Introduction To Connected Kids. Key Goal Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth

Introduction To

Connected Kids

Key Goal

Connected Kids: Safe Strong Secure is an AAP program designed to support clinicians’ efforts to prevent youth violence by promoting the development of resilient children.

Why Is This Important?

Violence is a major cause of childhood morbidity and mortality in the United States.

Homicide is the 2nd leading cause of death for 13- to 21-year-olds• The leading cause of death for African Americans 13 to 21

years old1

Increase in community violence during 1990s• 21st century rates in the United States still among the

highest in the world


Many parents and pediatricians feel community violence screening should be routine in well child care.2-5

Results from the 1998 and 2003 AAP Periodic Surveys of Fellows show that a majority of pediatricians feel unprepared to manage community violence.2-4

Parents want more doctors to discuss community violence.5

Results from the National Survey of Early Childhood Health


0 20 40 60 80 100

Alcohol/drug use in household

Parent's emotional support

Supportive partner

Community violence

%

Providershould askProviderasked

Connected Kids provides…

Tools and strategies to help parents raise resilient children: Educational materials for parents and

youth Effective anticipatory guidance Developmentally appropriate guidelines Easy-to-use Clinical Guide with links to

research

Development Process

Development of Connected Kids included6:

Input from parents, clinicians, and other experts Testing of program materials in focus groups

with diverse families and clinicians7

Incorporation of stakeholder feedback A broad and respectful approach for all of the

educational materials Coordination with other AAP efforts

Objectives

Connected Kids will:

Strengthen the connections among children and youth, their families, and their community

Reduce risk factors by building resilience8

Presentation Goals

1. Become familiar with the underlying theoretical model for Connected Kids

2. Review the counseling schedules for Infancy and Early Childhood, Middle Childhood, and Adolescence

3. Learn how to prepare a strategy for implementing this program in your practice

Connected Kids . . .

Uses an asset-based approach to prevention that:• Emphasizes the identification and enhancement of

strengths

• Enhances clinician-family alliance

Helps parents with strategies to:• Promote positive development

• Develop prosocial interpersonal skills

• Obtain support and resources to help raise children

Asset- Versus Risk-based Approaches to Guidance

Assets:

• Goal: Help improve child’s resilience

• Assess family strengths

• Link to community resources

Risks:

• Goal: Reduce known risks

• Screen for risk factors

• Refer to services

Connected Kids Includes:

Clinical guide Counseling schedule Handouts for parents and families Web site

• This training presentation

• Database of violence prevention materials

• Success stories

Clinical Guide

• This presentation supplements the clinical guide, available online at www.aap.org/ConnectedKids

• Clinical guide contains

• Background information

• Counseling schedule

• Visit-by-visit suggestions from birth to age 21

Building Blocks

Community Connections

Physical Safety

Connected Kids centers on 4 overlapping themes of anticipatory guidance

Child-Centered

Parent-Centered

Recognizes:• Child’s changing abilities

• Cognitive development of child

• Related parental concerns

Child-Centered

Child-Centered

Parent- Centered

Physical Safety


Parent- Centered

Parent-Centered

Addresses the importance of parental supports

Incorporates the idea that parents develop along with the child

Contributes to the quality of family life

Promotes positive parenting

Child-Centered

Physical Safety


Positive Parenting

Teaching desired behavior begins with a positive and nurturing foundation9

Ways to nurture your children and prevent misbehavior

How to manage conflictand teach responsibility

Whatto do when your child

misbehaves



Research underscores the importance of10:• Social capital: a measure of the

interconnectedness among people with their community

• Community connections

Clinicians can help connect families to community resources

Child-Centered

Parent- Centered

Physical Safety

Physical Safety

Counseling schedule focuses on violence and intentional injury• Complements AAP’s TIPP®

(The Injury Prevention Program)

Handguns in the home placed in the context of child development• Provides objective information to help

families make their own decisions

Physical Safety

Child-Centered

Parent- Centered


Connected Kids Counseling Schedule

Lists topics to introduce and reinforce at each visit

Provides asset-based assessment and anticipatory guidance for each visit

Links to use of parent and patient brochures:• Distributed when a topic is first introduced

• Promote discussion between provider and family

• Give useful information to foster the development of strong, resilient children

Counseling Schedule

Anatomy of a Brochure

Front Cover

Cover image visually conveys

core message

Designed by Artists for Humanity, a non-profit arts and entrepreneurship program for Boston teens.


Content Each brochure addresses

one specific issue Content based on all four

building block themes Reading level: 2nd to 6th

grade Contains concrete

examples for key concepts


Back Cover Summarizes topics Space provided for:

• Parent/patient guidance

• Follow-up suggestions

• Community resources

• Next appointment

• Practice name and address

Counseling Schedule

Infancy & Early Childhood

2 days – 4 years

Middle Childhood

5 – 10 years

Adolescence

11 – 21 years

Counseling Schedule: Infancy

• Establishing Routines• Discipline = Teaching• Firearms• Modeling Behavior

6 and 9 MONTHS

• Child Care• Family• Safe Environment• Parenting Style• Bonding and Attachment

2 and 4 MONTHS

• What Babies Do• Parental Frustration• Parent Mental Health• Parent Support

2 DAYS to

4 WEEKS

INTRODUCEVISIT

Infancy11-17

• Early caregiver relationships set the stage for future

relationships

• Securely attached young children have an easier time developing positive, supportive relationships

• Emerging evidence shows that securely attached young children are found to have more18-25:

• Balanced self-concept

• Advanced memory processes

• Sophisticated grasp of emotion

• Positive understanding of friendship

Infancy Counseling

Being a new parent can be exhausting. How are you doing?

If there is a gun in the home, how

is it stored?

How much time do you have off

from work?

Is this what you expected?

Who helps you with your baby?

Be on the lookout for families who are socially isolated or experiencing family discord.

Infancy Brochures

Welcome to the World of Parenting!Visit: 2 Days to 4 Weeks

Helps parents understand the normal development of newborns

Provides information about coping skills for parents

Discusses changes in the ways parents may now relate as a couple

How to Use this Tool

• Whenever appropriate, include both parents in the conversation

• Discuss infant crying and ways to handle it:

• Crying is normal

• Crying upsets parents

• Sometimes, parents just need to let the baby cry

Helpful Hint!

Support new parents with positive statements:

I love the way your baby looks at you, soothes to your voice. You’re doing a

great job!

Parenting Your InfantVisit: 2 and 4 Months

Helps parents understand normal development of 4- to 9-month-old infants

Stresses importance of building family connections

Discusses 3 problems:• Colic

• Trouble sleeping

• Clinging to parents


• Reiterate messages about crying and parental frustration

• Emphasize to parents the importance of having time together without their baby

Helpful Hint!

Support new parents with positive statements:

Your infant is alert, growing well, and has a beautiful smile!

How Do Infants Learn?Visit: 6 and 9 months

Offers practical suggestions to parents based on a newborn’s brain development• Encourages activities like reading or

singing to promote brain growth

Helps parents understand that exploration is a natural developmental need


• Ask parents about their social connections. Refer to sections “Others Who Care for Your Baby” and “Taking Care of Yourself”

• Utilize the “Social Connections” worksheet from the Clinical Guide

• Talk about child care arrangements

Helpful Hint!

Notice infant’s new behaviors and parent-child interaction:

Wow, your baby is really interested in my stethoscope! I like the way

she lets me examine her, but she is always looking over at you for

assurance.

Your Child is on the Move: Reduce the Risk of Gun Injury

Visit: 6 and 9 months

Correlates childhood injuries/ deaths due to firearms and presence of handguns in the home

Emphasizes that a child’s curiosity about guns overwhelms any lessons learned about gun safety

Provides information needed to make informed decisions


• Discuss handguns in the context of other household hazards

• Since some parents may not be in agreement concerning the presence of handguns in the home, encourage them to look at the brochure together to make an informed decision

Helpful Hints!

• In areas of country with high rates of gun ownership, some practices offer reduced price or free gun locks

• Be aware of the potential lethality of domestic violence in homes with handguns

Counseling Schedule: Early Childhood

• Peer Playing• Safety in Others’ Homes• Talking About Emotions• Promoting Independence

3 and 4 YEARS

• Child’s Assets• Guided Participation• Media

18 MONTHS and 2 YEARS

• Child Development andBehavior

12 and 15 MONTHS

INTRODUCEVISIT

Early Childhood26-30

Communication skills allow young children to sustain bouts of play

How young children learn to react is greatly influenced by:• Parental relationship

• Parental behavior

• Home environment

Early Childhood Counseling

“She really pays attention when

we talk; does she understand when

you speak to her?”

“Does your child have

opportunities to play with other

children this age?”

“What do you think your child does best? What does he enjoy

doing?”

“Teach your child by providing

positive reinforcement for

desired behaviors.”

Encourage alternatives to TV, such as outdoor activity

or reading.

Normal toddler behavior may be especially difficult for families with little social

support.

Early Childhood Brochures

Teaching Good Behavior: Tips on How to DisciplineVisit: 12 and 15 Months

Describes the basics of a behavioral approach to parenting toddlers• Positive reinforcement for desired

behaviors

• Limit setting

Advises parents about effective alternatives to corporal punishment


• Start conversations about toddler behavior with gentle inquiries

• “Your child is growing and developing well. Have tantrums started? How do you handle them?”

• “What is your child doing new since last visit? What do you want to change?”

• Endorse the core message: a simple approach for teaching toddlers how to behave well

Helpful Hint!Be on the lookout for children with difficult temperaments, families who are socially isolated, and families experiencing discord

Playing is How Toddlers LearnVisit: 18 Months and 2 Years

Helps parents understand normal toddler behavior and advises them how to

• Provide a stimulating environment during this period of major brain development

• Understand the natural curiosity and exploration of toddlers


• Discuss normal toddler play behavior

• Provide parents with guidance on the types of toys that stimulate imagination

• Help parents identify places where they can meet other toddlers and their parents

Helpful Hints!

• Check in with parents about how their family relationships are faring

• Support toddler’s parents with positive statements:

What a delightful child you have! He is really curious

about the world. This is great to see!

Pulling the Plug on TV ViolenceVisit: 18 Months and 2 Years

Provides information about the influence of TV violence on children

Offers tips for parents• Set limits on TV time• Know what children are watching• Watch programs with children• Do not put TV in a child’s room


• Identify alternatives to TV, such as toys that use imagination or outdoor play when possible

• Recognize that alternatives can be challenging, as TV often provides free in-home child care for families who cannot afford organized activities or who live in unsafe areas

Helpful Hint!

Ask the child: What’s your favorite TV show?

The child’s response often indicates the kind of TV programs being watched, which provides a topic to open discussion with parents

Young Children Learn A Lot When They Play

Visit: 18 Months and 2 Years

Introduces the importance of peer playing

Includes tips on how to make play opportunities successful

Assists parents in solving common difficulties, such as aggression and rejection


• Ask if child has opportunities to play with

other children of the same age

• Use parent’s answer to discuss how the child plays or how to find other children

• Help parents problem solve any play or playmate issues

Helpful Hint!

Try to notice something about what children are wearing, the toys they bring, or their behavior:

I see you really like trucks. Do you and your friends play

with trucks a lot?

• Child Mental Health• School Performance

Counseling Schedule: Middle Childhood

• School Connections• Alcohol and Drugs• Interpersonal Skills

8 YEARS

• Teaching Behavior• Bullying• Out-of-School Time

6 YEARS

• Establishing Routines and Setting Limits

5 YEARS

INTRODUCEVISIT

10 YEARS

Middle Childhood

Rapid development of knowledge and skills characterizes middle childhood

Routines and limits will help children feel loved and secure during this time of transition31,32

Children learn by watching and interacting with parents, other adults, and other children• Parents can consciously model and expect respectful

behavior33,34

Middle Childhood

Play is another way children learn social skills35 • Many parents have concerns regarding safety and

supervision for after-school activities

Schools can have a significant impact on preventing violence36,37 • Besides academics, children learn how to function in

society

• Parental involvement with schools improves their children’s experience and attachment

Middle ChildhoodCounseling for the Parent

Is your child happy most of

the time or withdrawn?

Who is your child’s best

friend?

How does your child help around

the home?

Do you have rules or limits with

respect to TV, video games, and

computer time?

Are you involved in any school-

related activities?

Children grow and develop within a context of family,

school, and community.

Middle ChildhoodCounseling for the Child

If you see someone being bullied, what do

you do?

What do you do for fun?

What do you like best about

school?

Have you been in any pushing or shoving fights?

What happens when you and your friends

argue or disagree?

School-age children need to be active

participants in learning how to avoid and react

to conflict.

Middle Childhood Brochures

Growing Independence: Tips for Parents of Young Children

Visit: 5 Years

Emphasizes importance of beginning parent-child communication about peer relationships early

Teaches parents how to:• Listen to children

• Help children assume more independence and responsibilities


• Address parents’ fears about children’s safety in the outside world

• Ask about how the child is doing in school and address any behavioral or emotional issues

Helpful Hints!• Let the child know that secrets are

not OK • Discuss child sexual abuse during

or after examination of the child’s genitals

I’m here with your mother so it’s OK. No adult should ever tell you to keep a secret from

your parents.

Bullying: It’s Not OKVisit: 6 Years

Provides guidance for parents of victims, bullies, and bystanders

Victims may seek medical attention, but the poorest future outcomes are among bullies themselves38,39

Schools can prevent bullying using proven interventions


• Place brochure in the waiting room; it may be of interest to both parents and children

• Discuss specific strategies with those families whose children are being bullied

• Use brochure as a guide when speaking to community groups

Helpful Hint!

Ask the child:

If the answer is yes, it is important to determine the child’s role.

Have you ever been in any pushing or shoving fights?

Drug Abuse Prevention Starts With Parents

Visit: 8 Years

Discusses connection between a teen’s use and abuse of drugs and/or alcohol and:• Parent behavior and attitudes

• Media influences

• Communication

Addresses parental role in modeling and maintaining open communication


• Encourage parents to talk with and listen to their children

• For parents who smoke, discuss the ease of starting and the difficulties of quitting; address other substance abuse problems if apparent

• Have substance abuse resources on hand

Helpful Hint!Start conversations about drug abuse with the recent news:

Did you hear about _____ being charged with _____? What do

you think about that?

Friends Are Important: Tips for Parents

Visit: 8 Years

Focuses on importance of peer relationships• Encourages parents to get to know their

child’s friends

Provides guidance on monitoring behaviors to prevent unsafe activities

Reiterates Connected Kids theme of clear, consistent, and positive communication


• Encourage parents to know their child’s whereabouts and talk about expectations for staying in touch

• Encourage parents to help their child develop a sense of belonging through prosocial youth groups and community-based organizations

Helpful Hints!• Address friendships and community activities while discussing

school progress and promoting physical activity

• Ask parent: “Who is your child’s best friend?” to initiate discussion

Everybody Gets Mad: HelpingYour Child Cope With Conflict

Visit: 10 Years

Developed for parents of pre- and early adolescents

Describes the physiology of anger and offers strategies to avoid fighting when angry

Guides parents in teaching their children how to respond to conflict

• Introduce the topic with general questions such as “Are there a lot of fights at school?” or “What happens when you get angry?”

• Discuss the body’s physical response to anger and how to stay calm


Helpful Hints!

• Ask patients who avoid fights if they have hints for other kids

• Consider the possibility of abuse, exposure to violence, or history of ADHD or minimal brain trauma in children who have difficulty dealing with anger

Counseling Schedule: Early Adolescence

VISIT INTRODUCE

11 to 14

YEARS• Family Time Together

• Peer Relationships

• Support System

• Staying Safe

• Teen Mental Health

• Conflict Resolution Skills

• Healthy Dating

• Gaining Independence

Early Adolescence

Independence is an overarching characteristic of the early teen years

Becoming independent means being more responsible for one’s own safety

Help teens stay safe by teaching them how to avoid violence through good communication skills

Effective communication is the common thread for the Connected Kids early adolescence counseling

Early Adolescence

Talk with teens and parents about activities that help families stay connected; many teens are unsure about family relationships40

Parents influence their teen children; discuss parental use of alcohol, tobacco, and other drugs

Involving adults from outside the family has a positive effect on teen development41

Encourage teens to get involved in their communities; it is one of the best ways to help them stay safe42

Early Adolescence

Teens with friends engaged in risky behaviors are more likely to imitate these behaviors43

Conversely, friends involved in constructive, prosocial activities encourage healthy and safe behaviors

Teen dating violence affects approximately 1 in 8 high school students. Discuss healthy dating with both teens and their parents44

Youth who have a variety of ways to solve conflicts are less likely to be hurt in a fight or arrested45

Early Adolescence

F I S T SFighting

Injuries

Sex

Threats

Self-defense

Use this mnemonic as the basis for assessing an adolescent’s risk for involvement in violence. See the Connected Kids Clinical Guide for more details.

Early Adolescence Counseling for Parents

What most concerns you about your

teenager’s safety?

What kind of activities does

your child enjoy?

How do you negotiate rules of behavior?

What do you think of your teenager’s friends?

How are you monitoring your

teenager?

Address parents’ concerns about safety

while still helping them encourage their teen’s

independence

Early Adolescence Counseling for Youth

Whom do you go to for help if you’re having trouble in your relationship?

What do you do to stay safe?

What do you and your friends like

to do?

What after-school activities are you involved with?

Whom do you turn to for advice and

encouragement?

With independence comes the responsibility

for staying safe.

Early Adolescence Brochures

Talking With Your Teen: Tips for Parents

Early Adolescence

Describes typical teen behaviors and feelings and emphasizes parent-child communication as independence increases

Teaches parents how to:• establish reasonable limits

• encourage safety as independence increases


• Initiate discussion at puberty by asking,“I’m sure there are many other changes going on that you can’t see with your eyes, aren’t there?”

• Speak with parents regarding concerns about their child’s puberty

Helpful Hints!• Having both teens and parents read this brochure may

encourage better communication between parent and child

• Ask parents to think about their own adolescence and how they behaved and coped at this age

Staying Cool When Things Heat UpEarly Adolescence

Encourages teens to think about ways to resolve conflicts other than fighting

Discusses the role bystanders play in promoting violent behavior


• Use different approaches based on violence history:

• “You’re very healthy, but I’m worried about all the fights you’re getting into.”

• “Your exam looks good and I’m also glad to hear that you haven’t been getting into a lot of fights.”

Helpful Hints!• Some clinicians leave this brochure in the waiting room for patients to read beforehand

• It may help to let patients know that this information came from other teenagers.

Expect Respect: Healthy RelationshipsEarly Adolescence

Discusses healthy relationships and ways to recognize and prevent partner violence

Teens are still experimenting with intimate relationships and may be more open to improving the quality of their relationships

While designed for all teenagers, it had the most resonance with young female teens in focus groups.


• Introduce when teens show an interest in relationships, dating, and sexual behavior

• Discuss healthy relationships along with physical concerns such as sexually transmitted diseases

• Can be used with sex education courses in schools

Helpful Hints! Today we have discussed some of the physical issues of intimate

relationships, but the emotional issues are just as important.

At the end of an exam, say:

Teen Dating Violence: Tips for ParentsEarly Adolescence

Discusses parental response when partner abuse is suspected

The main concern for parents is their child’s happiness and welfare, not pointing out what is wrong with the abusive partner


• Encourage parents to:

• empathize with what their child is experiencing

• support their child in finding and maintaining non-abusive, healthy relationships

Helpful Hint!

Give this brochure to parents at the same time Expect Respect: Healthy Relationships is given to teenagers

Counseling Schedule: Middle Adolescence

VISIT INTRODUCE

15 – 17

YEARS • Plans for the Future

• Firearms and Suicide

• Depression

• Resiliency

Middle Adolescence

There is a direct link between assets and the risk for violence and future success46

Identify and support a teen’s:• strengths

• functional abilities

• positive relationships with others

• connections to groups, role models, and mentors

Middle Adolescence

A key in helping teens avoid violence is to teach them how to:

• assess risk and make an immediate decision

• think about the long-term consequences of that decision

Middle Adolescence Counseling for Parents

What non-school activities is your

teen involved with?

Do you talk about future

plans?

How do you stay in touch with your teen?

If you have guns, how do you store

them?

How is your teen getting along with friends?

Help parents with the teen’s dilemma of quick decisions and long-term

consequences.

Middle Adolescence Counseling for Youth

Can you get a gun if you want to?

What do you want to do after

high school graduation?

How do you get along with your

friends?

What do you like best about yourself?

Do you have somebody to talk to when you feel

sad?

Teens are living in the moment, but need to

think about the future.

Middle Adolescence Brochures

Teen Suicide and GunsMiddle Adolescence

Discusses the risks of guns in the home and the link to completed teen suicides

Objectively discusses guns and gun storage


• Use on an individual basis to support counseling

• Can be distributed to schools and community groups

• Parents of teens with mood disorders may benefit from this along with the brochure Help Stop Teenage Suicide

Helpful Hints! Did you hear about the teen who killed himself last month? I’m talking

about this with all of my teenage patients.

Use current events:

Connecting With Your CommunityMiddle Adolescence

Teenagers who are involved in their communities are less likely to be involved with:• alcohol

• drugs

• violence

• promiscuous sexual activity


• As relationships with their parents become more complex, additional adult role models become more important for teens

• Support teens in finding adults in the community who believe in and support them

Helpful Hints!• Schools and community groups can help find opportunities that

meet the interests and talents of young adults

• It may be beneficial for clinics to develop a resource guide for teens about local community groups

Counseling Schedule: Late Adolescence

VISIT INTRODUCE

18 – 21

YEARS• Transition to

Independence

• Negotiating a New

Environment

(Post High School)

Late Adolescence

Transitioning to independence is a gradual process

Bringing closure to this process is essential

Many older teenagers are likely to be moving out of the home to:• higher education• their own living situation• an entirely new community

This is exciting and stressful for both teen and parent

Late AdolescenceCounseling for Youth

How do you feel about moving out?

Can I help with getting you

where you want to go?

Whom do you talk to about your future

plans?

What are your plans down the

road?

Do you plan to move out of your parents’ home?

Support patients with the transition to becoming a

young adult.

Late Adolescence Brochures

Help Stop Teenage SuicideLate Adolescence

Talks about common myths, gives the warning signs, and stresses that many teen suicides occur with little forethought

Designed for teens, parents, and other caregivers


• Use with patients with mental health issues, especially mood or conduct disorders, that often develop during these years

• Stress link between presence of a handgun and increased likelihood of lethal suicide attempts

Helpful Hint!• Teens who think they may be gay, lesbian, bisexual, or transgender

are at an increased risk for suicide; help them and their families find additional support

Next Stop Adulthood: Tips for ParentsLate Adolescence

Teens are renegotiating parental relationships as they transition into adult responsibilities

Helps parents let go while encouraging teens to seek guidance from their parents


• Use as a catalyst to discuss increasing independence

• Teens who are already in trouble may need a social worker to help better understand and implement these concepts

Helpful Hints!

• It is helpful to discuss employment, community service, sports, clubs, and other pursuits

• Teenagers need positive engagement with their outside community in order to thrive!

Ideas for Optimal Use

While implementing Connected Kids with an individual family depends on a family’s starting point—and the family’s interest in our input—we can begin to consider some strategies for implementation in the following areas:

• Intake Forms• Counseling• Educational Materials• Practice Changes• Community Connections

Intake Forms

Use the Bright Futures Pediatric Intake Form• Introduce Connected Kids in a cover letter to families

Use information gathered to prioritize issues for families and tailor the program

As your relationship with a family evolves, it may become easier to discuss sensitive topics

Use the information gathered at every visit

Counseling

Be sensitive to issues that might be difficult for a particular family

Include both statistics and stories

Prioritize topics covered on the families’ needs

Use the adolescent brochures to facilitate new ways for parents and teens to talk

Educational Materials

Use brochures to introduce sensitive topics, such as domestic violence

Encourage the parent to share the information with other adults caring for the child

Ask support staff to help distribute materials while patients are waiting to be seen

Educational Materials

Personalize the brochures:• Circling or underlining a passage increases the

likelihood that your advice will be followed

• Write down family-specific information in the box on the back cover during the visit

Suggest placing it on the refrigerator so the cover image can be a reminder of what to do

Encourage parents/patients to write questions in the box on the back while they are waiting

Practice Changes

Involve all office staff; receptionists observe how parents and children interact

Use the Counseling Schedule from the Clinical Guide to document when you have introduced and reinforced topics

Talk with colleagues about how they have successfully implemented Connected Kids


Become familiar with programs in your community

If resources do not exist, advocate for services

Get involved:• Join coalitions working to rid the community of

violence

• Speak to community and school groups

• Talk with the local media

In Summary

All children deserve to grow up:SafeStrongSecure

We can help families achieve these goals!

References

1. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System [Online]. (2001) National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Available at: www.cdc.gov/ncipc/wisqars

2. American Academy of Pediatrics. AAP Periodic Survey of Fellows #38. 19983. American Academy of Pediatrics. AAP Periodic Survey of Fellows #55. 20034. Trowbridge MJ, Sege RD, Olson L, O’Connor K, Flaherty E, Spivak H. Intentional injury

management and prevention in pediatric practice: results from 1998 and 2003 American Academy of Pediatrics Periodic Surveys. Pediatrics. 2005;116:996-1000

5. Kogan MD, Schuster MA, Yu SM, et al. Routine assessment of family and community health risks: parent views and what they receive. Pediatrics. 2004;113(6 suppl):1934-1943

6. Sege RD, Flanigan E, Levin-Goodman R, Licenziato VG, De Vos E, Spivak H. American Academy of Pediatrics’ Connected Kids program: case study. Am J Prev Med. 2005;29(5 suppl 2):215-219

7. Sege RD, Hatmaker-Flanigan E, De Vos E, Levin-Goodman R, Spivak H. Anticipatory guidance and violence prevention: results from family and pediatrician focus groups. Pediatrics. 2006;117:455-463

8. Resnick MD, Ireland M, Borowsky I. Youth violence perpetration: what protects? What predicts? Findings from the National Longitudinal Study of Adolescent Health. J Adolesc Health. 2004;35:424.e1-424.e10

References

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References

16. Sroufe LA, Carlson E, Schulman S. Individuals in relationships: development from infancy through adolescence. In: Funder DC, Parke RD, Tomlinson-Keasey C, Widaman K, eds. Studying Lives Through Time: Personality and Development. Washington, DC: American Psychological Association; 1993:315-342

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Acknowledgments

Howard Spivak, MD

Robert Sege, MD, PhD

Elizabeth Hatmaker-Flanigan, MS

Bonnie Kozial

Vincent Licenziato

Kimberly Bardy, MPH

This project was supported by Grant No. 2001-JN-FX-0011 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.

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