Resources

Publications, outreach and course materials from the HD faculty

Reprinted from NPR, "How To Help A Kid Survive Early Puberty," May 16, 2019, by Juli Fraga.

From surging hormones and acne to body hair and body odor, puberty can be a rocky transition for any kid. But girls and boys who start physically developing sooner than their peers face particular social and emotional challenges, researchers find.

Jane Mendle

"Puberty is a pivotal time in kids' lives, and early maturing boys and girls may be more likely to struggle psychologically," says Jane Mendle, a psychologist and associate professor at Cornell University.

2018 study conducted by Mendle and her team found that girls who entered puberty significantly earlier than their peers were at higher risk for mental health concerns. They're more likely to become depressed during adolescence, the study finds, and this distress can persist into adulthood.

"For some girls, puberty can throw them off course, and the emotional stress can linger," Mendle says, "even after the challenges of puberty wane."

While the age-range for puberty varies, says Jennifer Dietrich, a pediatric gynecologist at Texas Children's Hospital, the average age of menses is 12.3 years old. However, about 15% of females start puberty much sooner — by the age of 7.

Research from the American Academy of Pediatrics suggests boys are also developing earlier, by age 10, which is six months to one year sooner than previous generations.

Pediatricians haven't identified a lone cause for this shift, but Louise Greenspan, a pediatric endocrinologist at Kaiser Permanente in San Francisco, says childhood obesity, environmental chemical-contributors, and the effects of chronic stress — a hormonal response to neglect or abuse in the family, for example — may all play a role.

At a crucial time when kids long to fit in, puberty can make them stand out. And when breast buds and body hair sprout during elementary school, children often feel exposed. Unable to hide their sexual development from others, they may feel ashamed or embarrassed.

Cosette Taillac, a psychotherapist at Kaiser Permanente in Oakland, Calif., recalls a particular client, a 9-year-old girl, who was started to feel self-conscious playing soccer because her body was developing.

When the little girl no longer wanted to participate in sports — something she had always loved — her parents sought Taillac's help.

"She didn't want to dress in front of her teammates," says Taillac.

Studies show girls who physically mature early, may be more likely than boys to ruminate about these uneasy feelings. According to researchers, this can prolong the emotional distress, which may increase their risk of depression and anxiety.

Still, though girls are more likely to internalize the stress they feel, boys aren't unscathed, says Mendle.

In research by Mendle and her colleagues, early maturing boys were more likely than others to feel socially isolated and to face conflict with friends and classmates. "This may increase their risk of depression," she says,"but we're uncertain if these effects last into adulthood."

Because information about early development tends to focus on girls, parents are often perplexed when their sons start puberty early, says Fran Walfish, a child and adolescent psychotherapist in Beverly Hills, Calif.

Their first clue, she says, may come when a tween boy refuses to shower or wear deodorant.

Helping kids navigate these new social and emotional hurdles can be tricky, especially since puberty spans several years. But don't be afraid to reach out — or to start the conversation early.

Greenspan suggests talking to children about sexual development by the age of 6 or 7. "Starting the conversation when kids are young, and keeping lines of communication open can make the transition less scary," she says.

At times, parents may also need to advocate for their children. "My client's parents worked with the soccer coach to create more privacy for her when dressing for team events," says Taillac. The simple adjustment helped the girl feel safe and more confident.

Of course, not all kids are eager for a parent's help; some shy away from even talking about their newfound struggles. That's sometimes a sign they're confused or overwhelmed, child psychologists say.

"It's important for parents to realize that puberty triggers identity questions like 'Who am I?' and 'Where do I fit in?' for boys and girls," Walfish says.

Taillac says reading books together can help. "Books provide a common language to discuss what's going on, which can open up conversations between parents and children," she says.

For elementary school girls, "The Care and Keeping of You: The Body Book for Younger Girls," by Valorie Schaefer can be a helpful book. Reading "The Tween Book: A Growing Up Guide for the Changing You," by Wendy Moss and Donald Moses can be informative for boys and girls, even as they reach the teen years.

Seeing your child mature early can also worry a parent. If you find yourself unsure of how to intervene, psychologists say, remember that distraught kids often want the same thing we all seek when we're upset — a generous dose of empathy.

Luckily, compassion doesn't require parents to have all the answers. Puberty calls for the same good parenting skills as any other age: being emotionally available to kids through their developmental milestones, witnessing their growing pains, and providing comfort when life throws them curveballs.

That advice is simple; the effects powerful. Scientific evidence shows this kind of parental support helps foster emotional resilience, and that bolsters kids' health and relationships for years to come.

Listen to an interview with Jane Mendle to learn more about her research on early puberty in girls.

Listen to the HD Today e-NEWS Listen Notes playlists of podcasts featuring HD faculty interviews.

 

The Nurse-Family Partnership Program received California Evidence-Based Clearinghouse for Child Welfare's (CEBC) highest rating, "Well-supported by Research Evidence" in the following areas: Home Visiting Programs for Child Well-Being; Home Visiting Programs for Prevention of Child Abuse and Neglect; Prevention of Child Abuse and Neglect (Primary) Programs; Teen Pregnancy Services.

Resident-to-Resident Elder Mistreatment in Nursing Homes: Findings from the First Prevalence Study

This webinar, hosted by Consumer Voice in collaboration with the National Center on Elder Abuse (NCEA), discusses resident-to-resident mistreatment and how to prevent and respond to these incidents.

Dr. Karl Pillemer, Director, Bronfenbrenner Center for Translational Research, Hazel E. Reed Professor in the Department of Human Development, Professor of Gerontology in Medicine at the Weill Cornell Medical College, shared findings, recommendations, and best practices from his research regarding the prevalence of resident-to-resident elder mistreatment in nursing facilities. Consumer Voice staff shared information and resources to help increase awareness of these incidents and demonstrate how individualized care is critical in preventing and responding to resident-to-resident mistreatment.

The slides for this webinar can be downloaded as a PDF.

Additional Resources

Brochure for Consumers on Resident Mistreatment

This brochure (and large font fact sheet), a product produced by the National Consumer Voice for Quality Long-Term Care in collaboration with the National Center on Elder Abuse, identifies mistreatment, shares information about an individual’s rights, and offers resources where they can seek help. The brochure and large font fact sheet can be purchased in bulk from the Consumer Voice store.

Long-Term Care Ombudsman Advocacy: Resident-to-Resident Aggression (Technical Assistance Brief)

Resident-to-resident aggression is a serious issue that has a significant negative impact on all residents involved, but incidents are often not reported and investigated. The purpose of this brief is to provide an overview of resident-to-resident aggression in order to assist Long-Term Care Ombudsman (LTCO) programs in effectively responding to complaints involving resident-to-resident aggression, as well as help prevent RRA and reduce the prevalence of these incidents. Click here to view the brief.

Hebrew Home at Riverdale- Research Division R-REM Online Training

Reducing the Risk Plus (RTR+)  is an intervention for reducing sexual risk-taking in adolescents by Valerie Reyna and was rated as a best-evidence HIV behavioral intervention by the CDC. Best-evidence interventions are HIV behavioral interventions that have been rigorously evaluated and have been shown to have significant and positive evidence of efficacy (i.e., eliminate or reduce sex- or drug-risk behaviors, reduce the rate of new HIV/STD infections, or increase HIV-protective behaviors). These interventions are considered to be scientifically rigorous and provide the strongest evidence of efficacy. These interventions meet the PRS efficacy criteria for best evidence ILIs/GLIs/CPLs or efficacy criteria for best evidence CLIs.

The Cornell Research Program for Self-Injury Recovery is pleased to announce a unique set of evidence-informed and web-based education and training courses for individuals interested in understanding non-suicidal self-injury (also sometimes referred to as “cutting”) in youth. The courses are ideal for professionals who work directly with youth in schools or other community-based settings but will also be useful for clinicians and parents.

Non-Suicidal Self-Injury 101 (NSSI 101) was designed especially for professionals who work in schools or other youth-serving settings. Based on current, cutting-edge science, this training includes detailed information on the who, what, where, when and why of self-injury as well as evidence-informed strategies for detecting, intervening, treating and preventing. It also includes strategies for supporting the development of protocols for managing self-injury in school and other institutional settings.

This can be taken for continuing education credits (CEUs) from Cornell University or from the National Association of Social Workers. It is available as a self-paced course or as a 3-week facilitated course.

Non-Suicidal Self-Injury 101: A Web-Based Training

NSSI 101 can be taken as a self-paced or instructor-led course, is designed for individuals who need to know a significant amount about what self-injury is, where it comes from, what it is clinically associated with, how to respond individually and institutionally, and best practices in intervention and prevention.

There are two versions of the full 8-11 hour NSSI 101 course: a self-paced version and an instructor-led version. Both versions include videos, audio segments from well-known self-injury researchers and treatment specialists assignments and quizzes. The course will take between 8 and 11 hours, depending on the format you choose. There are discounts for students, groups, and parents. Scroll down for more information on discounts.

The content for the course is the same regardless of format but the facilitated version:

  • Offers a higher number of CEUs
  • Will allow discussion and strategies exchange with other students and with the instructor, an expert in NSSI
  • Allows for international participation and exchange
  • Increases the likelihood of course completion, since there are expectations about progress over the 3 week period.

Please note that we are working with Cornell’s premier e-education service provider, e-Cornell, to make this offering possible so you will be asked to sign up for an account at e-Cornell when you register.

What’s covered?
The course is designed to provide participants with broad grounding in non-suicidal self-injury, particularly as it shows up in adolescence and young adulthood. It contains material related to:

  • Adolescent development: Although a review for some of you, this section focuses on the features of brain, body, and identity development that affect self-injury onset, maintenance and recovery in the adolescent and young adult years. Since self-injury is most common during this time, understanding the way they are linked is useful.
  • Non-suicidal self-injury basics: In this section we get into the who, what, where, when and why of self-injury. We also discuss the important but poorly understood relationship between non-suicidal self-injury and suicide thoughts and behaviors, common myths, and factors that influence contagion.
  • Detection and intervention: Here we cover what you need to know about effective detection and responding, managing contagion, and common treatment approaches. There are also dedicated sections on effective intervention strategies and on and the nuts and bolts of developing protocols for handing self-injury in institutional settings.
  • Recovery: This section focuses primarily on how and why self-injury ends, what to expect as recovery happens, how you can best support the recovery process, and how self-injury can open opportunities for psychological growth.
  • Prevention: The final section covers prevention of self-injury behavior.

Are you a NYS Cornell cooperative extension educator?

All versions of Non-suicidal self-injury 101 are free to NYS Cornell cooperative extension educators. If you are an educator interested in enrolling in the course, please call (607) 255-6179 or e-mail us at self-injury@cornell.edu.

 

Valerie Reyna

Dr. Valerie Reyna is a member of National Academies' Committee on Pain Management and Regulatory Strategies To Address Prescription Opioid Abuse.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the  science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA’s development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.

Click to download a copy of the report.

This is an important report. Both untreated pain and the epidemic of opioid use are serious problems requiring urgent solutions. Somehow the balance must be found to both manage the increasing problem of pain in the aging US population, while regulating more effectively the diversion of prescription opioids into the broader population. This report represents the best thinking about how the balance might be made more effectively, while acknowledging the social determinants of opioid diversion and use in depressed communities.

Elaine Wethington

- Professor Elaine Wethington, Professor, Department of Human Development, Department of Sociology, and Gerontology in Medicine, Weill Cornell Medicine