Children are continuously confronted with everyday stressors in their daily routine, and their ability to deal with these stressors has been found to be significantly related to their psychological adjustment. In fact, numerous studies have indicated that having a repertoire of coping skills at a young age can be a "buffer" or moderator" of the effects of negative life stress on the development of psychological maladjustment. Because of the importance of developing adequate skills to navigate life's daily challenges, a number of school-based interventions have been designed with the goal of teaching children specific "problem-focused" skills that are presumed to enhance coping, yet fewer programs have taught children "emotion focused" skills such as cognitive restructuring or emotional regulation to deal with more uncontrollable stressors. This paper begins with a review of the theoretical and empirical literature on children's coping with everyday stress and then provides a description of several existing coping skills training programs for children, highlighting those that are school-based interventions. A description is provided of a brief, school based intervention that was recently implemented to determine the differential effects of teaching young children "problem-focused" skills and teaching "emotion-focused" skills on children's subsequent use of specific coping strategies. The study and its outcomes are reviewed. The final section of the paper focuses on issues related to conducting intervention research in the schools, and specific suggestions for researchers are delineated for every stage in the process of school based research, to best assure that the research program can be implemented in the schools efficiently and effectively.

Historical foundations of quality of life (QL) assessment, including those in adult oncology, are reviewed in the context of the current need for a developmental measure for clinical pediatric research. QL measures that can be applied to the assessment of children with cancer and other chronic and life-threatening diseases are urgently needed. Use of valid QL scales would facilitate the evaluation of patient status over time as well as the comparison of results of patients with different diagnoses, treatment histories, and outcomes of therapy. The attributes of an effective QL measure, based on clinical experience in pediatric oncology settings, include simplicity and brevity as well as conventional psychometric properties. Psychologists, in collaboration with their pediatric oncologist colleagues, are encouraged to develop new QL assessment methods. Suggestions are given for studies necessary to accomplish this goal.

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The ability of midazolam, a benzodiazepine, to reduce the distress associated with lumbar puncture and bone marrow aspiration was examined in 23 children with acute lymphocytic leukemia. Patients were randomized to receive 0.2 mg/kg midazolam HCl or placebo intravenously 3-5 min before the procedures, under double-blind conditions. Based on prior experiences, children in both groups anticipated severe pain from these procedures. Postprocedure pain ratings by patients were markedly reduced in the midazolam but not the placebo group. Both physicians and parents judged the midazolam group as significantly less distressed than controls during and after the procedures. Trained observers recorded significantly fewer pain- and anxiety-related behaviors in the midazolam group immediately before and after, but not during the procedures. The amnestic effects of midazolam, confirmed in a visual recall/recognition test, appear to account for the decreased pain ratings since the behavioral manifestations were similar in the two groups. There were no adverse drug reactions or significant changes in vital signs. Midazolam warrants further investigation as a premedication for painful diagnostic and treatment procedures in children with cancer.