An High quality pre-kindergarten has become something of an elusive luxury for middle class parents, caught between rising prices, the housing crisis and stagnating wages, according to An Health Sciences: UCLA Newsroom

• Study IDs three effective treatments for child anxiety
  Treatment that combines a certain type of psychotherapy with an antidepressant medication is most likely to help children with anxiety disorders, but each treatment alone is also effective, according to a new study funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health.   The study is currently available online in the New England Journal of Medicine.   Anxiety disorders are among the most common mental disorders affecting children and adolescents. Untreated anxiety can undermine a child's success in school, jeopardize his or her relationships with family and inhibit social functioning.   "This study represents a significant advance in the treatment of children and adolescents with anxiety disorders," said study author Dr. John Piacentini, a professor of psychiatry and director of UCLA's Child OCD, Anxiety and Tic Disorders Program. UCLA was one of six study sites.   The Child/Adolescent Anxiety Multimodal Study randomly assigned 488 children between the ages of 7 and 17 to one of the following four treatment options for a 12-week period:  
  • Cognitive behavioral therapy — a specific type of therapy that, for this study, taught children about anxiety and helped them face and master their fears by guiding them through structured tasks
  • The antidepressant sertraline (Zoloft), a selective serotonin reuptake inhibitor
  • Cognitive behavioral therapy combined with sertraline
  • A placebo (sugar pill)
    The children, recruited from six regionally dispersed sites throughout the United States, all had moderate to severe separation anxiety disorder, generalized anxiety disorder or social phobia. Many also had coexisting disorders, including other anxiety disorders, attention-deficit hyperactivity disorder and behavioral problems.   Piacentini and colleagues found that 81 percent of the children and adolescents who received the combination treatment improved, compared with 60 percent in the therapy-only group, 55 percent in the sertraline-only group and 24 percent in the placebo group.   Results also showed that the treatments were safe. Children taking sertraline alone showed no more side effects than the children taking the placebo, and few children discontinued the trial due to side effects. In addition, no child attempted suicide — a rare side effect sometimes associated with antidepressant medications in children.   The study findings echo previous studies in which sertraline and other selective serotonin reuptake inhibitors were found to be effective in treating childhood anxiety disorders. The study's results also provide further evidence that high-quality cognitive behavioral therapy, with or without medication, can effectively treat anxiety disorders in children, according to the researchers.   In addition to UCLA, study sites included Duke University; Columbia University/New York University; Johns Hopkins University; Temple University/University of Pennsylvania; and the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center.   Faculty within the UCLA Department of Psychiatry and Biobehavioral Sciences are experts in the origins of and treatments for disorders of complex human behavior. The department is an integral part of the Semel Institute for Neuroscience and Human Behavior at UCLA, an interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.
• Study finds fears of HIV transmission within families
  Despite ongoing efforts to educate the public about HIV, a new study by researchers from UCLA, the RAND Corp., Harvard University and Children's Hospital Boston has found that two-thirds of families with an HIV-infected parent experience fears about spreading HIV in the home.
  
  The qualitative study is the first to interview multiple family members, including minor children, in families with an HIV-infected parent about their concerns over HIV transmission in the household. The findings will be published in the November issue of the peer-reviewed journal Pediatrics.
  
  "We found that many of the worries were based on misconceptions about how HIV is spread," said lead study author Burt Cowgill, a staff researcher at the UCLA|RAND Center for Adolescent Health Promotion. "We also learned that HIV-infected parents had legitimate concerns about contracting infections such as a cold, flu or chicken pox while caring for a sick child. This knowledge could help pediatricians to address children's specific fears about HIV transmission as well as help clinicians who care for the HIV-infected parents."
  
  Between March 2004 and March 2005, the team conducted interviews with 33 HIV-infected parents, 27 of their minor children (ages 9 to 17), 19 adult children and 15 caregivers (spouses, partners, grandparents or friends). All HIV-infected parents had previously participated in the RAND Corp.'s HIV Cost and Services Utilization Study, a national probability sample of people over 18 with known HIV infection.
  
  Interview questions were open-ended and broad to elicit a detailed description of family members' experiences. In addition, follow-up questions focused on whether respondents' fears subsided over time and what was done in the household to address them.
  
  In a majority of the families, participants reported HIV transmission-related fears in the household. Concerns included acquiring HIV through contact with blood from a parent's cut, through saliva by sharing a bathroom or kissing, or by sharing food or beverages. HIV-infected parents were also concerned about catching an opportunistic infection from a sick child or other family member, and they were especially concerned about caring for a child with chicken pox, a cold or the flu.
  
  Families addressed their fears by educating children about how HIV is spread and establishing household rules and taking precautions to reduce risks. However, some of the fears were based on incorrect information and beliefs.
  
  "Fears about disease may substantially affect the relationship between the HIV-infected parent and child," said senior author Dr. Mark Schuster, chief of general pediatrics at Children's Hospital Boston and professor of pediatrics at Harvard Medical School. "It is critical not only to provide children with age-appropriate information on how the disease is transmitted, but also to clear up any misconceptions."   Schuster is also with the RAND Corp.   Findings from this paper and others coming from the qualitative study will inform researchers of the specific needs of families with an HIV-infected parent and aid in the development of interventions aimed at addressing their needs.
  
  This research was supported by the National Institute of Child Health and Human Development and the Centers for Disease Control and Prevention. The authors have no financial ties to disclose.
  
  In addition to Cowgill and Schuster, study authors included Laura M. Bogart, Rosalie Corona and Gery Ryan.
  
  The UCLA|RAND Center for Adolescent Health Promotion, a collaboration between the UCLA School of Public Health, the UCLA Department of Pediatrics and the RAND Corp., is a Prevention Research Center funded by the Centers for Disease Control and Prevention to conduct research on health-related issues relevant to children, adolescents and families.   For more news, visit the UCLA Newsroom.
• Pediatric patients celebrate Halloween at Mattel Children's Hospital UCLA
  WHAT: Despite being in the hospital, pediatric patients at Mattel Children's Hospital UCLA will still get to celebrate Halloween this year, by dressing up in costumes, decorating pumpkins and watching a magic show. In addition, canine teams from UCLA's People-Animal Connection (PAC) program will don costumes and accompany the kids while they trick-or-treat through the hospital hallways.   WHEN: 11 a.m.–1:30 p.m., Friday, Oct. 31
  • 11 a.m.: Creative arts, including crafts, face-painting and pumpkin-decorating
  • 11:45 a.m.: Magic show
  • 12:30 p.m.: PAC dogs greet kids, trick-or-treat parade begins
    WHERE: Child Life Playroom, on the fifth floor of Mattel Children's Hospital UCLA (757 Westwood Blvd., Los Angeles)   BACKGROUND: The annual Halloween party is