A multilevel modeling approach was used to investigate the influence of age composition in 70 urban preschool classrooms. A series of hierarchical linear models demonstrated that greater variance in classroom age composition was negatively related to development on the Child Observation Record (COR) Cognitive, Motor, and Social subscales. This was true when controlling for class size, general classroom quality, and socioeconomic status at the classroom level and for age, gender, and baseline ability at the child level. Additionally, to address possible concerns related to nonrandom assignment to classrooms, a series of models were run including variance in developmental age (i.e., baseline ability) at the classroom level and at the child level. The results were consistent for chronological age composition and developmental age composition at the classroom level; greater variance in classroom developmental age composition was negatively related to Time 2 scores on the COR Cognitive, Motor, and Social subscales. Furthermore, a cross-level interaction indicated that negative influence of greater variance in classroom developmental age composition was stronger for children older in developmental age. Implications for early childhood education policy are discussed.

OBJECTIVE. Previous studies have suggested a relationship between childhood asthma and behavior problems. However, few studies have used community-based samples to assess the prevalence of behavior problems among urban children with asthma symptoms. The objective of this study was to evaluate the relationship between asthma symptoms and behavior among a population-based sample of inner-city children and to determine the prevalence of behavioral comorbidity among children with asthma symptoms.METHODS. In 2003, parents of children who were entering kindergarten in the city of Rochester completed a detailed survey regarding the child's background, medical history (with specific questions about asthma symptoms), and behavior. We compared children with no asthma symptoms, intermittent symptoms, and persistent symptoms with regard to positive peer social skills (eg, makes friends easily), negative peer social skills (eg, fights with other children), task orientation (eg, concentrates well), and shy/anxious behavior (eg, is withdrawn) (validated scales; range: 1-4). We used multivariate regression to determine the independent association between symptom severity and behavioral outcomes. RESULTS.A total of 1619 children were included (response rate: 80%; mean age: 5.1 year), and 15% had asthma symptoms (8% persistent, 7% intermittent). Average negative peer scores were worse for children with persistent asthma symptoms compared with children with intermittent and no symptoms (mean scores: 1.88, 1.70, and 1.65). Children with persistent symptoms also scored worse than children with no symptoms on the assessment of task orientation (2.85 vs 3.03) and shy/anxious behavior (2.11 vs 1.89). Among children with persistent asthma symptoms, Ͼ20% scored Ͼ1 SD below average on 2 or more scales, compared with 16% of children with intermittent symptoms and 10% with no symptoms.CONCLUSIONS. Urban children with persistent asthma symptoms demonstrate more behavior problems across several domains compared with children with no symptoms. These findings suggest a clear need for an early biopsychosocial approach to care for vulnerable children with asthma. A STHMA IS THE most common chronic illness of childhood, 1-3 and hospitalization rates are increasing. [4][5][6] In the United States, impoverished children and children from minority ethnic and racial backgrounds suffer disproportionately from asthma. [7][8][9][10][11][12][13] The morbidity associated with asthma is extensive and includes emergency department visits, 6,14,15 hospitalizations, 4,5,16 and cost, 17,18 as well as less traditional factors, including impaired quality of life 19 and absenteeism. 20 In addition, co-existing medical conditions [21][22][23] as well as psychiatric conditions 24,25 now are considered issues that both children and adults with asthma face.Several studies have documented the relationship between asthma and psychosocial problems, with the suggestion that significant comorbidity exists for some children. A recent meta-analysis 26 demonstrated...

Objective To explore the relationship between sleep-disordered breathing (SDB) and behavioral problems among inner-city children with asthma. Patients and Methods We examined data for 194 children (age 4–10 yrs) who were enrolled in a school-based asthma intervention program (response rate: 72%). SDB was assessed using the Sleep-Related Breathing Disorder (SRBD) questionnaire that contains 3 subscales: snoring, sleepiness, and attention/hyperactivity. For the current study, we modified the SRBD by removing the 6 attention/hyperactivity items. A sleep score of >.33 was considered indicative of SDB. To assess behavior, caregivers completed the Behavior Problem Index (BPI) which includes 8 behavioral subdomains. We conducted bivariate analyses and multiple linear regression to determine the association of SDB with BPI scores. Results The majority of children (mean age 8.2 yrs) were male (56%), African American (66%), and insured by Medicaid (73%). Overall, 33% of children experienced SDB. In bivariate analyses, children with SDB had significantly higher (worse) behavior scores compared to children without SDB on total BPI (13.7 vs 8.8, p<.001), externalizing (9.4 vs 6.3, p<.001), internalizing (4.4 vs 2.5, p<.001), anxious/depressed (2.4 vs 1.3, p<.001), headstrong (3.2 vs 2.1, p<.001), antisocial (2.3 vs 1.7, p=.013), hyperactive (3.0 vs 1.8, p<.001), peer conflict (.74 vs .43, p=.011), and immature (2.0 vs 1.5, p=.001). In multiple regression models adjusting for several important covariates, SDB remained significantly associated with total BPI, externalizing, internalizing, anxious/depressed, headstrong, and hyperactive behaviors. Results were consistent across SBD subscales (snoring, sleepiness). Conclusions We found that poor sleep was independently associated with behavior problems in a large proportion of urban children with asthma. Systematic screening for SDB in this high-risk population might help to identify children who would benefit from further intervention.

This study examines patterns of organized activity and their concurrent association with academic achievement, problem behavior, and perceived adult support in a sample of urban, early adolescent, middle school students (mean age = 13.01; N = 2,495). Cluster analyses yielded six activity profiles: an uninvolved group ( n = 775, 31.1%), a multiply involved group ( n = 247, 9.9%), a sports group ( n = 469, 18.8%), a church group ( n = 486, 19.5%), a school and community clubs group ( n = 278, 11.1%), and a community clubs and sports group ( n = 240, 9.6%). These profiles are differentially associated with academic achievement, problem behavior, and adult support. While some form of organized activity is generally associated with more positive outcomes, the school and community and community and sports profiles also report the highest levels of delinquency, drug use, and school suspensions. Results support the utility of using person-centered approaches to studying youth-organized activities.

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