Research of Note for March 2003

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As kinship care continues to grow across the country, new research on the use of relatives to care for abused and neglected children is especially timely. Research on caffeine use, sleep habits and whether high school marijuana use predicts later drug abuse provides important reminders of the challenges facing youth in their daily lives and how they might influence their accomplishments now and in the future.

When Relatives Care for the Kids

A First Look at the Need for Enhanced Support Services for Kinship Care
Amy L. Gordon, Sharon McKinley, Mattie Satterfield and Patrick A. Curtis
Child Welfare, January/February 2003, Vol. 82, No. 1, pgs. 77-96.
Available free from Sharon McKinley, Child Welfare League of America, 50 F St. NW, Sixth Fl., Washington, DC 20001. (202) 638-2952.

Family members have always stepped in when parents cannot care for children. But this time-honored tradition has become more and more of an official arrangement in abuse and neglect cases, and has raised important questions. Are family members likely to perpetuate the same problems that resulted in the child being removed from the home in the first place? Are family members like other foster families?

The Child Welfare League of America conducted focus groups as a “first look” at what kind of services were needed to enhance these arrangements.

Groups ranging in size from four to 14 were used to gather information from 37 kinship care providers in Baltimore. Because studies indicate that kinship caregivers tend to be older, less educated, less healthy and less financially secure than unrelated foster parents, their needs might be quite different.

The children entered kinship care for many reasons, but the most typical were substance abuse, incarceration, HIV/AIDS, or housing instability. Circumstances varied widely: Some had cared for the child since birth; others had made multiple complaints to Child Protective Services (CPS) to have the child removed from their parents; and some were suddenly and unexpectedly contacted by CPS to care for a child they barely knew.

The researchers report that what they all had in common was the desire to “keep the family together” and keep the child “out of the system.”

Most family members described major adjustments resulting from caring for the child, sometimes “starting over” at a time when they were retired or thought they were finished raising children. Several had to find a second or third job or give up retirement plans to support the new child or children in their care.

Many experienced a loss of freedom, because now they had to plan their time very carefully, or a loss of intimacy with their spouses because of the demands of once again fulfilling the role of parent.

Biological mothers often resent another relative taking over the mothering role, and kinship care was sometimes described as causing a rift in the family. On the other hand, some kinship caregivers complained that they had all the responsibilities for the child while the birthparents had all the legal rights.

Most kinship caregivers described themselves as offering a safer, better home than the child had before. They felt they were protecting the child and offering a better chance in life.

Although grandparents may have also raised the parent who had turned out to be inadequate, most grandparents in the focus groups repeatedly stated that the birthparent “was not brought up to live their lives the way they do” and pointed out that their other children had done well.

In some cases, the grandparent or other kinship caregiver was afraid to let the birthparent care for the child without supervision.

Contrary to the CPS agency’s view, kinship caregivers felt that they should be included when decisions are made about when the child could return to the birthparent. Many did not understand that the children they were caring for were officially in the custody of CPS.

Although they did not understand the official meaning of “permanency planning,” they understood the need for predictability and permanency in the children’s lives. While some hoped the birthparents would eventually be able to raise their own children, others wanted to raise the children and found the rewards well worth the effort. Most did not understand the legal terms “custody,” “guardianship” or “independent living.”

Many did not feel appreciated by CPS, which they felt treated them like temporary babysitters and issued too many orders. Not surprisingly, they found that the frequent turnover of caseworkers made their lives especially difficult. Some caregivers were so suspicious of “the system” that they did not take advantage of subsidized adoption opportunities, even though they wanted to adopt and would have benefited from the financial help.

The authors concluded that kinship caregivers need more information and a better relationship with CPS. Author Sharon McKinley told Research Watch that kinship caregivers wanted written information about how to seek support services, so that they wouldn’t have to go through caseworkers for assistance.

The findings are based entirely on focus groups, which have become an increasingly popular, even trendy, research tool. They have substantial shortcomings, however, because they evaluate relatively few people, and there is a risk that one or two opinionated individuals can sway an entire focus group.

In this study, can we assume that the 37 individuals who consented to participate are representative of all the people in Baltimore who provide kinship care? In addition, in describing the results of the group, the authors made many subjective statements about the patterns that emerged, with little or no information about how many individuals fit the description of “many” or “most,” or whether specific examples given even applied to more than one individual.

Focus groups provide interesting information, but more objective measures and individual interviews are necessary to draw conclusions.

Does Smoking Marijuana Predict Other Drug Use?

Escalation of Drug Use in Early-Onset Cannabis Users vs. Co-Twin Controls
Michael Lynskey, Ph.D., Andrew Heath, D. Phil., Kathleen Bucholz, Ph.D. and others.
Journal of the American Medical Association, January 22/29, 2003, Vol. 289, No. 4, pgs. 427-33.

Available free from or Missouri Alcoholism Research Center, Washington University School of Medicine, 40 N. Kingshighway, Suite One, St. Louis, MO 63108.

Marijuana has traditionally been considered less worrisome than other illegal drugs, but the societal costs may be higher than most people think. There were 220,000 marijuana-related admissions to publicly funded substance-abuse programs in the United States in 1999, and approximately one-third were youth between 12 and 17. Another one-third were ages 18 to 25.

As marijuana has become a more powerful drug, there have been growing concerns about its short-term dangers as well as its long-term health risks, such as cancer. However, a long-standing concern has been based on the view that marijuana is a gateway drug, leading to the abuse of other, more dangerous illegal drugs.

Research has shown what most youth workers already knew: Teens often progress from marijuana to other drugs. But the studies have not been able to tease out whether marijuana use causes teens to seek more powerful drugs or merely increases their access to other illegal drugs. Another question is whether personal traits or genetic factors might predispose an individual to seek a way to become high, making marijuana a convenient first drug rather than a necessary first step toward addiction.

This study of 2,765 pairs of twins attempts to examine this progression while controlling for all the factors that twins have in common, such as genes, personality traits, home environment and (for the most part) access to drugs.

Researchers found that men and women who used marijuana or hashish before age 17 were more than twice as likely as others to become dependent on alcohol or to abuse any illegal drugs. Specifically, they were twice as likely to use marijuana/hashish, more than twice as likely to abuse sedatives, four times as likely to abuse stimulants or cocaine, and almost four times as likely to abuse heroin or other opiates. This was true whether the twins were identical or not.

In addition to the fact that twins have so much in common, the study also controlled for certain factors that were already known to predict illegal drug use, such as early alcohol or tobacco use, childhood sexual abuse, depression, social anxiety and parental conflict or separation.

The implications are that using marijuana or hashish before the age of 17 makes it much more likely that teens will abuse other drugs in their lifetimes – regardless of their genes or home life, or whether they have access to drugs through their twins.

The study has some shortcomings. Most importantly, it relied on self-report by adults (ranging in age from 24 to 36) who were asked to remember when they started using marijuana and to honestly report all their illegal drug use.

A second shortcoming to U.S. youth workers is that the twins were all Australians, and the social pressures might be different in Australia from here. That’s why Research Watch usually reviews studies based in the U.S. However, the overall findings about the impact of early marijuana use, even compared with twins who did not use marijuana, is likely to be relevant across cultures.

Caffeine for Sleepy Teens

Caffeine Consumption and Weekly Sleep Patterns in U.S. Seventh-, Eighth- and Ninth-Graders
Charles Pollak, M.D. and David Bright
Pediatrics, Vol. 111, No. 1, January 2003, pgs. 42-46.
Available from Pollak at the Department of Neurology, New York Presbyterian Hospital, Room ST 611, Cornell Medical Center, 525 E. 68th St., New York, NY 10021 or

Is caffeine worth worrying about? Nearly all adults consume caffeine at least once a week, often to intentionally cope with lack of sleep. Unfortunately, this can start a cycle of insomnia or sleep disturbance followed by more caffeine use. This article, co-authored by a high school student and a neurologist, found similar results for youths.

The study of 191 seventh-, eighth- and ninth-graders at a public middle school and high school in Columbus, Ohio, was based on daily diaries of their sleep times and use of food, drinks and over-the-counter medications containing caffeine. One of the authors of the study was a student at that high school; he recruited science teachers to let their students complete a questionnaire in class each morning for 14 consecutive days.

On average, the students went to sleep at 10:57 p.m. and woke up at 7:14 a.m. Caffeine intake ranged from zero to 800 milligrams per day, and averaged 1.1 caffeine-containing item per day, representing 63 milligrams of caffeine. (That’s a little more than a 12-ounce can of cola or a cup of tea, and about the same as three ounces of coffee.) Those who consumed more caffeine slept less at night, took longer to fall asleep and were more likely to fall asleep during the day.

Caffeine use did not increase between the ages of 12 and 15, but boys averaged 70 milligrams a day while girls averaged 55.

Sleep patterns did not change much with age, which is somewhat of a surprise: Bedtimes averaged 10:30 p.m. at age 12 and 11:10 p.m. at age 15. Average daily sleep varied from 6.1 hours to 9.8 hours, with an average of 8.3 hours, and only decreased by 18 minutes from age 12 to age 15. Students slept the longest on Saturdays and Sundays and the least on Mondays.

Since weekday sleep patterns differ from weekend sleep patterns, the findings might have been more useful if weekday and weekend habits had been analyzed separately. However, the charts show a clear spike on weekends – more hours of sleep, later waking and going to bed. Caffeine use peaked on Saturday at 77 milligrams.

Most people know that caffeine is in coffee, tea, cola and chocolate, but the researchers also counted caffeine that most of us never think about – such as an average of 40 milligrams in a serving of coffee ice cream or coffee yogurt, and 100 milligrams in many over-the-counter medications. Most caffeine consumption came from colas and other soft drinks with moderate caffeine levels, rather than highly caffeinated drinks such as Surge.

The implications for agencies and schools with vending machines is clear: The drinks and chocolate snacks may interfere with the nighttime sleep of youths.