A robust literature links childhood sexual abuse (CSA) to later substance use and sexual risk behavior; yet, relatively little empirical attention has been devoted to identifying the mechanisms linking CSA to risky behavior among youth, with even less work examining such processes in boys. With the aim of addressing this gap in the literature, the current study examined the indirect effect of childhood sexual abuse (CSA; from age 2 to 12) trajectory group on risky behavior at age 14 (alcohol use & sexual intercourse) via the intervening role of caregiver-reported internalizing and externalizing problems at age 12. Analyses were conducted with a subsample of youth (n = 657 sexual intercourse; n = 667 alcohol use) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), a multisite prospective study of youth at risk for maltreatment. For boys and girls, there was an indirect effect from CSA to sexual intercourse through externalizing problems. The same pattern emerged for alcohol use, but only for girls. Findings did not support an indirect path through internalizing problems for either boys or girls for either outcome. Findings suggest more focal targets for prevention efforts aimed at maintaining the health and safety of maltreated boys and girls during the adolescent transition.

Diapering, hand-washing, and food-preparation equipment that is specifically designed to reduce the spread of infectious agents significantly reduced diarrheal illness among the children and absence as a result of illness among staff in out-of-home child care centers.

The provision of Individualized services to families with young handicapped children has been hampered by the lack of a practical model. This article describes a functional model for assessing family needs, specifying family goals, implementing family services, and evaluating effectiveness. The model draws on the "goodness-of-fit" concept to individualize family services in order to optimize the "fit" between family, child, and services provided. 0 The importance of family involvement is a recognized principle in early intervention. Even though a recent meta-analysis of research suggests that empirical data to sup-

Objective Although widely studied in adults, the link between lifetime adversities and suicidal ideation in youth is poorly understood. The purpose of this study was to explore this link in adolescents. Methods The analyses used a sample of 740 16-year-old youth in the LONGSCAN sample, and distinguished between childhood (before the age of 12) and adolescent (between age 12 and age 16) adversities. Results There was a significant link between cumulative lifetime adversities and suicidal ideation. There was no evidence that this link was moderated by gender. Childhood adversities moderated the effects of adolescent adversities on suicidal ideation; effects of adolescent adversities were strongest at low levels of childhood adversities. There was also some evidence supporting a specific cumulative model of the effects of adversities on suicidal ideation; the most predictive model included the sum of the following adversities: childhood physical abuse, childhood neglect, childhood family violence, childhood residential instability, adolescent physical abuse, adolescent sexual abuse, adolescent psychological maltreatment, and adolescent community violence. Conclusion The timing and nature of adversities are important in understanding youth suicidal ideation risk; in particular, adolescent maltreatment and community violence appear to be strong predictors. Preventing and appropriately responding to the abuse of adolescents has the potential to reduce the risk of suicidal ideation.

Externalizing behavior is one pathway from childhood maltreatment to age of substance use initiation. Services for maltreated youth should incorporate substance use prevention, particularly among those with early externalizing problems.