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CHAPTER 2 The Biological Substrate and Physical Health in Middle Childhoocl Jack P. Shonkoff T n industrialized societies, schoolmate children are generally the healthiest Isegment of the population. In general, they are not exposed to the nu- tritional deficiencies and infections that plague so many children in devel- oping countries, and they have not yet experienced the myriad changes of adolescence or the increased risks of major diseases that adults face. For children ages 6-12, health issues are best defined in the context of the developmental tasks of this period. Whereas acute illnesses are generally brief and followed by the resumption of normal routines, chronic impair- ments and catastrophic diseases demand sophisticated medical treatments in conjunction with attention to the child's personal and social development. Moreover, although more research is needed on socioeconomic class differ' ences in health status and use of health services, and although poverty continues to pose a major threat to the physical and mental well-being of children in the United States, the most far-reaching basic research concerns from a public health perspective go beyond the domain of the organized health care system and involve the more pervasive matter of life-style. Accidents accounted for half the deaths of children ages 5-14 in the United States in 1978, and more than 50 percent of them were related to motor vehicles (Bureau of the Census, 1982~. Multiple risk factors for the most common adult diseases have been shown to include a number of behaviors whose antecedents are germinated, if not sprouted, during middle childhood. Exercise and attitudes toward physical fitness, coping with stress, tobacco and alcohol abuse, and dietary habits are some of the life-style characteristics that appear to warrant particular preventive attention during this age period. 24

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 25 This chapter provides an overview of the current research regarding health and illness during middle childhood. It reviews existing knowledge of the biological substrate of human function during this period. It also explores the problem of conceptualizing health and illness and analyzes it in the context of the child's emerging life-style and sense of his or her own health status both during the school years and in the future. An agenda for further study is proposed. THE BIOLOGICAL SUBSTRATE Physical Maturation Despite significant individual differences, the rate of increase in stature during middle childhood is generally similar and regular until the onset of puberty. Skeletal maturity, as measured by bone age, is the most useful biological indicator of overall physiologic maturation. Its determination is based on the predictable, ordered appearance of primary and secondary centers of ossification that develop in the growth regions (epiphyses) of bones. Although some variability related to ethnic factors has been docu- mented, measured differences in maturity are primarily related to variations in rate and not sequence. Thus, the order of epiphyseal ossification is gov' erned largely by genetic factors. The rate of skeletal maturation, however, is influenced by both nature and nurture; for example, lower socioeconomic status as well as a wide range of pathological processes have been shown to correlate with delays in bone age, and girls demonstrate a faster rate of maturation than boys by approximately 20 percent (Sinclair, 19781. In general, skeletal maturation parallels skeletal growth and, therefore, height, with both ending when hormonal influences cause the epiphyses to fuse in late adolescence. The onset of puberty heralds the beginning of reproductive maturity and provides a useful biological marker for the onset of adolescence. Pubertal changes have been reported to occur earlier in children from higher socio- economic groups, those living in urban rather than rural areas, and children living at lower altitudes (Benson and Migeon, 1975~. A later onset of puberty has been documenter! for children who are malnourished, those living in larger families, and girls engaged in strenuous exercise such as competitive athletics and dance (Frisch et al., 1980~. Generally speaking, however, genetic factors appear to have a greater effect than environmental influences on the onset of puberty, an event that is largely related to a child's overall level of maturation and body size and that correlates better with bone age than chronological age.

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26 DEVELOPMENT DURING MIDDLE CHILDHOOD Although the sequence of pubertal changes is relatively predictable, their timing is extremely variable. The normal range of onset is ages 8-14 in females and ages 9-15 years in males, with girls generally beginning two years earlier than boys (Benson and Migeon, 1975~. In girls, puberty begins with a growth spurt, usually the first noticeable event, and is soon accom- panied by enlargement of breast tissue and generally followed by menarche two years later. The onset of puberty in boys is typically marked by an increase in testicular size followed by a growth spurt. The peak growth velocity for both sexes (10.3 cm per year for boys and 9.0 cm per year for girls) is achieved 2 to 3 years after the beginning of the pubertal process (Smith, 19771. In general, the rate of maturation of boys is slower and less predictable than that of girls, and their age at the onset of puberty is more variable. For both sexes, pubertal changes before the thirteenth birthday are not uncommon. Growth and development studies over the past 200 years have demon- strated a so-called secular trend toward an earlier age of menarche in the industrialized world. Data also suggest larger increments of growth, greater size for age during childhood, and earlier final height attainment (Smith, 19771. Despite questions about the reliability of past data collection methods, these trends appear to be accurate and the differences statistically significant. The age of menarche occurred 2-3 months earlier per decade during the past 150 years in Europe and the United States, with a leveling off of growth and age of menarche as standards of living increased (Wyshak and Frisch, 1982~. More equitable socioeconomic conditions have also resulted in the elimination of discrepancies associated with social class and urban-rural differences. The current average age of menarche in the United States of 12.8 years has been relatively stable since 1947. The reasons for this secular trend are not well understood. The reduction of such growth-retarding factors as poor nutrition and chronic illness has been cited most often, and recently documented trends toward a later age of menarche in Bangladesh appear to support this hypothesis (Chow~hury et al., 1978~. Whether this historical acceleration in the rate of general body maturation has been associated with comparable changes in the rate of brain development and level of performance of children growing up in industrialized societies is unknown. Preliminary data do suggest, however, that variations in age of onset of puberty may have developmental and behavioral consequences during adolescence. In a study of more than 5,000 white males and females ages 12-17 (Duke et al., 1982), late-mat-tiring males scored lower on education-related variables and early-maturing males scored higher than those in the middle maturity groups. These differences were found to be independent of measured intelligence and weaker at age

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 27 12 than at older ages. No consistent and statistically significant differences related to maturational status were found among females. Other studies, reporting inconsistent findings that imply disadvantages for early-maturing girls as well as late-maturing boys, suggest that cultural context and social class may be important determinants of the influences on behavior of the differential timing of physical maturation (CIausen, 1975; Jones et al., 1971~. Interactions among academic achievement, personal and social develop- ment, and physiologic maturity are not well understood. Further studies of these relationships, particularly regarding the early onset of pubertal changes in the middle childhood years, are needed. Developmental Neurobiology Although the biology of physical growth and maturation during the middle childhood years is generally understood, the basic development and regu- lation of the nervous system and its relationship to behavior remain a com- plex mystery. The bulk of our knowledge regarding the process of neuromaturation comes from gross and microscopic anatomical studies that have demonstrated the highly regulated progression of cell proliferation, migration, and differentiation that characterizes the early development of the central nervous system in a wide variety of animal species. The relatively invariant timing of this process and the intricate coordination of its multiple interacting cellular systems strongly supports the assumption that early neu- romaturation is largely controlled by a genetically determined regulatory system. That environmental factors can influence this process has been documented by a substantial body of data showing reduced cell numbers during the proliferation stage and reduced cell size during the differentiation stage in the face of severe and prolonged undernutrition. Moreover, rela- tionships between differential visual experiences in early infancy and sub- sequent morphological changes in the brain suggest that behaviorally mediated contingencies can also have a significant effect on this highly controlled biological process (Hube! et al., 1977~. Since the average human brain is 65 percent of its adult size at birth and 90 percent by age 2, it is not suprising that anatomical studies alone have provided relatively little insight into the neuromaturational process beyond infancy. Thus, further understanding has required a shift in focus from structure to function. Available data on the biochemical and physiological mediators of human behavior, however, are extremely primitive, and their clinical applicability remains obscure. Several areas of investigation, espe- cially the concepts of neurotransmission and neuromodulation, appear wor- thy of examination in relation to the development of school-age children.

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28 DEVELOPMENT DURING MIDDLE CHILDHOOD Neurotransmission, the process whereby individual nerve cells commu- nicate, involves the highly specific synthesis, storage, release, uptake, and degradation of discrete chemical substances that cross synaptic clefts and relay excitatory or inhibitory messages to postsynaptic receptor sites. Neu- romodulation refers to the process whereby a specific substance simulta- neously affects large numbers of neurons, thereby modifying a number of neurotransmitter actions. Hormonal influences provide a classic example of this latter activity. Hormonal Influences Hormonal influences on the central nervous system have been studied in a wide variety of animal species. Accumulated data suggest that specific hormones may exert differential effects on the brain, depending on its ma- turational status. During the critical early stages of development, for ex- ample, the influence may be inductive or organizational. In the mature central nervous system, excitatory, activational, and inhibitory effects are noted. School-age children and comparable groups among other vertebrate species have been less well studied than the perinatal and adult organisms. Among the studies of hormonal influences on animal behavior, data on androgen effects are of particular interest for human development in middle childhood. The secretion of adrenal androgens in children begins to increase between ages 7 and 8, well before the dramatic rise in their plasma levels that accompanies the onset of puberty. The developmental and behavioral influences of these prepubertal androgens deserve further investigation. Studies in rats, chickens, and rhesus monkeys strongly suggest that the organization and maintenance of social rank is, at {east in part, affected by gonadal hormones. Positive correlations among aggressive behavior, social rank, and plasma androgen levels in males, and perhaps in females, have been extensively documented for a wide variety of species (Flickinger, 1966; Kling, 1975; Lloyd, 1971; Rose et al., 1971~. The degree to which exper- iential factors modify the physiological effects of sex hormones is still unclear. Edwards and Rowe (1975) acknowledge that the specific expression of be- haviors is related to environmental circumstances, but they view aggressive urges themselves as hormonally mediated, internal events. The relative validity of such assertions for human behavior is unclear, although evidence suggests that the influence of social experience increases as one ascends the phylogenetic tree (Lloyd, 1975~. Studies by Olweus et al. ( 1980) documented strong correlations between plasma testosterone levels in pubertal boys and the intensity of their aggressive responses to provocation and weak corre- lations with aggressive attitude for unprovoked aggression. They suggest that

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 29 further investigation requires careful delineation of different aggressive di- mensions as well as avoidance of omnibus measures. The neuromaturational timing of ancirogen influences is particularly in- triguing. In many animal species, androgens exert an early organizing effect on brain architecture as well as on subsequent patterns of function. Mor- phologic differences between male and female brains in rats and rhesus monkeys, for example, have been well described (Bubenik and Brown, 1973; Raisman and Field, 1971), In humans, gestational plasma levels of testos- terone have been directly correlated with aggressive postnatal behavior for children of both sexes (Kling, 1975), and girls exposed to increased andro- genic stimulation in utero (e.g., newborns with acirenogenital syndrome) have been notes! to later demonstrate more tomboy behavior than average female children (Ehrhardt, 1975; Money, 1973~. A recent study describing impaired spatial ability in men with idiopathic hypogonadotrophic hypo- gonadism (characterized by an isolatecT, severe pubertal androgen deficiency), normal spatial skills in men with hypogonadism acquired during or after an otherwise normal puberty, ant] the failure of exogenous androgens to reverse the deficits in the postaclolescent idiopathic group suggests that androgens may have a permanent organizing influence on cognitive function before or during puberty (Hier and Crowley, 1982~. Although a number of meth- odological questions were raised about the collection and analysis of these data (Kagan, 1982) and adult male superiority on tests of spatial reasoning has been well documented (Maccoby end Jacklin, 1974), the hypothesis that these sex differences are mediated by a specific androgen effect just before or during puberty requires further evaluation. The classic paradigm for hormonal research with experimental animals has involved extirpation of the gland, subsequent replacement therapy, and evaluation of behavior under both conditions. Aside from the ethical re- strictions imposed on human research, most studies have been flawed meth- odologically because they have excluded females and have failed to delineate potentially confounding factors in the physical and social environment. Despite the limitations of available data, a substantial body of evidence suggests that gonadal hormones, gonadotropins, and adrenal hormones in- fluence and are affected by social interactions among groups of experimental animals and may play an important role in the regulation of human social behavior (Lloyd, 1975; Rose et al., 1971~. Future research in this area will demand sophisticated multidisciplinary collaboration in order to adequately investigate levels of interaction between neurohormonal regulation and the social-emotional milieu. In addition to their association with aggression and dominance, adrenal steroids have been shown to be mobilized in response to a variety of aversive

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30 DEVELOPMENT DURING MIDDLE CHILDHOOD social stimuli, including crowding and defeat Floyd, 1975~. In fact, brain- mediated interactions between the endocrine and autonomic nervous systems appear to play a vita! role in the physiological response of humans to stress. The most commonly reported consequences of a stressful stimulus include increases in serum corticosteroid, catecholamine (epinephrine), growth hor- mone, and prolactin, with a corresponding fall in serum testosterone (Rose, 1980~. Although increased epinephrine release by the adrenal medulla shows no evidence of a habituation effect, even after the organism shows behavioral adaptation to a repeated stressor, the hypothalamic-mediated release of in- creased corticosteroid by the adrenal cortex diminishes with repetition of the stress stimulus. Recent neuropeptide research on hypothalamic-pituitary- adrenocortical system function (Sowers, 1980) and investigations of the stress-induced effects of the hypothalamic-limbic-midbrain circuits on en- docrine and autonomic nervous system responses (Usdin et al., 1980) have contributed to the rapidly increasing body of data documenting the physi- ological reactions produced by a variety of stressors, including situations that elicit a sense of threat, alarm, or distress as well as novelty, uncertainty, or unpleasantness (Hennessy and Levine, 1979~. These same neuroendocrine circuits have also been shown to be significantly involved in mediating adaptive functions of memory, appraisal, and motivational-emotional re- sponses. The contribution of these hormones to specific patterns of reaction and adaptation to social pressures and stress, however, remains to be elu- cidated and may ultimately provide critical insight into individual differences in resilience displayed by school-age children. Possible implications of these findings for health in middle childhood are discussed later in this chapter. Neurotransmission Perhaps the most promising area in research on brain-behavior relations is the current focus on the identification and functional understanding of neurotransmitters. The study of these substances, some of which have prob- ably not yet been discovered, directly addresses the question of how nerve cells communicate with each other and, therefore, how they produce such complex behaviors as coordinated ambulation, creative problem solving, and affective experiences. Neurotransmitters are the mediators of a highly regulated biological sys- tem. Virtually every neuron and tract in the brain is believed to exert its action through the release of a neurotransmitter, and virtually every recipient neuron has neurotransmitter receptor sites. Moreover, neurotransmitter sys- tems are continually reorganized during the development of the organism. Thus, whereas neuromaturation in the fetus and young infant may be dem

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 31 onstrated by observable changes in brain morphology, the maturational process in the older child may very well be characterized by significant modifications in neurotransmitter circuitry (Johnston and Singer, 1982~. In fact, it is reasonable to hypothesize that the relative plasticity of an immature nervous system may be related to the degree to which production and receptor sites can be modified to accommodate to different neurotransmitters. This hypothesis has particular relevance for the issue of age changes in respon- siveness to psychopharmacotherapy. Chemical substances that have been identified as neurotransmitters (amino acids, peptides, and biogenic amines such as dopamine, norepinephrine, epinephrine, and serotonin) have been the object of preliminary investi- gations whose potential findings may ultimately illuminate some of the neurological enigmas and developmental vicissitudes of the school-age pe- riod. Research with adults, for example, has shown that circulating epi- nephrine plays an important role in the coping behavior of healthy persons exposed to a variety of psychosocial stressors (Rose, 1980~. Under conditions of low and moderate behavioral arousal, a direct correlation has been reported between catecholamine secretion and efficiency of performance. Studies with children suggest that, among normal youngsters, those who secrete relatively more epinephrine tend to be socially and emotionally better adjusted than those with lower secretions (Frankenhaeuser and Johansson, 1975~. Lambert et al. (1969) reported that 8-year-old children with higher secretions of epinephrine were judged as being quicker and livelier, more decisive, open, curious, playful, and candid than their peers with lower epinephrine output. This trend was more pronounced for boys than for girls. The implications of these data for understanding differences in vulnerability and resilience are discussed later in this chapter. Preliminary evidence linking several neurological and functional disorders with abnormalities of specific neurotransmitter metabolism have provided the impetus for many clinical studies but no conclusive results. The report of elevated platelet serotonin in a subgroup of children with autism (Schain and Freedman, 1961), for example, and the recently described (though not replicated) improvement in behavior and cognitive function after pharma- cologic reduction of elevated blood levels in three autistic youngsters (Geller et al., 1982) has renewed interest in the role of serotonin in the development of the central nervous system without clarifying the pathophysiology of autistic behavior. The continuing search for the neurochemical bases of attention'6eficit disorders is particularly illustrative of the frustrations that have plagued investigators in this area. The successful therapeutic use of dextroamphe- tamine and methy~phenidate in appropriately selected children has been

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32 DEVELOPMENT DURING MIDDLE CHILDHOOD interpreted as indirect evidence for a catecholaminergic defect, inasmuch as these medications augment the function of catecholamines (Weeder, 1971~. Rodent studies in which the selective destruction of neurons rich in catecholamine was followed by clinical hyperactivity providecl further sup- port for this hypothesis (Shaywitz et al., 1976~. However, the marked het- erogeneity of the children clinically diagnosed as having attention deficits, the demonstration of decreased reaction time and improved performance on cognitive tests in "normal" prepubertal boys treated with dextroamphetamine (Rapoport et al., 1978), and the unavailability of a specific diagnostic test have thwarted attempts to characterize precisely the neurochemical basis of this clevelopmental disability. Pathogenetic mechanisms for well-docu- mentec] toxins, such as lead (NeedIeman et al., 1979), and objects of spec- ulation. such as food additives (Denny, 1982), remain to be elucidated. The neurophysiological mechanisms underlying the entire spectrum of learning disorders in school-age children are the subject of an extensive literature whose review is beyond the scope of this chapter. Although all learning is essentially mediated through brain function, the relevance of most available neuroscientific data for the practical management of school dysfunction is currently unclear. Repeated attempts to reliably link atypical electroencephalographic patterns and clinical signs of neuromaturational delay (so-called soft signs) with attention deficits and learning disabilities, for example, have yielded inconsistent results (Adams et al., 1974; Barlow, 1974; Lewis and Freeman, 1977; Touwen, 1972~. Although voluminous data on cerebral lateralization and hemispheric dominance have clearly dem- onstrated the linear, sequential, analytic, ant! verbal characteristics of left- brain function and the spatial, simultaneous, holistic, and intuitive nature of processing on the right, the translation of such findings into effective strategies for educational intervention has not been achieved. Neuropsy- chological assessment offers a promising vehicle for elucidating the biological basis for differences in learning style and proficiency among school-age chil- ciren. Its applicability for educational planning and curriculum design, how- ever, is unlikely to be realized unless neuroscientists, clinicians, and educators cooperate in the design, implementation, and analysis of collaborative in- vestigation. The study of neurotransmission, neuromodulation, and neuropsychology is in its infancy. Attempts to study interactions among multiple biochemical systems and the phenomenon of localized instead of whole-brain effects underline the technical complexity of this research. New technologies, such as positron emission tomography (PET scanning), offer methods for exam- ining neurotransmitter receptors in living patients (Wagner, 1980~. Their utility awaits the test of time.

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 33 It is reasonable to expect that basic neurobiological research will ul- timately elucidate the biochemical and physiological bases for a host of neurological disorders, specific learning difficulties, and behavioral dys- functions that afflict children in middle childhood. Furthermore, it is perhaps not unthinkable that neurotransmitter and neuroendocrine pro- files might ultimately provide insight into the biological bases for indi- viclual differences in temperament, coping style, ant] overall resilience and vulnerability throughout the life cycle. For the present and the near future, the application of neurochemical and neuropsychological assess- ment techniques to the study of the human nervous system is just begin- ning. In the more distant future, knowledge of brain-behavior relations might very well form the basis for a highly sophisticated system of diag- nostic assessment and prescriptive intervention for the developmental and behavioral concerns of school-age children. CONCEPTS OF HEALTH, ILLNESS, AND DISEASE A consideration of health issues of school-age children must begin with a clarification of what is meant by the terms health, illness, and disease. Perhaps the most pervasive metaphor in the history of medicine has been the concept of health as a state of equilibrium or balance. This concept provided an organizing principle for Hippocratic medicine in the fifth and fourth centuries B.C. and formed the basis for Galen's second-century A.D. popularization of the interaction of the four body humors, which dominated medical theory for several hundred years (Mechanic, 1978~. It is also clearly reflected in the ancient Chinese concepts of yin and yang (WalInofer and Von Rot- tauscher, 1972) and in the traditional health beliefs of many native American groups who believe that physical and mental health are a reflection of one's harmony with the earth (Primeaux, 1977~. The biological principle of ho- meostasis reflects the enduring influence of this concept of dynamic equi- librium in contemporary biomedical science. Despite the persistence of this seemingly universal principle, a satisfactory operational definition of health or welIness has not been developed. Dubos (1968:67) described health as a "modus vivendi enabling imperfect men to achieve a rewarding and not too painful existence while they cope with an imperfect world. " Parsons ~ 1972: 117) defined health as "the state of optimum capacity of an individual for the effective performance of the roles and tasks for which he has been socialized." The frequently quoted definition of the World Health Organization describes "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (Constitution of the World Health Organization, 1958:459~.

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34 DEVELOPMENT DURING MIDDLE CHILDHOOD From the literary to the political, such definitions underscore the wide- spread agreement on the importance of viewing health as a social concept (Lewis, 1953~. As noted by Mechanic (1978:53~: [EIven physical wellbeing is dependent on the context in which we live, our associations with others, and the physical and social assaults to which our living situation exposes us.... Moreover, even from a practical standpoint, we must come to appreciate that in the long run our wellbeing is less dependent on the elegance and sophistication of medical practice than on how we choose to live and what is done to the environment in which we live. The implications of this mode! for the health and development of school- age children are discussed later in this chapter. The phenomenon of sickness has been relatively easier to characterize. Its analysis has been significantly enhanced by those who have specified a differentiation between the concept of illness and that of disease. Eisenberg ( 1977:11 ) succinctly summarized this critical distinction by noting that "pa- tients suffer 'illnesses'; physicians diagnose and treat 'diseases.' " That is to say, disease refers to abnormality in the structure and/or function of body organs, whereas illness refers to the human experience of an uncomfortable change in one's state of being with or without an undesirable impairment of social function (Fabrega, 1974; Kleinman et al., 19781. Thus, disease and illness do not always coexist. Half of all adult visits to a physician's office are for symptoms whose biological basis is not identified (Stoeckle et al., 1964~. Many children with congenital heart disease never experience cardiac symptoms and therefore are not ill. Illness in any given individual is often distinct from the course of his or her disease. Among the many factors that contribute to these distinctions, the degree to which the human experience of poor health is affected by social and cultural influences has been extensively studied. Cultural Influences Physical illness implies a state of being that is undesirable, uncomfortable, or damaging in relation to the values and usual life situations characteristic of a given ecocultural niche. Thus, individual differences in perceptions, experiences, and coping patterns are significantly modified by systematic variations in the systems of meaning used to explain the phenomenon of sickness (Fabrega, 1972; Kleinman et al., 1978; Spector, 1979~. A seizure disorder may be variably regarded as a simple disease, a stigmatizing defect, or a reflection of supernatural powers (Mechanic, 19781. In some societies, obesity is the object of envy and desire; others define it as a health risk or

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALI7I 59 Berberian, R. 1916 The effectiveness of drug education programs: A critical review. Health Education Mon- ographs 4:377-398. Berenson, G., Frank, G., Hunter, S., Srinivasan, S., Voors, A., and Webber, L. 1982 Cardiovascular risk factors in children: Should they concern the pediatrician? Amencan Jourr~il of Diseases of Children 136:855-862. Berey, L., and Pollay, R. 1968 The influencing role of the child in family decision making. Journal of Marketing Research 5:70. Beverly, B. 1936 Effect of illness on emotional development. Journal of Pediamcs 8:533-543. Bibace, R., and Walsh, M. 1980 Development of children's concepts of illness. Pediarncs 66:912-917. 1981 Children's conceptions of illness. In R. Bibace and M. Walsh, eds., New Directions for Child Development: Cluldren's Conceptions of Heakh, Illness, Bodily Functions. No. 14. San Francisco: Jossey-Bass. Bland, I., Bewley, B., Banks, M., and Pollard, V. 1975 Schoolchildren's beliefs about smoking and disease. Health Educanon Journal 34:71-78. Blaney, N. 1981 Cigarette smoking in children and young adolescents: Causes and prevention. Advances in Behavioral Pediarucs. Vol. 2. Greenwich, Conn.: JAI Press. Blatt, I., Spencer, L., and Ward, S. 1972 A cognitive developmental study of children's reactions to television advertising. In E. Rubinstein, G. Comstock, and I. Murray, eds., Television and Social Behavior. Vol. 4. Television in Day lo Day Life: Patterns of Use. Washington, D.C.: U.S. Govemment Printing Office. Boles, G. 1959 Personality factors in mothers of cerebral palsy children. Genetic Psychology Monographs 59:159. Breslau, N., Weitzman, M., and Messenger, K. 1981 Psychologic functioning of siblings of disabled children. Pediarncs 67:344-353. Brewster, A. 1982 Chronically ill hospitalized children's concepts of their illness. Pediatrics 69:355-362. Brodie, B. 1974 Views of healthy children toward illness. Amencan Journal of Public Health 64:1156- 1159. Bubenik, G., and Brown, G. 1973 Morphologic sex differences in primate brain areas involved in regulation of reproductive activity. E=enenna 29:619. Bureau of the Census 1982 Current Population Reports, P-23, No. 114, ChaTaCtenSnCS of Amencan Children and Youth: 1980. Washington, D.C.: U.S. Department of Commerce. Available from the U.S. Government Printing Office. Bynner, J. 1970 Behavioral research into children's smoking. Some implications for anti-smoking strategy. Royal Society of Health Journal 90: 159-163. Caldwell, B., and Guze, S. 1960 A study of the adjustment of parents and siblings of institutionalized and non-institu- tionalized retarded children. A7r~an Journal of Mental Defic~y 64:845.

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60 Campbell, DEVELOPMENT DURING MIDDLE CHILDHOOD J 1975 Illness is a Faint of view: The development of children's concepts of illness. Child Development 46:92-100. 1978 The child in the sick role: Contributions of age, sex, parental status, and parental values. Journal of Health and Social Behavior 19:35-51. Charney, E., Goodman, H., and McBride, M. 1976 Childhood antecedents of adult obesity Do chubby infants become obese adults? New England Journal of Medicine 295:6. Chc~wdbury, A., Huffman, S., and Curlin, G. 1978 Malnutrition, menarche, and marriage in rural Bangladesh. Social Biology 24:316-325. Clausen, ]. 1975 The social meaning calf differential physical and sexual maturation. In S. Dragstin and G. Elder, eds., Adolescence in the Life Cycle. New York: Halsted. Cobb, S. 1976 Social support as a moderator of life stress. Psychosomatic Medicine 38:300-314. Constitution of the World Health Organization 1958 In The First Ten Years of the WHO. Geneva: Palais des Nations. Dawber, T. 1980 The Framingham Study: Epidemiology of Atherosclerotic Disease. Cambridge, Mass.: Harvard University Press. Denny, F. 1982 Defined diets and childhood hyperactivity: Consensus conference. Journal of the American Medical Association 248:290-292. Downey, A., and O'Rourke, T. 1976 The utilization of attitudes and beliefs as indicators of future smoking behavior. Journal of Drug Education 6:283-295. Dubos, R. 1965 Man Adapting. New Haven, Conn.: Yale University Press. 1968 Medicine, Man and Environment. New York: Praeger Publishers. Duke, P., Carlsmith, J., Jennings, D., Martin, ]., Dvmbusch, S., Gross, R., and Siegel-Gorelick, B. 1982 Educational correlates of early and late sexual maturation in adolescence. Journal of Pediatrics 100:633-637. Edwards, D., and Rowe, F. 1975 Neural and endocrine control of aggressive behavior. In B. Eleftheriou and R. Sprott, eds., Hormonal Correlates of Behavior. New York: Plenum Press. Egbuonu, L., and Starfield, B. 1982 Child health and social status. Pediatrics 69:550-557. Ehrhardt, A. 1975 Prenatal hormonal exposure and psychosexual differentiation. In E. Sachar, ea., Topics in Psychoendocrinology. New York: Grune & Stratton. Eisenberg, L. 1976 Medical ecology: The epidemiology of handicap. Birth. Defects: Original Article Series 12(4):181-188. 1977 Disease and Illness. Culture, Medicine, and Psychiatry 1:9-23. Elliott, G., and Eisdorfer, C. 1982 Stress and Human Health. New York: Springer. Engel, G. 1977 The need for a new medical model: A challenge for biomedicine. Science 196:129-135. 1979 The biomedical model: A Procrustean bed? Man and Medicine 4(4):257-275.

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BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 61 Evans, R., Henderson, A., Hill, P., and Raines, B. 1979 Smoking in children and adolescents: Psychosocial determinants and prevention strap egies. In Smoking and Health: A Report of the Surgeon General. Available from the U.S. Government Printing Office. DHEW Publication No. (PHS) 79-50066. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Fabrega, H. 1972 The study of disease in relation to culture. Behavioral Science 17:183-203. 1974 Disease and Social Behavior. Cambridge, Mass.: MIT Press. Flickinger, G. 1966 Response of the testes to social interaction among grouped chickens. General and Com- parative Endocrinology 6:89. Fraiberg, S. 1977 Insights From the Blind. New York: Basic Books. Fr~nkenh~ft~ser. M.. and lohansson. G. 1975 Behavior and catecholamines in children. In L. Levi, ea., Society, Stress and Disease. Vol. 2. Childhood and Adolescence. London: Oxford University Press. Freud, A. 1952 The role of bodily illness in the mental life of children. In P. Eissler, ea., Psychoanalytic Study of the Child. New York: International Universities Press. Frisch, R., Wyshak, G., and Vincent, L. 1980 Delayed menarche and amenorrhea in ballet dancers. New England Journal of Medicine 303:17-19. Gayton, W., Friedman, S., Tavormina, ]., and Tucker, F. 1977 Children with cystic fibrosis: I. Psychological test findings of patients, siblings, and parents. Pediatrics 59:888-894. Geller, E., Ritvo, E., Freeman, B., and Yuwiler, A. 1982 Preliminary observations on the effect of fenfluramine on blood serotonin and symptoms in three autistic boys. New England Jounce of Medicine 307:165-169. Gilliam, T., and Burke, M. 1978 Effects of exercise on serum lipids and lipoproteins in girls, ages 8 to 10 years. Artery 4:203. Gilligan, C. 1979 Woman's place in man's life cycle. Harvard Education Review 49(4). Gliedman, J., and Roth, W. 1980 The Unexpected Minority: Handicapped Children in American Society. New York: Harcourt Brace Jovanovich. Glomset, ]. 1980 High-density lipoproteins in human health and disease. Advances in Internal Medicine 25:91. Gochman, D. 1971 Some correlates of children's health beliefs and potential health behavior. Journal of Health and Social Behavior 12: 148-154. Goehman, D., and Sheiham, A. 1978 Cross national consistency in children's beliefs about vulnerability. International Jourrm1 of Health Education 21 (3): 189- 193. Goldberg, B., Veras, G., and Nicholas, ]. 1978 Sports medicine: Pediatric perspective. New York State Journal of Medicine 78: 1406. Green, D. 1979 Youth education. In Smoking and Health: A Report of the Surgeon General. DHEW Pub- lication No. (PHS) 79~50066. Washington, D.C.: U.S. Government Printing Office.

OCR for page 24
62 Haggerty, R. DEVELOPMENT DURING MIDDLE CHILDHOOD 1980 Life stress, illness and social supports. Developmental Medicine and Child Neurology 22:391- 400. Hamburg, D., Elliott, G., and Parron, D., eds. 1982 Health and Behatnor: Frontiers of Research in the Biobehauioral Sciences. Report of a study from the Institute of Medicine. Washington, D.C.: National Academy Press. Hamilton, P., and Andrew, G. 1976 Influence of growth and athletic training on heart and lung functions. European Journal of Applied Physiology 36:27. Heisel, I., Ream, S., Raitz, R., Rappaport, M., and Coddington, R. 1973 The significance of life events as contributing factors in the diseases of children. III. A study of pediatric patients. Journal of Pediatrics 83:119- 123. Hennessy, I., and Levine, S. 1979 Stress, arousal, and the pituitary-adrenal system: A psychoendocrine hypothesis. In I. Srague and A. Epstein, eds., Progress in Psychobiology and Physiological Psychology. New York: Academic Press. Hewett, S., Newson, J., and Newson, E. 1970 The Family and the Handicapped Child. Chicago: Aldine. Hier, D., and Crowley, W. 1982 Spatial ability in androgen~deficient men. New England Journal of Medicine 306:1202- 1205. Hobbs, N., Perrin, J., and Ireys, H. 1983 Summary of Findings and Recommendations. Public Policies Affecting Chronically III Children and Their Families. Nashville: Center for the Study of Families and Children, Institute for Public Policy Studies, Vanderbilt University. Holt, K. 1958 The influence of a retarded child upon family limitation. Journal of Mental Deficiency Research 2:28. Hovell, M., Bursick, J., and Sharkey, R. 1978 An evaluation of elementary students' voluntary physical activity during recess. Research Quarterly of the American Association of Health and Physical Education 49:460. Hubel, D., Wiesel, T., and LeVay, S. 1977 Plasticity of oculardominance columns in monkey striate cortex. Philosophical Transactions of the Royal Society of London 278:411. Hughes, L., and Bontemps, A. 1958 The Book of Negro Forbore. New York: Dodd, Mead. Hunt, G. 1973 Implications of the treatment of myelomeningocele for the child and his family. Lancet 2:1308. Iammarino, N. 1980 The state of school heart health education: A review of the literature. Health Education Quarterly 7:298-320. Johnston, M., and Singer, H. 1982 Brain neurotransmitters and neuromodulators in pediatrics. Pediatrics 70:57-68. Jones, M., Bayley, N. and Macfarlane, I., eds. 1971 The Course of Human Development. Toronto: John Wiley & Sons. Kagan, J. 1982 The idea of spatial ability. New England Journal of Medicme 306:1225-1227 (Editorial). Kleinman, A., Eisenberg, L., and Good, B. 1978 Culture, illness, and care Clinical lessons from anthropologic and cross-cultural re- search. Annals of Intemal Medicine 88:251-258.

OCR for page 24
BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH Klima, E., and Bellugi, V. 1979 The Signs of Language. Cambridge, Mass.: Harvard University Press. Kling, A. 63 1975 Testosterone and aggressive behavior in man and non-human primates. In B. Eleftheriou and R. Sprott, eds., Hormonal Correlates of Behavior. New York: Plenum Press. Koos, E. 1954 Labov, W. 1972 Language in the Inner City: Studies in the Black English Vernacular. Philadelphia: University of Pennsylvania Press. Lambert, W., Johansson, G., Frankenhaeuser, M., and Klachenberg-Larsson, I. 1969 Catecholamine excretion in young children and their parents as related to behavior. Scandinavian Journal of Psychology 10:306-318. Lanese, R., Banks, R., and Keller, M. 1972 Smoking behavior in a teenage population: A multivariate conceptual approach. Amer' ican Journal of Public Health 62:807-813. Langford, W. 1948 Physical illness and convalescence: Their meaning to the child. .1Ou~1 of Pediatrics The Health of Regionville. New York: Columbia University Press. 33:242-250. Laoye, J., Creswell, W., and Stone, D. 1972 A cohort study of 1,205 secondary school students. Journal of School Heals 42:47-52. Lavigne, I., and Ryan, M. 1979 Psychologic adjustment of siblings of children with chronic illness. Pediatrics 63:616- 627. Levitt, E., and Edwards, J. 1970 A multivariate study of correlative factors in youthful smoking. Developmental Psychology 2:5- 11. Levy, R. 1979 Testimony before the Subcommittee on Nutrition of the Committee on Agriculture, Nutrition, and Forestry, United States Senate, 96th Congress, May 22. Levy, S. 1980 Nutrition~education research: An interdisciplinary evaluation and review. Health Edu' cation Quarterly 7: 107- 126. Lewis, A. 1953 Health as a social concept. British Journal of Sociology 2:109-124. Lewis, C., and Lewis, M. 1974 The impact of television commercials on health related beliefs and behaviors of children. Pediatrics 53:431-435. Lewis, D., and Freeman, J. 1977 The electroencephalogram in pediatric practice: Its use and abuse. Pediatrics 60:324 330. Lloyd, J. 1971 Weights of testes, thymi, and accessory reproductive glands in relation to rank in paired and grouped house mice. Proceedings of the Royal Society of Experimental Biology and Medicine 137:19. 1975 Social behavior and hormones. In B. Eleftheriou and R. Sprott, eds., Hormonal Correlates of Behavior. New York: Plenum Press. Lowenberg, M. 1977 The development of food patterns in young children. In P. Pipes, ea., Nutrition in Infancy and Childhood. Saint Louis: C.V. Mosby.

OCR for page 24
64 Lynn, D., Glaser H., and Harrison, G. DEVELOPMENT DURING MIDDLE CHILDHOOD 1962 Comprehensive medical care for handicapped children: III. Concepts of illness in children with rheumatic fever. American Journal of Diseases of Children 103:42-50. Maccoby, E., and Jacklin, C. 1974 The Psychology of Sex Differences. Stanford, Calif.: Stanford University Press. Maccoby, N., Farquhar, J., Wood, P., and Alexander, I. 1977 Reducing the risk of cardiovascular disease: Effects of a community-based campaign on knowledge and behavior. Journal of Community Health 3: 100- 114. Marcus, L. 1977 Patterns of coping in families of psychotic children. American Journal of Orthopsychiatry 47:388-395. Mattson, A. 1972 Long-term physical illness in childhood: A challenge to psychosocial adaptation. Pediatrics 50:801-811. Mattson, A., and Gross, S. 1966 Social and behavioral studies on hemophiliac children and their families. Journal of Pediatrics 68:952. Mayer, J. 1975 Obesity during childhood. In M. Winick, ea., Childhood Obesity. New York: John Wiley & Sons. McAlister, A., Perry, C., Killen, J., Slinkard, L., and Maccoby, N. 1980 Pilot study of smoking, alcohol and drug abuse prevention. American Journal of Public Health 70:719-721. McAlister, A., Perry, C., and Maccoby, N. 1979 Adolescent smoking: Onset and prevention. Pediatrics 63:650-658. McAnamey, E., Pless, I.B., Satterwhite, B., and Friedman, S. 1974 Psychological problems of children with chronic juvenile arthritis. Pediatrics 53:523- 528. McNeal, ]. 1969 An exploratory study of consumer behavior of children. In I. McNeal, ea., Dimensions of Commercial Behavior. New York: Appleton-Century-Crofts. Mechanic, D. 1964 The influence of mothers on their children's health attitudes and behavior. Pediatrics 39:444-453. 1972 Social psychologic factors affecting the presentation of bodily complaints. New England Journal of Medicine 286:1132- 1139. 1978 Medical Sociology. Second edition. New York: Free Press. Merritt, R. 1982 Obesity. Current Problems in Pediatrics 12(11). Meyer, R., and Haggerty, R. 1962 Streptococcal infections in families: Factors altering individual susceptibility. Pediatrics 29:539. Micheli, L., and Smith, A. 1982 Sports injuries in children. Current Problems in Pediatrics 12(9). Money, J. 1973 Effects of prenatal androgenization and deandrogenization on behavior in human beings. In W. Ganong and L. Martini, eds., Frontiers in Neuroendocrinology. New York: Oxford University Press. Murphy, M. 1982 The family with a handicapped child: A review of the literature. Journal of Developmental and Behavioral Pediatrics 3(2):73-81.

OCR for page 24
BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 65 Nader, P., Baranowski, T., Vanderpool, N., Dunn, K., Dworkin, R., and Ray, L. 1983 The Family Health Project: Cardiovascular risk reduction education for children and parents. Joutnal of Developmental and Behavioral Pediatrics 4:3-10. Nagy, M. 1951 Natapoff, I. 1978 Children's ideas on the origin of illness. Health Education Journal 9:6. Children's views of health: A developmental study. American Journal of Public Health 68:995-1000. Nathan, S. 1973 Body image in chronically obese children as reflected in figure drawings. Journal of Personality Assessment 37:456-462. National Heart, Lung, and Blood Institute 1981 Arteriosclerosis, 1981. DHHS Publication No. (NIH) 81 2034. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Available from the U.S. Government Printing Office. National Science Foundation 1977 Research on the Effects of Television Advertising in Children: A Review of the Literature and Recommendations for Future Research. Washington, D.C.: National Science Foundation. Needleman, H., Gunnoe, C., Leviton, A., Reed, R., Peresie, H., Maher, C., and Barrett, P. 1979 Deficits in psychologic and classroom performance of children with elevated dentine lead levels. New England Journal of Medicine 300:689-695. Neuhauser, C., Amsterdam, B., Hines, P., and Steward, M. 1978 Children's concepts of healing: Cognitive development and locus of control factors. American Journal of Orthopsychiatry 48:335-341. big, L., Davis, D., Manderscheid, R., and Elkes, J. 1981 Toward a conceptual formulation of health and well being. In L. Eng and D. David, eds., Strategies for Public Health. New York: Van Nostrand Reinhold. Olweus, D., Mattson, A., Schalling, D., and Low, H. 1980 Testosterone, aggression, physical, and personality dimensions in normal adolescent males. Psychosomatic Medicine 42:253-269. Owen, G., and Lippman, G. 1977 Nutritional status of infants and young children: U.S.A. Pediatric Clinics of North America 24(1):211-227. Paffenbarger, R., and Hyde, R. 1980 Exercise as protection against heart attack. New England Journal of Medicine 302:1026. Page, L., and Friend, B. 1978 The changing United States diet. BioScience 28:192-197. Pantell, R., Stewart, T., Dias, J., Wells, P., and Ross, W. 1982 Physician communication with children and parents. Pediatrics 70:396-401. Parsons, T. 1972 Definitions of health and illness in the light of American values and social structure. In E. Jaco, ea., Patients, Physicians, and illness. Second edition. New York: Free Press. Pate, R., and Blair, S. 1978 Exercise and the prevention of atherosclerosis: Pediatric implications. In W. Strong, ea., Atherosclerosis: Its Pediatric Aspects. New York: Grune & Stratton. Perrin, E., and Gerrity, P. 1981 There's a demon in your belly: Children's understanding of illness. Pediatrics 67:841- 849. Perrin, E., and Perrin, J. 1983 Clinicians' assessments of children's understanding of illness. American Journal of Diseases of Cluldren 137:874-878.

OCR for page 24
66 DEVELOPMENT DURING MIDDLE CHILDHOOD Pless, I.B., and Douglas, M. 1971 Chronic illness in childhood: Part I. Epidemiological and clinical characteristics. Pedi- atucs 47:405-414. Pless, I.B., and Pinkerton, P. 1975 Chronic Childhood Disorder: Promoting Patterns of Adjustment. London: Henry Klimpton Publishers. Primeaux, 1977 Pless, I.B., and Roghmann, K. 1971 Chronic illness and its consequences: Observations based on three epidemiologic surveys. Journal of Pediatrics 79:351-359. President's Council on Physical Fitness and Sports 1977 The Physically Underdeveloped Child. Washington, D.C.: U.S. Government Printing Of- fice. M. American Indian health care practices: A cross-cultural perspective. Nursing Clinics of North America 12:57. Prugh, D., Staub, E., Sands, H., Kirschbaum, R., and Lenihan, E. 1953 A study of the emotional reactions of children and families to hospitalization and illness. American Journal of Orthopsychiatry 23:70- 106. Puska, P. 1973 The North Karelia project: An attempt at community prevention of cardiovascular disease. World Health Organization Chronicle 27:55-58. Radius, S., Dielman, T., Becker, M., Rosenstock, I., and Horvath, W. 1980 Health beliefs of the school-aged child and their relationship to risk taking behaviors. luternational Journal of Health Education 23(4):227-235. Rahe, R., and Arthur, R. 1978 Lite change and illness studies: Past history and future directions. Journal of Human Stress 4:3-15. Raisman, G., and Field, P. 1971 Sexual dimorphism in the preoptic area of the rat. Science 173:731. Rapoport, ]., Buchsbaum, M., Zahn, T., Weingartner, H., Ludlow, C., and Mikkelsen, E. 1978 Dextroamphetamine: Cognitive and behavioral effects in normal prepubertal boys. Science 199:560-562. Rizek, R., and Jackson, E. 1980 Current Food Consumption Practices and Nutrient Sources in the American Diet. Hyattsville, Md.: Consumer Nutrition Center, Human Nutrition Science and Education Adminis- tration, U.S. Department of Agriculture. Rose, R. 1980 Endocrine responses to stressful psychological events. Psychiatric Clinics of North America 3:251-276. Rose, R., Holaday, J., and Bernstein, I. 1971 Plasma testosterone, dominance rank and aggressive behavior in rhesus monkeys. Nature 231:366. Rowland, T. 1981 Physical fitness in children: Implications for the prevention of coronary artery disease. Current PToble7ns in Pediatrics (9). Rutter, M. 1981 Stress, coping and development: Some issues and some questions. Journal of Child Psy- chology and Psychiatry 22:323-356. Schain, R., and Freedman, D. 1961 Studies on 5-hydroxyindole metabolism in autistic and other mentally retarded children. Journal of Pediatrics 58:315-320.

OCR for page 24
BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH 67 Schneider, F., and Vanmastrigt, L. 1974 Adolescent-pre~adolescent differences in beliefs and attitudes about cigarette smoking. Journal of Psychology 87:71 -81. Select Panel for the Promotion of Child Health 1981 Better Health for OUT Children: A National Strategy. DHHS (PHS) Publication No. 79- 55071. Washington, D.C.: U.S. Department of Health and Human Services. Shaywitz, B., Yager, R., and Klopper, J. 1976 Selective brain dopamine depletion in developing rats: An experimental model of min- imal brain dysfunction. Science 191:305. Shonkoff, J. 1982 Biological and social factors contributing to mild mental retardation. In K. Heller, W. Holtzman, and S. Messick, eds., Placing Children in Special Education: A Strategy for Equity. Panel on Selection and Placement of Students in Programs for the Mentally Retarded, Committee on Child Development and Public Policy, National Research Council. Washington, D.C.: National Academy Press. Sinclair, D. 1978 Human Growth After Birth. Third edition. London: Oxford University Press. Smith, D. 1977 Growth and Its Disorders. Philadelphia: W.B. Saunders. Sowers, ]., ed. 1980 Hypothalamic Hormones. Stroudsburg, Pa.: Dowden, Hutchinson and Ross. Spector, R. 1979 Cultural Diversity in Health and Illness. New York: Appleton-Century-Crofts. Sperling, E. 1978 Psychological issues in chronic illness and handicap. In E. Gellert, ea., Psychosocial Aspects of Pediatric Care. New York: Grune & Stratton. Stamler, J. 1 978 Introduction to risk factors in coronary artery disease. In H. McIntosh, ea., Baylor College of Medicine Cardiology Series (3). Northfield: Medical Communications. Stein, R., and Riessman, C. 1980 The development of an impact-on-family scale: Preliminary findings. Medical care 18:465- 472. Stoeckle, ]., Zola, I., and Davidson, G. 1964 The quantity and significance of psychological distress in medical patients. Journal of Chronic Disease 17:959-970. Task Force on Pediatric Education 1978 The Future of Pediatric Education. Evanston, Ill.: American Academy of Pediatrics. Telch, M., Killen, J., McAlister, A., Perry, C., and Maccoby, N. 1982 Long-term follow up of a pilot project on smoking prevention with adolescents. louTnal of Behavioral Medicine 5:1-8. Tew, B., and Laurence, K. 1973 Mothers, brothers, and sisters of patients with spine bifida. Developmental Medicine and Child Neurology 15 (Suppl. 29):69-76. Thomas, G., Lee, P., Franks, P., and Paffenbarger, R., eds. 1981 Exercise and Health: The Evidence and the Implications. Cambridge, Eng.: Oelgeschlager, Gunn, and Hain. Tc~uwen, B. 1972 Laterality and dominance. Developmental Medicine and Child Neurology 14:747-755. Turk, ]. 1964 Impact of cystic fibrosis on family functioning. Pediatrics 34:67.

OCR for page 24
68 DEVELOPMENT DURING MIDDLE CHILDHOOD U.S. Public Health Service 1979 Smoking and Health: A Report of the Surgeon General. DHEW Publication No. (PHS) 79- 50066. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Avail able from the U.S. Govemment Printing Office. Usdin, E., Kvetnansky, R., and Kopin, I., eds. 1980 Carecholamines and Stress: Recent Advances. New York: Elsevier/Noreh Holland. Vance, J., Fazan, L., Satterwhite, B., and Pless, I.B. 1980 Effects of nephrotic syndrome on the family: A controlled study. Pediatrics 65:948-955. Van Itallie, T. 1979 Obesity: Adverse effects on health and longevity. American Journal of Clinical Nutrition 32:2723-2733. Vogel, F., and Motulsky, A. 1979 Human Genetics: Problems and Approaches. Berlin: Springer-Verlag. Wagner, H. 1980 Nuclear imaging: New developments. Hospital Practice 15:117. Wallnofer, H., and Von Rottauscher, A. 1972 Chinese Folk Medicine. New York American Library. Ward, S., Levinson, D., and Wackman, D. 1972 Children's attention to television commercials. In E. Rubinstein, G. Comseock, and ]. Murray, eds., Television and Social Behavior. Vol. 4. Television in Day to-Day Life: Pattems of Use. Washington, D.C.: U.S. Government Printing Office. Warren, M. 1980 The effects of exercise on pubertal progression and reproductive function in girls. Jourrml of Clinical Endocrinology and Metabolism 51:1150. Webb, T., and Oski, F. 1973 Iron deficiency anemia and scholastic achievement in young adolescents. ]ournal of Pediarrics 82:827-830. Weil, W. 1981 Obesity in children. Pediatrics in Review 3:180-189. Weisenberg, M., Kegeles, S., and Lund, A. 1980 Children's health beliefs and acceptance of a dental preventive activity. Journal of Health and Social Behavior 21:59-74. Weiss, P. 1967 1 + 2 = 2: When one plus one does not equal ewo. In G. Quarton, T. Melnechok, and F. Schmidt, eds., The Neurosciences: A Study Program. New York: Rockefeller Uni versity Press. Wellman, H., and ]ohnson, C. 1982 Children's understanding of food and its functions: A preliminary study of the devel- opment of concepes of nutrition. Journal of Applied Developmental Psychology 3:135-148. Wender, P. 1971 Minimal Brain Dysfunction in Children. New York: Wiley Interscience. Werner, E., and Smith, R. 1982 Vulnerable But Invincible-A Study of Resil~ent Children. New York: McGraw-Hill. Wright, E. 1982 Children's perceptions of vulnerability to illness and dental disease. Community Dentistry and Oral Epidemiology (10) 1 :29-32. Wyshak, G., and Frisch, R. 1982 Evidence for a secular trend in age of menarche. New England]ournal of Medicine 306:1033- 1035. Yankelovich, D. 1970 Mothers' Atritudes Toward Children's Programs and Commercials. Newton Center, Mass.: Action for Children's Television.

OCR for page 24
BIOLOGICAL SUBSTRATE AND PHYSICAL HEALTH Zborowski, M. 1952 Cultural components in responses to pain. Joumal of Social Issues 8:16-30. Zola, I. 1966 Culture and symptoms: an analysis of patients' presenting complaints. American Socio- logical Review 31:615-630. 69