developed to allow for different ages at time of initial assessment as well as variable intervals between follow up visits. The study results show that both acute and chronic measures of malnutrition significantly affect baseline developmental status as well as the rate of improvement in both MDI and PDI scores. This study contributes to the body of literature with its prospective nature, unique statistical model for longitudinal evaluation, and use of a validated assessment tool to assess outcomes.

1476Screening for Latent Tuberculosis Infection in Internationally Adopted Children in the era of Interferon-Gamma Release Assay (IGRA) Testing

Adopted Children in the era of Interferon-Gamma Release Assay (IGRA) Testing Cherie Priya Dhar, MD; Anna Mandalakas, MD, MSEpi; Therese Dragga, RN, BSN; Denise Bothe, MD; Blanca E Gonzalez, MD; Adolescent Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA; Global TB and Mycobacteriology Program, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX; Adoption Health Service, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH; Developmental Behavioral Pediatrics, University Hospitals Rainbow Babies and Children’s Hospital, Cleveland, OH; Center for Pediatric Infectious Diseases, Cleveland Clinic Children’s Hospital, Cleveland, OH

THE CHILDREN IN DISASTERS PROJECT: ADDRESSING THE SPECIAL NEEDS OF CHILDREN IN MAN-MADE AND NATURAL DISASTERS

INTRODUCTION: Natural and man-made disasters have increased dramatically over the past 15 years. Children are the most vulnerable population in disasters and suffer acute and long-term physical and psychological damage. In 2005, there were 17 million children displaced from their homes as a result of humanitarian emergencies. OBJECTIVE: The Children in Disasters Project of the Rainbow Center for Global Child Health aims to reduce the traumatic acute and long-term effects of disasters for children by providing training to health professionals and relief workers, both in the United States and around the world, on how to recognize and respond to the special needs of children in disasters. RESULTS: Since 1996 the project has provided intensive, interactive, 5-day training programs entitled “Management of Complex Humanitarian Emergencies: Focus on Children and Families.” These were the first programs to emphasize that children need special attention in disasters. This course has been replicated with colleagues in 9 countries and has trained 980 people to help care for disaster-affected children. Course evaluations have been excellent, and trainees have done well in disaster work. CONCLUSIONS: Because of ongoing humanitarian emergencies, there is a need to continue training relief workers about the special needs of children.