National statistics show that substance use and abuse is a much greater threat to the health of adolescents than to that of children in middle childhood. The use of substances like alcohol and tobacco develops very rapidly during early adolescence. However, research suggests that the most persistent drug use and abuse begins in middle childhood and, therefore, warrants understanding of the factors that predict such use during these years.
We have very reliable data on the use of alcohol by adolescents who are in grades 9 through 12 as a result of several national surveys (e.g., Monitoring the Future, a survey sponsored by the National Institute on Drug Abuse, and the Youth Risk Behavior Survey, sponsored by the Centers for Disease Control). We do not, however, have the same national data on alcohol use in children ages 6 to 12. A series of studies, however, examined substance use (both alcohol and tobacco) in approximately 2500 students from grades 6 to 9 who attended seven middle schools in Maryland. Students were studied over multiple years to understand not only the prevalence of alcohol and tobacco use in sixth graders and older students but also the factors that predict early onset and increased use of substances in this age group (Simons-Morton, 2004; Simons-Morton, Haynie, Crump, Saylor, Eitel, & Yu, 1999; Simons-Morton, Haynie, Saylor, Crump, & Chen, 2005). In this sample, 6.5% of sixth graders and 19.6% of eighth graders reported drinking in the past 30 days (Simons-Morton et al., 1999). These figures can be compared to 58% of twelfth graders from a national sample who reported using alcohol in the past month (Johnston, O’Malley, Bachman, & Schulenberg, 2006).
Studies have shown that early drinking behavior (e.g., in sixth grade) can lead to a longer period of increased risk in adolescence and is associated with later alcohol and drug abuse (Grant, 1997) and delinquent and problem behavior (Dawkins, 1997). Factors that predict which children are more likely to initiate early alcohol use are having friends who drink and engage in antisocial behavior, having high expectations about drinking, and having parents who won’t disapprove or don’t monitor drinking behavior (Donovan, 2004; Simons-Morton, 2004). Childhood personality factors, such as impulsivity and a lack of control flexibility, as well as childhood aggression may help to identify which children might be at risk for the early onset of drinking (Lochman, Wells, & Murray, 2007; Wong et al., 2006).
Factors associated with early alcohol use include poorer physical and mental health, low grades in school, low educational aspirations, and engagement in antisocial behavior/delinquency (Perkins & Borden, 2003). Health and psychological consequences of long-term alcohol misuse are liver disease, cancer, cardiovascular disease, and neurological damage as well as psychiatric problems, such as depression, anxiety, and antisocial personality disorder (Naimi et al., 2003; Sher, 2006).
Because early alcohol use has such long-term consequences for both the individual and society at large, a range of prevention programs have been designed to deter children in middle childhood from drinking. One such program is The Coping Power Program, designed to identify aggressive children in elementary school (Lochman et al., 2007). Over an 18-month period, practitioners work intensively with both children and parents to reduce aggressive behavior. The program focuses on improving the child’s social competence and ability to get along with other children, self-regulation and impulse control, school engagement and academic success, and improving parental interactions and interventions. Results have shown that this program produces significant preventative effects in children’s substance use by improving factors presumed to mediate substance use. Children who were involved in the prevention program had lower levels of substance use compared to children who were not in the program (Lochman & Wells, 2004). The success of this program indicates that supporting positive skills in school-age children is one approach to keeping them on a path to healthy development.
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