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EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS GREAT TRANSITIONS PREPARING ADOLESCENTS FOR A NEW CENTURY CONCLUDING REPORT CARNEGIE COUNCIL ON ADOLESCENT DEVELOPMENT CARNEGIE CORPORATION OF NEW YORK 1 OCTOBER 1995 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Copyright © 1995 by Carnegie Corporation of New York 437 Madison Avenue, New York, NY 10022 All rights reserved. Large portions of this publication may not be reproduced, stored in a retrieval system. or transmitted in any form or by any means, electronic, mechanical, photocopying. recording, or otherwise without permission of Camegie Corporation. Copies of this report may be obtained for $10.00, (single copies, bulk rate available) from: Carnegie Council on Adolescent Development. P.O. Box 753, Waldorf, MD 20604. Telephone (202) 429-7979. LIBRARY OF CONGRESS CATALOGING- N - PUBLICATION DATA Camegie Council on Adolescent Development. Great transitions: preparing adolescents for a new century/ concluding report of the Carnegie Council on Adolescent Development. p. cm. ISBN 0-9623154-4-3 (pbk.) 1. Parent and teenager-United States. 2. Teenagers-United States-Attitudes. 3. Social work with teenagers-United States. 4. Teenagers-Health and hygiene -United States. 5. Adolescent psychology. I. Title. H0799.15.C374 1995 95-37472 305.23'5-dc20 cip Designed and produced by Meadows Design Office Incorporated, Washington, DC Printed by Graphtec, Inc., Woodlawn, MD H - EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CONTENTS EXECUTIVE SUMMARY 9 PART I GREAT TRANSITIONS CHAPTER ONE Early Adolescence: The Great Transition 19 CHAPTER TWO Growing Up in Early Adolescence: An Emerging View 27 CHAPTER THREE Old Biology in New Circumstances: The Changing Adolescent Experience 35 CHAPTER FOUR Reducing Risks, Enhancing Opportunities: Essential Requirements for Healthy Development 49 PART 11 PREPARING ADOLESCENTS FOR A NEW CENTURY CHAPTER FIVE Reengaging Families with Their Adolescent Children 63 CHAPTER SIX Educating Young Adolescents for a Changing World 75 CHAPTER SEVEN Promoting the Health of Adolescents 91 CHAPTER EIGHT Strengthening Communities with Adolescents 105 CHAPTER NINE Redirecting the Pervasive Power of Media 115 EPILOGUE Looking to the Future, by David A. Hamburg 125 NOTES 136 ACKNOWLEDGMENTS 144 APPENDICES A. Task Force, Working Group, and Advisory Board Members 147 B. Publications 151 C. Meetings and Workshops 154 D. Biographies of Members of the Council 156 E. Index of Programs Cited in the Report 164 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CARNEGIE COUNCIL ON ADOLESCENT DEVELOPMENT David A. Hamburg, Chair Fred M. Hechinger President Senior Advisor Carnegie Corporation of New York Carnegie Corporation of New York New York, New York New York, New York H. Keith H. Brodie David W. Hornbeck President Emeritus Superintendent Duke University School District of Philadelphia Durham, North Carolina Philadelphia, Pennsylvania Michael I. Cohen Daniel K. Inouye Chairman United States Senator Department of Pediatrics Hawaii Albert Einstein College of Medicine James M. Jeffords New York, New York United States Senator Alonzo Crim Vermont Professor Richard Jessor Spelman College Director Atlanta, Georgia Institute of Behavioral Science Michael S. Dukakis University of Colorado at Boulder Visiting Distinguished Professor Helene L. Kaplan Political Science Department Of Counsel Northeastern University Boston, Massachusetts Skadden, Arps, Slate, Meagher, & Flom New York, New York William H. Gray III Nancy L. Kassebaum President United States Senator United Negro College Fund Kansas Fairfax, Virginia Thomas H. Kean Beatrix A. Hamburg President President William T. Grant Foundation Drew University Madison, New Jersey New York, New York Ted Koppel David E. Hayes-Bautista Director ABC News Nightline Washington, D.C. Center for the Study of Latino Health University of California at Los Angeles EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Hernan LaFontaine P. Roy Vagelos Professor of Administration Former Chair and Chief Executive Officer and Supervision Merck, Inc. Southern Connecticut State University Whitehouse Station, New Jersey New Haven, Connecticut James D. Watkins Eleanor E. Maccoby Admiral, U.S. Navy (Retired) Barbara Kimball Browning Professor of President Psychology, Emerita Joint Oceanographic Institute Stanford University Washington, D.C. Stanford, California William Julius Wilson Ray Marshall Lucy Flower University Professor of Audre and Bernard Rapoport Centennial Sociology and Public Policy Chair in Economics and Public Affairs University of Chicago Lyndon B. Johnson School of Chicago, Illinois Public Affairs University of Texas at Austin Julius B. Richmond John D. MacArthur Professor of Health Policy, Emeritus Harvard Medical School Boston, Massachusetts Frederick C. Robbins University Professor, Emeritus Department of Epidemiology and Biostatistics Case Western Reserve University Cleveland, Ohio Kenneth B. Smith President Chicago Theological Seminary Chicago, Illinois Wilma S. Tisch President Emeritus WNYC Foundation New York, New York EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EXECUTIVE SUMMARY Adolescence is one of the most fascinating and complex transitions in the life span: a time of accelerated growth and change second only to infancy; a time of expanding horizons, self-dis- covery, and emerging independence; a time of metamorphosis from childhood to adulthood. Its beginning is associated with biological, physical, behavioral, and social transformations that roughly correspond with the move from elementary school to middle or junior high school. The events of this crucially formative phase can shape an individual's life course and thus the future of the whole society. Early adolescence, encompassing the sexual awakenings of puberty as well as new social and educational demands, is an age of particular vulnerability. Barely out of childhood, young peo- ple ages ten to fourteen are today experiencing more freedom, autonomy, and choice than ever at a time when they still need special nurturing, protection, and guidance. Without the sus- tained involvement of parents and other adults in safeguarding their welfare, young adolescents are at risk of harming themselves and others. Many adolescents manage to negotiate their way through this critical transition with relative success. With caring families, good schools, and supportive community institutions, they grow up reasonably well educated, committed to families and friends, and prepared for the workplace and for the responsibilities of citizenship. Even under less-than-optimal condi- tions for growth and development-the absence of supportive and caring adults, poverty, unsafe schools, and distressed communities-adolescents can become contributing mem- bers of society. Some achieve this status despite facing threats to their well-being, such as AIDS and easy access to lethal weapons and drugs, that were all but unknown to their par- ents and grandparents. For many others, however, the obstacles in their path can impair their physical and emotional health, destroy their motivation and ability to succeed in school and jobs, and damage their personal relationships. Many reach adulthood ill-equipped to participate responsibly in our democratic society. 9 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS NEW RISKS FACING TEN- TO FOURTEEN-YEAR-OLDS Across America today, adolescents are confronting pressures to use alcohol, cigarettes, or other drugs and to have sex at earlier ages. Many are depressed: About a third of adolescents report they have contemplated suicide. Others are growing up lacking the competence to han- dle interpersonal conflict without resorting to violence. By age seventeen, about a quarter of all adolescents have engaged in behaviors that are harmful or dangerous to themselves and others: getting pregnant, using drugs, taking part in antisocial activity, and failing in school. Altogether, nearly half of American adolescents are at high or moderate risk of seriously dam- aging their life chances. The damage may be near term and vivid, or it may be delayed, like a time bomb set in youth. The social and technological changes of this century, and especially of recent decades, have provided many young people with remarkable material benefits and opportunities to master technical skills; they have also introduced new stresses and risks into the adolescent experi- ence. Today, with high divorce rates, increases in both parents working, and the growth of sin- gle-parent families, slightly more than half of all American children will spend at least part of their childhood or adolescence living with only one parent. In this situation, exacerbated by the erosion of neighborhood networks and other traditional social support systems, children now spend significantly less time in the company of adults than a few decades ago; more of their time is spent in front of the television set or with their peers in age-segregated, unsuper- vised environments. Such conditions occur among families of all income levels and backgrounds and in cities, sub- urbs, and rural areas. But they are especially severe in neighborhoods of concentrated poverty, where young adolescents are more likely to lack two crucial prerequisites for their healthy growth and development: a close relationship with a dependable adult and the perception of meaningful opportunities in mainstream society. For today's adolescents, particularly those who do not intend to go beyond high school, there is much less chance to earn a decent living wage, support a family, and participate actively in the life of the community and nation than there was a few decades ago. Many adolescents feel adult-like pressures without experiencing the rewards of belonging and of being useful in the valued settings of adult life. Especially in low-income neighborhoods where good education and jobs are scarce, young people can grow up with a bleak sense of the future. MEETING THE ESSENTIAL REQUIREMENTS FOR HEALTHY ADOLESCENT DEVELOPMENT In the face of the social and economic transformations of the late twentieth century, all adoles- cents have enduring human needs that must be met if they are to grow up to be healthy, con- structive adults. All must: Find a valued place in a constructive group Learn how to form close, durable human relationships Feel a sense of worth as a person 10 EXECUTIVE SUMMARY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Achieve a reliable basis for making informed choices Know how to use the support systems available to them Express constructive curiosity and exploratory behavior Find ways of being useful to others Believe in a promising future with real opportunities Meeting these requirements has been essential for human survival into adulthood for millen- nia. But in a technologically advanced democratic society-one that places an increasingly high premium on competence in many domains-adolescents themselves face a further set of chal- lenges. They must: Master social skills, including the ability to manage conflict peacefully Cultivate the inquiring and problem-solving habits of mind for lifelong learning Acquire the technical and analytic capabilities to participate in a world-class economy Become ethical persons Learn the requirements of responsible citizenship Respect diversity in our pluralistic society Adolescence is the last phase of the life span in which social institutions have reasonably ready access to the entire population, so the potential for constructive influence and for improving adolescents' life chances is great. Early adolescence-the phase during which young people are just beginning to engage in very risky behaviors, but before damaging patterns have be- come firmly established-offers an excellent opportunity for intervention to prevent later ca- sualties and promote successful adult lives. ADAPTING PIVOTAL INSTITUTIONS TO FOSTER HEALTHY ADOLESCENCE: GENERIC APPROACHES The American institutions that have the greatest influence on young adolescents are primarily the family and the schools, but also youth-serving, health-care organizations, and the media. The Carnegie Council on Adolescent Development urges these five institutions to adapt to the impact of a hyper-modern, high-tech, pluralistic society in ways that meet the essential re- quirements for healthy adolescent development. These institutions have fallen behind in their vital functions and must now be strengthened in their respective roles and linked in a mutually reinforcing system of support for adolescents. Many current interventions on behalf of young adolescents are targeted to one problem be- havior, such as drug abuse or teenage pregnancy. While targeted approaches can be useful, they often do not take adequate account of two important findings from research: (1) serious problem behaviors tend to cluster in the same individual and reinforce one another; and (2) such behaviors often have common antecedents in childhood experience and educational fail- ure. The other side of the coin is that those who engage in healthy lifestyles are more likely to EXECUTIVE SUMMARY 11 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS do well in school and to come from supportive family and community structures that reward their effort, promoting self-respect and decent human relations. These observations suggest that families, schools, and other social institutions have a special opportunity-and obliga- tion-to foster healthy lifestyles in childhood and adolescence, taking into consideration the underlying factors that promote either positive or negative outcomes. The Carnegie Council focuses on approaches that deal with the factors that predispose ado- lescents to engage in high-risk or problem behaviors. These are generic in nature; they are dis- tinguished from categorical or targeted approaches that focus on single problems, often after they have already occurred. Generic approaches focus on the positive possibilities inherent in the adolescent transition-possibilities for educating and motivating young adolescents in the pursuit of healthy lifestyles, for fostering interpersonal and decision-making skills to help them choose alternatives to very risky behavior, and for providing them with reasons and tools to build constructive lives. Generic approaches that can be adopted by the pivotal institutions include not only strong family relationships and excellent basic education but also a variety of related approaches such as social support networks, adult mentoring, health promotion programs incorporating hu- man biology, peer-mediated services, and life skills training to help young people cope with day-to-day living. If sustained over a period of years, such interventions can offset the negative effects of low self-respect, undeveloped social and decision-making skills, indifference to ed- ucation, lack of information about health matters, low perception of opportunities, and lim- ited incentives for delaying short-term gratification. CORE RECOMMENDATIONS Ensuring the healthy growth and development of adolescents must involve the commitment of all institutions that have a profound impact on youth. No single influence can be responsible for the successful transition from adolescence into adulthood. Families, the schools, the health sector, community organizations, and the media must work singly and in concert to launch all young people on a successful life course. In the twenty-first century, every young person will be essential; no individual will be expendable if our country is to maintain a dynamic, civil so- ciety and a flourishing economy in the face of accelerating technological, demographic, and socioeconomic change. The following recommendations of the Carnegie Council offer ways to adapt to the transforming world and provide life chances for adolescents conducive to a bet- ter future for the entire society. REENGAGE FAMILIES WITH THEIR ADOLESCENT CHILDREN Parental involvement in school activities declines steadily as children progress to middle and high school. Parents need to remain actively engaged in their adolescents' education; schools, for their part, should welcome the families of students as allies and cultivate their support. Schools and other community institutions, including health-care agencies, can help parents deal with the adolescent transition. They can create parent support groups, parent education programs, and education for prospective parents. Employers, both public and private, can pur- 12 EXECUTIVE SUMMARY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS sue more family-friendly policies for parents with young adolescents. Examples are flexible work hours and other measures allowing parents to spend more time with their young adoles- cents or volunteer in school or youth programs. Under special circumstances, child care tax credits could be extended to parents of young adolescents so they may be enrolled in high- quality after-school programs supervised by responsible, caring adults. CREATE DEVELOPMENTALLY APPROPRIATE SCHOOLS FOR ADOLESCENTS States and school districts should give teachers and principals the authority and resources to transform middle schools and junior high schools into health-promoting as well as learning environments-environments that are small-scale and safe, that promote stable relationships between students and their teachers and peers, that are intellectually stimulating, that employ cooperative learning strategies and de-emphasize tracking, that provide health education and life-skills training, and that offer primary health-care services either in or near the school. Schools that are developmentally appropriate provide a core curriculum and teaching meth- ods that excite students' curiosity and build on their desire to explore, strengthen their ana- lytical and problem-solving abilities, and provide an understanding of human biology and its place in the world. DEVELOP HEALTH- PROMOTION STRATEGIES FOR YOUNG ADOLESCENTS Poor health interferes with learning; good health facilitates it. Since 1960, the burden of ado- lescent illness has shifted from the traditional causes of disease to behavior-related problems, such as sexually transmitted disease, teenage pregnancy, motor vehicle accidents, gun-related homicides and accidents, depression leading to suicide, and abuse of drugs (alcohol and cig- arettes as well as illegal drugs). Instilling in adolescents the knowledge, skill, and values that foster physical and mental health will require substantial changes in the way the health pro- fessionals work and the way they connect with families, schools, and community organizations. This effort can be facilitated by a conjunction of the life sciences curriculum, life skills train- ing, and social supports for healthy behavior. It will also require filling serious gaps in health services for adolescents. At least three measures are needed to meet these goals. The first is the training and availability of health providers with a deep and sensitive understanding of the de- velopmental needs and behavior-related problems of adolescents. The second is expanded health insurance coverage for adolescents who now experience barriers to these services. The third is expanded school-based and school-related health facilities for adolescents. Taken to- gether, these measures could significantly improve the health outcomes of adolescents. STRENGTHEN COMMUNITIES FOR YOUNG ADOLESCENTS Communities should provide more attractive, safe, growth-promoting settings for young ado- lescents during the out-of school hours-times of high risk when parents are often not available to supervise their children. More than 17,000 national and local youth organizations, including EXECUTIVE SUMMARY 13 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS those sponsored by religious groups, now operate in the United States, but they do not ade- quately provide opportunities for about one-third of young people who most need their sup- port and guidance. These organizations must now work to expand their reach, enlisting the help of community residents, families, schools, volunteers, and adolescents themselves in offer- ing more activities that convey information about life, careers, and places beyond the neigh- borhood-as well as engage them in community service and other constructive activities. PROMOTE THE CONSTRUCTIVE POTENTIAL OF THE MEDIA An ever-expanding array of media bombard adolescents with messages that powerfully shape their attitudes and behavior. Growing, serious criticism has been directed at television, music media, and video games for their emphasis on violence as the ultimate problem solver and on unrestrained sexuality. The undeniable power of the media could be used far more construc- tively in the lives of young adolescents. Families, schools, and other pivotal institutions can help young people become more "media literate" so they can examine media messages more critically. They can work with media organizations in developing health-promoting program- ming and media campaigns for youth. And they can support social actions that discourage the media from glamorizing violence and sex as well as drinking, smoking, and other drug use. WHAT OTHER INSTITUTIONS CAN DO Business, universities, scientific and professional organizations, and government at all levels can help pivotal institutions meet the essential requirements of healthy adolescent development. BUSINESS The business community can help directly, by providing funds and technical support to im- plement the recommendations of this report, and indirectly by mobilizing community leader- ship on behalf of the education and health of youth. Within the workplace, it can institute fam- ily-friendly policies and practices, and it can cooperate in diminishing the production of sex- and violence-saturated media programming. UNIVERSITIES AND SCIENTIFIC AND PROFESSIONAL ORGANIZATIONS These "science-rich" institutions and organizations can stimulate interdisciplinary research and publication on the problems and opportunities of adolescent development, recognizing the implications for practice, policy, and social action, and bringing the facts before the pub- lic by taking education beyond the campus. GOVERNMENT Government at all levels can recognize the critical adolescent years, particularly early adoles- cence, in its policies and programs and assist communities in translating youth-oriented pro- grams into action. One example is the recent creation of an Office of Adolescent Health in the 14 EXECUTIVE SUMMARY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS U.S. Department of Health and Human Services. That effort, so far, is rudimentary, but it could become a vital focus for healthy adolescent development. Fifteen states are supporting major reforms of middle and junior high schools to make them more developmentally appropriate for young adolescents. More states need to join this movement. Cities and counties can also organize effectively for youth development. MOBILIZING COMMUNITIES FOR YOUTH With a combination of informed community leadership and vigorous grass-roots organizing, communities can be mobilized to engage in a strategic planning process on behalf of adoles- cents and their families, similar to what many communities are today doing to promote a healthy start for newborns. This process can be led by community councils for youth com- posed of relevant professionals, business and media leaders, local youth organizations, par- ents, and adolescents themselves. Such councils carefully assess local needs, formulate useful interventions, and inform the entire community about the problems and opportunities of ado- lescence. Experience thus far has shown that community mobilization is not readily accom- plished, but recent constructive examples provide useful guidance. INVESTING IN OUR FUTURE Much of the current spending for adolescence could achieve better results if it were redi- rected toward fundamental, comprehensive approaches. Preventing much of the damage now occurring would have a powerful social and economic impact, including higher pro- ductivity, lowered health costs, lowered prison costs, and improved human welfare. In the long run, the vitality of any society and its prospects for the future depend on the quality of its people-on their knowledge and their skill, and on the health and the decency of their human relations. In an era when there is much well-founded concern about losing a vital sense of community, these initiatives on behalf of all our children can have profound collat- eral benefits of building solidarity, mutual aid, civility, and a reasonable basis for hope. A key lesson learned from the Council's experience is the importance of serious, careful ex- amination of the facts, nonpartisan analyses, broad dissemination with involvement of key sec- tors, and sustained commitment over a period of years. Above all, a long-term view is essen- tial to bring about the difficult, indeed fundamental, changes necessary in modern society to improve the life chances of all our children. ........ EXECUTIVE SUMMARY 15 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS PART I Great Transitions EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS LAND OF DIMINISHING DREAMS The year is two thousand fifty-four, The world is full of curses. People walk the streets no more, No women carry purses. The name of the game is survival now- Safety is far in the past. Families are huge, with tons of kids In hopes that one will last. Drugs are no longer looked down upon, They are a way of life. They help us escape the wrenching stress Of our fast world's endless strife I wake up now-it was only a dream, But the message was terribly clear. We'd better think hard about the future Before our goals and our dreams disappear. JESSICA INGLIS 16 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER ONE Early Adolescence: The Great Transition Adolescence is one of the most fascinating and complex transitions in the life span: a time of accelerated growth and change second only to infancy; a time of expanding horizons, self- discovery, and emerging independence; a time of metamorphosis from childhood to adult- hood. Its beginning is associated with biological, physical, behavioral, and social transfor- mations that roughly correspond with the move to middle or junior high school. The events of this crucially formative phase can shape an individual's entire life course and thus the fu- ture of the whole society. In these often tumultuous years, a young person experiences much growth and joy, some anx- iety and dread. Relationships with peers and family take on new meaning. Doubt and confu- sion abound. Some young people believe they can see into their future and find nothing to hope for. Others dream but often have no more than a vague image of the future as they em- bark on a prolonged search for the pathways to promising adulthood. In societies everywhere, the onset of adolescence is closely synchronized with the biological changes of puberty. In most technologically advanced countries today, puberty begins on av- erage two years earlier than it did a century ago, and the transition to adulthood can last a decade or more. In the United States, adolescence now extends over so many years that it can be usefully subdivided into several phases. Early adolescence, encompassing the changes of pu- berty as well as sexual and psychological awakenings, extends roughly from ages ten through fourteen. Middle adolescence, a time of increased autonomy and experimentation, covers ages fifteen to seventeen. Late adolescence, occurring for those who delay their entry into adult roles because of educational or social factors, can stretch from age eighteen into the twenties. The distinction between early and late adolescence can be illustrated by comparing eleven- and twelve-year-olds to seventeen- and eighteen-year-olds. They have very little in common with each other. Young adolescents are barely out of childhood and, much like younger chil- dren, still need special nurturing and protection; older adolescents share many of the attrib- utes of adults. Many young people manage to negotiate their way through the critical adolescent years with relative ease. With good schools, caring families, and supportive community institutions, they grow into adulthood well educated, committed to families and friends, and prepared for the workplace and the responsibilities of citizenship. Even under less-than-optimal conditions for growth and development, many become contributing members of society.2 Some achieve this 19 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS status despite having faced threats to their well-being (such as AIDS and easy access to guns) that were all but unknown to their parents and grandparents. For others, however, the obstacles in their path can impair their physical and emotional health, destroy their motivation and ability to succeed in school and jobs, and damage personal rela- tionships. Many are at high risk of reaching adulthood ill-equipped to participate responsibly in our democratic society.3 Both groups of adolescents-those who appear to be making a reasonably successful transi- tion to adulthood and those for whom meaningful options may seem closed by the age of four- teen or fifteen-are the urgent concern of the Carnegie Council on Adolescent Development, established in 1986 as a program of Carnegie Corporation of New York. Since 1987, the Coun- cil has worked to generate broad-based understanding of this vulnerable age group. Composed of national leaders from education, law, science, health, religion, business, the media, youth- serving agencies, and government, the Council has sought to synthesize the best available knowledge and experience about adolescence in America and to stimulate public and private interest in facilitating the transition from adolescence to adulthood. Ultimately, the Council's mission has been to place the challenges of the adolescent years higher on the nation's agenda. In the 1990s, it also has sought to stimulate interest in this critical transition as it occurs in other countries. WHY EARLY ADOLESCENCE? In its work, the Council has focused attention on the challenges of early adolescence, ages ten to fourteen. Important in its own right as a potentially rewarding time of personal growth and development, it is the age in which individuals adopt behavior patterns in education and health that can have lifelong significance. For this reason, early adolescence presents a vital opportu- nity for shaping enduring patterns of behavior that can set a young person on a successful course for life.⁴ Until recently, early adolescence was neglected in scientific inquiry, in policy formation, and in public understanding. Within the scientific and professional practice communities, how- ever, a notable consensus has begun to emerge on new ways of viewing the risks and opportu- nities inherent in the early adolescent transition. This consensus is based on a growing body of research and practical experience regarding adolescent health, education, and development.5 The new view asserts that early adolescence is part of a developmental continuum, pro- foundly shaped by practices and policies that affect young people both before and after this period. It reflects recent research strongly suggesting that the problems that impair learning and health tend to cluster in individual adolescents⁶ and that the behavior patterns associ- ated with these problems often have common antecedents in childhood experiences and in educational failure.⁷ Such a view of early adolescence requires that those responsible for policies and programs affecting adolescents take a broad approach to the promotion of health and the prevention of high-risk behavior. Typically, policymakers have adopted categorical approaches to single prob- lems without seeking to coordinate these approaches. The Council believes that more effec- 20 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS tive solutions can be found if those responsible for nurturing adolescents build a supportive and caring infrastructure for adolescents composed of several pivotal institutions working in concert to meet the fundamental requirements for healthy development.8 No one institution in isolation can ensure that today's adolescents will grow into responsible, decent, thoughtful, and competent adults. Rather, it is the mutual influence of these institu- tions that will be critical. Together, they have the potential to address the underlying factors that increase the likelihood of millions of young people becoming involved in serious health- compromising behaviors. The approaches to the myriad problems of adolescents at risk pre- sented here can be adapted for use in a variety of settings. In the Council's view of adolescence, all adolescents must meet the same fundamental requirements if they are to be prepared for success in adulthood. They must find ways to earn respect, establish a sense of belonging to one or more highly valued groups, make close and en- during human relationships, and build a sense of personal worth based The problems of adolescence deal with on useful skills. They must learn, in our pluralistic society, to live peace- deep and moving human experiences. fully and respectfully with a wide array of ethnic, religious, and cultural groups. They must have the help of caring adults to develop a positive They center on a fateful time in the life vision of the future, to see images of what adulthood offers and re- quires, and to prepare themselves for opportunities that are available course when poorly informed decisions to them. With appropriate guidance and support from families, schools, and other institutions, young people can grow up with the can have lifelong consequences. The skills and values needed to participate in a humane, civil society. tortuous passage from childhood to The social and economic costs of adverse circumstances that distort adolescent development are unacceptable. They encompass not only adulthood requires our highest personal tragedies, but also widespread disease and disability, igno- attention, our understanding, and a new rance and incompetence, crime and violence, alienation and hatred. Such tragedies are not confined in any tidy way to certain geographic level of thoughtful commitment. areas or specific groups. Like a toxin, they poison the environment and do wide-ranging harm throughout the nation. DAVID A. HAMBURG, PRESIDENT CARNEGIE CORPORATION OF NEW YORK Although disturbing numbers of today's young adolescents face tremendous odds, there is not the slightest reason to believe that they are less talented or resourceful than were their predecessors. The difference is their transformed circumstances, which are creating unprecedented challenges for them. To help young adolescents learn what they must to survive and flourish, we have to understand these changed circumstances and new challenges better. Such understanding can contribute to formulating useful strategies for helping young adolescents cope with a world that itself is in the process of transformation. The United States is a large, heterogeneous, multiethnic nation with a strong tradition of in- dividualism. These are significant assets, but they also make it difficult for Americans to arrive at a shared understanding of complicated social problems and to turn that understanding into solutions that can win broad acceptance. Can we envision how schools, churches, families, businesses, youth organizations, health-care agencies, the media, organizations of the scientific THE IMPACT ON SOCIAL TRANSFORMATION 21 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS community, and government can cooperate in addressing the developmental needs of youth? Reaching a consensus on the values and behaviors appropriate for adolescents and on the steps that can be taken to help young people make a successful transition to adulthood will certainly be arduous. But we must try, for it is not only the lives of young people that are at stake: it is also our common future. THE REPORT'S PERSPECTIVE Great Transitions: Preparing Adolescents for a New Century, the Carnegie Council's conclud- ing report, draws together the findings and analyses from its decade-long efforts on behalf of young adolescents. In doing so, the report presents for the first time the Council's distinctive view of adolescence and of the steps our nation must take to ensure each adolescent's safe pas- sage into adulthood. Although the focus is on early adolescence, the concepts for the most part apply to middle adolescence as well, as reflected in some of the data and examples. Much of the material for this report has been drawn from the Council's published reports, syn- theses of research, and working papers, all of which were prepared with the guidance of the Council members and with support from Carnegie Corporation of New York. This body of work (see the Appendices for a complete listing) includes the Council's first major report, Turning Points: Preparing American Youth for the 21st Century (1989); At the Threshold: The Developing Adolescent (1990); Life Skills Training: Preventive Interventions for Young Adolescents (1990); School and Community Support Programs that Enhance Adolescent Health and Education (1990); A Matter of Time: Risk and Opportunity in the Nonschool Hours (1992); Fateful Choices: Healthy Youth for the 21st Century (1992); and Promoting the Health of Adolescents: New Directions for the Twenty-first Century (1993). This concluding report also considers important aspects of ado- lescent development addressed in other Council publications, meetings, and cooperative efforts. One of these is a three-volume publication of the U.S. Congress's Office of Technology Assess- ment, Adolescent Health (1991).⁹ The Council's approach to fostering healthy development during adolescence and beyond takes into account scientific knowledge about adolescents and identifies factors that will en- able adolescents to meet developmental challenges successfully. This approach rests on six basic concepts about adolescence: Early adolescence is a critical turning point in life's trajectory. This period, therefore, rep- resents an optimal time for interventions to prevent destructive behavior and promote endur- ing healthful practices. Education and health are inextricably related. Adolescents have difficulty learning when they are not in good health. Good health during adolescence facilitates learning, with power- ful lifelong effects. By the same token, education constitutes one of the most powerful influences on health through the entire lifespan.¹⁰ Destructive, or health-damaging, behaviors in adolescence tend to cluster. Positive, or health-promoting, behaviors also tend to cluster.¹¹ 22 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Common underlying factors contribute to many problem behaviors in adolescents. One is academic difficulty; another is the absence of strong and sustained guidance from caring adults.¹² Preventive interventions are more likely to be successful if they address the underlying factors that contribute to problem behaviors. Given the complexity of influences on adolescents, the essential requirements for healthy, positive development must be met through the joint efforts of a set of pivotal institutions that powerfully affect adolescents' experiences. These pivotal institutions begin with the fam- ily and include schools as well as a wide array of neighborhood and community organizations. Based on these six concepts, the Council's recommendations for change take into account the many factors that influence learning and health, both in and out of school. If the recommen- dations in this report are fully implemented, the institutions of society that most influence the development of adolescents will be strengthened to foster healthy choices among adolescents- choices that can make the difference between the fulfillment of aspiration or the eclipse of hope. EARLY ADOLESCENCE 23 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Young In 1993, approximately 7.3 percent (19 million) of the Although it is illegal to sell alcohol to individuals un- U.S. population were young adolescents, ages ten to der twenty-one years of age, two-thirds of eighth Adolescents fourteen. Of these, approximately 20 percent were graders report that they have already tried alcohol living below the federal poverty line, which in 1993 and a quarter say that they are current drinkers. was $14,763 for a family of four. Minority adolescents Face Serious Twenty-eight percent of eighth graders say that they were disproportionately poor: 43 percent of African have been drunk at least once.⁷ American adolescents and 38 percent of Hispanic/ Risks Among eighth graders, who are thirteen to fourteen Latino adolescents lived in poverty, compared with 15 percent of white adolescents. By the year 2000, years old, the rate of current smoking (smoking any more than one-third of all young adolescents will be cigarette in the past 30 days) rose by 30 percent be- members of racial or ethnic minorities: African Amer- tween 1991 and 1994, from 14.3 to 18.6 percent.8 icans (16 percent); American Indian, Eskimo, and Marijuana use among eighth graders more than dou- Aleut (1 percent), Asian/Pacific Americans (5 per- bled between 1991 and 1994 from 6.2 to 13.0 percent.⁹ cent), and Hispanic/Latino (14 percent).¹ To compete Over the last three decades, the age of first inter- in the global economy of the twenty-first century, course has declined. Higher proportions of adoles- America will need all of these young people to be healthy and well educated. cent women and men reported being sexually expe- rienced at each age between the ages of fifteen and twenty in 1988 than in the early 1970s. In 1988, 27 per- HEALTH RISKS cent of girls and 33 percent of boys had intercourse by their fifteenth birthday.¹⁰ Injuries are the leading cause of death for young adolescents. The largest single cause of death While the number of births to those ages fifteen and among these adolescents is injuries from motor ve- younger is not large, this group is experiencing the hicle crashes.² greatest rate of increased births. Pregnancy rates for The firearm homicide rate for ten- to fourteen-year- all girls younger than fifteen years old rose 4.1 per- cent in the United States during the period between olds more than doubled between 1985 and 1992 (from 0.8 to 1.9 per 100,000). For black males, the rate in- 1980 and 1988-higher than any other teenage group.¹¹ creased from 3.0 to 8.4 per 100,000 during the same period.³ Current evidence indicates that increases in depres- sive disorders and mood are greater for girls than for In 1992, twelve- to fifteen-year-olds had a high over- boys during adolescence. By age fourteen to fifteen, all victimization rate. They were victims of assault girls are twice as likely as boys to suffer from de- more than any other age group.⁴ pression, a gender difference that persists into In a national representative sample of adolescents adulthood. ten to sixteen years old, one-fourth of respondents reported having experienced an assault or abuse in From 1980 to 1992, the rate of suicide among young the previous year.5 Approximately 20 percent of the adolescents increased 120 percent and increased documented child abuse and neglect cases in 1992 most dramatically among young black males (300 involved young adolescents between the ages of ten percent) and young white females (233 percent). Sui- and thirteen years.⁶ cide rates for ten- to fourteen-year- old American In- dians are four times higher than those for ten- to Use of alcohol and cigarettes remains more wide- fourteen-year- olds of all races.¹² spread than use of illegal drugs. GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EDUCATIONAL RISKS 9. Johnson, L D., O'Malley, P. M.., & Bachman, J. G. (1994) Na- tional survey results on drug use from the Monitoring the Future The average proficiency in science, mathematics, study, 1975-1993. Rockville, MD: National Institute on Drug Abuse. and writing among thirteen-year-olds was slightly 10. The Alan Guttmacher Institute. (1994). Sex and America's higher in 1992 than it was in the 1970s. However, teenagers. New York: Author. these achievements have not improved enough to 11. U.S. General Accounting Office. (1995). Welfare dependency: keep pace with the higher level of skills required in a Coordinated community efforts can better serve young st-risk global economy.¹³ teen girls. GA0/HEHS/RCED-95-108. Washington, DC: Author. Only 28 percent of eighth graders scored at or above 12. Morbidity and Mortality Weekly Report. Suicide among chil- the proficiency level in reading in 1994. Two percent dren, adolescents, and young adults-United States, 1980-1992. Vol. 44, No. 15, April 21, 1995; and U.S. Congress, Office of Tech- read at or above an advanced level.¹⁴ nology Assessment. (1990). Indian adolescent mental health In 1990, 7 percent of the eighth-grade class of 1988 (OTA-H-446). Washington, DC: U.S. Government Printing Office. (most of whom were then fifteen and sixteen years 13. U.S. Department of Education, National Center for Education old) were dropouts.¹ By their senior year (1992), 12 Statistics, "1994 NAEP reading: A first look." April 1995. percent of this class were dropouts.¹⁶ Dropout rates 14. Ibid. vary by students' race/ethnicity: white (9.4); black 15. They were not enrolled in school and had not finished high (14.5); Hispanic (18.3); Asian/Pacific Islanders (7.0); school. and American Indian (25.4).¹⁷ 16. U.S Department of Education, 1995. 17. National Center for Education Statistics. (1994). The condi- SOURCES tion of education, 1994. NCES94-149. Washington, DC: U.S. Gov- emment Printing Office. 1. Day, J.C. (1993). Population projections of the United States by age, sex, race, and hispanic origin: 1993-2050. U.S. Bureau of the Census, Current Population Reports. Washington, DC: U.S. Government Printing Office. 2. National Center for Health Statistics, Unpublished data, 1994. 3. Ibid. 4. Bureau of Justice Statistics. (1994). Criminal victimization in the United States, 1992. NCJ-145125. Washington, DC: U.S. Gov- ernment Printing Office. 5. Finkelhor, D., & Dziuba-Leatherman, J. (1994). Children as vic- tims of violence: A national survey. Pediatrics 94:413-420. 6. U.S. Bureau of the Census. (1994). Statistical abstract of the United States, 1994 (114th edition). Washington, DC: U.S. Gov- ernment Printing Office. 7. Johnston, L D., O'Malley, P. M., & Bachman, J.G. (1994). Na- tional survey results on drug use from the Monitoring the Future study, 1975-1993, volume I, secondary school students. Wash- ington, DC: National Institute on Drug Abuse. 8. Johnson, L D., O'Malley, P. M., & Bachman, J. G. (1995). Na- tional survey results on drug use from the Monitoring the Future study, 1975-1994. Rockville, MD: National Institute on Drug Abuse. EARLY ADOLESCENCE 25 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER TWO Growing Up in Early Adolescence: An Emerging View For all young people, adolescence involves a daunting array of interrelated developmental chal- lenges: the biological changes of puberty with their meaning for reproductive capacity and new social roles; the handling of feelings of sexual arousal in situations that demand the postpone- ment of sexual behavior; the move toward psychological and physical independence from par- ents; the search for friendship and belonging among peers; the negotiation of new and conflict- ing demands and pressures; the exploration of novel ideas and risky behavior; the engagement in more complex intellectual tasks; and the formulation of a distinct identity. Substantial progress has been made through research in capturing the complexity of adoles- cence and in determining the common features of adolescent experiences.¹ As a result, we now understand how adolescents navigate the transition from childhood to adulthood, how devel- opment can go wrong even in affluent circumstances, and how those in less advantaged cir- cumstances, especially from areas of concentrated poverty, succeed or succumb. New knowledge about adolescence has begun to illuminate the positive and adaptive qualities of this transitional stage in development as well as the problems.3 Although young adolescents are often stereotyped as moody, rebellious, self-indulgent, and incapable of learning anything serious, research indicates that this portrait is greatly overdrawn. Young adolescents are also, at this time, full of curiosity, imagination, and emerging idealism. For many, adolescence is a time of remarkable psychological and social growth that offers excitement and hope, if some- times anguish and disappointment. 27 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHALLENGES TO PREVAILING STEREOTYPES Although much is still unexamined and further research is greatly needed, the emergent view directly challenges the predominantly negative connotations of the term "adolescent." Several important findings challenge prevailing stereotypes about adolescents. Adolescents are a heterogeneous group. Adolescents are a far-from-monolithic group. On the contrary, they vary greatly in their physical development, life experiences, values, and as- pirations. Even individuals of the same age differ enormously in their growth patterns, per- sonalities, aptitudes, and coping skills. Some move into adult roles as early as age fifteen or six- teen, particularly if they are from low-income or working-class backgrounds. Others, especially those born into relative affluence, engage in a protracted period of search and discovery, sort- ing out their sense of identity, their career directions, and their expectations of adult life be- fore making critical decisions. Puberty, which opens the door to adolescence, also varies from person to person.⁵ Puberty be- gins in some individuals as early as age eight and in others as late as age fourteen, making a difference in their self-image, expectations, experiences in school, and relationships with peers and adults. Social, environmental, and hormonal factors are all important in shaping development. It is widely believed that pubescent adolescents are prey to "raging hormones," with the im- plication that they are out of control and that little can be done to influence them. The drastic changes in secretion of sex hormones during early adolescence do have profound effects on every tissue of the body-most notably the reproductive system but also the brain. These hor- mones produce the growth spurt, secondary sex characteristics, and feelings of sexual arousal. They also herald an increase in emotional intensity, with girls experiencing more depression⁶ and boys experiencing more aggression. But these changes do not mean that young adoles- cents are inherently difficult, contrary, or uneducable. The effects of these changes are highly influenced by social and interpersonal factors. When such influences are positive, the biolog- ical transition goes more smoothly.7 Youth culture is different from that of adults but not necessarily in opposition to adult values. The social organization of adolescents is distinct from that of the child or the adult, with its own music, heroes and heroines, language, and styles. Within this society, there are adolescent subgroups, each emphasizing particular interests, attitudes, and values.⁸ But youth culture is not essentially oppositional or hostile to adults. Many adolescents report that they continue to consult with their parents on matters of concern to them, and many re- late well to adults other than their parents.⁹ Although tensions are inevitable in this time of major transition, only a minority of teenagers engages in rebellion against their parents as they seek to establish a sense of autonomy and separate identity. The process of moving away from parental authority usually leads not to estrangement but to a renegotiated interdepen- dence with family and kin.¹⁰ 28 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Peer influence among adolescents may be positive as well as negative. Despite negative stereotypes, the influence of peers often is beneficial to adolescents.¹¹ In favorable circum- stances, adolescents feel secure with their friends, find joy in the group, and acquire a basis for hope. Peers can contribute to a young person's self-esteem, sense of identity, and achievement. If a young teen becomes solidly established in a constructive peer network-one oriented to study and learning, good health, and decent human relations-the chances are enhanced that he or she will evolve into an inquiring and problem-solving, caring individual. Adolescents are capable of complex reasoning, including the weighing of consequences. Research has shown that the capacity for critical thinking and for competent decision making is achieved or achievable by early to middle adolescence.¹² For young adolescents, yielding the certainty of childhood is accompanied by a new appreciation of the relativity and complexity of knowledge and ideas. Unfortunately, many school systems do a profound disservice to young adolescents by withholding challenging instruction from them. Educators have a great opportunity to capture the young person's emergent sense of One-third of American adolescents self and curiosity about the world. today are of non-European descent from Along with their growing capacity for thinking and decision mak- ing, adolescents have enhanced opportunities for self-determination a wide array of religious, ethnic, and in many areas of their lives. They have more control, for example, over how vigorously they apply themselves in school, the kinds of national backgrounds. Learning to friends they have of both genders, and the extent to which they adopt or avoid such perilous behavior as smoking, using alcohol or live peacefully while respecting other harmful drugs, and engaging in early or promiscuous sexual diversity will be a major task for adults activity. Unfortunately, the tendency of young adolescents to focus on the here and now rather than on the long-range consequences in the twenty-first century. of their actions places them in substantial danger of making serious errors of judgment. ADOLESCENT ATTRIBUTES OFFER OPPORTUNITIES Certain characteristics of this period of life make possible adaptive responses to the challenge of major change. If the pivotal institutions that influence adolescents can harness these char- acteristics, they can provide adolescents with a crucial advantage, enabling them not only to survive but also to thrive under the extraordinary dislocations of contemporary society. Three characteristics are especially significant. Adolescents are eager for authoritative information. Young adolescents are interested in and receptive to information about themselves and their bodies.¹³ In earlier times, their world view and much of the information available to them was shaped by the nuclear and extended fam- ily and older peers. Today, information conveyed to adolescents comes largely from the media and peers. Much of it is incorrect or misleading or embodies values that are inimical to young people's self-image and health. Yet the eagerness of these young people for information rele- vant to their development is a fundamental asset, and pivotal institutions can respond in many constructive and helpful ways. GROWING UP IN EARLY ADOLESCENCE 29 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Adolescents are explorers of the unknown. Much exploration by adolescents is develop- mentally appropriate and socially adaptive, even though it can introduce new demands and generate new conflicts. Adolescents ask many questions about themselves and the world- questions that constitute stepping stones across the rapids between childhood and adult life. What is happening? Is it interesting? Is it fun? Does it lead anywhere? What can I do to be bet- ter liked? What can I do to be smarter, stronger, better looking? What kind of person am I any- way? Does anyone care about me? What do I really care about? Can I make a difference? How does school relate to the rest of my life? What kind of work do I want to do? How do I give myself a good future? Families, friends, schools, community organizations, religious institu- tions, health care providers, and the media have a serious responsibility to deal respectfully with the questions that preoccupy teenagers. Adolescents are strongly influenced by what they see of adult behavior as they "try on" their eventual roles as adults. At this time of life, a young adolescent is confronted with mul- tiple concepts of what it means to be an adult. Older peers, who are looked up to as having links to the adult world, play an important role as young adolescents select among these images. Some will conclude that it is grown-up to be cool and reject education, to live for the moment, to take what they can get without respect for others, to get high on alcohol or other New knowledge about adolescence drugs, to be tough, unyielding, even violent. Such damaging con- cepts of adulthood are available in abundance in the social environ- has begun to illuminate the positive and ment of young adolescents. But there are also positive, enriching im- adaptive qualities of this transitional ages available that can influence the choices and decisions that young people make. stage in development as well as the To help adolescents meet the challenges of adulthood in a changing problems. Although young adolescents world that is growing ever more complex, adults in key institutions must respond to make the best use of these positive and adaptive qual- are often stereotyped as moody, ities of adolescents. Right now, the vulnerability of young adolescents to health and educational risks is far greater than most people are rebellious, self-indulgent, and incapable aware of, and the casualties are mounting. The following chapter will clarify the economic and social consequences of preventable damage of learning anything serious, and the sadly lost potential of youth in the context of ongoing trans- research indicates that this portrait is formation. Tragedies are not inevitable. Using the guidance provided by the new research on adolescence, the leadership of key institutions greatly overdrawn. throughout society can take steps to intervene in young lives during the pivotal moment of early adolescence. Small steps, taken at this crit- ical time of life, can make a big difference in determining an adoles- cent's life chances. 30 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Further Reading Feldman, S.S., & Elliott, G.R. (Eds.) (1990). At the threshold: The developing adolescent. Cam- bridge, MA: Harvard University Press. Hamburg, B.A. (1974). Early adolescence: A specific and stressful stage of the life cycle. In G.V. Coelho, D.A. Hamburg, & J.E. Adams (Eds.), Coping and adaptation (pp. 101-124). New York: Basic Books. Hamburg, D.A. (1989). Early adolescence: A critical time for interventions in education and health. Presidential Essay reprinted from 1989 Annual Report of Carnegie Corporation of New York. Lerner, R.M. (Ed.). (1993). Early adolescence: Perspectives on research, policy, and intervention. Hillsdale, NJ: Lawrence Erlbaum Associates. GROWING UP IN EARLY ADOLESCENCE 31 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Economic Consequences of Preventable Problems Adolescent pregnancy and substance abuse are not Providing family planning services is one way to simply problems when they happen. The conse- lower taxpayers' costs. Each public dollar spent on quences of these acts reach far into the future, and family planning services saves an average of $4.40 their antecedents emerge even before adolescence. by reducing expenditures on medical, welfare, and The following costs illustrate the importance of pre- nutritional programs.⁵ venting such problems. SUBSTANCE USE AND ABUSE DROPPING OUT Substance abuse costs the United States more than Remaining in school is the single most important ac- $238 billion a year, including the expense of treating tion adolescents can take to improve their future substance abuse, the productivity losses caused by economic prospects. In 1992, a high school graduate premature death and inability to perform usual activ- earned almost $6,000 per year more than a high ities, and costs related to crime, destruction of prop- school dropout.¹ erty, and other losses.⁶ Going to college boosts income even more. In 1992, Each year more than a million young people start college graduates had a mean annual income of smoking regularly, a decision that will cost the health $32,629, while high school graduates had a mean an- care system $8.2 billion in preventable medical ex- nual income of $18,737. Earning a professional de- penditures during their lifetimes.⁷ gree added $40,000 a year to the mean annual in- come of college graduates.¹ During the last two decades, the tobacco industry has dramatically increased the money it spends on Gender also affects income. A male high school advertising. In 1992, the industry spent more than $5.2 graduate's mean monthly income is likely to be twice billion on advertising, making cigarettes second only as much as a female high school graduate's, a sta- to automobiles in advertising dollars spent.⁸ tistic that highlights the significance of education for women.² INJURIES BEARING CHILDREN An estimated 10 to 20 percent of all injuries to chil- Women who become mothers as teenagers are more dren and young people occur in and around schools. likely to find themselves living in poverty later in their Falls were the most common cause of injuries. Rep- lives than women who delay childbearing. Although resenting 46 percent of all incidents, falls were fol- 28 percent of women who gave birth as teenagers lowed by sports activities at 30 percent and assaults were poor in their 20s and 30s, only 7 percent of at 10 percent. The resulting costs of these injuries women who gave birth after adolescence were liv- vary substantially. The bill for treating something as ing in poverty in their 20s and 30s.³ simple as a forearm fracture, for example, can ex- ceed $3,900. A serious injury such as spinal cord In 1992, the federal government spent nearly $34 bil- damage can incur medical costs higher than lion on Aid to Families with Dependent Children, $188,000.º Medicaid, and food stamps for families begun by adolescents.⁴ 32 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Injuries to young adolescents, ages ten to fifteen, in motor vehicles cost more than $13 million in 1991, or about $56,000 per injured child.¹⁰ The U.S. Centers for Disease Control and Prevention estimates that simply switching to break-away bases for softball games could prevent 1.7 million injuries a year and save $2 billion in acute medical costs.¹¹ A recent U.S. Government Accounting Office report estimated that the nation's schools need $112 billion to complete all of the repairs, renovations, and mod- emizations required to restore facilities to good over- all condition and comply with federal mandates that 6. Institute for Health Policy. (1993). Substance abuse: The na- ensure the safety of students.¹² tion's number one health problem: Key indicators for health pol- icy. Waltham, MA: Author. VIOLENCE 7. Lynch, B.S., & Bonnie, R.J. (1994). Growing up tobacco free: Preventing nicotine addiction in children and youths. Weshing- Violence is a social problem with tremendous eco- ton, DC: National Academy Press. nomic costs. In 1993, the cost of providing emer- 8. Federal Trade Commission. (1992). Report to Congress pur- gency transportation, medical care, hospital stays, suant to the federal cigarette labeling and advertising act for rehabilitation, and related treatment for American 1992. In remarks by David A. Kessler. The Samuel Rubin Pro- firearm victims ages 10 through 19 was $407 million.¹³ gram at the Columbia University School of Law, March 8, 1995. 9. Children's Safety Network. (1994). Injuries in the environment: A resource packet. Newton, MA: Author. SOURCES 10. Children's Safety Network Economics and Insurance Re- 1. U.S. Department of Commerce, Bureau of the Census. (1994). source Center, National Public Services Research Institute. More education means higher career earnings. Statistical Brief Child Occupant Injury Facts. Landover, MD SB/94-17. Washington, DC: Author. 11. National Institutes of Health. (1992). Sport injuries in youth: 2. U.S. Bureau of the Census. (1994). Statistical abstract of the Surveillance strategies. NIH Publication No. 93-3444. Wash- United States: 1994. (114th edition). Washington, DC: U.S. Gov- ington, DC: U.S. Government Printing Office. ernment Printing Office. 12. U.S. General Accounting Office. (1995). School facilities: 3. Alan Guttmacher Institute. (1994). Sex and America's teen- Condition of America's schools. HEHS-95-61. Washington, DC: agers. New York: Author. Author. 4. U.S. Government Accounting Office. (May 1995). Welfare 13. Miller, T. (1995). Children's Safety Network Economics and dependency: Coordinated community efforts can better serve Insurance Resource Center, and National Public Services Re- young at-risk teen girls. RCED-95-108. Washington, DC: Author. search Institute. Unpublished data. 5. Teenage pregnancy and birth rates-United States, 1990. (1990). Morbidity and Mortality Weekly Report. October 1, 1993, 42(38): 733-737. GROWING UP IN EARLY ADOLESCENCE 33 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER THREE Old Biology in New Circumstances: The Changing Adolescent Experience The biology of puberty in today's adolescent is essentially the same as it always has been. Trig- gered by events in the brain, the pituitary gland produces hormones that stimulate the secretion of sex hormones. These hormones, in turn, have powerful effects on many tissues of the body, including the brain, and lead to significant changes in social, emotional, and sexual behavior. In modern, complex societies such as the United States, however, the social context for this biological series of events has changed dramatically. Industrialization, urbanization, techno- logical advances, geographic mobility, and cultural diversity have radically transformed the hu- man environment. The interaction between the old biology and this new environment, in turn, has fundamentally altered the conditions for growing up as an adolescent in America. The swiftness of this change, in historical terms, challenges our understanding and the ca- pacity of our key socializing institutions to adapt to meet new needs. As a result, many fami- lies and their adolescents are not faring as well as they should. The often startling statistics on negative events during adolescence (e.g., school-age pregnancy, crime and violence, poor achievement in school, and disability and death because of risky health behaviors) cross boundaries of socioeconomic status, ethnicity, and neighborhood. THE CHANGED CONTEXT FOR DEVELOPING ADOLESCENTS The essence of human survival is the ability to adapt to the changing environment. In earlier generations, the transition from childhood to adulthood was gradual and cumulative. Despite generally greater vulnerability to the vicissitudes of nature, children mainly grew up in the con- text of a cohesive family and a small community with shared values and relatively slow tech- nological and social change. In such an environment, adolescents could count on authorita- tive information, adult guidance, and social stability. Adolescents spent most of their time in the presence of adults. Young people worked on family-based farms or in small businesses and youth apprenticeships. Most adolescents' leisure time was spent in the homes of their families and neighbors. Except in large cities, adolescents' social contacts were largely limited to near neighbors. It was scarcely possible for a "youth cul- ture" to develop, except for gangs in some big cities. 35 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS In earlier times, children observed their elders closely and learned by so doing. The tasks they were given from an early age pointed toward their future responsibilities. These tasks increased in scope and complexity as the children grew up; valued skills were developed step by step. When they reached adolescence, young people were familiar with what they would have to do as adults and what their opportunities would be. Adults controlled the sexuality and repro- duction of the young by arranging marriages soon after girls reached puberty. With dowries, parents often helped provide the economic basis for the start of a new family. The changes of this century, and especially of recent decades, have provided most children Dramatic Changes in American Families, 1790-1989 with remarkable material benefits as well as PERCENTAGE OF CHILDREN AGES 0-17 opportunities to master many skills; but they 100% have also brought with them major disloca- 90 tions of families, communities, and the econ- 80 omy and thus introduced new stresses into Dual-earner nonfarm Two-parent farm family and one-parent families the adolescent experience. Consequently, 70 many adolescents now must navigate these 60 treacherous transitional years with fewer so- 50 cial supports and with far less guidance than was formerly available. Among the most sig- 40 nificant transformations influencing adoles- 30 cent development today are the following: Father breadwinner, mother homemaker 20 Dramatic Changes in American Families. 10 As kinship and neighborhood networks No-parent situations have steadily eroded and divorce has be- 0 1790 1810 1830 1850 1870 1890 1910 1930 1950 1970 1989 come common, family life has splintered. YEAR Note: Estimated for 10-year intervals to 1980 and for 1989. Today, slightly more than half of all Ameri- Source: America's Children: Resources from Family, Government and the Economy, can children will spend at least part of their by O.J. Hemandaz, 1993, New York: Russell Sage Foundation. Adapted with permission. childhood or adolescence in a single-parent family-a much higher proportion than a few decades ago.¹ By age sixteen, close to half of the adolescent children of married parents will have seen their parents divorce or marry again.2 Remarriage presents children with the task of managing multiple family ties and dis- ruptions in family relationships. Less Time Spent with Adults. With the growth of two-worker families and the geographic dispersal of the extended family, adolescents are spending much of their time with peers in age- segregated environments. Although there has been less research than the problem deserves, the time that American children spend with their parents has decreased significantly in the past few decades.³ A 1988 survey found that about 27 percent of eighth graders spent two or more hours at home alone after school. Unsupervised afterschool hours represent a period of significant risk for engaging in substance abuse and sexual activity.5 36 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Changing Structure of Work. Economic restructuring and the globalization of the market- place have occurred so rapidly that unskilled individuals can find only low-paying work, often with little prospect of improvement. Entire adequate wage/low-skills industries have virtually disappeared in recent years. High school graduates who do not go on to postsecondary edu- cation are typically relegated to low-status, dead-end jobs.⁶ The growing disparity in incomes between the economically advantaged and the poor⁷ constitutes a threat to the prospects and morale of many adolescents and their parents. The material deprivation and job loss that in- terfere with effective parenting under conditions of poverty can give young people a bleak sense of the future. Earlier Reproductive Capacity Yet Later Marriage and Work. The hiatus between the ad- vent of reproductive capacity in individuals and their attainment of independent adult status has lengthened.8 Infection control and better nutrition in developed countries have lowered the average age at which menstruation begins to twelve and a half. At the same time, the period required for education and training and for achieving stable, productive employment has in- creased and marriages occur later. For many adolescents, there are few meaningful opportu- nities to participate directly in the adult world and in community life. Many, therefore, are un- certain how to be useful and earn the respect of their elders; they feel adultlike stresses without experiencing the rewards of belonging in the valued settings of adult life. Dominance of Electronic Media. More than any prior generation in history, young adoles- cents in America today have become immersed in media. Television and radio, along with per- sonal computers and videocassette recorders, are a dominant presence in the lives of both chil- dren and adolescents and a major shaping influence. By mid-adolescence, children have watched about 15,000 hours of television-more time that they have spent with their teachers, their friends, and even their parents.⁹ What young people see on television profoundly influences their fears and expectations about the future, their relationships with others, their concept of self and others, and their values.¹⁰ More Pluralism. The United States has now become one of the leading multiethnic nations in the world. One-third of American adolescents today are of non-European descent and come from a wide array of religious, ethnic, and national backgrounds.¹¹ In major metropolitan ar- eas, these young people are the majority in the public schools. By the year 2050, close to 50 percent of the entire American population is projected to be African American, American In- dian, Asian/Pacific Islander, and Latino/Hispanic.¹² Learning to live peacefully while re- specting diversity will be a major task for adults in the twenty-first century. All adolescents and their families have been affected by these interrelated social transforma- tions, and the pace of change promises only to accelerate in the new century. Consequently, a primary task for American institutions is to find innovative ways to help adolescents adapt to these changes. Such institutional responses are necessary so that individuals of all ages, but es- pecially young people in the midst of profound biological, psychological and social transfor- mation, will be able to build and maintain successful, satisfying lives. OLD BIOLOGY IN NEW CIRCUMSTANCES 37 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS More Education Is Linked to Higher Annual Earnings, 1992 MEAN ANNUAL EARNINGS (IN DOLLARS) $80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 Not a High school Associate Bachelor's Master's Doctorate Professional high school graduate LEVEL OF EDUCATION graduate Source: "More Education Means Higher Career Earnings," by the U.S. Bureau of the Census, 1994, Washington. DC: Government Printing Office The Ethnic Composition of Young Adolescents is Changing (1995-2050) PERCENTAGE OF YOUTH AGED 10 TO 14 80% White 70 60 50 40 30 Hispenic Origin 20 Black Asian and Pacific Islander 10 American Indian, Eskimo and Aleut 0 1995 2005 2015 2025 2035 2045 2050 YEAR Note: Percentages may total more than 100 because Hispanic Origin group overlaps with other ethnic groups. Source: Population Projections of the United States, by Age, Sex, Race, and Hispanic Origin: 1993 to 2050, by the U.S. Bureau of the Census, 1993, Washington, DC: U.S. Governent Printing Office EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS YOUNG ADOLESCENTS FACE NEW RISKS Across America, the demands and expectations as well as the risks and opportunities facing adolescents are both more numerous and more complicated than they were even a generation ago. Millions are growing up under conditions that do not meet enduring human needs for optimal development. They are not receiving the careful, nurturing guidance they need from parents and other adults. They are dealing with social pressures to use drugs, including al- cohol and cigarettes, and to engage in sex at distressingly early ages. Too many are alienated from school and moving toward dropping out. Many are engaging in antisocial activities and violence. Although adolescents generally have more autonomy and more money to spend than they used to, they have less real responsibility. Urban neighborhoods once secure are unsafe; even class- rooms and hallways can erupt into battlegrounds. With easier access to the weapons and drugs that endanger themselves and others, adolescents have increasing reason to fear each other. Many have not learned how to handle conflict without resorting to violence. Today younger adolescents are commonly exhibiting many of the very risky behaviors that were once associated with middle and late adolescence. Countless poignant examples exist of trou- bled, self-destructive, even violent behavior in the ten-to-fourteen-year age group, among rich and poor alike. One-Third of Eighth Graders Use Drugs Binge Drinking Is a Serious Drug Lifetime Use of Any Illicit Drug Including Inhalants, Problem in the Eighth Grade by Grade, 1994. Use of 5 or More Drinks in a Bow in Past 2 Weeks, 1994 PERCENTAGE INDICATING USE OVER LIFETIME PERCENTAGE REPORTING BINGE DRINKING 50% 30% 25 40 20 30 15 20 10 10 5 0 0 8th Grade 10th Grade 12th Grade 8th grade 10th grade 12th grade GRADE GRADE Source: The Monitoring the Future Study, by the University Source: Monitoring the Future Study, by the University of Michigan Institute for Social Research, December 1994, of Michigan Institute for Social Research, December 1994, unpublished data. unpublished data. OLD BIOLOGY IN NEW CIRCUMSTANCES 39 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS More Adolescent Males Are Engaging in Sex PERCENTAGE OF ADOLESCENT MALES WHO HAVE HAD INTERCOURSE 80% 70 Turned 20 in1985-87 60 50 Turned 20 in 1970-72 40 30 20 10 0 13 14 15 16 17 18 19 20 AGE Source: Sex and America's Teansgers, by The Alan Guttmacher Institute, 1994, New York: The Alan Guttmacher Institute. Adapted with permission. More Adolescent Females Are Engaging in Sex PERCENTAGE OF ADOLESCENT FEMALES WHO HAVE HAD INTERCOURSE 80% 70 Turned 20 in 1985-87 60 50 40 30 Turned 20 in 1970-72 20 10 0 13 14 15 16 17 18 19 20 AGE Source: Sex and America's Teenagers, by The Alan Guttmacher Institute, 1994, New York: The Alan Guttmacher Institute. Adapted with permission. 49 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Births to Older Adolescents Remain High, 1972-1992 NUMBER OF BIRTHS, MOTHER 15 TO 19 YEARS OLD 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 YEAR Source: Tabulations by American Demographics, Inc., 1995, based on National Center for Health Statistics unpublished data. Adapted with permission. Births to Young Adolescents Are Rising, 1972-1992 NUMBER OF BIRTHS, MOTHER YOUNGER THAN 15 YEARS OLD 14,000 12,000 10,000 8,000 6,000 4,000 2,000 0 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 YEAR Source: Tabulations by American Demographics. Inc., 1995, based on National Center for Health Statistics unpublished data. Adapted with permission. OLD BIOLOGY IN NEW CIRCUMSTANCES 41 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Earlier Experimentation with Drugs. A troubling number of young adolescents are smok- ing cigarettes and drinking alcohol. They perceive little or no risk to using these addictive sub- stances, which are gateways to the use of illicit drugs (including marijuana, LSD and other hal- lucinogens, inhalants, stimulants, barbiturates, cocaine, and crack). Fully one-third of eighth graders reported using an illicit drug in 1994.¹³ Earlier Sexual Activity. Rates of sexual initiation are increasing among younger girls and boys.14 Many American teenagers are startlingly ignorant of the most elementary facts of the human body and human sexuality, despite their wholesale exposure to sex in the mass media, the availability of sexually related materials, and efforts to provide sexuality education in the schools. Among teenagers in the United States, pregnancy rates are higher than in any other industrialized na- tion.¹⁵ In 1990, adolescents gave birth to 12 Among Young Adolescent Girls, Sex Is Usually Forced percent of all newborns. Four percent were to PERCENTAGE OF SEXUALLY EXPERIENCED WOMEN AGES 19 AND YOUNGER those under age eighteen, and 8 percent were WHO HAVE HAD INVOLUNTARY INTERCOURSE 70% to eighteen- and nineteen-year-olds.¹⁶ Inadequate Learning. In the past two 60 decades, achievement levels and rates of high school graduation have remained virtually 50 stagnant.¹⁷ The performance of American students is lower than that of same-aged stu- 40 dents in both Asia and Europe. Such perfor- mance is too low to support increasing living 30 standards in a high-technology, information- based society. 20 More health-damaging behavior. As the 10 communicable diseases of childhood have been controlled by biomedical research and 0 13 and younger 14 15 16 17 18 19 public health advances, new behavior-based AGE AT FIRST INTERCOURSE morbidities of adolescence have come to the Source: Sex and America's Teensgers, by The Alan Guttmacher Institute, 1994, New York: fore.¹ Suicide and gun-related homicides The Alan Guttmacher Institute, based on tabulations by K.A. Moore, C. W. Nord, and J.L. Peterson of data from the 1967 National Survey of Children. Adapted with permission. are at record-high levels.¹⁹ Injury, homicide, and suicide taken together account for most adolescent deaths.20 By age eighteen, about a quarter of all adolescents have engaged in behavior that is harmful or dangerous to themselves or others. Another quarter are deemed at moderate risk for such be- havior. On average, about half of all American adolescents-an estimated 14 million girls and boys-are at high or moderate risk of impairing their life chances through engaging in prob- lem behaviors.2¹ In distressed communities, the proportion of adolescents at very high risk for poor outcomes is even larger. 42 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS The Science and Mathematics Achievement of American 13-Year-Olds Is a Serious Concern AVERAGE SCORE 80 70 60 50 40 30 20 10 0 Korea Taiwan Switzerland Hungary Italy Israel Canada France Spain USA Ireland Jordan Math Science COUNTRY Source: Learning Math and Learning Science, by A.E. Lapointe, N. A. Mead, and J. M. Askew. 1992, Princeton, NJ: Educational Testing Service. Adapted with permission. Percent of Adolescents Ages 10 to 14 Living in Distressed Neighborhoods Living Below the Poverty Line, 1993 PERCENTAGE OF YOUTHS YOUNGER THAN AGE 18 MEAN ANNUAL EARNINGS (IN DOLLARS) 30 50 25 20 40 15 30 10 5 20 0 Black Hispanic White ETHNIC BACKGROUND 10 Note: A distressed neighborhood is defined by high levels (at least one standard deviation above the mean) of: 0 (1) poverty; (2) female-headed families; (3) high school Total White Black Hispanic dropouts; (4) unemployment; and (5) reliance on welfare. ETHNIC BACKGROUND Source: From Kids Count Data Book 1994: State Profiles of Child Well-Being, by the Annie E. Casey Foundation, Source: Current Population Survey, by the U.S. 1994, Baltimore, MD: Annie E. Casey Foundation. Bureau of the Census, March 1994, unpublished date. Adepted with permission. OLD BIOLOGY IN NEW CIRCUMSTANCES 43 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Leading Causes of Death in Adolescents by Age, 1992 Unintentional injury AGES 10-14 Motor vehicle Malignant neoplasms Homicide Suicide Congenital anomalies Unintentional injury AGES 15-19 Motor vehicle Homicide Suicide Malignant neoplasms Heart diseases 0 5 10 15 20 25 30 RATES PER 100,000 Note: A recent addition to the leading causes of death for adolescents aged 15-19 is infection with the human immunodeficiency virus (HIV). HIV infection was the tenth leading cause of death for this age group, at # rate of 0.3 per 100,000. Source: The National Center for Health Statistics, 1994, unpublished data. The Rate of Suicide Is Rising Among White and Black Adolescents, 1980-1992 PERCENTAGE CHANGE, 1980 TO 1992 300 10-14 15-19 250 200 150 100 50 0 White Males White Females Black Males Black Females Source: "Suicide among Children, Adbiescents, and Young Adults-United States, 1980-1992." April 21, 1995, Morbidity and Mortality Weekly Report, 44, (15). 44 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Firearm Deaths of 10-to 14-Year-Olds, 1980-1992 FIREARM DEATHS PER 100,000 POPULATION 12 10 Black male 8 6 White male 4 Total Black female 2 White female 0 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 YEARS Source: "Firearm Mortality among Children, Youth, and Young Adults 1-34 Years of Age, Trends and Current Status: United States, 1979-88," by L Fingerhut, J. C. Kleinman, E. Godfrey, and H. Rosenberg, 1991, Monthly Vital Statistics Report, 39, (11): and National Center for Health Statistics. data from the National Vital Statistics program, 1994, unpublished data. Firearm Dealths of 15- to 19- Year-Olds: 1980 to 1992 FIREARM DEATHS PER 100,000 POPULATION 160 White females Black females 140 Total White males 120 Black males 100 80 GO 40 20 D 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 YEARS Source: "Firearm Mortality among Children, Youth, and Young Adults 1-34 Years of Age, Trends and Current Status: United States, 1979-88," "by L. Fingerhut, J.C. Kleinman, E. Godfrey, and H. Rosenberg, 1991, Monthly Vital Statistics Report, 39, (11): and National Center for Health Statistics, data from the National Vital Statistics program, 1994, unputlished data. OLD BIOLOGY IN NEW CIRCUMSTANCES 45 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Overcoming Even adolescents at risk of developing serious learn- Even for the Kaua'i adolescents with problems, the ing or behavior problems can beat the odds and in- vast majority became successful adults by their The Odds crease their chances to lead successful adult lives. early thirties. Their experiences with supportive A three-decade, longitudinal study of all children people and structured lives-such as joining the born on the island of Kaua'i, Hawai'i, in 1955 offers us military or a church group, having close and stable some clues about what makes for resiliency under relationships with caring mates or spouses, and adversity and how the design of effective prevention obtaining post- secondary education - provided strategies can be informed by naturally occurring in- opportunities to turn their lives around. These re- terventions. sults are consistent with those from other com- One-third of Kaua'is Asian Pacific American children munities where taking on adult roles as workers, were designated as "high ris" because they were parents, and spouses can overturn adolescent de- born into chronic poverty, had experienced perinatal viance. In all cases, the commitment of nurturing, stress, and lived in families plagued by conflict, di- competent adults to a young person is crucial. For vorce, alcoholism, or mental disorders. By age eigh- some, the adults were parents, but for others, they teen, two-thirds of this high-risk group did experi- were concerned teachers, coaches, youth work- ers, or relatives. ence problems, including delinquency, mental health problems, or teenage pregnancy. The remaining chil- Werner emphasized the importance of naturally oc- dren were described by researchers Emmy Werner curring informal support networks in shaping the life and Ruth S. Smith as "vulnerable, but resilient," and trajectories of adolescents who overcome great they emerged as competent young adults who were odds. Where such support networks do not exist as gainfully employed, involved in stable relationships they did on Kaua'i, "a continuum of care and caring with spouses or partners, and active in their com- by professionals as well as volunteers" is required. munities. None developed problems during child- The children of Kaua'i, who are now adults ap- hood or adolescence. proaching middle age, and children in similar studies Three clusters of protective factors distinguished this throughout the world offer compelling testimony about what can make a difference in lives threatened "resilient" group from the other high-risk individuals who did develop problems by adolescence: (1) tem- by conditions of economic and personal adversity. peramental characteristics and engaging social skills, that involve family members and others, and at least SOURCES average intelligence; (2) strong attachments with Werner, E.E, & Smith, R.S. (1992). Overcoming the odds: High- parents or parental substitutes, including grandpar- risk children from birth to adulthood. Ithaca, NY: Cornell Uni- ents and siblings; and (3) a broad community support versity Press. system such as a church, youth group, or school that Werner, E.E., & Smith, R.S. (1983). Vulnerable but invincible: A offered stable support and consistent guidance, with study of resilient children. New York: McGraw-Hill. the hope that they could expect a good future. In this Werner, E. E., Bierman, J. M., & French, F.E. (1971). The children and more than 250 studies of children growing up in of Kauai: A longitudinal study from the prenatal period to age adverse circumstances-war, poverty, dysfunc- ten. Honolulu: University of Hawaii Press. tional families-results present a consistent picture that these common factors enable young people to beat the odds. GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS THE UNMET NEEDS OF HIGHLY VULNERABLE YOUTH Many low-income neighborhoods lack jobs that generate adequate family incomes, thus con- centrating poverty in a way that pervades the community.22 There, young people are rarely ex- posed to role models who can raise their expectations about stable jobs and family life. Few adults are available for sustained attention, guidance, and supervision. Areas of concentrated poverty have high crime rates and dangerous streets. Young adolescents from these areas of- ten are tempted to get involved with illicit drugs, not only as users but also as sellers. They spend a lot of time alone, often watching television with all its vivid violence and putative badges of adulthood and hanging out on street corners where real violence threatens or with antisocial peer groups. They may be engaged in sexual activity earlier than their parents were, even as they progressively disengage from school. Not all troubled adolescents are disadvantaged, and not all disadvantaged adolescents are troubled. But those adolescents from economically disadvantaged backgrounds are often at higher risk than their more privileged counterparts of reaching adulthood ill equipped for work, family life, and full participation in our democratic society. They are more apt to be indifferent to their health and cynical about future opportunities that could motivate them to adopt health-enhancing behavior.25 They are more likely to bear children in adolescence- indeed, 87 percent of teen mothers are poor or near poor.24 Yet, even high-risk behavior need not be the case, as shown by a recent decline in smoking reported by African American ado- lescents.²⁵ As we shall see, there is much that can usefully be done for young people even in circumstances of deep adversity. TURNING NEW RISKS TO NEW OPPORTUNITIES Although the profound changes of adolescence create vulnerability, they also provide a unique window of opportunity. Adolescents initially explore new behavior patterns and possibilities ten- tatively. That is why, before damaging patterns are firmly established, adults have a major oppor- tunity to shape interventions to prevent later casualties and promote more successful outcomes. Adolescence represents the last phase of the life course during which society has reasonably ready access to the entire population, so the potential for constructive influence is great. With the supportive guidance of pivotal institutions, namely the family, schools, community and health-care organizations, and media, adolescents can be helped to form healthier, problem- solving lifestyles and thereby increase their odds of successfully meeting the challenges of adult life in a transformed world. Further Reading Commission on Behavioral and Social Sciences and Education, National Research Council. (1993). Losing generations: Adolescents in high-risk settings. Washington, DC: National Academy Press. Dryfoos, J. G. (1990). Adolescents at risk: Prevalence and prevention. New York: Oxford Uni- versity Press. Hawley, W.D, & Jackson, A. W. (Eds.). (1995). Toward a common destiny: Improving race and ethnic relations in America. San Francisco: Jossey-Bass. OLD BIOLOGY IN NEW CIRCUMSTANCES 47 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS per EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER FOUR Reducing Risks, Enhancing Opportunities: Essential Requirements for Healthy Development Although new social circumstances have vastly altered the landscape for adolescent develop- ment, all adolescents continue to have fundamental human requirements that must be met if they are to grow up into healthy, constructive adults. All run the risk of diminished lives if these requirements are not met. To make a successful transition to adulthood, adolescents must still have the kind of help and support that was once commonly available within the network of family and kin but now is eroded. They must have sustained, caring relationships with adults; receive guidance in fac- ing serious challenges; become a valued member of a constructive peer group; feel a sense of worth as a person; become socially competent; know how to use the support systems available to them; achieve a reliable basis for making informed choices; find constructive expression of the curiosity and exploration that strongly characterize their age; believe in a promising future with real opportunities; and find ways of being useful to others. Meeting these requirements has been basic for survival into adulthood for millennia. But in a democratic society that places an increasingly high premium on competence in many domains, adolescents now face an even stiffer set of challenges. They must learn the elements of re- sponsible citizenship; master social skills, including the ability to manage conflict peacefully; become ethical persons; respect diversity in our pluralistic society; and cultivate inquiring and problem-solving habits of mind. Further, to compete for good jobs in a rapidly changing work- place, young people must not only acquire the technical and analytical capabilities to partici- pate in a worldwide economy, they must also have motivation for lifelong learning and for adaptability throughout the life span. Indeed, an important part of preparation for adulthood today is preparation for change itself. 49 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS THE POWER OF GENERIC APPROACHES Many of the adolescents who have serious problems lack critical social supports and are at risk of not meeting the challenges of the twenty-first century. Serious adolescent problems, such as delinquency, substance abuse, adolescent pregnancy, and school failure, are strongly associ- ated with family discord or violence, poor communication, lack of parental monitoring, and inconsistent discipline.¹ They are typically associated with parents who are either highly au- thoritarian or very permissive in their child-rearing practices. One of the important insights to emerge from scientific inquiry into adolescence in the past two decades is that problem behaviors tend to cluster in the same individual and reinforce one another.2 Crime, school dropout, teenage childbearing, and drug abuse typically are consid- ered separately, but in the real world they occur together. Those who drink and smoke in early adolescence are thus more likely to initiate sex earlier than their peers; those who engage in these behavior patterns often have a history of difficulties in school. When young people have a low commitment to school and education, and when teachers or parents have low expecta- tions of the children's performance, trouble lurks. Once educational failure occurs, then other adverse events begin to take hold. Just as health-compromising behaviors cluster, health-enhancing behaviors of young adoles- cents also tend to be linked.3 These observations suggest that families, schools, and other so- cial institutions have a unique opportunity to foster healthy lifestyles during early adolescence by addressing the common roots of both positive and negative behavioral clusters. Such an ap- proach to adolescent development is generic, to distinguish it from a categorical or targeted ap- proach that focuses on a specific or single problem. Generic approaches emphasize the posi- tive possibilities inherent in the adolescent transition: possibilities for educating and motivating adolescents in the pursuit of healthy lifestyles;4 for fostering interpersonal and decision-mak- ing skills to help them choose alternatives to very risky behavior;5 and for providing them with ways to build constructive lives. Generic interventions address some of the underlying or predisposing factors that increase the likelihood that an adolescent will engage in high-risk or problem behaviors. These factors in- clude low self-esteem, underdeveloped interpersonal and decision-making skills, lack of in- terest in education, inadequate information regarding health matters, low perception of op- portunities, the absence of dependable and close human relationships, and meager incentives for delaying short-term gratification. Generic approaches seek to meet the fundamental developmental needs of adolescents and promote a cluster of healthy behaviors that are likely to emerge when these needs are met. Generic approaches are especially useful for the population of young people who are at mod- erate risk of negative outcomes and who, therefore, can readily go either way: toward additional problem behavior or toward healthy adolescent development. There is a complementary relationship between generic approaches that tackle these underly- ing factors and targeted approaches that deal with specific problems. For instance, a generic approach can help a shaky adolescent earn self-respect, find a place in a valued and construc- tive group, and make durable friendships, all of which enhance the individual's resistance to 50 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS New Jersey Offers Comprehensive Services for Youth Trouble for many young adolescents comes in mul- Today the program operates in thirty-seven sites in or tiple doses. A young person may have parents who near schools in urban, rural, and suburban communi- face unemployment and housing problems or may ties. Sites are open during and after school, on week- have a father or mother who is an alcoholic or drug ends, and all summer long. They offer a core set of abuser. The young person may be performing poorly services, all of which require parental consent. Cen- at school, may lack adequate medical or dental care, ters offer adolescents basic services: primary and and may know no reliable adult to whom to turn to preventive health services; referrals to health and so- for advice. cial services; individual and family counseling; crisis intervention; drug and alcohol abuse counseling; em- Human service agencies that could help these young ployment counseling, training, and placement; sum- people may themselves be geographically dispersed, mer and part-time job development; and recreation. unattractively labeled or socially unacceptable to Beyond this core of services, the state encourages adolescents, and not linked to one another. The centers to provide classroom-based health education; agencies may rely heavily on informal referrals, with arts, cooking, and sports activities; transportation; no systematic way of accepting students from the family planning examinations and referrals; parenting school system. Furthermore, if the agencies do not skills instruction; violence prevention programs; child provide family counseling, they may be unable or care; outreach to adolescents who have left school; unwilling to address problems in family relationships. or twenty-four-hour hotlines. Mental health services One promising state-based model to provide needed are the most frequently used service across the state, help for adolescents is New Jersey's School-Based followed by other health, employment, education, and Youth Services Program, which brings together ex- substance abuse services. isting services for adolescents under one roof, most often at the school. State officials have found that In 1991, about one of every three New Jersey teen- schools offer the most effective sites for reaching agers-more than 19,000 students-participated in and assisting large numbers of adolescents on a reg- this state-sponsored program. A recent survey re- ular basis. vealed that more than half of the students receiving services are African American and nearly a quarter Led by then-Governor Thomas Kean, the New Jersey are Hispanic. More than half of the adolescents are Department of Human Resources initiated the School- considered at risk for dropping out of school. Girls Based Youth Services Program in 1988 as a way of and boys use the service about equally, and they are connecting the state's education, health, and human most likely to be ninth and tenth graders. services, and creating "one-stop service centers" for adolescents and their families. By changing the tradi- Although evaluative data are not yet extensive, pro- tional institutional arrangements of the state's agen- grams like New Jersey's appear to be efficient, cost- cies from a targeted approach to one that support effective ways to connect adolescents and their fam- the overall well-being of the state's teenagers by ilies to critical services. Administratively, the state providing comprehensive services, this program has requires that each host community provide at least encouraged teenagers to complete their education, 25 percent of the program costs through direct fi- obtain the skills they need for employment or for ad- nancial contribution or in-kind services, facilities, or ditional education, and lead healthy, productive lives. materials. Each site costs the state approximately REDUCING RISKS, ENHANCING OPPORTUNITIES 51 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS $230,000 annually, or about $200 per student served. development and to strengthen the parent-child re- Stable funding is a strong factor in convincing com- lationship. Parent support groups provide an oppor- munity organizations and schools that they should tunity for students to talk about what it is like to raise work together on the program. children as they struggle for their own indepen- At Plainfield High School, in response to the inci- dence. Students are encouraged to share their ideas dence of teenage parenthood, the Plainfield School- and experiences, to see their similarities and differ- Based Youth Services Program developed and im- ences, and to help each other solve problems and plemented the Plainfield Teen Parent Program in work through tough times. collaboration with the Parent Linking Project of the An evaluation of the project found that 84 percent of New Jersey Chapter, National Committee for Pre- program mothers graduated from high school, com- vention of Child Abuse, AT&T, Community Coordi- pared to 41 percent of the control mothers. Two years nated Child Care of Union County, and the Plainfield after their first births, 11 percent of program mothers Health Center. The program provides a comprehen- had a second birth, compared to 33 percent of the sive array of services to mothers and their babies, in- control mothers. Program mothers were more likely cluding school-based child care, parent education than comparison mothers to report having 8 regular classes, mentoring, tutoring, parent support groups source of medical care for their children. Stress as- for both pregnant and parenting teens, life skills train- sociated with parenting decreased significantly ing, job skills training, health care, including prena- among program mothers, while general self-esteem tal, well-baby, and adolescent health care, and in- rose. Students and faculty at Plainfield High School formation and referral to other social service generally supported the presence of a child-care agencies. Services are also provided to young fa- center on the school grounds and felt that it made a thers, grandparents, and guardians. All students who difference in making it possible for some girls to have children in the Plainfield Infant Toddler Center graduate. This program was developed by and in- are required to enroll in a parenting class that teaches cludes representatives from all segments of the com- the student-parents activities to enhance their child's munity and private and public sectors. drugs, weapons, or early sexual activity. At the same time, it is important for adolescents to ac- quire accurate information about each of these major risks and to develop specific skills in avoiding them. In this way, the generic and targeted approaches are mutually supportive. SOCIAL SUPPORTS TO ADOLESCENTS AND FAMILIES At the heart of a generic approach to adolescent development is the restoration and strength- ening of social supports that once were available to young adolescents within their families and communities. A working group on social support networks, established by the Carnegie Coun- cil on Adolescent Development and chaired by Richard Price of the University of Michigan, examined the potential of schools and youth organizations to offer young adolescents the prac- tical services and material benefits that promote healthy development; the feedback that raises self-esteem and strengthens identity; and the affection, caring, and nurture they need. Care- fully reviewing dozens of such programs across a variety of settings, the working group noted the following critical ingredients of effective or promising approaches:6 52 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS They tend to respond to more than one serious problem or risk factor. They recognize that ado- lescent problems occur in clusters. They plan interventions in ways that can make a difference before damaging patterns are firmly established. They take developmental information into account-for instance, they take note of the point at which high-risk behavior is likely to begin in offering guidance to the young to diminish the risks. They create incentives that adolescents are likely to perceive as relevant to their own lives. For example, they open up social roles that are respected and provide the opportunity to learn new skills. They tend to provide some combination of knowledge and skill that can help young peo- ple earn respect. They are broad enough in scope and flexible enough in mode of operation to adapt to a consider- able range of needs. SUPPORT STRATEGIES FOR CREATING MEANINGFUL SOCIAL ROLES One of the problems adolescents have is that they often do not perceive what their place is in society or what they are being prepared for.⁷ They wonder how they can earn appreciation and approval. Particular support strategies have arisen to foster meaningful social roles for them during early adolescence. These strategies include adult mentoring, peer tutoring, and service to others in the community. Successful efforts to help prepare young people for adult social roles share the following characteristics:8 They foster active participation by adolescents. They provide opportunities for direct involve- ment, high initiative, and leadership. For example, they may arrange for rotation of leadership in group activities and construct opportunities for adolescents to give as well as to receive. They foster relationships among several elements of the social support system. For example, there are programs aimed at preventing school failure that actively engage both teachers and parents, helping each to understand the adolescent better and to work together in supporting efforts to improve the students' educational performance. They provide considerable continuity over time. They are arranged to provide dependable, trust- ing relationships for one year or longer, providing incentives and guidance for adolescents to pursue a constructive course with respect to their health and education. They promote activities that fit well in sponsoring organizations. They try to build upon orga- nizational readiness for change. ADULT MENTORING A crucial need of adolescents is for an enduring, stable, supportive bond with a caring adult. For this reason, another aspect of social support that has captured great interest in recent years, especially for its benefits in communities with very low incomes, is adult mentoring.9 A variety of innovative efforts have explored ways to construct such dependable one-to-one relations over an extended period of time. REDUCING RISKS, ENHANCING OPPORTUNITIES 53 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Mentoring can be a powerful way to provide adult involvement with adolescents who are largely isolated from the world of adults. It can help adolescents prepare for social roles that earn re- spect and encourage them to persist in education. Elder citizens can contribute substantially as mentors to adolescents, bringing new meaning to their own lives while helping the younger generation grow up. On the basis of this trusting and stimulating experience, other relation- ships may be built in the future. However, the mentor's task is not easy. He or she is expected to provide sustained support, guidance, and concrete assistance as the adolescent goes through a difficult time, enters a new situation, or takes on new tasks. It is also important that a men- toring program be integrated with other resources in the community. Particularly for high-risk youth, where problems tend to cluster, the connection with education, health, and social ser- vices is necessary. PEER-MEDIATED PROGRAMS THAT PROMOTE HEALTH AND EDUCATION Peer relations in adolescence are powerful influences, for better or worse. Within the group, there can be opportunities to become a person worthy of respect, with a distinctive contribu- tion to make. Programs led by peers can be valuable in giving young adolescents the ongoing, sympathetic attention they need to cope with risk factors. The credibility of peers during ado- lescence can help some young people who would otherwise be very hard to reach. Both edu- cation- and health-oriented interventions can function well with peer leadership, if teachers or other professional adults provide proper training and supervision. Indeed, continuing guid- ance of peer tutors and counselors by mature, qualified adults is important. Peer-led programs on smoking, for example, show they can substantially reduce the onset of smoking in early adolescence.¹⁰ In these programs, older peer leaders who themselves have successfully resisted the lure of addictive substances can serve as models for young ones only now on the verge. Peer leaders can be effective in teaching younger adolescents social skills to resist pressures to use drugs or engage in premature sex and can help them identify and prac- tice health-enhancing behaviors. Abundant evidence also exists of the value of one-to-one tutoring as an effective teaching method. With a trained tutor, 98 percent of students do better in school than they otherwise would.¹ This is true not only when the tutoring is conducted by teachers or professional tu- tors; it also works well when the tutor is a suitably prepared student, especially one who is older. Students in elementary and secondary school can benefit from tutoring by older peers in difficult subjects such as mathematics. As with peer counseling, there is considerable evidence that tutoring benefits the young tu- tors.¹² When these programs are firmly established, teachers also benefit.¹ 13 The classroom cli- mate is likely to improve. Since fewer students are feeling left out or seriously alienated, a more cooperative atmosphere conducive to learning tends to emerge. A well-functioning program of students serving as auxiliary teachers allows teachers to use their professional skills more fully than they could otherwise. 54 GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS LIFE SKILLS DEVELOPMENT If adolescents are to solve problems of human relations, develop healthy lifestyles, access so- cial systems, cultivate intellectual curiosity, and meet the demands of the workplace, they must learn basic life skills. By and large, these are practical skills that help in coping with day-to-day living. In favorable circumstances, adolescents acquire these critical adaptive skills in the fam- ily, in friendship groups, in the neighborhood, and in school. To the extent that families and neighborhood resources are unable to fulfill these requirements, however, specially designed interventions may be crucial. In considering ways to prevent damaging outcomes in education and health during adolescence, the Carnegie Council on Adolescent De- velopment has given in-depth scrutiny to the role of specific train- ing in such "life skills," especially in early adolescence, when young I think that being a kid is the most people are making fateful decisions that involve education, drugs, weapons, and how they use their bodies.¹⁴ Such training offered at important stage of your life. It's a time this decisive time can capitalize on young adolescents' emerging cognitive capabilities-marked by a change from the concrete think- when you start to develop a personality. ing of childhood to the capacity for higher-order thinking-to de- It's when you start to learn about who velop the social skills and competence needed for success in the mainstream. you are, and what you want to do with Life skills training should become a vital part of education in all rele- vant institutions, including most especially the family, schools, and yourself. And it's a time when you develop community-based organizations, so that adolescents learn to make in- trust. It's a time when you learn how to formed, deliberate, and constructive decisions. Such decision making requires one to stop and think, obtain information and assess it, for- be a person in society. mulate or consider options, try new behavior, and get feedback. Linked to a curriculum in the life sciences in middle grade and junior high schools, for example, life skills training could answer many ques- Unfortunately a lot of kids don't have that. tions that adolescents have about their bodies and how to use them If you don't grow up learning how to be responsibly. One such life skill that adolescents often lack and that can be taught a productive person, then you're going to is the ability to pursue constructive relations with others. Adolescents who are vulnerable because they have been isolated and lonely, de- have a problem once you grow up. pressed, angry, and lacking in interpersonal skills can be helped through life skills training to form solid friendships, learn from expe- SARAH ROSEN, 16 rience, and participate in cooperative groups. Another useful skill is assertiveness. An aspect of assertiveness is knowing how to resist pres- sure or intimidation to use drugs or weapons or have sex-without disrupting valued relationships or isolating oneself. Yet another aspect is nonviolent conflict resolution-the ability to achieve personal and social goals in ways that make use of the many nonviolent opportunities that exist in the society. REDUCING RISKS. ENHANCING OPPORTUNITIES 55 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Mentors Rewrite the Future of Youth A downward trajectory is not inevitable for youth liv- The program required students to participate in (1) ing in neighborhoods of concentrated poverty. Young academic-related activities outside school hours, in- people from extremely disadvantaged situations can cluding reading, writing, math, science, and social rewrite their futures with the help of a caring adult studies, peer tutoring, and computer skills training; mentor from the community if the mentoring takes (2) community service projects, including tutoring place in combination with a multiyear mix of educa- elementary school students, cleaning up the neigh- tional, developmental, and cultural activities and with borhood, and volunteering in hospitals, nursing service to others in the community. The Quantum Op- homes, and libraries; and (3) cultural enrichment and portunities Program (OOP), a four-year, year-round personal development activities, including life skills youth development program, funded by The Ford training, college and job planning, attending plays Foundation, has shown that intervening during the and concerts, visiting museums, and reading and dis- high school years, beginning during the freshman cussing the great books. Community service activi- year (age thirteen), can more than marginally im- ties connected the students to their communities and prove the prospects for African American adoles- helped them develop many of the skills needed for cents in poverty. The program, initiated during the work-reliability, following through on tasks, and 1989-1990 school year, was designed to test the abil- working cooperatively. Through personal develop- ity of community-based organizations to foster aca- ment activities, students learned how to set goals, demic and social competencies among high school manage their time, and choose behavior appropriate students from families receiving public assistance. for varying situations. They learned the life skills needed in the home, at work, and in the marketplace. Participants were selected at random from high Consequently, the program encouraged students to schools in five sites-Philadelphia, Oklahoma City, develop meaningful relationship with their mentors, Saginaw, Milwaukee, and San Antonio. Students form strong ties to their peers because of the family- were eligible for the program if they were entering like environment provided by the program, and the ninth grade, attending a public high school in a strengthen their ties to their neighborhoods through neighborhood with high rates of poverty, a member service. of a minority group, and from a family receiving pub- lic assistance. Each group of twenty-five students In exchange for their commitment to the program, at the five sites was matched with a paid mentor students were offered financial incentives that en- who stayed with the group for the four years of high couraged participation, completion, and long-range school, including summers. Extremely committed to planning. A stipend of $1.33 was given to students their students, mentors provided what children for each hour they participated in these activities. need most-an adult who cares about them and For every 100 hours of education, service, or devel- who sticks with them over the long term no matter opment activities in a cycle, students received a what. Each day for four years, mentors provided completion bonus payment of $100. The accrued sustained support, guidance, and concrete assis- amount with interest became available to the stu- tance to their students, all of whom were growing dent for college, job training, technical training, or up in poverty. other approved education upon graduation from GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS high school. The average cost per participant was $10,600 for the four years, which is one-half the cost of a year in prison. Brandeis University faculty conducted an evaluation of the program using a random-assignment control- group design to assess effects while students were in the program and after they graduated. The results are encouraging. The fall 1993 follow-up evaluation of participants and controls in three sites (Philadel- phia, Saginaw, and Oklahoma City) shows the effec- tiveness of an intensive effort that offers an array of coordinated services, coupled with a continuing relationship with a peer group and a caring adult. Sixty-three percent of program participants gradu- ated from high school, and 42 percent are currently enrolled in college, versus 42 percent and 16 per- cent, respectively, of the controls, Program partici- pants bore fewer children than controls (24 percent compared to 38 percent of control group members). In addition, participants were half as likely to receive As part of The Ford Foundation's continuing support, food stamps or welfare and average fewer arrests the program will be tested further in five additional than controls (19 percent compared to 23 percent). sites that include approximately 700 participants. A QOP members are significantly more likely to be in- key ingredient of this program is the sustained in- volved in community service, to be hopeful about volvement of community organizations and residents. their future, and to consider their life a success than Given the interest in empowering local communities, are control group members. this program offers a working model that has the po- To students like Jacqueline Jones, participation in tential to overcome the intergenerational transmis- the program has made a difference. She said it has sion of poverty and its negative outcomes. given her a sense of "respect, trust, friendship, and, most important, love. It has been a vital part of my life and education. It helped to enhance my knowledge and understanding of the world I live in. I got in- volved in the community by doing community ser- vices, and helping others as the QOP program had helped me." REDUCING RISKS, ENHANCING OPPORTUNITIES 57 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Substance Training in life skills is an essential part of a compre- sessions in ninth grade. The booster sessions were hensive approach to prevent adolescents from en- designed to review and reinforce the material COV- Abuse gaging in health-compromising behaviors. Through ered during the first year of intervention. life skills, young adolescents can learn to enhance The main focus of the intervention was on imparting their competence to resist social influences that re- Prevention information and skills for resisting social influences sult in high-risk behaviors. This prevention strategy to use drugs and generic personal and social skills is designed to help young people, particularly in mid- and Life for increasing overall competence and promoting the dle or junior high school, develop basic personal and development of characteristics associated with de- social skills and an increased sense of control by Skills creased risk of using drugs. In contrast to other pre- teaching them to apply and practice skills that are vention programs, only minimal information con- relevant to the social situations that adolescents cerning the long-term health consequences of drug Training confront. The program objectives of life skills train- use was provided. Information relevant to adoles- ing are to: cents in their daily lives was taught, including the im- Provide students with the necessary skills to resist mediate negative consequences of drug use, the de- social pressures to smoke cigarettes, drink alcohol creasing social acceptability of use, and the actual excessively, or use marijuana; prevalence rates among adults and adolescents. Decrease students' susceptibility to social pressures Findings from this six-year follow-up study suggest to use tobacco, alcohol, and other drugs by helping that drug abuse prevention programs conducted dur- them develop greater autonomy, self-esteem, and ing junior high school can produce significant and confidence; sustained reductions in tobacco, alcohol, and mari- juana use if they teach a combination of social re- Teach students to resist the influence of advertising sistance skills (including general life skills), are prop- that promotes addictive substances; erly implemented, and are followed by at least two Enable students to cope effectively with anxiety, par- years of booster sessions. ticularly anxiety induced by social situations; Increase awareness of the negative consequences SOURCES of substance use, particularly the more immediate Botvin, G.J., Baker, E., Dusenbury, L, Botvin, E.M., & Diaz, T. physical and social consequences; (1995). Long-term follow-up results of a randomized drug abuse prevention trial in a white middle-class population. Journal of Correct normative expectations concerning sub- the American Medical Association, 273:1106-1112. stance use by providing them with accurate infor- Hamburg, B.A. (1990). Life skills training: Preventive interven- mation concerning the actual prevalence rates of to- tions for young adolescents. Washington, DC: Carnegie Coun- bacco, alcohol misuse, and marijuana use. cil on Adolescent Development. In evaluating the long-term efficacy of a school- based approach to drug abuse prevention, Gilbert Botvin and his colleagues found significant reduc- tions in both drug and polydrug use (tobacco, alco- hol, marijuana) in a random sample of twelfth-grade students who had received a life skills intervention while in the seventh grade. The intervention con- sisted of fifteen classes taught in seventh grade, ten booster sessions in eighth grade, and five booster GREAT TRANSITIONS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Recent research has shown that life skills training can help prevent adolescent problem be- havior.15 When tasks are clarified and appropriate skills provided, negative attitudes can be changed and adolescent motivation strengthened to tackle life's problems. To be successful, however, life skills must become a part of daily life and must be reinforced. Increasingly, training in life skills is being oriented toward disadvantaged youths in impoverished social environments, to good effect.¹⁶ COMPREHENSIVE SOLUTIONS FOR INTERRELATED PROBLEMS All these approaches-strengthening social support networks, establishing meaningful social roles for adolescents, creating adult mentoring opportunities, fostering peer-mediated pro- grams, and developing life skills training-are generic in character. They have the potential to prevent a wide range of problems in adolescent health and education. The enduring significance of a comprehensive approach is that it responds directly to the ba- sic requirements of adolescents as they begin to move toward adulthood. Adults and institu- tions can address these aspirations, meeting adolescents halfway in seeking fulfillment. The chapters that follow in Part II review the most promising approaches available by which to- morrow's institutions can create such generic interventions, building on today's strengths to offer young adolescents a decent chance in life. Further Reading Dryfoos, J. G. (1994). Full-service schools: A revolution in health and social services for chil- dren, youth, and families. San Francisco: Jossey-Bass. Hamburg, B. A. (1990). Life skills training: Preventive interventions for young adolescents. Washington, DC: Carnegie Council on Adolescent Development. Hamburg, D.A. (1992). Today's children: Creating a future for a generation in crisis. New York: Times Books. Price, R. H., Cioci, M., Penner, W., & Trautlein, B. (1990). School and community support pro- grams that enhance adolescent health and education. Washington, DC: Carnegie Council on Adolescent Development. REDUCING RISKS. ENHANCING OPPORTUNITIES 59 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS PART II Preparing Adolescents for a New Century EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS WHAT'S COOKING IN NATURE'S KITCHEN The World ½ cup good times 1/2 сир bad equal shares work, play ½ cup tithing pinch of death I cup love Simmer violence, prejudice, hate. Melt into loving hearts. Summer-Stir the world Fall-Bake and cool Winter-Ice with hearts Enjoy in Spring MICHELLE MONIZ 12 EMBARGOED UNTIL 10 AM, OCTOBER 2,1995 UNCORRECTED PAGE PROOF 6 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER FIVE Reengaging Families with Their Adolescent Children Being a parent of an adolescent in today's America is a formidable responsibility. Within our lifetime, dramatic changes have occurred in the structure of American families and of the work- place. There are many more single or divorced parents and more two-worker families than ex- isted a generation ago. Many parents must take two jobs to make ends meet. These changes have decreased the time parents have available for supervising their children and for instilling values. With all the dislocations in the global economy, parents are uncertain about their chil- dren's future. On a more immediate level, both adolescents and their parents report that life is more difficult and neighborhoods more dangerous than in the past.¹ Many parents see their teenagers drifting into an amorphous, risky peer milieu popularly termed "the youth culture." This culture is heavily materialistic and derived mainly from the adult world and the commercial media. It has its own cultural heroes, made up of rock and film stars and prominent athletes, and its own preoccupations-cars, clothes, being part of the crowd, being physically attractive. As a result, many adolescents spend little time with their families. With more money of their own, whether from earnings, an allowance, or illegal ac- tivity, adolescents do not need to go home even for dinner; they can buy their meals at a fast- food place. Often parents become perplexed, even angry, as they feel their authority weakened and their values challenged. They may be confused about their roles in the lives of their adolescent chil- dren and lack guidance about how to proceed. They may find very little consensus, even at the community level, about the values and behavior appropriate for adolescents. ADOLESCENTS NEED THEIR FAMILIES Compared to families with young children, families with adolescents are neglected in com- munity programs and public policies. Little work has been done to strengthen support net- works for middle-class families during the critical transition from childhood to adulthood. Still less attention has gone into strengthening networks for families that live in poverty. Although an industry of books, videos, and experts exists for parents with young children, much less 63 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS information is available to parents with adolescent children. A social consensus holds that knowl- edge about infant and child development is critical to a child's future. No such consensus yet exists in defining the knowledge parents should have about the adolescent years or about their roles during that critical period. To the contrary, many parents mistakenly believe they should get out of the way when their children reach adolescence, letting them become instant adults! But this attitude ignores the fact that the transition to adulthood takes place over a period of years. Young adolescents still have a lot of growing and learning to do; they still need the sup- portive guidance of their parents and kin. Although adolescents are moving toward indepen- dence, they still are intimately tied to their families, which are much more important to them than they usually admit or even understand. This close connection is essential for young ado- lescents. Strong family relationships can be a potent force to help adolescents deal with the radically transformed conditions of contemporary life. A poignant response of young people to questions about why they join gangs is that these groups become the families they never had. This response is compelling testimony to a funda- mental human need for close, reliable relationships within a supportive, protective group that confers respect and identity and recognizes competence. This is what many gangs do, although often at the price of strict conformity to norms that tend to be antisocial and dangerous. In survey after survey, young adolescents from all ethnic and economic backgrounds lament their lack of parental attention and guidance in making educational and career decisions, in forming adult values, and in assuming adult roles.³ Their responses are supported by fifteen years of research on families and adolescents, from midwestern farms undergoing economic The Experience of Living in a Two-Parent Family dislocation to African American neighbor- Is Declining for White, Black, and Hispanic Youth hoods of concentrated poverty.4 PERCENTAGE OF CHILDREN YOUNGER THAN 18, BY ETHNIC BACKGROUND The conclusions drawn from this research 100 are that adolescents develop best when they White-2 parents have a supportive family life characterized by 80 warmth and mutual respect; by the serious Hispanic-2 parents and sustained interest of their parents in their Black-2 parents lives; by parental responsiveness to their 60 changing cognitive and social capacities; by the articulation of clear standards linked to discipline and close supervision; by the com- 40 munication of high expectations for achieve- Black-1 parent Hispanic-1 parent ment and ethical behavior; and by demo- 20 cratic, constructive ways of dealing with White-1 parent conflict.5 Such a family atmosphere can pro- vide powerful protection against the risks of 0 1960 1970 1980 1990 engaging in unhealthy practices and anti- YEAR social behavior as well as against poor health, Source: Households, Families, and Children A 30-Year Perspective, by the U.S. Bureau of the Census, 1992, Washington, DC: U.S. Government Printing Office. particularly depression. 64 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Many adults erroneously believe that hostility and conflicts between parents and their teenage children are inevitable, and that parents should disengage or detach from them in the interest of fostering adolescents' need for autonomy. Yet families who have good relations with their adolescents find they can usually negotiate a balance that satisfies the young person's growing desire for autonomy within the context of interdependence, despite normal intergenerational tensions.⁶ Continuity and change can coexist in the bonds between adolescents and parents, along with much shared love and commitment. Professionals who work with adolescents also have had misconceptions about relationships between adolescents and their families. A previous generation of studies, which focused on troubled parent-adolescent relationships, emphasized the alienation of adolescents from fam- ilies as inevitable. The perspective drawn from these studies overlooks the potential of fami- lies to promote good health, high educational achievement, and ethical values for future adult responsibilities. It has discouraged education, health, and youth-development professionals from seeking ways to strengthen families in their critical role during the second decade of their children's lives. STRENGTHENING PARENTS' ROLE DURING THE CRITICAL TRANSITION OF EARLY ADOLESCENCE During early adolescence, three approaches-parent involvement in middle grade schools, par- ent peer support groups, and parental guidance on healthy adolescent development-can be helpful as parents renegotiate relationships based on the changing needs and capacities of both parties. These approaches can be incorporated into any number of settings: the first two in schools, religious institutions, and community and youth organizations; the latter wherever preventive health-care services are available to adolescents. These three approaches to supporting parents during their children's transition into adoles- cence are most appropriate for families who have adequate financial resources. For families ex- periencing financial hardship or living in high-risk situations, family support approaches must be expanded to address the economic, social, and cultural factors that constrain the capacities of these families to carry out their essential protective and guiding functions.⁷ SUSTAINING PARENT INVOLVEMENT INTO THE MIDDLE GRADES As children become young adolescents, the percentage of parents who are actively involved in school activities declines. Approximately three-quarters of American parents report high or moderate involvement in schools when their children are eight to ten years of age. By the time their children reach age sixteen, however, only 50 percent of parents report such involvement.8 Parents who want their children to do well in school must maintain their close involvement in their children's education from the elementary through the middle and high school years. Yet parents who try to remain involved often encounter barriers to their participation as their chil- dren progress to middle and high school. Existing school practices, including policies and teacher attitudes, have long accepted the absence and often discouraged the involvement of parents beyond the elementary school years. REENGAGING FAMILIES WITH THEIR ADOLESCENT CHILDREN 65 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Although schools that recognize the importance of parental involvement beyond the elemen- tary school years are relatively rare, their numbers are slowly growing.9 Schools can engage parents of adolescents in several productive ways. 10 They can: Organize parent education and support groups to learn about normal changes during adolescence Exchange information about ways to guide adolescents and help shape a community of shared values about appropriate behavior Inform parents about programs and students' progress on a regular basis Provide specific suggestions for ways in which parents can assist with homework and other learning activities, including community youth service Involve parents as volunteers in schools Include parents in school governance committees Create partnerships among schools, parents, and key community organizations in joint re- sponsibility for adolescents' educational achievement and healthy development Create family resource centers that provide educational programs for parents, including com- puter literacy, job-employment counseling, English as a second language, health promotion, and citizenship classes. Parental Participation in School Activities Declines As Adolescents Enter Middle Grade Schools PERCENTAGE OF PARENTS INDICATING HIGH OR MEDIUM INVOLVEMENT se 70 60 50 40 30 20 10 0 8 9 10 11 12 13 14 15 16 17 18 AGE OF CHILD Source: Running in Place, by N. Zill and C. W. Nord, 1994, Washington, DC: Child Trends. Data from U.S. Department of Educaiton. National Center for Education Statistics, 1993 National Household Education Survey. Adapted with permission. " PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS If significant progress is to be made in improving the educational performance of teenage stu- dents, meaningful changes in the attitudes and practices of teachers and principals toward the involvement of parents will be required. The professional preparation of educators should include course work and practical experience about ways to foster parental participation in the schools and parental support for their adolescents' education. PARENT PEER SUPPORT GROUPS Parent peer support and education groups, in which participants share information and experience about handling the transition from childhood to adolescence, are important means of strengthening I'd like to design a building rather than relationships between adolescents and their families. In these fight. I'd like to be an architect or groups, parents can learn about normal adolescent development, how to improve their communication skills, ways to renegotiate the something like that. I've had a nice life parent-adolescent relationship, how to set and enforce limits, and where to find resources in the community. In low-income commu- SO far, for eleven years, but I wish nities, these groups also can assist parents in gaining access to health care, adult education, including literacy classes, and job training and everybody would pay more attention to placement.¹¹ kids. That's something we really need. Peer support groups also can help parents cope with midlife changes. Midlife can be a difficult time for parents of growing adolescents. Par- Sometimes grown-ups pay attention, ents may be struggling with their own marital relationship, issues re- but not a lot. They're kind of all lated to aging and work, and the illness and frailty of elderly parents.¹² Mutual aid groups of this kind can be formed in diverse communities wrapped up in their jobs and they don't and reach a large number of families in an efficient way. If they become really pay attention to little children. sufficiently widespread, such groups could clarify and strengthen community norms regarding parent-adolescent relationships and de- I think it wouldn't be SO violent if sired behaviors in the adolescent peer group. By stressing prevention by meeting adolescents' developmental needs, such groups can gen- people paid attention. erate positive attitudes and skills (in both adolescents and adults) that extend beyond the home and family. RAOUL, 11 PROSPECTIVE GUIDANCE TO PARENTS ON ADOLESCENT TRANSITIONS The Guidelines for Adolescent Preventive Services of the American Medical Association (AMA) recommend that parents or other caregivers of adolescents receive prospective information and guidance on early, middle, and late adolescence as part of adolescents' annual health exami- nations.¹³ Currently, such guidance to parents of infants and young children is accepted health practice, but it is not widely recognized as a need for parents of adolescents. During these vis- its, the AMA recommends that parents learn about: Normal adolescent physical, sexual, and emotional development The signs and symptoms of disease and emotional distress REENGAGING FAMILIES WITH THEIR ADOLESCENT CHILDREN 67 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Ways to promote healthy adolescent adjustment Ways to prevent potential problems (e.g., how to help adolescents drive responsibly, how to monitor social and recreational activities, and how to restrict sexual behavior and the use of tobacco, alcohol, and other drugs). KEY OPPORTUNITIES FOR POLICY REASSESSMENT Legislation and public policies do not yet recognize the potential of families to make a differ- ence in their adolescents' health and educational outcomes. To encourage and support par- ents' and other adults' constructive roles in the lives of adolescents, changes in policies, pro- grams, and laws are essential. Schools, cultural, arts, religious, and youth organizations and health-care agencies in the community should examine the extent to which they involve parents in activities with ado- lescents and should develop ways to engage parents and adolescents in mutually reward- ing activities.¹ There may be instances when parents should be explicitly excluded (e.g., ado- lescent peer support groups), but the reasons for such exclusion should be clear. Professionals such as teachers, nurses, social workers, physicians, psychologists, youth development specialists, and others who work with adolescents must be prepared to work not only with individual adolescents but also with their families. Employers should extend to parents of young adolescents the workplace policies now available for those with young children, including flex time, job sharing, telecommuting, and part-time work with benefits. Such family-friendly workplace policies allow parents to become more involved in middle and high schools, to serve as volunteers in community orga- nizations, and to spend more time with their teens. Community institutions such as business, schools, and youth organizations should be- come involved in providing after-school programs. After-school programs for elementary- age children are growing, but those for young adolescents remain scarce. More high-quality, community-based programs for adolescents are needed during the after-school, weekend, and vacation hours. 15 Parents' assumption that young adolescents are old enough to be without adult supervision or planned activities must change to reflect what young adolescents say they need. Congress should consider extending the child-care tax credit to the early adolescent pe- riod, ages ten to fourteen. Although such an extension raises complex issues, the value of such a policy change is clear. Families can benefit from placing their young adolescents in high- quality after-school programs to the same degree that they now benefit from placing young children in child-care and early childhood centers and elementary-age children in after-school programs. The cost savings obtained by keeping in place the current cap on the upper age limit for child care tax credits should be reevaluated by comparing them to the costs of treating prob- lems of substance abuse and teen pregnancy, problems that often are the result of inadequate supervision. 68 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Characteristics of Supportive Families Contrary to conventional wisdom, adolescents want They develop constructive ways of handling to have a good relationships with their parents. They conflict. Disagreements are a normal part of family tend to seek regular contact with them and other life. As long as conflict occurs within the context of caring adults. Adolescents also needthese close re- good parent-adolescent relationships, it is not nec- lationships. Supportive families are very important in essarily detrimental. In fact, conflict has an important enhancing both educational achievement and good role to play in bringing differences of opinion out into health. Research has clarified some major charac- the open so that they can be discussed and resolved. teristics of families that are effectively supportive. Constructive conflict resolution helps adolescents They combine warmth and authoritativeness. Par- develop good psychosocial and interpersonal skills. ents should encourage family relationships based on They seek active involvement with their young mutual respect and democratic principles, commu- adolescents beyond education. Most working par- nicate their high expectations for achievement and ents complain about not having enough time to spend ethical behavior, provide firm discipline, and balance with their adolescents. This lack of time is detrimen- monitoring and supervision with their adolescents' tal to both parents and adolescents. Without the su- desire for independence. They also should acknowl- pervision of responsible adults, adolescents are vul- edge and adapt to their adolescents' changing cog- nerable to negative peer pressure. Changes in nitive and social capacities. workplace policies and practices can help forestall the power of such influences. Effective parents ac- They get involved in their adolescents' education. tively seek favorable settings in which to spend mu- Parents often think they no longer need to be in- volved with their children's schooling after their chil- tually enjoyable time with their children. dren have left elementary school. But research shows that parents can enhance adolescents' edu- SOURCE cation by remaining actively engaged in the school- Small. S.A. (1990). Preventive programs that support families ing process and other aspects of their children's with adolescents. Washington, DC: Carnegie Council on Ado- lives. Participation in parental support groups may lescent Development. help parents share experiences and understand their growing adolescents. REENGAGING FAMILIES WITH THEIR ADOLESCENT CHILDREN EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS American Businesses Invest in Young Adolescents More parents of young adolescents must find ways to "WE HAVE FUN BUILDING balance their work and family responsibilities today THINGS" than ever before. As the number of dual-earner and To help parents find attractive and educational alter- single-parent families continues to rise, parents who natives for their young adolescents, members of ABC work outside the home find few safe, high-quality pro- funded the development of summer science and grams to provide structure and adult guidance for technology (Sci/Tech) camps for ten- to fourteen- their young adolescents after school and during va- year-olds, where campers learn about computer cations and holidays. Finding quality care is even graphics, solar power, and architecture. Members of more difficult for parents who work nontraditional ABC see the camps as an investment in the future and hours, in workplaces that operate twenty-four hours as a child-care solution for their employees with a day. In response to the growing needs of parents, young adolescents. The camps open early and stay a number of American corporations have begun to open late to fit parents' work schedules. Attendance diversify their dependent benefits programs to sup- at these camps is not limited to the children of the port parents of young adolescents. sponsoring corporations-the parents of 64 percent of the campers at STAR (Science and Technology Ad- REACHING OUT TO FAMILIES venture Researchers) Camp in South Brunswick, New Jersey, work for other companies. The Sci/Tech Some major employers have joined forces to provide camps reach out to girls and to minorities, who are activities for their employees' young adolescents traditionally underrepresented in science and math during the out-of-school hours. The American Busi- camps. In New Jersey, two new Sci/Tech camps em- ness Collaboration for Quality Dependent Care (ABC) phasize hands-on science experience for young ado- is a coalition formed in 1992 by 137 corporations (ex- lescents, who are challenged to ask questions, make panded to 156 companies by the end of 1994), to as- scientific predictions, and plan for their futures. sist employees in finding reliable, local care for their dependents. To address the lack of programs for At the STAR Camp, sponsored by several ABC partners young adolescents when schools are not in session, including AT&T, IBM, and Johnson & Johnson, the ses- the ABC provided funding for the creation of adven- sions held at the camp's Liberty Science Center are ture camps, ropes and challenge courses, and sci- the highlight of each day. Campers go on field trips to ence and technology camps. explore the working world of science. They meet sci- entists, engineers, and technicians at Mobil Re- search and Development's Water Toxicology Lab and other area companies. There, campers are scientists for a day, wearing lab coats and goggles and prepar- ing real experiments. Such experiences show young adolescents that what they learn in the classroom during the school year and at camp during the sum- mer does apply to the "real world." According to one 70 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS camper, "STAR Camp is much better than other camps about thirteen of Marriott's units; in 1995, the service because you get to play computers and go to more is expected to be expanded to include seventy-five field trips than other camps." more units. Toyota Motor Manufacturing in Georgetown, Ken- BALANCING WORK AND tucky, operates a twenty-four-hour child develop- FAMILY LIFE ment center on site for children whose parents work round-the-clock shifts. The center arranges for Other companies, either in addition to or independent school-age children to be picked up at school and of ABC, have their own work and family divisions that dropped off at the center, where they receive assis- develop programs to help employees balance work tance with their homework from 4:30 to 6:30, eat din- and family life. IBM, for example, offers its 150,000 em- ner, and go to bed at 9:00 on school nights. During ployees (60 percent of whom are part of a dual-in- the summer, the center runs a full-day summer come couple, 30 percent of whom have children who camp. About 60 percent of the children enrolled in require supervision, and 5 percent of whom are sin- the camp are between the ages of ten and thirteen. gle parents) several Work and Personal Life Balance Programs. These programs provide flexible leave and telecommuting options to parents. THE FUTURE To develop ways to make flexible schedules available The companies of ABC are winning praise for their ef- to parents and to reduce absenteeism and tardiness, forts to respond to the needs of their employees' Marriott International, AT&T, Stride Rite, and Hewlett- families. These innovators also are inspiring other Packard formed Flex Group. Flex Group members be- companies to follow their lead. As more and more lieve that flexible schedules make good business young adolescents are part of families where both sense: employees who have schedule flexibility are parents or guardians work full time outside the home, more productive and are loyal to their companies. the availability of flexible work options and quality out-of-school programs becomes increasingly im- Marriott International's Work-Life Department has portant. These companies demonstrate that the ex- developed alternative working arrangements for tension of dependent care benefits to parents of their employees who are parents of young adoles- young adolescents is a viable way to increase par- cents. In addition to job sharing, condensed work ents' productivity. weeks, and telecommuting, the department offers in- formational videos and materials on parenting, child care, and other concerns to help parents balance work and family demands. Marriott also established a bilingual and confidential Associate Resource Line (ARL) pilot service. Staffed by master's-level social workers, ARL provides twenty-four-hour counseling and advice to employees about concerns that arise from balancing work and family. ARL currently serves REENGAGING FAMILIES WITH THEIR ADDLESCENT CHILDREN 71 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CONNECTING FAMILIES WITH SUPPORTIVE COMMUNITY INSTITUTIONS Young adolescents are seeking to build new strengths. Yet these new strengths typically are constructed on existing foundations. Adolescents want new interdependence with parents and other relatives, not a rupture in the name of independence. To build this interdependence takes time, sensitivity, resilience and, above all, the persistence of parents even in the face of provo- cation or disappointment. Unfortunately, there are circumstances in both affluent and economically disadvantaged fam- ilies in which parents are unable or unwilling to fulfill their responsibilities to their children. Parents may be depressed and lacking in hope; they may be substance abusers who physically or emotionally neglect or abuse their children. The provision of family-like or -equivalent func- tions by a wide range of individuals and groups beyond the family is essential for adolescents to survive these nonsupportive situations. Although there is no easy substitute for a deeply caring parent, adolescents cannot thrive un- less some person or group steps in to meet their developmental needs. Family-like functions can be provided by committed, long-term mentors; sensitive, trustworthy advisors in middle schools; close relationships with kin in an extended family network; and other stable, mature adults in youth and community organizations. Parents who are themselves experiencing difficulties may benefit from family support, including substance abuse treatment and coun- seling in health and community agencies, including schools. 16 The next four chapters of this report are devoted to community institutions that support families in their vital functions- and that at times must substitute for them. ........ Further Reading Epstein, J. L. (1995). School/ family/ community partnerships: Caring for the children we share. Phi Delta Kappan 76:701-712. Feldman, S.S., & Elliot, G.R. (Eds.). (1990). At the threshold: The developing adolescent. Cam- bridge, MA: Harvard University Press. Zill, N., & Nord, C. W. (1994). Running in place: How American families are faring in a chang- ing economy and an individualistic society. Washington, DC: Child Trends. 72 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EMBARGOED UNTIL 10 AM, CTOBER 12, 1995 UNCORRECTED PAGE PROOFS OF 0000000 00 00 A EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER SIX Educating Young Adolescents for a Changing World If it were possible to reach any consensus about high-priority solutions to our society's prob- lems, a good education throughout the first two decades of life would be a prime candidate. Every modern nation must develop the talents of its entire population if it is to be economi- cally vigorous and socially cohesive. Education is a key ingredient in an individual's success as well: for example, well-educated and healthy young adults are rarely found in our burgeon- ing prison population. In contemporary societies, a significant transition occurs during early adolescence when a young person moves from elementary school to middle grade or junior high school. Often this move is from a neighborhood school, where the student has spent most of the day in one classroom with the same teacher and classmates, to a larger school farther from home, with many different classes and teachers. This transition coincides with a time when most adolescents are experi- encing profound physical, cognitive, and emotional changes. The juxtaposition of these changes adds up to a situation in which the capacities of young adolescents to cope are severely tested.¹ A middle grade education designed specifically to meet the developmental needs of young ado- lescents can provide potent intellectual challenge and social support that both enhance edu- cational achievement and promote healthy development during adolescence. It can link re- search on child and adolescent development with research on education in daily practice. Although education in the middle grades clearly has the potential to make a positive difference in the futures of students, this level of education was largely ignored in the educational reform movement of the 1980s. In a landmark report, Turning Points: Preparing Youth for the 21st Century, published in 1989, the Carnegie Council on Adolescent Development took a major step toward filling this serious gap. It reinforced an emerging movement to create develop- mentally appropriate schools for young adolescents and to strengthen their education through new linkages among schools, families, communities, and health organizations. Today, with the support of a major grant-making program of Carnegie Corporation, called the Middle Grade School State Policy Initiative (MGSSPI), the core recommendations of this report are being ex- tensively implemented in fifteen states, involving nearly one-hundred schools throughout the United States and the Commonwealth of Puerto Rico. 75 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS TURNING POINTS SCHOOLS In Turning Points, the Council asserted that a volatile mismatch exists between the organiza- tion and curriculum of middle grade schools (junior, intermediate, or middle schools) and the intellectual, emotional, and interpersonal needs of young adolescents. It then proposed a set of high-aspiration but not utopian reforms for the middle grades. The new middle grade school, the report stated, should be oriented to meet the essential re- quirements of healthy adolescent development. It must have teachers who are specially pre- pared to work with young adolescents. It should have curricula that provide the information, skills, and motivation for adolescents to learn about themselves and their widening world. It should have a mutual aid ethic among teachers and students, manifest in team teaching, coop- erative learning, and academically supervised community service. The report's prescriptions would have applicability to the earlier grades and beyond the middle grade schools as well. At the heart of Turning Points is a set of eight principles for transforming the education of young adolescents. The principles were created by integrating current research knowledge with the experience and judgment of eminent researchers, educators, policymakers, and ad- vocates for children and youth. The principles are: CREATE COMMUNITIES FOR LEARNING Many American middle grade schools are large, impersonal institutions. Opportunities for teach- ers to develop the stable personal relationships with students that are essential to teaching them well and to provide guidance during the at-times turbulent period of early adolescence often are nonexistent. Unacceptably large schools can be brought to human scale by creating schools- within-schools or "houses" within the school and then dividing these subunits into smaller "teams" of teachers and students. Such arrangements enable each student to receive a significant amount of individual attention within a supportive group that each must have to thrive. TEACH A CORE OF COMMON KNOWLEDGE Much of learning and the development of solutions to complex problems lies in the ability to integrate disparate bodies of information. Yet in many middle grade schools, the curriculum is so fragmented by subject matter that students have virtually no opportunity to make con- nections among ideas in different disciplines. Even in classes, middle grade students often are not challenged intellectually, reflecting the persistent misapprehension that young adolescents generally are incapable of critical or "higher-order" thinking. A primary task for middle grade educators, especially as part of teaching teams, is to iden- tify the most important principles and concepts within each academic discipline and to con- centrate their efforts on integrating these main ideas to create a meaningful interdisciplinary curriculum. To make such a curriculum possible, teachers must embrace the idea that "less is more-that is, the current emphasis in the curriculum on coverage of a large quantity of information must yield to an emphasis on the depth and quality of understanding of a limited number of major concepts in each subject area. 76 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Creating Powerful Interdisciplinary Curricula The creation of thoughtful interdisciplinary curricula Students at Graham and Parks also study acting and and learning strategies is time consuming and intel- write plays. The last months of a recent school year lectually challenging. It requires significant effort by were spent creating a student-written and -acted play the middle grade interdisciplinary teaching team. that highlights the concepts and themes studied Teachers may be fearful that important concepts within the interdisciplinary approach. The play was from their subject of specialization will be lost within performed for the school, parents, and other middle an integrated approach or that they will be unable to school students and educators across the city. satisfy state and local requirements to cover masses All students are required to maintain a portfolio con- of information. taining draft and finished written work, photographs Despite these difficulties, many middle schools have of three-dimensional projects (such as sculptures), created effective interdisciplinary curriculum, in- videotapes of all presentations and exhibitions, and cluding some remarkable schools serving disadvan- art work. At the end of the year, students assemble taged students. One example is the Graham and their portfolios, create a table of contents, and write Parks School in Cambridge, Massachusetts, which a cover essay explaining their portfolio's contents focuses on interdisciplinary project learning and and reflecting on their learning for the year. Students portfolio assessment. Its humanities program, which present their portfolios to a panel consisting of one combines language arts and social studies, builds or two prominent people from outside the school and curriculum around concepts that are important in their teacher. The portfolio and presentation are students' lives-for example, power and authority, rated according to a previously agreed upon scale. individual and group responsibility, and conflict. Graham and Parks school continues to have the The school's humanities curriculum is structured highest scores on state tests and the widely used around some overarching questions: What is courage? California Achievement Test of any middle school in What does it mean to be a hero? Why do individuals the city. The school also has the largest waiting list take action to change and improve the world around of families wishing to enroll their children. them? To explore these questions, students focused in-depth on the Holocaust and the civil rights move- ment, as well as historical and present-day issues in the local community. The curriculum strongly em- phasizes primary source material, oral history, jour- nal writing, process and peer review writing, small- group and individual project construction, media use, and other interactive approaches. EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD 11 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Integrating Science with Health HUMBIO, an The weakest link in middle grade school reform has In our current world, it is virtually impossible to be a been the lack of appropriate curricula that provide fully healthy, productive, active citizen without some the information, skills, and motivation for adolescents basic understanding of science. Yet students alien- Interdisciplinary to learn about themselves and their widening world. ated from school as adolescents rarely achieve a One such curriculum development initiative over the science education higher than the most elementary Life Sciences past six years has focused on a life sciences cur- level. HUMBIO is based on the experience of Stan- riculum for the middle grades. A life sciences cur- ford's twenty-five-year-old undergraduate program Curriculum for the riculum matched to the needs and interests of young in human biology. It provides young people with a adolescents can provide them with essential con- unique, systematic curriculum that attempts to capture Middle Grades cepts in biology and can relate these concepts to their interest in their own development and allow problems that students encounter in their daily lives. them to apply their knowledge of the life sciences to Study in the life sciences can stimulate the natural their own health and to the social, behavioral, and curiosity of young adolescents, who have reason to family challenges they face as adolescents. be especially interested in growth and development, Much of the current middle grades school reform ef- as they are themselves in the midst of the early ado- forts rely on interdisciplinary "teaming" of teach- lescent growth spurt that is one of the most striking ers-involving science, mathematics, English, and developmental experiences of the entire life span. social studies. The HUMBIO curriculum is founded on They are already asking, "What's happening to my the premise that interdisciplinary teaching improves body? How does the human body work anyway?" the student's understanding of and interest in the sub- Therefore, it makes sense for them to address ject. The entire two-year HUMBIO curriculum consists growth and development, particularly their own, sci- of twenty-four units, and schools may choose among entifically. them. The units begin with "The Changing Body, Re- The Human Biology Middle Grades Curriculum, de- production, and Sexuality" and move to "Genetics", veloped and tested by Stanford University scientists "The Nervous System", "The Life of Cells", "From in collaboration with middle grade teachers across Cells to Organisms: Human Development, The Circu- the country, integrates the study of ecology, evolu- latory System", "Breathing", and "Digestion and Nu- tion, and genetics; physiology, human development trition". They seek to show what is meant by becom- (intellectual, psychological, and social); society and ing an adult, the individual's place in the family, in the culture; and health and safety. It not only engages community, and in the biological world. the average middle grade student in science but also In using HUMBIO, teachers work cooperatively from helps simultaneously to promote healthy behavior for the perspectives of their individual disciplines toward life. The decision-making component of the curricu- imparting a central lesson. For example, when a unit lum connects with life skills training. It teaches skills in science class deals with the impact of food and in decision making and the capacity to draw upon in- drugs on circulation, the physical education teacher formation carefully, not to jump to conclusions but to makes the connection between lung function and be deliberate in considering the meaning of the in- smoking. Students study the relationships among cir- formation for one's own life. culation, breathing, food intake, and drugs. The study of health includes decisions regarding smoking, an PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS analysis of different ways of planning menus, the riculum units or modules, not a textbook on human facts behind eating disorders, and ways to reduce biology. They suggested that the units should contain stress. One lesson helps students understand how an abundance of hands-on activities that would al- drugs affect their bodies. Seventh graders at Egan In- low students to engage in the process of scientific termediate School in Los Altos, California, examine investigation, provide better access to these materi- the effects of adrenaline, which the body produces als for lower-achieving students who often get left when stimulated by cocaine use, on metabolism by out of more traditional science courses driven by watching brine shrimp react to a single drop through long vocabulary lists, and make direct connections a microscope. Students have an opportunity to dis- between the science presented and the health and cuss the ideas demonstrated in the experiment, to ask well-being of the student. questions, and to offer solutions. Teachers report that At the test sites, teachers and students report that the curriculum makes science more meaningful for all the activities and their applications to health, social, students and that the integrated approach helps in- and environmental issues have been the most suc- crease girls' comfort with science. cessful features of the HUMBIO units. The curriculum In mathematics, students learn the meaning of ra- does not necessarily replace a life science curricu- tios, percentages, and probabilities. They may cal- lum in the middle school, but instead schools may culate the amount of smoke inhaled by a cigarette chose the HUMBIO units that fit their particular needs. smoker, and the amount of second-hand smoke in- Schools may also choose to use some of the HUMBIO haled by nonsmokers in a shared work space. They units for their health requirement. Teachers report may be asked to figure the actual financial cost to that the practical applications of the lessons help an individual who smokes one pack a day from age students make personal health decisions based on seventeen to seventy. Throughout all phases of the scientific knowledge and understand the conse- unit, students keep journals to describe their obser- quences of their actions. Addison-Wesley, a pub- vations and findings. In physical education, students lisher, will produce the units and their related examine the effects of their activities on their heart teacher manuals. The first ten units will be available beat, pulse, and blood pressure as well as the im- to schools and for review by state adoption commit- pact of smoking on lung functioning. At the end of tees in the spring of 1996. The HUMBIO curriculum the unit, students plan and cook a nutritionally bal- demonstrates that science is a field of study in anced lunch. which all students can be involved and that students learn best when their teachers connect what is English teachers may encourage students to read learned in school with the real world. books related to what they have observed in science class; social studies teachers may deal with the im- pact of biological and other scientific developments SOURCE on society or explore the changing views about hu- Heller, H.C. (1993). The need for a core, interdisciplinary, life - man biology at different stages of history. Talking sciences curriculum in the middle grades. In R. Takanishi (Ed.), about evolution may involve science, history, and so- Adolescence in the 1990s: Risk and opportunity (pp. 189-196). cial studies teachers. New York: Teachers College Press. HUMBIO has been thoroughly field-tested at schools selected for their diversity in student population and geographic location. HUMBIO teachers have been trained in three summer institutes at Stanford. From the beginning, teachers were full partners in the pro- ject. They favored the development of a series of cur- EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD 7 $ EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS In Turning Points schools, curriculum and instruction combine to stimulate interest in the sciences, especially in the life sciences, as a way of both sharpening intellectual capacities and of enabling young people to evaluate potentially high-risk behavior in relation to the body's functional systems. The life sciences, dealing with living organisms and life processes, offer a distinct opportunity for young adolescents to cultivate an early affinity for science and to become motivated to develop healthy practices based on scientific understanding. Turning Points schools also consider community service or "service learning" to be an inte- gral part of the core curriculum. As a form of project-based learning, community service pro- motes critical thinking about real-world problems, while allowing young people to make a val- ued social contribution, develop key skills for employment, and build self-esteem through solid accomplishment. PROVIDE OPPORTUNITY FOR ALL STUDENTS TO SUCCEED One of the most troubling aspects of middle grade schools-and of American education in gen- eral-is the inequitable distribution among youth of opportunities to learn. One way in which this occurs is through "tracking," a system by which students are assigned to a class based on their past academic achievement. Tracking is almost universal in American middle grade schools. It was implemented to reduce the heterogeneity of students in a class, thus, in theory, enabling teachers to adjust the level of instruction to match students' knowledge and skills. In practice, wide disparities in the quality of instruction and the competence of teachers are com- mon between the high and low tracks. Middle grade educators can do a great deal to teach students of diverse ability. One well-re- searched instructional method is cooperative learning.3 Numerous studies on cooperative learning demonstrate that in mixed-ability learning groups high achievers deepen their un- derstanding of material by explaining it to lower achievers who, in turn, benefit by receiving help as needed from their peers. Cooperative learning has been shown to help students learn course material faster, retain it longer, and develop critical reasoning power more rapidly than they would working alone. Cooperative learning also requires students to get to know and to work with classmates of different ethnic, racial, and cultural backgrounds, which sets the stage for students to negotiate successfully the requirements of adult work life and of citizenship in a pluralistic society. STRENGTHEN TEACHERS AND PRINCIPALS Currently, teachers and principals at all levels of elementary and secondary education, in- cluding middle schools, are severely limited in their ability to make decisions about their own practice. They are bound by tradition, by their own educational experiences, and by the specific rules and regulations of federal, state, and local educational agencies. Yet these same professionals increasingly are being asked to develop and implement innovations that will produce high levels of achievement among a much larger proportion of students than is cur- rently the norm. : PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS States and school districts should give teachers and principals the authority to transform mid- dle grade schools. Teachers, principals, and other members of the school staff know more about how to do their jobs than those far removed from the classroom. Teachers especially need control over the ways they meet curricular goals. Creation of governance committees com- posed of teachers, administrators, support staff, parents, and representatives from community organizations is one way to make schools more effective. PREPARE TEACHERS FOR THE MIDDLE GRADES Most teachers in middle grade schools are not now specifically educated to teach young ado- lescents. Although there are a few graduate education programs that prepare middle grade teachers, most teachers are educated either as elementary or secondary school teachers. To orient teachers effectively for the middle grades, teacher education programs must prepare teachers to teach as part of a team, to design and assess meaningful interdisciplinary curricula, to participate in decisions that promote continuous school improvement, and especially to un- derstand adolescent development. Teachers' professional education, and that of administra- tors, must also include specific training in working with students and families of various in- come, ethnic, and racial backgrounds. IMPROVE ACADEMIC PERFORMANCE THROUGH BETTER HEALTH AND FITNESS Middle grade schools often do not have the support of health and social service agencies to ad- dress young adolescents' physical and mental health. Turning Points calls for the establish- ment of developmentally appropriate health facilities for young adolescents that are related to the curriculum and to the health-promotion potential of the school environment. These cen- ters, based in or near schools, are discussed in chapter seven. REENGAGE FAMILIES IN THE EDUCATION OF YOUNG ADOLESCENTS Despite the clearly documented beneficial effects of parental involvement on students' achieve- ment in school and attitudes toward school, as noted in Chapter Five, parental involvement of all types declines steadily during the elementary school years.5 By middle grade school, the home-school connection has been significantly reduced and too often is nonexistent. A key recommendation of Turning Points is to involve parents in decision making in significant ways. Particularly in low-income and racial- and ethnic-minority neighborhoods, parents often are considered part of the problem of educating young adolescents rather than an important po- tential educational resource. Parents who are involved in planning the work of the school feel useful, develop confidence in their relations with school staff, and are more likely to attend school activities, a practice that signals to their young adolescents the importance of education. In low-income communities, parents' participation with school staff members on a governance committee can help heal the schism that often exists between families and schools. EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD #1 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Schools as Partners with Families and Communities Schools can become partners with families and com- SALOME UREÑA MIDDLE munities in order to strengthen and broaden their ed- ACADEMIES ucational work. During the last fifteen years, states In a collaboration between the New York City school and communities have been developing programs to system and the Children's Aid Society, Salome Ureña improve adolescents' access to health, social, and Middle Academies, or IS 218, have invited commu- educational services in or near schools. Whether nity organizations to provide school-based program- they are "full-service" schools or simply school-af- ming for 1,200 students and their families since 1992. filiated health centers, such programs represent a The curriculum includes the entire school day-and powerful attempt to address the scope of adoles- beyond. During "zero period," for instance, students cents' needs. Some programs serve students' fami- can eat breakfast together, dance, and participate in lies as well. Drawing students and families into a va- other recreational activities. During the after-school riety of constructive activities, they can be especially program, more than 500 students receive tutoring de- helpful for students who are at risk of failing or drop- signed to maximize their academic and artistic ping out. strengths and interests. Despite increased state and local funding, these ef- The school's family resource center, open from 8:30 forts are still precarious. Without secure financing, a.m. to 8:30 p.m., is a valuable source of information they frequently face operational, managerial, and and support for the community. Staffed by parents, staffing problems. Many are remarkably successful, social workers, and other volunteers, the center pro- however. The Salome Ureña Middle Academies in vides adult education, drug abuse prevention activi- Washington Heights, New York, for example, grew ties, and other forms of assistance. Because many of out of a city school district's partnership with a non- the neighborhood's families are of Dominican origin, profit community center and now provides compre- the school offers an English-as-a-Second Language hensive services to adolescents and their families. program, in which four-hundred parents are cur- The Hanshaw Middle School in Modesto, California, rently enrolled. They in turn volunteer to teach their grew into a community center. Although each of these native tongue to the precinct's police officers. Next programs takes a different approach, they share a door to the resource center is a clinic that provides common vision of community education. medical care, dental care, and referrals to students. The clinic will soon include mental health services, which will be provided by a full-time psychologist and a part-time psychiatrist. The Children's Aid Society, which operates the school, has been inundated with requests for tours of the school and for information and assistance in establishing similar schools elsewhere. It has hosted more than five hundred visitors, and requests for vis- its now average three per week. To respond to these PREPARING ADDLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS requests, a technical assistance and information clearinghouse has been established at the school to facilitate partnerships in other communities by con- necting interested schools with potential local or re- gional partners. T HANSHAW MIDDLE SCHOOL "Always do your personal best" is the prominently displayed motto of this community school, where the emphasis is on individuality, flexibility, responsibility, and cooperation. Established in 1991, Hanshaw Mid- dle School aims to meet the needs of the community as well as provide educational and social opportuni- ties for the adolescents of California's Stanislaus County. Adjacent to a recreation center, the school itself serves as the neighborhood's community cen- ter. The six buildings on the school's campus house an auto shop, a home economics lab, a gymnasium and multipurpose auditorium, laboratories, arts and crafts rooms, and state-of-the-art music rehearsal SOURCES rooms. The school's library is actually a branch of the local county system. Dryfoos, J.G. (1994). Full-service schools: A revolution in health and social services for children, youth, and families. San Fran- The school also is a resource center for its students' cisco: Jossey-Bass. families. Parents can take classes in parenting or U.S. General Accounting Office (1994). School-based health computers or study for their high school equivalency centers can expand access for children (GAO/HEHS-95-35). degrees. Hispanic parents can receive help commu- Washington, DC: Author. nicating with the school's faculty and administrators. U.S. General Accounting Office. (1993). School-linked human Also on site is a center for primary health and dental services: A comprehensive strategy for aiding students at risk care. Established by the Healthy Start Support Ser- of school failure (GAO/HRD-94-21). Washington, DC: Author. vices for Children Act of 1991, the center features a case management team and referral service avail- able to students and their families. EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD 83 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CONNECT SCHOOLS WITH COMMUNITIES Frustrated by their inability to stem the high rates of adolescent problems and by the fact that adolescents most at risk were not making use of available services, social service professionals and leaders in community organizations in the 1980s began moving their activities to where young people are-in the schools. "Full-service schools" are major innovations in human ser- vices whose development has been led by in- dividual states.⁶ They represent a variety of Disparities Exist in Dropout Rates school-based efforts to assist students and among Ethnic Groups, 1972-1992 their families, going beyond health centers to PERCENTAGE STATUS DROPOUTS include comprehensive youth-service pro- 40 grams, community schools, and family re- 35 source centers. Strengthening the academic Hispanic environment in conjunction with supporting 30 students and the basic human needs of their families is the common core of all such efforts. 25 Black School districts pay for only a few of these 20 programs. Funding comes from outside sources, primarily states, which contract with Total 15 one or more community agencies to work in partnership with the school. Each state has 10 White designed its own version of school-based ser- 5 vices. In some states, the initiative lies in the domain of the department of education, and 0 1972 1975 1978 1981 1984 1987 1990 1993 the focus is on preventing dropouts and pro- YEAR moting academic achievement. In other Note: Status rates measure the proportion of the population who have not compared high school and are not enrolled at one point in time, regurdless of when they dropped out. states, the department of health or the de- Source: Dropout Rates in the United States: 1993, by the National Center for Education Statistics, partment of human services is the lead U.S. Department of Education, 1994, Washington, DC: U.S. Government Printing Office. agency, whose goal is to reduce high-risk be- havior through school-based interventions. THE MIDDLE GRADE SCHOOL STATE POLICY INITIATIVE Turning Points marked the beginning of Carnegie Corporation's effort to stimulate nationwide reform of American middle grade schools by offering a plan of action for transforming them. In 1990, the Corporation initiated the Middle Grade School State Policy Initiative (MGSSPI), a program of grants to states (usually the state department of education) to stimulate statewide changes in middle grade educational policy and practice.⁷ Designed as a "top-down, bottom- up" comprehensive reform strategy, the initiative promotes widespread implementation of the Turning Points reform principles through changes in state policies that encourage local schools to adopt promising practices and fosters the development of schools that serve educationally disadvantaged young adolescents, an urgent national priority. The initiative is focused on fifteen states whose work to reform the middle grade educational policy is producing meaningful results. Most of these states have developed or are actively im- 84 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS plementing comprehensive middle grade policy statements reflecting Turning Points. These statements, which have been approved by the state board of education or legislature, guide re- structuring efforts statewide and, in some states, are among the criteria for state accreditation of schools, a powerful incentive for change. Several states have established a middle grade unit within the state education agency where no such unit existed before the initiative. Most of the states have established or accelerated implementation of teacher certification requirements for middle grade teachers or made it possible to earn a special endorsement as a trained mid- dle grade teacher. State projects have been Los Angeles Unified School District Dropouts, actively involved in developing statewide Grades 6-9, 1992-93 middle grade curriculum and assessment PERCENTAGE OF TOTAL DROPOUTS frameworks, incorporating a middle grade fo- 70 cus into existing frameworks, and evaluating 60 the new frameworks' usefulness in reforming classroom practice. Most projects have es- 50 tablished strong relationships with health and other state agencies outside the educa- 40 tion department to expand and coordinate the resources available to schools for com- 30 prehensive health programs. To improve curriculum, instruction, and as- 20 sessment under the MGSSPI, ployed a variety of sophisticated methods, 10 often involving a multilayered infrastructure of support. The states have developed, for 0 American Asian Black Hispanic White example, week-long summer institutes on Indian Pacific Islander interdisciplinary instruction and portfolio- ETHNIC BACKGROUND based assessment; on-site, professional de- Source: Los Angeles Unified School District, Office of Communications, 1995, unpublished data. velopment seminars facilitated by university faculty members; formal networks to ex- change information and resources between schools; systems for identifying, training, and deploying expert consultants; and many other forms of assistance. At the local level, the MGSSPI has stimulated improvement in more than one hundred mid- dle schools in the fifteen states. Since 1993, each state has focused its effort on creating net- works of four to ten schools serving high concentrations of disadvantaged students. These schools tend to be the least effective in educating young adolescents because the most inex- perienced teachers are often assigned to them, teacher and administrator turnover is extra- ordinarily high, low expectations for student performance prevail, and staff members have minimal access to professional development experiences that enable them to reach students who have often been poorly prepared in elementary school. Educating students well in schools in low-income communities is also especially difficult be- cause the young people themselves often are caught up in circumstances that make learning extremely difficult. These young adolescents, more often than more advantaged students, face EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD 85 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Turning Through its Middle Grade School State Policy Initia- feel part of a closely knit group of peers; if a student tive (MGSSPI), Carnegie Corporation of New York is has a personal problem, he or she feels comfortable implementing the Turning Points recommendations Points in approaching the teacher-advisor for advice. in nearly one hundred schools and fifteen states na- A peer mediation program teaches the students how tion wide. Some schools stand out as having accom- Schools in to resolve conflict peacefully. Ten peer mediators per plished their goals against formidable challenges: grade are on duty, two per day, every day to help stu- their communities have few resources; adolescents Action dents resolve potentially serious conflicts. The peer have limited access to health care; or the violence mediators complete a training session before they and worsening social circumstances of their com- begin service. They monitor the hallways with teach- munities seem too overwhelming to conquer. Two ers to look out for fights or arguments and then ask schools, Turtle Mountain Community Middle School those involved in the dispute if they can intervene. in Belcourt, North Dakota, and Morningside Middle They are allowed to leave class to mediate disputes School in Fort Worth, Texas, have met these chal- and may use the principal's office as a neutral terri- lenges and made significant strides toward achiev- tory. The program has cut down on discipline prob- ing middle school reform. lems by enabling students to learn how to solve prob- lems on their own before they require intervention by TURTLE MOUNTAIN a teacher or the principal. COMMUNITY MIDDLE SCHOOL Through the BRIDGES program, which links six mid- Turtle Mountain Community Middle School is located die schools to University of North Dakota (UND) fac- on an Indian reservation in Belcourt, North Dakota. ulty for cooperative development, the teachers at Ninety-eight percent of Turtle Mountain's 450 stu- Turtle Mountain can earn ten graduate credits in dents in grades six through eight are American Indi- middle grade education free of charge. A university ans of the Turtle Mountain Band of Chippewa Indi- friend, a representative of UND, is present at all ans. In response to the needs of its students, many times at the school to act as a liaison between the of whom come from one-parent families, Turtle university and the middle school. The university Mountain has placed a special focus on mentoring friend brings a knowledge base to the school's and the development of social competence. teachers and shares educational developments with them, connects teachers with other university One of the longest-standing social support programs resources; and assesses the effects of the Turning at Turtle Mountain is the T/A (Teacher-Advisor) pro- Points recommendations. gram. Each teacher is assigned a small group of stu- dents (ten to fifteen in seventh and eight grades; Teachers also participate in the Quality Council, twenty in sixth) for which he or she is their mentor, which is composed of one teacher from each teach- advisor, and counselor. In daily group meetings that ing team, student representatives, and parents. The take the place of a home room period, students learn Quality Council meets to discuss school policy and about human development, improve their self-es- curriculum and to make changes. Block scheduling teem, and build their public speaking skills. The staff has allowed teachers to devote more time to plan- at Turtle Mountain have found that these morning ning an interdisciplinary curriculum for the students. sessions focus the students on school and learning Team teaching, as recommended in Turning Points, and help them deal with their family problems. The is facilitated by providing planning time every day for small group size allows the teacher-advisor to get to the teachers. The core courses (reading, math, lan- know his or her students well, and the student can guage arts, science, and social studies) are taught in the morning. In the afternoon, students attend their related arts courses, with the art team teachers, al- PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS lowing the core team teachers to meet. During this Morningside also offers opportunities for the parents planning time, the team teachers can discuss how to to get involved in school activities. Twice a year it integrate their individual specialties into an inter- sponsors a Health Fair, where parents can be tested disciplinary program. for glucose intolerance and high blood pressure and learn more about promoting their and their children's health at educational booths. In an effort sponsored MORNINGSIDE MIDDLE in part by the Interfaith Alliance, a Practical Parent SCHOOL Education (PPE) course is available to parents and At Morningside Middle School in Fort Worth, Texas, others responsible for raising the students. Taught by Principal Odessa Ravin is proud of the progress that counselors and trained volunteer parents, the PPE has been made to expand opportunities for her stu- course is designed to educate the parents about the dents to learn about the world of work. Ninety-six basic Turning Points reform objectives of the school: percent of the school's 650 sixth through eighth parents are taught what a lesson plan is, what the graders are African American. Through the district- school is doing to prepare their children for further wide Vital Link program, connecting the students to secondary school education, what systemic reform the world of work, students learn about career op- is, and what kind of specialized middle grade train- portunities by visiting area hospitals, offices, and ing the teachers at Morningside receive. The PPE other work sites to talk with the staff and learn how course is a means for families to become truly in- school helped them achieve their professional goals. volved in their children's education. In a related effort, the Young Doctors Club brings the Health services and health education are available most promising students (those with the highest sci- to the students and to their parents at the school. ence grades) together with local physicians and Once a week, the Teddy Bear Clinic, a mobile clinic other health care professionals; the majority of the in an equipped van, visits Morningside with a pedi- 1994-95 club members are girls. The students visit a atrician, a nurse, and other technicians to do rou- local medical school, where they attend science tine check-ups. In addition to the clinic, a nurse or classes and explore the classroom laboratories. a nurse's assistant is available on campus at all Additional field trips allow them to talk with young times in case of illness or medical emergency. A Be- doctors, many of whom come from similar socio- cause We Care specialist is on staff to work with economic backgrounds. the students to help reduce substance abuse. The specialist also works with the adolescents in con- flict resolution exercises. In the 1994-95 school year, incidences of conflict were 40 percent lower than the previous year's. EDUCATING YOUNG ADDLESCENTS FOR A CHANGING WORLD 87 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS violence in and outside the home, poor health and nutrition, drug trafficking and usage, un- equal access to resources, and other negative influences. If they are nonwhite, they often are victims of discrimination. Together, these factors place economically disadvantaged youth at substantial risk of not receiving the education they need to succeed in the future. Yet disad- vantaged youth are a significant proportion of students in America's public schools. Creating middle schools that can overcome the risks is the MGSSPI'S highest priority. Within Turning Points' comprehensive framework, reform efforts in these schools have focused on two critical areas: (1) the integration of health and education for young adolescents and (2) the reform of curriculum, instruction, and assessment. In the health arena, the majority of these schools have established or strengthened linkages to health services, both on site in the form of school-based centers, or "wellness centers," and through ties to health agencies serving ado- lescents in the community. Many schools have attempted to integrate health education more firmly into the middle grade curriculum, including efforts in several states to implement the Stanford University HUMBIO Curriculum. PROMISING RESULTS OF MIDDLE GRADE REFORM A national evaluation of the MGSSPI was begun in 1993 under the direction of Robert Felner, director of the Center for Prevention Research and Development within the University of Illi- nois' Institute for Governance and Public Affairs. Baseline data were collected in the spring of 1994 from nearly all the schools and now are being analyzed. Since 1991, Felner has also been studying a group of middle grade schools in Illinois that have been implementing the Turning Points recommendations. This effort, called Project Initiative Middle Level (PIML), is being conducted by the Association of Illinois Middle Schools. PIML began as an initiative separate from the MGSSPI project in Illinois but will merge with it in the fall of 1995. As in the national MGSSPI evaluation, data collected for the PIML study are primarily drawn from surveys of teachers, administrators, and students in the reforming schools. They are asked to provide information on the extent to which the structures and experiences recommended in Turning Points actually occur. These implementation data are compared to three outcome measures: student scores on state-administered achievement tests, teachers' rating of students' behavior, and students' own ratings of their behavior and attitudes. Results thus far from the Illinois study show that, in forty-two schools participating in at least one year of the study since 1991, implementation of the Turning Points recommendations is associated with significant improvements in students' reading, mathematics, and language arts achievement. Moreover, teachers' ratings and student self-reports show that, as these propos- als are implemented, students in these schools are less likely to feel alienated, fearful, or de- pressed in school and more likely to have high self-esteem. In thirty-one schools for which there are several years of data, the same pattern of results is found within schools over time. That is, as schools continue to implement Turning Points recommendations, achievement and behavior continue to improve. PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS These promising findings from the MGSSPI initiative demonstrate that, although most schools are not now designed specifically to meet the needs of young adolescents, the potential is there and can be readily tapped. Without a good education, adolescents are unprepared for life; but with the support of schools redesigned expressly to equip youth for the future, all adolescents have a better chance at educational and personal success. ........ Further Reading Council of Chief State School Officers. (1992). Reform in middle grade education: Current sta- tus, future directions. Washington, DC: Author. Council of Chief State School Officers. (1992). Turning points: States in action. Washington, DC: Author. Lewis, A. C. (1993). Changing the odds: Middle school reform in progress, 1991-1993. New York: Edna McConnell Clark Foundation. Task Force on Education of Young Adolescents. (1989). Turning points: Preparing American youth for the 21st century. New York: Carnegie Council on Adolescent Development. EDUCATING YOUNG ADOLESCENTS FOR A CHANGING WORLD 89 R EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER SEVEN ....... Promoting the Health of Adolescents The continuing decline in the health status of American adolescents is deeply disturbing. Since 1960, the burden of adolescent illness has shifted from the traditional causes of disease toward the "new morbidities" associated with health-damaging behaviors, such as depression, sui- cide, alcohol, tobacco and drug use, sexually transmitted diseases, including HIV/AIDS, and gun-related homicides. Early adolescence is characterized by exploration and experimentation, which to some extent are developmentally appropriate and socially adaptive, even if they involve a certain amount of risk taking. But carried to extremes, these risky behaviors can impair mental and physical health. The damage may be near term and vivid, or it can explode in the long term, like a time bomb set in youth. Examples of near-term damage are sexually transmitted diseases, death or trauma from violence, and disabling accidents related to alcohol. Delayed consequences in- clude cancer and cardiovascular disease in adult life, made more likely by high-calorie, high- fat dietary patterns, inadequate exercise, and heavy smoking. Destructive behaviors may, fur- thermore, result in constricting life options: a teenage mother who drops out of junior or senior high school diminishes her prospects for lifetime employment and increases the chances she will live in poverty, with its attendant risks to her own health and the health of her child.¹ But just as early adolescence is a time when damaging patterns of behavior can begin to take hold, it also represents an optimal opportunity for the formation of healthy practices, which have equally near-term and long-term effects. Families, schools, and community organizations have an obligation, in partnership with health care professionals and organizations, to address the fundamental needs of young adolescents for information about health risks and foster the skills and motivation to avoid these risks and adopt healthy practices. Beyond this, they must create real opportunities for work and a productive adult life. The health-related perceptions of adolescents can play a major role in motivating them to adopt healthy behavior.2 Although their health concerns vary according to their gender, ethnicity, and socioeconomic status and change as they grow older, almost all adolescents are preoccu- pied with how they look and how they feel about themselves, with their relationships to their peers, and with educational pressures. Many adolescents are similarly concerned about issues of substance use, sexuality, nutrition, and exercise. By and large, they show the same tendency as adults to wishfully minimize the potentially damaging effects of their risky behavior,3 per- sisting in the belief that "it can't happen to me." As a practical matter, such views should be 91 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS taken into consideration in the design of appropriate supports to adolescents. If such supports ignore adolescent perceptions and preoccupations, and if they are not user-friendly, they are not likely to be sought by the very individuals who need them most. EDUCATION FOR HEALTH IN EARLY ADOLESCENCE: A ROLE FOR MIDDLE GRADE SCHOOLS A central theme of the Council's work is the inextricable link between education and health. Adolescents in poor health have difficulty learning: for example, deficits in vision and hearing can impair the processing of information; malnutrition causes lethargy; substance abuse de- stroys attention to instruction. Conversely, young people fully engaged in learning tend to have good health habits and to be healthy. The relationship between education and health pertains at every level of development throughout the life span.5 As we have seen, a great many adolescents arrive at middle grade school with inadequate skills to cope with their great transition to adulthood. Much of what they need goes beyond the tra- ditional curriculum offered by the public school system-a fact that is increasingly recognized by education leaders. SCHOOLS AS HEALTH-PROMOTING ENVIRONMENTS Middle grade schools can play a crucial role in fostering health among young adolescents. Through the curriculum, through school policy, and through the clear examples they set of health-promoting behavior, schools can encourage students to form good health habits and recognize that education and health are mutually reinforcing. In short, they can provide an en- vironment in which good health as well as education is pursued and reinforced throughout the day, including: The teaching of proper nutrition in the classroom and offering of nutritious food in the cafeteria Smoke-free buildings and programs to prevent student and staff use of tobacco Education on the effects of alcohol and illicit drugs on the brain and other organs Opportunities for exercise for all in the school community, not just varsity competition be- tween different schools Emphasis on safety and the prevention of violence, including discouraging drug dealing and the carrying of weapons in and around schools. TURNING POINTS REFORMS Many of Turning Points' recommended reforms are broadly aimed at creating a health-pro- moting, developmentally appropriate environment in the middle schools. For example, by or- ganizing smaller units out of large schools, they operate on a human scale. They provide sus- tained individual attention to students in the context of a supportive group. They foster cooperation and a mutual aid ethic among teachers and students alike, manifest in interdisci- 12 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS plinary team teaching, cooperative learning, and academically supervised community service. They stimulate thinking skills in the context of the sciences, especially the life sciences. They offer life skills training to develop judgment in decision making, healthy interpersonal relations, nonviolent problem solving, and the ability to use information and opportunities effectively. THREE PREVENTIVE APPROACHES Three kinds of programs offered by Turning Points schools have particular relevance for health promotion in early adolescence. These are a life-sciences curriculum, life skills training, and social support programs, described in previous chapters in more detail. A life sciences curriculum. The life sciences tap into the natural curiosity of young adolescents, who are already intensely interested in the nature of life by virtue of the changes taking places in their own bodies. The life sciences can tackle growth and development, specifically ad- dressing adolescent development in the context of a distinctly human biology. The study of human biology leads naturally to the scientific study of behavior and the ways in which high- risk behavior, especially in adolescence, bears on health throughout the lifetime. Life skills training. A strong underpinning of protective knowledge, derived in large part from the life sciences curriculum, is crucial but by itself is not sufficient. Such information becomes more effective when combined with training in interpersonal and decision-making skills. Hav- ing these skills can help students resist pressure from peers or from the media to engage in high-risk behaviors; increase their self control; acquire ways to reduce stress and anxiety with- out engaging in dangerous activity; learn how to make friends if they are isolated; and learn how to avoid violence and assert themselves effectively. Students can acquire these essential life skills through systematic instruction and practice and through role playing. Calling atten- tion to unattractive short-term effects, such as nicotine-stained fingers, bad breath, and being out of control, can be effective in deterring tobacco and alcohol use among adolescents. Social support programs. Research evidence shows that social supports, revolving around shared values and goals, can provide powerful leverage in the promotion of health among ado- lescents and their families. Schools, along with community and health care organizations, can supplement the family by arranging constructive social support programs that foster health and education. These three approaches-the life sciences curriculum, life skills training, and social supports- linked together constitute powerful facilitators of healthy adolescent development. Such a com- bination of influences on young adolescents can have a strong bearing on preventing serious health problems. TARGETED APPROACHES TO HEALTH PROMOTION To fulfill their potential for promoting health, schools must make durable linkages with other institutions. Instilling widespread knowledge and encouraging the development of healthy lifestyles in youth will require substantial changes in the way the health professions work and also in the ways they connect with schools, community organizations, and families. PROMOTING THE HEALTH OF ADOLESCENTS 93 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Health care providers are generally viewed by adolescents as reliable sources of information about their health. Effective adolescent health care requires the active involvement of health professionals who view all clinical encounters with adolescents as opportunities for health pro- motion. These professionals should take the time necessary to gain the confidence of adoles- cents, learn to identify adolescents' problems, be willing to ask questions that might uncover alcohol and other drug abuse or sexual activity, and help them avoid dangerous behavior. In the absence of a broad perspective on health promotion as exemplified in Turning Points schools, the most common approach to enhancing adolescents' health has been through cat- egorical programs that focus on specific risks. Such categorical approaches should be com- plementary to the generic approach of educating youth for lifelong health. Four of these issues are selected for brief illustration here: sexuality, preparation for parenthood, violence, and drug abuse. It is important to note that other issues also deserve attention, such as mental health, nutrition, physical fitness, and injury prevention. TOWARD RESPONSIBLE SEXUALITY Although early adolescence clearly is not a time to become seriously engaged in sexual activity, adolescents receive conflicting messages about desirable body image and appropriate sexual behavior, especially from the media and from peers. Consequently, adolescents have a great need to understand issues related to sexuality, such as the dynamics of intimate relationships, when to become sexually active, the biological process of conception, and the risks of con- tracting sexually transmitted diseases, including HIV infection. Proper understanding of all these issues depends on accurate information being conveyed in sensitive and age-appropriate ways. Young adolescents obtain their information about sexuality primarily from peers but also from family, school, television, and movies. Peer information is often inaccurate, and it may be in- directly communicated. Moreover, adolescents tend to assume erroneously that "everybody does it," even if this is not the case. Because they have a greater potential than peers to convey accurate and age-appropriate in- formation, families and schools are in a better position to encourage health-protective choices by young adolescents. Those adolescents who rate communication with their parents as poor are likely to have initiated sex, as well as smoking and drinking, earlier than their peers who rate communication with their parents as good.⁶ Many parents, however, need help in be- coming well informed about issues in reproductive health and in learning how to overcome their embarrassment about talking to their children about sexuality issues. Adolescents should learn about human sexuality and reproduction early, before they become sexually active. Programs promoting sexual health should begin not later than early adolescence in middle grade schools and in youth-serving organizations. Information about preventing the transmission of the AIDS virus should also be part of health education for young adolescents. Young adolescents typically do not know, for example, that the incubation period for AIDS can be ten or more years and that mothers can transmit the virus to their offspring. Interventions should identify the sexually oriented situations that adolescents may encounter and provide life skills training on how to avoid the situation or manage it. Schools, families, and the media, through health-promoting messages and programs, can contribute to this effort. 14 PREPARING ADDLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 Armed with good information and skills, young adolescents must also be motivated to make UNCORRECTED PAGE PROOFS constructive choices regarding their sexuality and to prevent pregnancy-not an easy task given their inexperience and social milieu. Determining how to bring this about remains a formida- ble task. A recent Institute of Medicine study concluded that fewer than twenty-five programs to reduce unintended pregnancy have been carefully evaluated; of these programs, about half of them were found to be effective in the short term.⁷ This is one of the many indications that research in this field has not been given adequate priority. The vast majority of adolescent pregnancies are unintended.8 Any sound educational approach needs to make it clear that becoming a parent at the right time, when a young person has at- tained the maturity to raise a family, involves more than information, birth control, and the pre- vention of unwanted pregnancies. Young people should be taught, and public attitudes should reinforce, that raising a family brings responsibilities as well as joys, and that much is involved in being a reliable, competent parent. PREPARING FOR PARENTHOOD Another important aspect of healthy development is preparing adolescents for the time when they form families of their own in adulthood. The fulfillment of each child's potential requires a huge parental investment of time, energy, thought, caregiving, sensitivity, and money. It re- quires patience, persistence, understanding, and resilience in coping with adversity. All too many adolescents become pregnant only to find later that they are extremely ill prepared for the challenge of raising a child. Young people moving toward parenthood generally have less experience caring for a child than their predecessors had. Both father and mother are likely to be in the paid labor force. With the birth of the baby, they will have to renegotiate their relationship: they will have to decide how to divide the baby-care chores; what kind of flexibility they can build into their schedules; how they will handle the housework; what sort of parental leave, if any, each will take; and how they will balance work and family life. The 1993 Carnegie Corporation report, Starting Points: Meeting the Needs of Our Youngest Children, emphasized the importance of preparing adolescents for responsible parenthood. When people make an informed, thoughtful commitment to have children, they are more likely to be good parents. Their growing children are more likely to meet life with optimism, trust, and competence. On the other hand, when people are unprepared for the opportunities and responsibilities of parenthood, the risks to their children are serious. The nation needs a substantial expansion of efforts to educate young people about parenthood. Families are naturally the first source of such education, but schools, places of worship, and community organizations can also be useful. Community service in child care centers provides a valuable learning experience for adolescents about what is required to raise young children. Age-appropriate, culturally sensitive education about parenthood should begin in late ele- mentary school but no later than early adolescence. It can be a part of a life sciences cur- riculum or a part of health education. In either case, it must be substantial and meaningful to adolescents. PROMOTING THE HEALTH OF ADOLESCENTS 95 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CONFLICT RESOLUTION AND VIOLENCE PREVENTION Nearly 1 million adolescents between the ages of twelve and nineteen are victims of violent crimes each year.¹⁰ Yet evidence is emerging that interventions can reduce or prevent young people's involvement in violence. As with the prevention of adolescent pregnancy, youth violence is not a simple problem with a single answer. To be effective, prevention requires a comprehensive ap- proach addressing both individual and social factors.¹¹ It should include generic approaches that meet essential requirements for healthy adolescent development, through developmentally appropriate schools, supportive families, and youth and community organizations. A specific set of interventions that targets youth violence and enhances adolescents' ability to deal with conflict in nonviolent ways is also necessary. Policy changes, such as implementing stronger measures to restrict the availability of guns, are urgently needed, especially in light of the grow- ing propensity of juveniles to use semiautomatic and other guns to commit crimes.¹² One promising strategy for preventing youth violence is the teaching of conflict resolution (en- compassing the management of anger and other life skills training) as part of health education in elementary and middle schools. Research indicates that conflict resolution and mediation programs can reduce violence; better results, however, are achieved with longer-term, com- prehensive programs designed to address multiple risk factors.¹ Serious, in-depth conflict- resolution training over extended periods is increasingly important in a culture saturated with media and street violence. Supervised practice of conflict-resolution skills also is critical. As- sertiveness, taught as a social skill, helps young people learn how to resist unwanted pressures and intimidation, resolve conflicts nonviolently, and make sound decisions about the use of weapons. To build resources for the development of such programs, Carnegie Corporation is support- ing a national network of violence prevention practitioners based at the Education Develop- ment Center, linked with a national research center on youth violence at the University of Col- orado. These resources can provide a solid knowledge base and foster evaluative research in violence prevention. The two centers are joined to Mediascope, an organization addressing the depiction of violence in movies and on television. High-risk youth in impoverished communities urgently need social support networks and life skills training. Both can be created in a wide range of existing settings, not only in schools and school-related health centers but also in community organizations, including church-related youth activities and sports programs. They work best if they foster enduring relationships with adults as well as with helpful peers. This approach can potentially promote constructive al- ternatives to violent groups by providing a sense of belonging, a source of enjoyable activity, a perception of opportunity, a site for mentoring, and a chance to prepare for social roles that can earn respect. PREVENTING DRUG ABUSE Drugs are cheaper and more plentiful today than they were a decade ago. Heroin, for exam- ple, costs less than half its 1981 street price. The United States has the highest addiction rate in its history;14 courts and jails are bulging with drug-related cases. " PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Adolescents consider drugs and alcohol less harmful today than they did three years ago, and they are more accepting of drug use.¹⁵ For many young people, the use of drugs, even the sale of drugs, constitutes an attractive path to what they perceive as adult status. Some community-wide preventive interventions have substantially diminished the use "gate- way" substances (such as tobacco, alcohol, and marijuana) in early adolescence while en- hancing personal and social competence. These efforts have been carried out using rigorous research designs on a long-term basis.¹ Several preventive programs for young adolescents have been shown to reduce drug use.¹⁷ The learning of life skills has been usefully applied to the prevention of cigarette smoking and alcohol and marijuana use. 18 This research shows how the explicit teaching of these skills can contribute to personal and social competence and pro- vide constructive alternatives to health-damaging behavior. Recent studies report that when booster sessions are provided in high school, the preventive effects of early interventions are sustained through the senior year.¹⁹ Other programs focus on the prevention of cigarette smoking, which is very important, since, aside from tobacco's "gate- way" function, many casualties throughout the life span flow from the start of this addiction in early adolescence. In addition, the very early start of smoking is a slippery slope to other drugs.21 The results of well-designed, community-wide interventions are encouraging; their success suggests that social norms on drug use can be changed by systematic, intensive, and long-term efforts. A dramatic example is the recent decline in smoking reported by African American adolescents. Beyond the direct approach to substance abuse, parents, teachers, and health professionals should understand that many adolescents engage in dangerous behavior because of develop- mental problems such as low self-esteem, poor performance in school, depression, or inabil- ity to make careful decisions. This underscores the importance of addressing underlying fac- tors that lead to high-risk behavior. Using drugs may be a way of feeling mature, courageous, sophisticated, or otherwise grown up. Disadvantaged youth need to be shown how individu- als from comparable backgrounds have done well in legitimate ways, in sharp contrast to "suc- cessful" drug dealers involved in crime and tragedy. The provision of family-augmenting func- tions by community organizations can be helpful in this context. STRENGTHENING HEALTH CARE SERVICES FOR ADOLESCENTS An exhaustive study of adolescent health, conducted by the U.S. Congress Office of Tech- nology Assessment in 1991, pointed to serious barriers to establishing developmentally ap- propriate health services for adolescents.25 Current services are particularly lacking in dis- ease prevention and health-promotion services. A variety of studies and innovations in the past decade have been undertaken to overcome the barriers and to improve the delivery of health care services to adolescents.2⁴ These studies show what can be done, but there is a long way to go. PROMOTING THE HEALTH OF ADDLESCENTS 17 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Barriers An estimated 39.7 million Americans (15.3 percent) panic doctors; long waiting times at neighborhood were without health insurance coverage during the and hospital clinics; and dissatisfaction with physi- to Health entire 1993 calendar year. cian behavior. As many as one in seven adolescents has no health The clinical visit provides an opportunity for health Care insurance; one in three poor adolescents is not COV- promotion and disease-prevention interventions. Dur- ered by Medicaid, and private insurance coverage of ing this visit, physicians or other practitioners in the Services for adolescents is increasingly restricted. office setting should be able to provide health guid- ance, including health education, health counseling, Adolescents are among those least likely to have and anticipatory guidance. This is especially impor- Adolescents health insurance because most adolescents, ages tant for adolescents with chronic disease and dis- ten to eighteen, live with parents who are also unin- ability to maximize their function and ability to cope. sured. Adolescents whose families are poor or of Hispanic origin or whose parents have little formal A critical issue in the provision of health care to ado- education are most likely to be uninsured. In 1993, lescents is that there are relatively few health care despite the existence of programs such as Medicaid personnel who have training or experience in deal- and Medicare, 29.3 percent of the poor (11.5 million) ing with this age group's health problems. Training had no health insurance of any kind. programs for physicians do not include information about and skills to serve adolescents. Preventive services, such as psychological and sub- stance abuse counseling, are especially needed dur- ing adolescence and not covered by many insurance SOURCES plans. U.S. Department of Commerce, Bureau of the Census. (October 1994). Statistical brief (SB/94-28). Health insurance coverage- To meet adolescents' health care needs, develop- 1993. mentally appropriate services must be available in a Klein, J. D., Slap, 6. B., Elster, A. B., & Cohn, S. E. (1993). Ado- wide range of health care settings, including com- lescents and access to health care. Bulletin of the New York munity health centers, school-based and school- Academy of Medicine, 70, 219-235. linked health centers, physicians' offices, family Kronick, R. (1989). Adolescent health insurance status: Analysis planning clinics, HMOs, and hospitals. Adolescents of trends in coverage and preliminary estimates of the effects now depend on multiple sources of care for pre- of an employer mandate and Medicaid expansion on the unin- ventive services. For approximately 80 percent of sured. Washington, DC: U.S. Congress, Office of Technology school-based clinics, for example, adolescents need Assessment. another source for contraceptive health services be- Lieu, T. A., Newacheck, P. W., & McManus, M.A. (1993). Race, cause making the full range of contraceptives avail- ethnicity and access to ambulatory care among U.S. adoles- able to teens in schools is highly controversial. cents. American Journal of Public Health, 83:960-965. There are ethnic and cultural differences in the use of health care services. If African American and His- panic youth had income and health insurance COV- erage equal to that of whites, they would still not make as many visits to the doctor. Different beliefs regarding health may influence the use of health care services; other factors include discrimination in institutional access or physician behavior; the rel- atively small numbers of African American and His- PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS BROADENING HEALTH INSURANCE COVERAGE All adolescents require preventive primary health care and treatment for health problems, yet they are likely to face barriers to these services. For one in seven American adolescents, health insurance coverage is simply not available, and for many more it is inadequate. Within the Medicaid population, only one-third of eligible adolescents are currently covered because of funding constraints, and this proportion is unlikely to increase in the foreseeable future.25 Health insurance for working families may not be provided by employers or, when provided, may not include their adolescent children. Coverage of adolescents is a critical part of the debate over health care reform. As managed care spreads rapidly throughout the United States, it will be crucial to include explicit provi- sions for comprehensive coverage of adolescents. This will be especially important to mon- itor, along with such matters as access, quality, and continuity of care, as states increasingly en- roll their Medicaid population in managed care plans. Managed care organizations should be encouraged to contract with school-based health centers serving adolescents. Even when health coverage is available, adolescents may have inadequate information about the availability of ser- vices, or they may be concerned that confidentiality will be breached. Too often, health ser- vices are not user-friendly for adolescents. Some community health and school-based adoles- cent health centers have demonstrated how these barriers can be overcome.²⁷ DEVELOPING APPROPRIATE HEALTH PERSONNEL AND SCHOOL- RELATED SERVICES Currently, there is a dearth of experienced and well-trained health providers who can sensi- tively treat the health problems of adolescents, with special attention to continuity of care. Of equal concern is the lack of adequate preparation of the larger number of nonspecialist physi- cians, nurses, nutritionists, psychologists, and social workers who must work as part of a multi- disciplinary team to deal effectively with the adolescents they encounter.28 Serious gaps must be filled in service systems for all adolescents, especially those with multiple health problems, chronic disease, or disability, such as attention deficit disorders. One promis- ing approach to filling this service gap is by establishing more school-related health facilities ex- pressly for young adolescents, either at the school or near the school and functionally integrated with it with respect to both of curriculum and accessibility. Such facilities have demonstrated their ability to deal with acute medical problems, including mental health. They have strong po- tential for disease prevention and health promotion. States and communities, with help from the federal government and private funds, already have established more than six hundred school-based or school-linked health centers nationwide since 1980. Local health professionals and institutions work with the schools to provide these services. National health and education organizations have issued policy statements support- ing these centers, including the American Medical Association, the Association of School Nurses, the American Academy of Pediatrics, the National Education Association, the Na- tional Association of State Boards of Education, the Society for Adolescent Medicine, the American College of Obstetrics and Gynecology, and the American Public Health Association. PROMOTING THE HEALTH OF ADOLESCENTS 99 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS In 1995, the National Assembly of School-Based Health Clinics was established. Parents also are supportive of the centers and of adolescents' use of them. The average annual cost per stu- dent of these centers is less than $200.30 Students use these services primarily for physical examinations, acute illness, and minor emer- gencies. Since students often request help with feelings of depression, loneliness, and anxiety, these centers also should provide appropriate mental health services. There is an important opportunity here; treatment of depression, for example, can prevent self-medication leading to substance abuse and addiction. Until now, most of these centers have operated in high schools. Reproductive health care ac- counts for less than 20 percent of the services provided there.31 In middle grade schools, an even lower percentage is expected. Evidence suggests that counseling can delay the initiation of sexual activity.32 Nevertheless, some young people become sexually active during the mid- dle grade years. Therefore, it is appropriate for school-based or school-linked centers to pro- vide family planning information. School-based centers should be open beyond school hours, have outreach programs and trained staff, and receive community-wide support. THE PROMISE OF HEALTHIER LIVES The early adolescent years are increasingly the starting point of an upsurge of health- compromising behaviors that have lifelong ramifications. Although grim statistics about the health of adolescents are a continual reminder of the potentially tragic consequences of choices at this age, early adolescence presents an often overlooked opportunity for health pro- motion. Properly nurtured, adolescents' interest in their own developing bodies can be a po- tent force for building healthy lifestyles of enduring significance. The best chance to fulfill this promise lies in connecting health care professionals with schools, community organiza- tions, families, and media. A crucial ingredient in this formula for lifelong health is the guiding and motivating influence of caring adults. Information and skills are not sufficient to influence the behavior of adolescents unless they are willing and able to put them to use in the interests of fostering their own health. To encourage this willingness requires the protection and support of their families, friends, health professionals trained to work effectively with the adolescent age group, and other adults. Health promotion assumes that adolescents will have access to primary health care services for prevention and early intervention. Health policymakers must work with communities and fam- ilies to find new ways to improve adolescents' access to health care services through stable pri- mary care providers or through school-linked adolescent health centers that emphasize pre- ventive services, including dental and mental health care. Schools and communities alike must become places that enhance healthy behaviors among adolescents and the people around them. A comprehensive health-promotion strategy, therefore, requires a community-wide commit- ment not only from adolescents but from the full range of institutions with whom adolescents are involved. Making this commitment to young adolescents is potentially one of the most pow- erful means of changing health outcomes for life. 100 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS A member of the Carnegie Council on Adolescent sis suggested that one out of every five adolescents Development, Michael I. Cohen, chair of the Depart- has at least one serious health problem. Increasingly, OTA Study ment of Pediatrics at the Albert Einstein College of these problems are behavioral in nature, including Medicine, served as vice chair of the advisory panel drug abuse, accidents and injuries, homicides, sui- on for the Office of Technology Assessment (OTA) study cides, sexually transmitted diseases, and premature of adolescent health. In a presentation before the pregnancy. Research that seeks to understand paths Adolescent Carnegie Board of Trustees, he called attention to the to healthy outcomes in adolescence and contribut- highlights of the first national study on the health of ing risk factors-individual, familial, and social-is Health American adolescents: urgently needed for informed, effective prevention approaches. Collection of health statistics should be informed by developmental phases within the adolescent period. Disease prevention and health promotion are Researchers have divided the adolescent period crucial during the adolescent years. Health care roughly into three phases: early, middle, and late. agencies and professionals, using current under- The use of chronological age, given individual vari- standing about the behaviorally based factors re- ability at a specific age during adolescence, is not lated to adolescent health status, must work toward a good substitute for developmental status. How- achieving a better balance between treatment of ill- ever, currently published data make it difficult to or- ness and health promotion and disease prevention. ganize information based on these phases and on A variety of approaches to healthy adolescent de- adolescence itself. For example, national data are velopment must be tested. Adolescents are a di- often reported for "children below the age of eigh- verse group, and many organizations, including teen" or "for youth from fifteen to twenty-four." The health agencies, can foster healthy lifestyles in this OTA study has focused more attention on the ado- age group. As a major option, OTA sees special lescent years, and increasingly health statistics are promise in school-related health centers, as well as being reported for adolescents from ten to fourteen community-based, comprehensive adolescent health and from fifteen to nineteen years, as indicated in centers. this report. Health professionals must be prepared to work Collection of health statistics should take into with adolescents. While adolescent health special- account important characteristics of diversity ists are still rare within the health professions, an within the American adolescent population. Data even greater problem exists in preparing health pro- are typically reported by race and ethnicity and by fessionals-nonspecialist physicians, nurses, psy- gender. Since the OTA report, and reflecting changes chologists, and social workers-to work effectively in the U.S. population, more statistical reporting in- with the adolescents they encounter. cludes Hispanic-Latino, American Indian, and Asian Pacific adolescents. However, information that sep- Health care reform must take into account the de- arates race or ethnicity from socioeconomic status velopmental needs of adolescents. Any reform of is still rare. health care financing and provision of services must include attention to adolescents as a group with Behavioral science research is crucial to under- needs separate from young children. standing the new behavior-linked morbidities of adolescence. Research on adolescent develop- ment and health must be a high national science SOURCE policy priority. Adolescents have been commonly U.S. Congess Office of Technology Assessment. (1991). Adoles- regarded as the healthiest Americans and those in cent health-Volume I: Summary and policy options. Washington, least need of health services. However, DTA'S analy- DC: U.S. Government Printing Office. PROMOTING THE HEALTH OF ADOLESCENTS 101 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS An Depression, suicide, alcohol and drug use, HIV/AIDS no longer safe to assume that the skills necessary for and other sexually transmitted diseases, gun-related succeeding-or even surviving-in a complex soci- homicides-this is the minefield of deeply disturbing Integrated ety are being transmitted. When coupled with social health problems American adolescents in the 1990s support networks, such training can help adoles- have to cross. For young people to grow up healthy, cents make wise, informed decisions and steer clear Approach to an integrated approach is necessary-one that of high-risk behavior. takes into account individual responsibility for health Health Adolescents need health services, including pre- as well as society's responsibility to support individ- ventive health, dental, and mental health care. uals' decisions to enhance their health. Many adolescents lack access to the health services Promotion Adolescents need information. To develop healthy they need. One way to rectify this situation is to ex- habits and avoid risks, adolescents need facts. They tend insurance coverage-both public and private- need to know the importance of good nutrition and to all adolescents. Another way is to establish health exercise, the harmful consequences of substance centers in or near schools. Cooperative efforts abuse, and the responsibilities of sexual involvement. among education, health, and social service groups Furthermore, students need the facts early. These could provide students better access to such ser- facts should be part of the core curriculum in the vices. Centers should offer health promotion and dis- higher elementary school grades and in the middle ease prevention education, treat or refer students schools. Life sciences classes can teach students suffering from injuries and acute and chronic ill- how their minds and bodies develop and function, nesses, and arrange for treatment of dental and vi- what strengthens them, and what harms them. sion problems. To successfully serve adolescents, centers must guarantee confidentiality. Adolescents need critical life skills. To protect their health and expand their options, adolescents Adolescents need motivation to protect their health. need life skills such as problem solving, planning, de- Providing information, skills, and services is not cision making, resisting negative influences of peers enough. To protect their health, adolescents must and the media, resolving conflict nonviolently, and have incentives to put what they have learned into coping with stress. Because of profound changes in action. The social environment can provide these in- our nation over the last few decades, however, it is centives. Adolescents living in poverty are more at Further Reading Falco, M. (1992). The making of a drug-free America: Programs that work. New York: Times Books. Hechinger, F. M. (1992). Fateful choices: Healthy adolescents for the twenty-first century. New York: Hill and Wang. Hendee, W.R. (Ed.). (1991). The health of adolescents: Understanding and facilitating biolog- ical, behavioral, and social development. San Francisco: Jossey-Bass Publishers. Lynch, B. S., & Bonnie, R. J. (Eds.). (1994). Growing up tobacco free: Preventing nicotine ad- diction in children and youths. Washington, DC: National Academy Press. 102 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS risk for engaging in unhealthy behavior because of the cultural, social, and economic constraints they face. Adolescents need the support of relatives and other adults, especially educators and health providers. Adolescents need close, ongoing contact with car- ing and competent people whose judgment they trust. To establish these critical relationships, edu- cators, mentors, health professionals, and other adults who work with adolescents should receive training in adolescent development and develop the skills needed to counsel young people effectively. Primary care providers who work with diverse pop- as gang involvement, alcohol and drug use, and pre- ulations of adolescents must be culturally sensitive mature sexual activity. Because the lack of employ- and able to bridge not only the generation gap but ment opportunities suitable for young people com- also cultural differences that may exist. pounds other problems, connecting adolescents with the world of work can have a positive effect. Men- Adolescents need environments that foster healthy social and economic development. Many adoles- toring programs, part-time internships during the cents today live in environments where problems school year and full-time internships during the sum- mer, and apprenticeships that take a "learn-while- ranging from violence to hopelessness adversely af- you-earn" approach can help adolescents feel com- fect their health. Neighborhoods in which the adults are connected by an extensive set of expectations, petent and useful, improve their economic prospects, obligations, and social networks are in a better posi- and provide a sense of a promising future. tion to control and supervise the activities and be- havior of children and adolescents. In neighborhoods SOURCES with weak social controls and monitoring, adoles- Millstein, S.G. Petersen, A. C., & Nightingale, E. 0. (Eds.). (1993). cents are more likely to be affected by peer group Promoting the health of adolescents: New directions for the culture and may succumb to high-risk behaviors such twenty-first century. New York: Oxford University Press. Millstein, S. G., Petersen, A. C., & Nightingale, E. O. (Eds.). (1993). Promoting the health of adolescents: New directions for the twenty-first century. New York: Oxford University Press. Palfrey, J.S. (1994). Community child health: An action plan for today. Westport, CT: Praeger. U.S. Congress, Office of Technology Assessment. (1991). Adolescent health, volumes 1-3. Wash- ington, DC: U.S. Government Printing Office. Wilson, M. H., Baker, S. P., Teret, S., Shock, S., & Garbarino, J. (1991). Saving children: A guide to injury prevention. New York: Oxford University Press. PROMOTING THE HEALTH OF ADOLESCENTS 103 CORRECTED PAG PAGE PRO PRO AGOED UNT 10 AM, OCTOBER 2, 995 OFS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER EIGHT Strengthening Communities with Adolescents The experience of growing up in American communities has changed significantly in recent decades. For most young adolescents, the feeling of belonging to a community that offers mutual aid and a sense of common purpose, whether it is found in their families, schools, neighborhoods, houses of worship, or youth organizations, has been greatly compromised. Each school day, America's 19 million young adolescents decide how they will spend at least five of their waking hours when they are not in school.¹ A significant number of the twelve-to- fourteen-year-olds are home alone for more than two hours each school day.2 On weekends, holidays, and during the summer months, American youth have even greater amounts of dis- cretionary time without adult guidance. For them, the out-of-school hours constitute a time of increased vulnerability for high-risk behavior. Those left on their own or only with peers stand a significantly greater chance of becoming involved in substance abuse, sexual activity leading to unwanted pregnancy and sexually transmitted diseases, and crime and violence than their peers who are engaged in activities with adult supervision.3 Young adolescents from all economic strata often find themselves alone in communities where there are few adults to turn to and no safe places to go. Inadequate public transportation sys- tems and Americans' reliance on the private car limit the ability of young adolescents to travel to activities in places such as clubs away from home or school. In some communities, the main place to meet others and socialize is in a shopping mall. Where such malls do not exist, the streets offer ample opportunities for illegal and often dangerous, violent activities. Time spent alone is not the crucial contributor to high risk. What adolescents do during that time, where they do it, and with whom leads to either positive or negative results. The task is to turn the now-lost opportunities of the out-of-school hours into attractive, growth-promoting settings. Many youth and community organizations, in partnership with schools and corpo- rations, are beginning to respond. 105 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS TAPPING THE POTENTIAL OF COMMUNITY ORGANIZATIONS FOR YOUTH In the critical transition from childhood toward a still-distant adulthood, adolescents have a lot to learn-not only about new subjects at school but also about people, career opportuni- ties, places beyond the neighborhood, arts, sciences, and themselves. Families help. Schools help. But increasingly they are not enough. More than 17,000 national and local youth organizations now oper- ate in the United States.⁵ These youth organizations include both large national organizations and small, independent grassroots orga- nizations not affiliated with a national structure. Some are private, I'll be going to middle school next year. nonprofit agencies whose central mission is to provide opportunities I'll be in the sixth grade. I come to the for youth, such as the Boy Scouts, 4-H Clubs, the YMCA, and YWCA. The potential of these youth organizations can be extended greatly by community center to play basketball, lift adult service groups, such as Rotary or Kiwanis Clubs, religious or- ganizations, minority organizations, sports leagues, arts programs, se- weights, have other activities and stuff. nior citizens' groups, museums, and public-sector institutions such as libraries and parks and recreation departments. It's fun, 'cause my friends are here and A Carnegie Council report, A Matter of Time: Risk and Opportunity it's much better than sitting at home in the Nonschool Hours, focused attention on how youth-oriented organizations can play an urgently needed and expanded role in help- and watching TV all day. It's like a place ing America's young people prepare for lives as responsible, inquir- where I can come when I'm bored, ing, and vigorous adults. The report illustrated ways that these or- ganizations can extend family- and school-like functions into the 'cause there's always people that crucial after-school, weekend, and summer hours when neither schools nor parents are available to provide supervision. Youth or- can help me whenever I have problems ganizations can connect young adolescents with reliable adults who provide social support and guidance while offering young adoles- or anything. Also I've got somebody here cents opportunities to be of service to their communities, learn about that I can depend on. I have my friend the world of work, earn money, build a sense of worth, and make durable friendships. Greg in the other room. He gives A Matter of Time noted that promising programs already exist, but me advice, we play basketball together, they reach all too few of the young people who most need their sup- port and guidance. Some 29 percent (approximately 5.5 million) of and he takes me out and stuff. young adolescents are not served by any of the existing 17,000 youth organizations.⁶ Many programs for youth operate only an hour or two a week, which is neither intensive enough nor adequate in time TERENCE. 11 to meet essential needs for healthy adolescent development. Many programs, too, are run by well-meaning adults who are untrained in dealing with young adolescents and their distinctive attributes. Membership in these groups declines precipitously as children move into adolescence. When these programs do not address requirements and interest of developing adolescents, as is often the case, the young people drift away. PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Based on its three-year study of youth and commu- planning. Young adolescents' contributions to the nity organizations, the Carnegie Council's Task Force program and their communities should be regularly Elements on Youth Development and Community Programs recognized and publicly rewarded. In many commu- identified characteristics of community programs nities, young adolescents' desire to gain meaning- of Effective that are responsive to the needs of young adoles- ful employment skills and experiences can be met cents. Such programs through community and service programs and by ca- Youth reer awareness and job skills classes. Are safe and accessible to all youth. They should be located in safe, easy-to-reach settings that are open Reach out to families, schools, and other community Programs to all youth who seek them out. Programs in school partners to create stronger community support sys- facilities during the after-school hours may have an tems for young adolescents. They can provide link- advantage of providing such an environment but ages to schools as 8 way to support the academic must be year-round operations and open during the achievement and learning of young adolescents. evenings, weekends, and vacations to avoid a dan- Such programs should encourage parental partici- gerous vacuum. Transportation and child care are of- pation by creating real opportunities to become in- ten needed if all adolescents are to have genuine ac- volved in the life of the school and in improving their cess to these opportunities. own education and training. Tailor their content and methods to the characteris- Identify their objectives and evaluate their methods tics, interests, and diversity of young adolescents and outcomes for young adolescents, staff, and com- based on a systematic assessment of community munity impact. Process evaluations enable staff to needs and existing services. Programs should be en- adapt and improve what they are doing. Outcome joyable, culturally relevant, and linked to activities evaluations can provide information on near-term that capture adolescents' interests, such as sports outcomes. However, it must be recognized that im- and recreation, drama, business skills, the arts, life portant outcomes, such as employment in the legiti- skills, and academic enhancement. Programs need mate workforce, may not be measurable until some to be flexible enough to respond to adolescents' re- years later. quests to integrate new activities, as they are Advocate vigorously for and with youth to improve needed and reasonable, into the ongoing program. opportunities for education and health in their com- Work with a variety of other community organizations munities. and governmental agencies to extend their reach to Establish strong organizations with a vision of youth vulnerable adolescents, especially those in resource- development, led by energetic and committed board poor neighborhoods. They should offer a wide array leadership. of services, including primary health services-sub- stance abuse prevention, mental health, and family Strengthen research on community organizations planning-that facilitate healthy development. and youth development, giving it a higher priority in science policy than ever before because of the po- Strengthen the preparation and the diversity of their tential importance of these opportunities to prevent adult leadership. Staff of youth organizations should casualties in adolescence and beyond. be knowledgeable about the development of adoles- cents and prepared to work with them. SOURCE Enhance the participation of young adolescents as resources to building and improving their communi- Task Force on Youth Development and Community Programs. (1992). A matter of time: Risk and opportunity in the nonschool ties. Activities should involve young people in all as- hours. New York: Carnegie Corporation of New York. pects of program development, including day-to-day STRENGTHENING COMMUNITIES WITH ADOLESCENTS 107 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Collaborating Low-income neighborhoods often lack safe places initiative in 1987. At the heart of the plan was the de- for young adolescents to congregate and to partici- cision to expand its efforts in public housing projects. for Youth pate in recreational or educational activities. Meet- Today, with the ongoing support of the U.S. Depart- ing the needs of adolescents living in these areas is ment of Housing and Urban Development and several the mission of the Boys & Girls Clubs of America, a key federal agencies and private foundations, 270 Boys & Girls Clubs national federation of independent local clubs. clubs are located in housing projects nationwide and in Public Housing Opening their doors to all young people, ages six to in Puerto Rico. They are also the only national youth- eighteen, clubs offer a wide variety of activities. serving agency with a major presence in public Projects Grouped in six core areas, these include health and housing. Through this public-private collaboration, physical education, personal and educational devel- thousands of young people have a positive alterna- opment, citizenship and leadership development, tive to hopelessness and lives frequently filled with violence. cultural enrichment, recreation, and outdoor envi- ronmental education. Through these activities, the Research conducted over a three-year period in fif- clubs hope to instill such values as good work habits, teen public housing projects has shown that these self-reliance, perseverance, teamwork, and consid- clubs have a positive impact on parental involvement eration of others. Club programs are designed to pro- and school performance, and their presence also en- vide girls and boys with responsible adult guidance, courages residents to organize and improve their encouragement and support that are frequently not community. The clubs also had positive effects on re- available at home, in school, or elsewhere in the ducing drug use, juvenile crime, and the presence of community. crack in housing projects compared to housing pro- Each year, Boys & Girls Clubs serve 2 million young jects without them. Boys & Girls Clubs in public hous- people. More than half of these youth come from mi- ing are significant for two key reasons: They are re- nority groups, single-parent households, or low-in- sponsible for bringing about many broad-based and come families. To reach even more young people in dramatic social changes, and they provide a self- need, Boys & Girls Clubs launched an ambitious new sustaining program of assistance. When asked what they want from programs, young adolescents say they want secure and sta- ble relationships with caring peers and adults, safe and attractive places to relax and be with their friends, and opportunities to develop life skills, contribute to their communities, and feel competent.⁷ Good youth programs offer precisely what adolescents want: mentoring and coach- ing relationships; drop-in activities; development of social skills; safe havens; community ser- vice, and programs that nurture interests and talents, public performance, and recognition. To expand the reach of good programs, the Council's report urged the development of inno- vative partnerships that can provide these organizations with financial and other resources. For example, several federal agencies provide such organizations with funds directed toward their preventive potential in areas of substance abuse and youth violence.8 With both public and private funds, these community-based organizations can reach neglected adolescents, who are likely to benefit a great deal from opportunities to belong to a valued group. These settings present a powerful alternative to the appeal of youth gangs and other negative influences. A Matter of Time has contributed to efforts across the country to recreate communities with youth. Urban parks and recreation groups used the report to argue for more safe, open spaces, 108 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS particularly in neighborhoods of concentrated poverty.9 Theater and arts groups cited its find- ings in their requests for increased support of their activities. Federal agencies pointed to the report when including after-school programs as part of a crime-prevention strategy.¹ National youth organizations turned to it for guidance in reorganizing their priorities. In several cities, including San Francisco, Chicago, and Denver, the report was the basis for examining how youth-serving agencies in both the public and private sectors could better meet the needs of adolescents in their cities. 11 All of these efforts are the hopeful signs of movement toward what John Gardner, a member of the task force that issued the report, called "reinventing commu- nity" to adapt to new social conditions.¹² COMMUNITY ORGANIZATIONS AS AWAYOF OVERCOMING DISADVANTAGE Young adolescents from families with very low incomes are likely to live in unsafe neighbor- hoods and to be unsupervised during the out-of-school hours. Already penalized by economic disadvantage and the stresses of life in their neighborhoods, they also are the least likely to have access to enriching youth programs in their neighborhoods.¹⁵ They are at extremely high risk. They are young people whose lives hang in the balance. Communities of color are trying to focus their institutions on encouraging young people to stay in school and pursue education in a determined way even in the face of frustration. Much can be accomplished by community-based youth organizations to support and extend the ed- ucational functions of schools. A variety of organizations and institutions can provide long- term mentors who are like parents, older siblings, and an extended family. Across the country, examples of such interventions exist. Some programs are based in churches (such as Project SPIRIT, the initiative of the Congress of National Black Churches); some are based in community organizations (such as the Boys & Girls Clubs); others involve youth service (such as Youth L.A. and the Early Adolescent Helper Program); others are based in minority organizations, including the National Coalition of Hispanic Health and Human Service Organizations, National Urban League, minority fra- ternities and sororities, and ASPIRA.¹⁴ National scientific associations, such as the American Association for the Advancement of Science, are working with churches and other community organizations to increase young people's interest and active involvement in the sciences. Through the Association of Science-Technology Centers, science and youth museums throughout the country are involving adolescents from low-income - communities as docents and exhibition designers. Pursuing such efforts typically requires the involvement of neighborhood residents and vol- unteers who know their communities well. Usually there is need for a highly competent corps of paid staff working with able and dedicated volunteers and for firm links with relevant pro- fessionals. Promising models exist, but there is no large-scale system. As worthwhile lines of innovation emerge, it is crucial to have careful evaluations so that the effects can be broadly un- derstood. What works for whom under what conditions? Such knowledge can help in scaling up the best efforts for use where they are most needed. STRENGTHENING COMMUNITIES WITH ADOLESCENTS 109 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS RECONNECTING YOUTH TO THEIR COMMUNITIES Among the most powerful means of enriching young lives is to enlist their energies in improv- ing their own communities. Young adolescents can and want to contribute to their communi- ties, and they learn much from such engagement. Aside from experiencing the rewards of ser- vice to others, they learn skills and develop habits that will serve them well in the world of work. They learn about the importance of collab- orative problem solving when teams work Weekly Afterschool Activities of Eighth Graders together to achieve group objectives; about AVERAGE NUMBER OF HOURS PER WEEK the importance of being prompt, courteous, 30 Television and cooperative; and about the inevitable ne- Homework cessity of patience and persistence in pursu- Outside Reading 25 ing long-term goals. Under the auspices of the American Library Association, as one ex- 20 ample, public libraries are addressing ado- lescents' needs with programs that include paid employment and volunteer opportuni- 15 ties to work with younger children. 10 When programs encourage young adoles- cents to participate in community life as valued resources, they enable young people 5 to become stakeholders in the community's values, traditions, and accomplishments. 0 Total White Black Hispanic Asian and American Adolescents with such a sense of belonging Pacific Indian ETHNIC BACKGROUND Islanders and Native are more likely to choose positive paths to Alaskan achievement. Their self-efficacy grows as they Source: From A Profile of the American Eigth Grader: NELS:88 Student Descriptive Summary, by the National Center for Education Statistics, U.S. Department of Education, 1990, Washington, DC: see their contributions bear fruit. Adolescents U.S. Government Printing Office. often adopt as role models the adult leaders who help them build their own futures. To be successful, service learning programs must take into account the interests and talents of young adolescents and the ways in which they learn. Activities must be carefully planned to offer meaningful experiences with tangible results so that young adolescents feel a sense of accom- plishment. Often the most successful programs are ones in which young people participate in all aspects of program development, including day-to-day planning. In addition, building pride in solid accomplishments must be part of the core of the program. Young adolescents' contributions to the program and their communities should be regularly recognized and publicly rewarded. STRENGTHENING ADULT LEADERS IN COMMUNITY ORGANIZATIONS The adult leaders in community organizations often are available to young people at all hours of the day, labor without adequate compensation, have limited benefits, and go unrecognized for their contributions to youth and community development. Yet they are society's frontline workers who breathe life into youth programs. 110 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Community Service Opportunities Community service can be a powerful tool for young school to identify, analyze, and address community adolescents to learn about important human values problems. Using oral histories and other activities, such as compassion, cooperation, tolerance, respect, the CityYouth curriculum helps teachers and stu- and faimess. That is one of the reasons Turning Points dents understand such community issues as health, recommends that community service be a part of safety, and crime and provides the skills students middle schools' core curriculum. need to address community problems. The CityYouth curriculum also promotes respect for the racial, eth- Often called "service learning," community service nic, and socioeconomic diversity characteristic of activities can reinforce skills like problem solving and Los Angeles's student population. The Los Angeles conflict resolution taught in other parts of the cur- Unified School District piloted the program in 1992 in riculum. In fact, the most effective programs inte- four middle schools, involving about 150 students. To- grate service learning into the traditional curriculum, day the program features nine teaching teams who embedding activities in the study of mathematics, reach a thousand students. science, language, art, or social studies in ways that encourage interdisciplinary integration and team teaching. Service learning can take place virtually EARLY ADOLESCENT HELPER anywhere. At school, students can serve as peer tu- PROGRAM tors, teaching assistants, or other kinds of helpers. The Early Adolescent Helper Program is another ap- Away from school, they can be child care volunteers proach to service learning. A program of the National or environmental workers. Helpers Network, it has promoted service learning among young adolescents since 1982. With the dual CITYYOUTH, L.A.: EDUCATION goals of raising adolescents' self-esteem and im- AND COMMUNITY ACTION proving communities with adolescents' service, the program views community service as a valuable part One noteworthy example of service learning is City of adolescent education. The Helpers Network has Youth, L.A.: Education and Community Action. Spon- developed two intergenerational programs. The sored by the Constitutional Rights Foundation, the Learning Helpers Program creates opportunities for program gives teachers the training and materials to young adolescents to assist in after-school programs help their pupils use what they have learned in for children. Learning Helpers read aloud to children, supervise their play, and teach them games. The Partners Program gives adolescents the chance to work with older people at senior centers and nursing homes. Other programs focus on environmental is- sues, neighborhood improvement, and tutoring. In addition to their community service, students partic- ipate in weekly seminars designed to stimulate re- flection on their active involvement in community set- tings. Led by trained adults, these seminars use curricula developed by the Network. STRENGTHENING COMMUNITIES WITH ADOLESCENTS 111 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Black Churches Support Youth Development Through Project SPIRIT Since 1978, the Congress of National Black Churches who are recruited into the program and trained in (CNBC) has worked to build on and strengthen the providing motivation and support. They then receive black church's ministry by serving as an organiza- supplementary tutoring from workbooks and curric- tional umbrella for the eight major Black American ular materials. A portion of the afternoon is devoted religious denominations. Headquartered in Wash- to the development of African American cultural and ington, D.C., CNBC represents approximately 19 mil- ethnic pride and improved self-concepts as well as lion African Americans in more than 65,000 local practical living skills through games, skits, songs, churches. and role playing real-life experiences. Project SPIRIT also organizes Saturday programs for parents and CNBC seeks to harness the historical mission of black children and provides parent education programs fo- churches to respond not only to the spiritual but also cused on child and adolescent development, parent- to the economic and social needs of the black com- child communication, discipline, and financial man- munity. The organization launched its first major na- agement. The program has served more than two tional demonstration effort-Project SPIRIT- in 1986. thousand children with tutorials aimed at strength- Project SPIRIT, which stands for Strength, Persever- ening their skills in reading, writing, and arithmetic ance, Imagination, Responsibility, Integrity, and Tal- and in building their self-esteem. ent, aims to instill those very qualities in African American youth, ages six to twelve. Goals of the pro- The Pastoral Counseling Training Component of Pro- ject are to provide constructive after-school activi- ject SPIRIT provides pastors of participating churches ties for young people growing up in low-income com- with a fifteen-session workshop designed to help munities, to expand their network of relationships them become more effective in the care, education, with caring adults, to support academic achieve- and guidance of African American youth. Because ment, and to teach practical life skills. The project fo- this type of training is missing from most seminaries cuses on three target populations: Children and and in-service education programs for black minis- young adolescents, parents, and African American ters, it is a critical component of Project SPIRIT. pastors. Project SPIRIT is currently operating in sixty-five churches in seven states-Arkansas, Cali- fornia, Florida, Georgia, Indiana, New York, and Min- nesota-and in the District of Columbia. The youth component revolves around daily after- school programs conducted in church facilities. Pro- ject SPIRIT generally enrolls young people who are underachievers, bored with the traditional school setting, earning low grades, and experiencing disci- pline problems. For three hours after every school day, they concentrate on their homework, supervised by retired or active teachers and other professionals, 112 PREPARING ADDLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS The professional development of adults, both as new and existing staff in youth organizations, is a continuing concern to the field. Different avenues to expanding opportunities for prepa- ration for youth work, whether through postsecondary educational institutions or on the job, are now being explored by resource centers such as the Academy for Educational Develop- ment's Center for Youth Development and Policy Research. 15 These efforts are likely to en- hance the effectiveness of programs experienced by young adolescents as well as increase the recognition of youth-development work as a valued service. BUILDING YOUTH- ORIENTED COMMUNITIES Community programs are natural partners with the other key institutions that influence young lives. These programs extend the school's responsibility for education and facilitate the transi- tion from school to work into the out-of-school hours. They reinforce the family's responsibil- ities for teaching enduring values and building character during the hours when parents are not available. Ideally, these linkages will be not accidental but planned and carefully coordinated; for example, community programs can create meaningful opportunities for parents and schools to become involved in fostering and recognizing young people's accomplishments. Adults in these key institutions can themselves cooperate to become effective advocates for youth. The voices of young adolescents rarely are heard in the corridors of policy decision making. Adolescents need powerful and well-informed adult advocates to see that their devel- opmental requirements are met in consistent and constructive ways. Neighborhoods and communities in today's global village often are not well organized to pro- vide a network of support for vulnerable young adolescents. Schools, community organiza- tions, health care institutions, and families must work together to revive for young people the experience of belonging to caring communities where all can thrive. Young adolescents, work- ing with these organizations committed to their future, can turn their out-of-school hours into the time of their lives. Further Reading Connell, J. P., Kubisch, A. C., Schorr, L. B., & Weiss, C. H. (Eds.). (1995). New approaches to evaluating community initiatives: Concepts, methods and contexts. Washington, DC: The Aspen Institute. Task Force on Youth Development and Community Programs. (1992). A matter of time: Risk and opportunity in the nonschool hours. New York: Carnegie Corporation of New York. McLaughlin, M. W., Irby, M. A., & Langman, J. (1994). Urban sanctuaries: Neighborhood or- ganizations in the lives and futures of inner-city youth. San Francisco: Jossey-Bass. Zeldin, S., & Price, L. A. (Eds.). (1995). Creating supportive communities for adolescent de- velopment: Challenges to scholars [Special issue]. Journal of Adolescent Research, 10 (1). STRENGTHENING COMMUNITIES WITH ADOLESCENTS 113 EMB ARGOED UNTIL 10 AM, C TOBER 1 UNCORRECTED PAGE PRO CLEANER DATA ASTER? EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER NINE Redirecting the Pervasive Power of Media The world of the adolescent cannot be understood without considering the profound influence of the mass media, especially television, but also movies and popular music. Together with the increasing penetration of cable television and video cassette recorders in American homes, these electronic conduits for programming and for the marketing of products have become strong competitors to families, schools, and community institutions in shaping young people's attitudes and values about acceptable behavior, their perceptions of what kind of society they live in, their place in that society, and their expectations of the future. Even greater influences may emerge as the United States develops a high-speed global "in- formation superhighway," merging signals from telephone, television, high-capacity storage media such as CD-ROM, and multimedia computers into a single medium capable of transmit- ting and receiving enormous amounts of information. As the potential-both positive and negative-of these new media unfold, one fact is clear: cyberspace has the potential to trans- form education, health care, and many of the vital aspects of life, including the experience of growing up. Already, the personal computer-the gateway to this superhighway-is becom- ing commonplace among more advantaged families as an interactive, home-based source of consumption, entertainment, information, and socializing. For the near future, however, television's cheaper price, accessibility, and convenience virtu- ally guarantee its dominion in American homes and much of the world. Adolescents un- questionably spend a great deal of time watching television: twenty-two hours per week, on average, and for some individuals as many as sixty.¹ By the time they reach age eighteen, ado- lescents as a group will have logged more hours in front of the television set than they will have spent in the classroom.2 During this viewing time, the average child or adolescent will see about one thousand murders, rapes, or aggravated assaults each year.3 Overall, adoles- cents from lower-income households watch more television than those from higher-income households; indeed, young people who have the poorest life chances watch more television than any adolescent group. The greatest amount of television viewing takes place among children and young adolescents. It peaks at around age twelve and declines through the later teen years in response to increas- ing interest in competing media, such as radio and music, and to the demands of a social life.⁵ The question of what these younger adolescents are learning from these media should, there- fore, be of deep concern to their families and communities. 115 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS MEDIA'S IMPACT ON ADOLESCENTS One would have to ignore human learning capacities to suppose that media's saturation of the cultural environment has no effect on young minds. Producers of the programming and ad- vertisements for television, radio, and other media certainly believe it is in their power to influence adolescents, who now represent a $230 billion annual market. It is because television and radio advertising are such powerful forces in shaping behavior that tobacco and alcohol commercials, except for wine and beer, have been banned from the air. Our understanding of mass media's role in shaping adolescents' psychological development is still incomplete, but certain of its effects on the young have been established during decades of research. For example, research has shown that passive consumption of commercial televi- sion can lead to attention deficits, nonreflective thinking, irrational decision making, and con- fusion between external reality and packaged representations.⁶ One study of the influence of entertainment television found that frequent viewing of crime shows by adolescents in grades six through twelve led them to develop an image of a mean world in which people cannot be trusted. Such an image of social reality was associated with opposition to civil liberties for per- sons accused of crimes.⁷ Adolescents who spend more than five hours a day sitting in front of the television set are much more likely to be obese than their counterparts who watch less than one hour.8 The food products adolescents consume while viewing television are the same as those most ad- vertised on the screen, notably ones high in sugar, fat, or sodium. On the other hand, in ad- vertisements for beauty products, messages abound that in order to be accepted, girls must be thin and pretty. For some girls, the ideal of thinness contributes to the development of eating disorders such as bulimia and anorexia. There is, furthermore, considerable evidence that viewing a great deal of violent content can contribute to aggressive feelings and behav- ior. 10 Violent content itself is not the only problem. An equally important question is whether the programming deals with conflict and violence in a responsible manner.¹¹ Are there con- sequences, such as pain? Who is the aggressor-the hero or the villain? Were other options explored before the protagonists resorted to violence? Is nonviolent resolution of conflict se- riously portrayed? There is arguably an opportunity cost in the amount of time teenagers spend in solitary, pas- sive television watching. Young people glued to the television set are not participating in so- cial or cultural events, excursions, or outdoor games; they are not with church, school, or mu- sical groups. Studies also show a negative association between heavy viewing of entertainment television and academic achievement, particularly on reading tests.¹² Those who view greater amounts of television, moreover, are less likely to learn the social skills that are developed through group membership and physical activity. Commercial television scarcely touches upon the profound social transformations that have disrupted family life and worsened economic disparities, and it rarely explores seriously the ways that ordinary families are coping. Networks consistently avoid subjects that may be of ed- ucational value to adolescents, such as contraception, because they do not consider these sub- jects entertaining and because they fear these subjects might offend a segment of their viewers. 116 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Much of the attention regarding the impact of media on adolescents has focused on television. Hence, less is known about the impact of different forms of music and their lyrics, although speculation about their harmful effects is widespread.13 Even less well understood is the cyber- space experience that a growing number of adolescents are exposed to through the use of per- sonal computers at home or at school. The influence of what is called "virtual reality" (i.e., computers that involve the user in a multisensory experience of a simulated event) is so new that researchers can only speculate about its effects. The content readily available to adoles- cents through such media includes sexually explicit materials and those promoting alcohol, often disguised as infomercials. Video games tend to be exceedingly violent. MEDIA'S CONSTRUCTIVE POTENTIAL FOR YOUTH Despite the frequently cited negative influences of media on youth, never have the media had more potential than they do today to affect positively the lives of young adolescents. Clearly, television, video cassettes, music videos, video games, and, increasingly, computers provide interests and pleasures that are novel and attractive to teenagers and contribute to rising ex- pectations. Even if, as now used, they are often a distraction from school and other learning opportunities, they can also be powerful tools for teaching a wide range of cognitive and so- cial skills. They can promote compassionate understanding, nonviolent problem solving, and decent intergroup relations. They can portray human diversity while highlighting shared hu- man experience. They can provide models of healthy development in childhood and early ado- lescence that increase public understanding of what it takes to raise competent youth. Because personal computers are a growing presence in American homes, the opportunity to create programs that are educational and attractive is enormous. Health and educational pro- fessionals should seize this opportunity and collaborate with software designers to develop interactive programs that are enjoyable and educational and that actively engage participants. THE ROLE OF REGULATION The U.S. Federal Communications Commission requires that television networks broadcast educational children's programming as a condition of license renewal. However, the require- ments do not delineate how much of this programming must be broadcast, nor do they include content standards. As part of communications deregulation in the 1980s, television stations were no longer required to air public service announcements. Today, few stations or networks make an effort to provide quality children's programming. A coalition of public interest orga- nizations, including the Center for Media Education, is working toward requiring the networks to broadcast three hours of children's television per week. Decades of public debate have finally led American media industries to adopt certain self-regu- latory strategies that bear mention. Film and television entertainment executives have acted in re- cent years to avoid glamorizing alcohol, tobacco, and other drugs, although the industry's track record has not been consistent. Some local television stations have decided to limit children's ex- posure to advertisements for alcoholic beverages. Both the television cable networks and the video game industry have unveiled rating systems and advisories that will allow parents more control REDIRECTING THE PERVASIVE POWER OF MEDIA 117 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS over what their children watch.' 14 The Motion Picture Association of America has responded to public concern by releasing, for the first time, limited explanations of the reasons for its ratings of individual films. In addition, new technologies are being developed that could enable con- sumers to block out shows with specific unwanted content, such as violent programming. Despite three decades of public debate, films, television, and certain forms of music have be- come increasingly more violent and often demeaning of women and other groups. In the ab- sence of strong public clamor for change, there may be little that can be accomplished to di- minish the glamorizing of violence and irresponsible sex on the screens without provoking cries of censorship from the entertainment industry. However, censorship is a matter of gov- ernment action, not public pressure by private organizations. Recent surveys have shown that the public is unhappy with the increase in violent and sexually suggestive content and wants the industries involved to do more to regulate themselves.¹ Media could do much more voluntarily to promote healthy messages and to model health- enhancing behavior in their programs and advertising. But there is also much that parents, schools, and communities can do to educate the young about the nature of this pervasive influence in their lives. As the number of homes with access to the information superhighway grows, efforts to regulate the content of electronic networks, such as the Internet, are likely to increase. By and large, this process is not likely to come from government but rather through industry self-regulation and vigorous debate in a free society with wide latitude for public crit- icism of dangerous practices. INCREASING MEDIA LITERACY FOR THE INFORMATION AGE Knowledge of media production, and especially of the ways commercial messages are shaped and used to manipulate audiences, may help protect young adolescents against strong advertising pres- sures to smoke, drink, have sex, or eat unhealthy foods. 16 Such knowledge also may help counter the development of social or peer norms that reinforce and maintain unhealthy behavior. Parents should watch television shows with their children and initiate family discussions about the messages that are being communicated. Schools would do well to introduce instruction and activities that contribute to media literacy. Training in media literacy skills can be included in community and youth development programs during the out-of-school hours. Settings for tele- vision viewing that both encourage social interactions and imbue teenagers with critical habits of mind can help them become effective users of technology, restoring personal control. Media literacy is a required part of the language arts curriculum for grades seven through twelve in Great Britain, Canada, Australia, and Spain. In contrast, teacher education, curricula, and community centers aimed at fostering media literacy in the United States are in their infancy. In many American communities, individual teachers are implementing media literacy programs in their classrooms, but district-level or statewide programs are rare. The State of New Mex- ico has adopted media literacy as a basic skill and pioneered a comprehensive media literacy program from kindergarten through grade twelve. North Carolina has included media literacy in both its English and information skills curricula. Efforts such as these deserve widespread consideration in schools and community organizations as an essential part of becoming a well- educated citizen. PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS At the threshold of the twenty-first century, media Advocates for Youth is a Washington, D.C.-based or- are an ever more pervasive presence in the lives of ganization that works to increase the opportunities Media young adolescents. As heavy users of television, ra- for youth to make sound decisions about sexuality. dio, film, and computers, adolescents are aggres- Advocates for Youth created The Media Project in re- Literacy: sively targeted as a profitable consumer market by sponse to the sexual content in music videos and advertisers. Their lives are saturated with entertain- lyrics. Based in Los Angeles, The Media Project pro- A Basic ment and advertising. Their capacity to make sense motes responsible portrayals of sexuality in the en- of messages from this array of powerful sources of tertainment media. The Project works with media Skill in the influence is essential to their development. professionals by sponsoring informational events and offering free consultation services to writers, Information MEDIA LITERACY producers, critics, and others. One of the project's publications, the annually produced Talking with TV, Organizations such as Mediascope (discussed in this outlines the plots of television shows aimed at ado- Age chapter) and the Center for Media Literacy have lescents and suggests ways for adults to engage been longtime advocates of education for critical adolescents in honest conversation about these media literacy. These organizations produce books, shows. videos, and lesson plans for parents to teach their children about the media and for teachers to create Girls, Inc. developed a four-part curriculum with the media literacy curricula for their students. The As- Center for Media Literacy called Girls Re-Cast TV, to sembly on Media Arts and the Commission on Media, teach girls to identify and counter gender biases in both parts of the National Council of Teachers of Eng- the media. This curriculum is designed to teach girls ages eleven to fourteen to recognize and understand lish, have worked to make media literacy part of the national English curriculum. The efforts of these or- stereotypes and other messages in the media. Ac- ganizations have inspired the inclusion of media lit- cording to Isabel Stewart, executive director of Girls, Inc., "Female characters of all races, ethnicities, and eracy education programs both in and out of school. abilities are still outnumbered by male characters The Girl Scouts of the USA offer three badges in three to one in prime time [television] and four to one media literacy and communication: "Do You Get the in children's programs; behind the cameras, the num- Message?," "Basic Audiovisual Production," and bers are even more discouraging." This program also "Communication Arts." To earn these badges, scouts offers the opportunity for girls to become involved in complete activities in which they learn about com- local media production and to learn about careers in puters; producing films and videotapes; analyzing ad- the media. vertisements in magazines, newspapers, and televi- Collectively, the various media are among the most sion; and critiquing movies and television programs. These activities include recognizing gender and pervasive influences in the lives of young adoles- racial stereotypes in the media. cents. Media literacy education provides the oppor- tunity for young adolescents to be active, critical consumers of media's messages. Together with fam- ilies, community organizations, and schools, media- savvy adolescents may shape their own media envi- ronment in the next century. REDIRECTING THE PERVASIVE POWER OF MEDIA 119 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS FOSTERING COOPERATIVE CONSULTATIONS WITH THE ENTERTAINMENT INDUSTRY Efforts to bring together professionals in media, health, education, and adolescent develop- ment on a regular basis to discuss the responsible depiction of violence and of sexual rela- tionships have made some headway in the media entertainment industry. These efforts have led to more responsible depictions, but much more is required. A model for future coopera- tive efforts is the work of Mediascope and Advocates for Youth, nonprofit organizations that work with media professionals. Conferences and educational programs provide opportuni- ties for media leaders and independent experts to cooperate in support of positive adolescent development. As a result of such linkages, prosocial television programs such as DeGrassi Junior High and In the Mix have made serious efforts to address family conflict, emotional and physical abuse, drug abuse, AIDS, depression, and sexuality. Such successes offer some basis for hope, but the connections made must be sustained in an ongoing way for many years. MEDIA AS PART OF COMPREHENSIVE HEALTH PROMOTION CAMPAIGNS Media have been successfully involved in community-wide health-promotion campaigns to prevent cardiovascular disease and to reduce the consumption of legal and illegal drugs.¹⁷ Us- ing a public health approach, these campaigns use television, radio, and print media, supple- mented by direct interventions in community organizations and schools, to inform target au- diences about risk-reducing behavior and to support individual efforts to achieve healthier lifestyles. Interventions range from the broadcast of public service announcements on radio and television to the distribution of kits on weight loss and smoking cessation. Research and experience have shown that public service announcements alone have limited impact on behavioral change.¹⁸ In the context of broader efforts, however, they can be valu- able in directing viewers or listeners to additional sources of specific information and action. Media can be used to familiarize audiences with health-enhancing behavior, to promote prod- ucts and services that foster health, and to encourage audiences to call, write, or participate in health-promotion programs. MEETING THE CHALLENGES OF THE INFORMATION SUPERHIGHWAY The media and entertainment industries can do much more to capitalize on their potentially positive influence on the learning, competence, and character of young adolescents. They are also one of this nation's most potent forces for improving public understanding about the requirements for positive youth development. They can join families, schools, community organizations, and health care agencies to enhance knowledge, skills, and health-promoting behavior in the young and to provide positive role models for future generations of youth who look to the media for adult images. 120 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Connecting the Media and Adolescent Development Professionals Mediascope, headed by Marcy Kelly, emerged from For school and university classrooms, Mediascope a series of seminars and meetings organized by the has produced "The Kids Are Watching," a short film Carnegie Council on Adolescent Development to dis- on children's reaction to what they see on television CUSS the impact of the media on young people. Me- and in films. Typical of children's comments, Zack, a diascope's mission is to work with media profession- twelve-year-old participant in the program, said: "I als in an effort to reduce violence in television, film, don'tremember (its name]. It was a really gross movie music, video games, and other entertainment and and there's parts in it where they wrap bodies in foil news presentations. The organization has sponsored and then light it on fire, you know, and then I got a lot many informational forums with Hollywood-based or- of scary things like that, and I get a lot of scary night- ganizations such as the Writers Guild of America, the mares." The video also exposes the marketing to chil- Directors Guild of America, the American Film Insti- dren of toys inspired by R-rated violent movies. It in- tute, and the Caucus for Producers, Writers, and Di- cludes interviews in the Los Angeles Central Juvenile rectors. These meetings offer creative people in the Hall, a correction facility, with adolescents who have industry opportunities to confer with professionals in committed violent crimes. adolescent development, the behavioral and social Mediascope is developing an ethics curriculum on sciences, health, and violence prevention. Working violence to be used in courses that train 64,000 film with a variety of entertainment industries, Medias- students who hope to become movie makers. In 1992, cope is also developing voluntary guidelines and rat- the National Cable Television Association contracted ings that address violent content. with Mediascope to serve as an independent moni- Kelly's approach is to persuade the entertainment in- tor to analyze and report on the level of violence on dustry to deal with conflict and violence in a respon- television. Mediascope, in conjunction with four uni- sible manner rather than to eliminate conflict from versities, is monitoring the entire television industry the screen. She believes that the media can serve as to assess several issues, including the gratuitous use a positive influence on human behavior. As exam- of violence, responsible scheduling, and the use of ples, she cites television's and the movies' virtual ratings and advisories. An annual report will be is- elimination of cigarette smoking on the screen and sued to give consumers a tool to help them make the news media's effective presentations on healthy more informed choices about what they and their diets and physical exercise. families watch. The presidents of the American Psychological Asso- Mediascope's services and resources are used by ciation, the American Academy of Pediatrics, the screenwriters, journalists, researchers, producers, American Psychiatric Association, and the Society critics, educators, media executives, members of for Adolescent Medicine have enlisted Media- Congress, professional associations, and students. scope's aid in sending a letter to 125 board chairs, chief executive officers, and other entertainment in- dustry leaders, offering them assistance in reducing the harmful effects of media-produced violence. REDIRECTING THE PERVASIVE POWER OF MEDIA 121 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Promoting the Constructive Potential of the Media An ever-expanding array of media bombard adoles- Use the media for comprehensive health promo- cents with messages that shape adolescent opinion tion campaigns. Successfully influencing young and behavior. The power of the media can be used people's attitudes and behaviors requires a consis- constructively in the lives of young people. Educa- tent message from all the social institutions that tors, families, and others can help enhance the con- touch young people's lives. Families, schools, health structive potential of the media in the following ways: care agencies, community organizations, and the Encourage socially responsible media program- media must all work together to promote messages ming. Three decades of research point to a consis- that encourage healthy behavior. Community-wide tent, causal linkage between exposure to violence on campaigns using public service announcements in television and aggressive behavior in children and the television, radio, and print media have success- adolescents. Violence is not the only issue, however. fully promoted smoking cessation and physical fit- The media also shape adolescents' views of every- ness among adolescents. The entertainment indus- thing from gender, ethnic, and occupational roles to try has particular power when it comes to influencing standards of beauty, family life, and sexuality. Writ- behavior; movie makers should be persuaded to de- ers, producers, directors and executives should rec- pict health-enhancing behavior on the big screen. ognize how important positive images are and work Expand opportunities to include young people's with experts on child and adolescent development so views in the media and to involve them in media that such knowledge can be taken into account. production. Media should increase the number of Support public efforts to make the media more ado- young voices in their publications and programs lescent friendly. American media basically regulate through the publication and broadcast of editorial themselves when it comes to their influence on chil- opinions, news stories, and videos written or pro- dren and adolescents. Some film and television per- duced by young adolescents. Some schools have sonalities, for example, try not to glamorize the use shown that this can be a useful part of education. of tobacco, alcohol and other drugs. Yet much more is needed. For example, every other Western nation has stronger regulations than the United States to foster educational programming for children. Make media literacy programs a part of school curricula, of youth and community organization activities, and of family life. Adolescents absorb a very large number of media messages every day, yet many lack the skill to analyze and evaluate those messages critically. Designed to help young people identify the media's underlying assumptions about the world, training in media literacy should cover the whole spectrum of contemporary media-including newspapers, magazines, radio, television, videos, music, computer programs, and electronic games. 122 PREPARING ADOLESCENTS FOR A NEW CENTURY EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS The emergence of a new digital electronic world via the information superhighway provides unprecedented opportunities to shape policies and practices to ensure that all children and adolescents have excellent opportunities in the next century. On-line computer and cable ser- vices already are becoming highly commercialized, and efforts to assure equitable access to in- formation technology by all young people will be essential in our democratic society.¹⁹ Wide- spread public education about the positive potential and the negative consequences of leading-edge communications technologies must be a high priority. Further Reading Aufderheide, P. (1992). Media literacy: A report of the national leadership conference on media literacy. Washington, DC: The Aspen Institute. Christenson, P. G., & Roberts, D.F. (1990). Popular music in early adolescence. Washington, DC: Carnegie Council on Adolescent Development. Flora, J. A. (1990). Strategies for enhancing adolescents' health through music media. Wash- ington, DC: Carnegie Council on Adolescent Development. Minow, N. N., & LaMay, C.L. (1995). Abandoned in the wasteland: Children, television, and the first amendment. New York: Hill and Wang, Inc. Strasburger, V.C. (1995). Adolescents and the media: Medical and psychological implications. Newbury Park, CA: Sage Publications. REDIRECTING THE PERVASIVE POWER OF MEDIA 123 EMBA GOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORR CTED PAGE PROOFS EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EPILOGUE Looking to the Future: Sustaining the Council's Perspective DAVID A. HAMBURG About a decade has passed since I proposed to the board and staff of Carnegie Corporation that we establish a broad-based body to consider the problems of adolescent development. This report draws that effort to a close. It is appropriate to reflect briefly on some ways in which the main thrust of the Carnegie Council's work might be carried forward in the years and even decades ahead. A long-term view is essential because we are necessarily considering difficult, indeed fundamental, changes in modern society to improve the life chances of young people. First, let me express my heartfelt gratitude to the members of the Carnegie Council on Ado- lescent Development; to its executive director, Ruby Takanishi; and to the members of the staff working group and Council staff. These wonderful people are noted in the acknowledgments, and they deserve far more recognition than this report gives them. They are authentic leaders of diverse sectors and have contributed in many ways to the Council's accomplishments. Let us keep in mind the essence of what the Council has done and why its work is likely to mat- ter for a long time. At the outset, we made a strategic decision to focus squarely on early ado- lescence (ages ten to fourteen), a phase of life that is crucially formative for the entire life span and that has been badly neglected throughout most of the world.¹ Early adolescence is a time of biological transformation and social transition, characterized by exploratory behavior, including risky behavior that has lifelong consequences. Many dan- gerous patterns commonly emerge during these years. Initially, adolescents explore these new possibilities tentatively with the experimental attitude that is typical of adolescence. Before damaging behavior is firmly established, therefore, there is a unique opportunity to prevent lifelong casualties. Today's adolescents have grown up in a situation rather different from that of their parents and remarkably different from that of their grandparents. The technological world we take for granted-saturated with airplanes, telephones, radios, movies, television, computers, fax ma- chines, compact discs and video cassettes-was much simpler a few decades ago. The techno- logical changes linked to economic opportunities have had a huge impact on communities and on families. These changes, in turn, have had powerful effects on children and young people. 125 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Dramatic changes also have occurred in the structure and function of American families in just a few decades. Although some of these changes represent new opportunities and bring tangi- ble benefits, others involve serious jeopardy to the well-being of children and adolescents. The latter are common and serious enough to constitute a major challenge for the entire society. In light of the new social conditions that have a strong impact on the experience of growing up, we must find different ways to meet the essential requirements for effective child and ado- lescent development-not only through the family but also through a set of pivotal institutions that have significant influence on the ultimate results. This report describes ways in which these institutions, starting with the family, can do what needs to be done in a world still re- lentlessly in transformation. Let us look at what the Council actually did, so that we can consider whether certain functions ought to be continued in future years, and if so, by whom. The Carnegie Council on Adoles- cent Development, composed of leaders from various sectors of American society, drew to- gether the most reliable information about adolescent development, including health, educa- tion, and the social environment. It tackled serious adolescent problems by seeking preventive interventions based, to the extent possible, on systematic research and also on careful assess- ment of creative innovations. Thus, best practices were identified and their improvement sought in an ongoing way through research and development. Efforts in this field have long been plagued by professional divisions among health, educa- tion, and social service systems and by the lack of communication among people engaged in each of the individual problem domains. Similarly, there is a gap between scholars and those who run programs for young people. The result is that scholars are deprived of the direct ex- perience of practitioners, while innovative approaches go unevaluated and their potential util- ity for other settings remains unknown. Consequently, many local organizations continue to pursue approaches that are plausible but lack evidence of effectiveness. Finally, there is a gap between all these people and the general public, especially parents, who in dealing with their adolescent offspring lack the kind of guidance that is widely available to them concerning younger children. There has been no bright spotlight on adolescent development in the policy arena, no broadly integrative center for taking stock of existing approaches and stimulating new ones, no one in- stitution where the different sectors of American society come together to pool their efforts in this field. To fill this gap, the Council established three main objectives: (1) to synthesize ex- isting reliable information and make it widely available in intelligible form; (2) to extend this information beyond its present limits by stimulating crucial lines of research and innovation; and (3) to use reliable information more effectively by connecting the research arena with prac- titioners, policy makers, and the public. Toward these ends, the Council stimulated diverse activities: studies; task forces; publications; local, national, and international meetings; working models; cooperative efforts among grant- making agencies; and linkage of independent experts with policy makers and the public. The Council is part of Carnegie Corporation's integrated, life span strategy from conception through the adolescent years, a strategy that aims to foster every child's chance for productive 126 EPILOGUE EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS adult life. A 1994 Corporation report, Starting Points, focused on the prenatal period through age three*; the Council's work highlighted early adolescence from ten to fourteen years of age. In 1996, the Corporation's Task Force on the Primary Grades will bridge the gap between ages three to ten with its recommendations for education and healthy development during the mid- dle childhood years. A common thread woven through all of these activities is meeting the de- velopmental needs of children and adolescents through potentially supportive institutions such as families, schools, health agencies, community organizations, and the media. This major Corporation effort will continue in the years ahead. The main lesson learned from the Council's experience is the importance of serious, careful examination of the facts, non- partisan analyses, broad dissemination with involvement of key sectors, and sustained com- mitment over a period of years. Are there elements of the Council's work that should be continued by others in the years ahead? Presumably, some of this work will go on in ways that we cannot now foresee. The reports of the Council, including this one, are widely available and may well have continuing repercus- sions. They form a set of to-whom-it-may-concern messages, which should be of particular in- terest to the pivotal institutions and may set in motion efforts to strengthen these institutions. WHAT BUSINESS AND GOVERNMENT CAN DO The Council's findings and recommendations challenge other powerful institutions that can be singularly helpful-business and government, for example. Moreover, this final report and some of the Council's earlier reports connect with an informed, concerned public that can help the pivotal institutions do their jobs better.3 The business community can help schools and community organizations for youth in several ways: directly, by providing money, people, or both to implement recommendations made in this report;4 indirectly, by using its considerable influence through community leadership on behalf of youth and through its impact on government at all levels. In addition, it can make its own policies and practices as family friendly as possible.⁵ Another way that business can have a powerful influence is by choosing not to support violent or sexual shows with its advertising dollars. A focal point in the business community for youth development studies also could be exceedingly helpful. The work of the Committee for Economic Development on younger chil- dren and on the modern workforce provides a useful model.6 There is a growing consensus in the business and scientific communities that it is urgent to im- prove education in order for the United States to be able to compete effectively in a world econ- omy being transformed by technological advances. If so, what is the federal role? The role of the federal government in protecting the health of the American people is a large one, ranging from the biomedical and behavioral research of the National Institutes of Health, to the health services of Medicare and Medicaid, to the disease prevention activities of the Cen- ters for Disease Control and Prevention. A modest but highly significant portion of these fed- eral expenditures focuses on children and youth. Early adolescence, crucial as it is for lifelong health, has been neglected historically in federal efforts but has recently gained some attention. EPILOGUE 127 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS One direct outgrowth of the Council's work, made possible by its Congressional members and especially the leadership of Senator Daniel K. Inouye, is the creation of an Office of Adoles- cent Health in the U.S. Department of Health and Human Services.⁷ When it comes to education, the federal role has traditionally been small. This fact changed under the impetus of World War II, again with Sputnik, then with the civil rights movement, and now is being reconsidered in light of the drastic, technology-driven changes in the world economy. Somehow, the powerful institutions of American society, such as federal and state governments and the business community, must address education issues of immense practi- cal significance. These issues include The national interest in promoting economic vitality and growth; hence, the need for a work force with education adequate to the sophistication of contemporary and future technology.8 A workforce composed increasingly of the children of immigrants, poor families, and minori- ties and the weak performance of the educational system in working with these groups. Disappointing results for students generally in such areas as mathematics, science, and prob- lem-solving skills. Ineffective school structures characterized by rigid and extensive regulations, compartmental- ization, and top-down management; hence, the need for leadership in judicious deregulation and for strengthening the teaching profession, which is central to the enterprise.⁹ The growing need-far exceeding previous requirements-to build the understanding of sci- ence and technology throughout the educational system to prepare children and youth for a technically based economy and for intelligent participation as citizens in a world full of complex issues.¹⁰ Serious analytical work and thoughtful national discussion is needed to sort out priorities for federal and state action. State education policies have neglected adolescence. If there is indeed a crisis in education and if education is crucial for the future of our economy and democratic institutions, then we have to determine what must be done and who can do what. In our plu- ralistic and creative way, we surely can sort out sensible guidelines for state and federal action as well as constructive roles for other sectors. This activity should not be highly partisan, bit- terly ideological, or narrow in scope. It should address realistically the problems our young people face and should formulate practical options. It should recognize the gravity of these problems and the fact that potentially valuable opportunities do indeed exist to tackle them and that all sectors, public and private, must find ways to contribute in an open-minded spirit, looking to the future of our country. WHAT UNIVERSITIES, SCIENTIFIC INSTITUTIONS. AND PROFESSIONAL ORGANIZATIONS CAN DO Universities, scientific institutions, and professional organizations might well pursue specific functions performed by the Council: illuminating the problems and opportunities of adoles- cent development, getting the facts straight, fostering objective analysis, and recognizing the implications for practice, policy, and social action. Let us briefly consider a few examples. 128 EPILOGUE EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS America's universities are recognized throughout the world as outstanding institutions of truly global significance in education and research. The attributes that have earned such respect in- clude: high standards of science and scholarship; free and open inquiry; objective methods of assessing information, ideas, and people; respect for diversity in people and subject matter; serious attention to opportunities for young people; broad scope of coverage of subject matter on an in-depth basis; a premium on the advancement of knowledge; and a sense of social re- sponsibility. These strengths can be brought to bear on child and adolescent development-a fundamen- tal subject if there ever was one. Universities could vigorously stimulate interdisciplinary re- search and education on these topics; publish periodic syntheses of knowledge-not only for technical-professional audiences but also for a broader educated public; actively undertake education beyond the campus in view of the pervasive interest in these problems; link inde- pendent experts with policy makers in government, with business leaders, with responsible media or with all. Universities and scientific academies can mobilize a wide range of talent to address great is- sues in a sustained and effective way. They can get the complex facts straight and clarify the most promising options in a way that is credible and intelligible to nonspecialists. Such efforts can be helpful to open-minded policy makers and also can contribute to the education of a well- informed public. To deal effectively with real-world problems requires novel conjunctions of knowledge and tal- ent. Many facets of a complex problem must be taken into account. The great problems do not come in packages that fit the traditional disciplines or professions, however excellent they may be. Organizations such as universities and scientific academies can make a greater contribu- tion than they have in the past if they can organize effectively to share information, ideas, and technical abilities widely across traditional barriers of disciplines. The opportunity is clear in this field where biological, psychological, and social factors interact in shaping adolescent de- velopment. There is an ongoing need to clarify gaps in knowledge, priorities, and scientific opportunities for research-both on fundamental aspects of adolescent development and on the utility of var- ious interventions intended to prevent damage. From 1990 to 1994, the Council conducted an- nual symposia on research opportunities in adolescence.¹¹ The first symposium dealt with ba- sic developmental processes during adolescence and with the influence of various institutions on that development. The second examined research gaps and scientific opportunities for im- proving the education and health of adolescents. The third addressed concepts of and ap- proaches to health promotion in adolescence. The fourth focused on relations among ethnic groups during childhood and adolescence. These symposia were remarkably well attended by leaders of both public and private grant- making organizations, including the National Institutes of Health, the National Science Foun- dation, and private foundations. They covered a broad spectrum of biomedical, behavioral, and social science research and have a distinguished track record of accomplishment in many fields. The Council's symposia evidently had a stimulating effect on their commitment to re- search in adolescent development. For example, there appeared to be substantial recognition EPILOGUE 129 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS that research in this field constitutes a great frontier for public health, because even modest gains in meeting the essential requirements for healthy adolescent development are likely to be projected through the lifespan. Such gains for a significant portion of the population would produce for the public a net benefit of considerable importance. The experience with these re- search symposia suggests that similar efforts undertaken by scientific organizations such as the National Academy of Sciences could do much to foster intellectual vitality and sustained com- mitment to research on adolescence, including the main factors that influence learning and healthy development. Professional organizations are composed of large numbers of respected and dedicated people who can have a strong impact on adolescent development. There have been encouraging signs of interest by these organizations in recent years, facilitated by the Council's work and in some cases by grants from Carnegie Corporation. For example, the National Board for Professional Teaching Standards has given a high priority to developing sophisticated assessment proce- dures for teachers who work in early adolescent education. This effort is likely to inspire teach- ers and could in due course greatly strengthen the capability of middle grade schools. 12 Sim- ilarly, the American Medical Association (AMA) undertook a remarkable initiative on adolescent health, one that has been sustained over a period of years.¹³ The AMA'S effort has produced im- portant publications, one of which is summarized in this report. It has held a variety of meet- ings and has had a constructive effect not only on medicine but also to some extent on other health professions. It is not difficult to imagine other efforts similar to these two. For instance, educational orga- nizations could pursue the recommendations of Turning Points on a systematic basis and also foster links between schools and other useful entities: community organizations, along the lines suggested by A Matter of Time; organizations of the health sector, to pursue the recommenda- tions of the health chapter; and scientific organizations, to strengthen science education. In the same vein, other health professional organizations could follow up on the American Med- ical Association's initiative, especially to build links with middle grade schools but also to build links with the media for health promotion. Such activities could provide vital foci of innova- tion in many communities.¹⁴ MOBILIZING COMMUNITIES FOR YOUTH At a Carnegie Corporation meeting in 1994, John Gardner discussed American renewal and made this suggestion: Let us persuade our fellow Americans that they-as citizens- have to move with energy and discipline to solve their problems, bringing to bear all the dynamism that the American people are capable of when they put their hearts into something. Let us tell people that there is hope. Let us get the word out about the good grass-roots problem solving that is going on. Let us tell them that there is hard, hard work ahead if we are to put our country back on a good track-and there is a role for everyone. Let us tell them that there are innu- merable ways in which they can help build community, help the young and the old, help reduce the tensions that lead to conflict.15 130 EPILOGUE EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS In this spirit, a number of attractive possibilities arise. If there is a concerted effort across differ- ent sectors, it would be possible to mobilize communities to support adolescents and their fam- ilies. With a combination of informed leadership and vigorous grass roots organizing, it would be possible to focus the attention of most communities on the needs of adolescents and their families by initiating a community-based strategic planning process. We could create commu- nity councils for youth, with active participation of relevant professionals, business and media leaders, local organizations, and adolescents themselves. Such councils would carefully assess local needs, formulate useful interventions, and inform the entire community about problems and opportunities. Participation of local media would be important. Governments at local, state, and federal levels could remove the obstacles faced by communi- ties in their attempts to provide more effective services and otherwise open up opportunities for healthy, constructive adolescent development. Mechanisms could be established at the state level to formulate comprehensive policy and program plans that focus on the second decade of life and to help communities translate these plans into action. As a practical matter, it will be necessary to achieve cooperation among several institutions in a particular community. The mix might well differ from one community to another. Schools, universities, clinics, social service agencies, the media, churches, business, community orga- nizations, government at various levels, and professional organizations-all could be highly constructive in cooperative efforts for youth development. Any such combination of institutions could serve several valuable functions. They could Clarify the nature of child and adolescent problems Stimulate interest and hope in the possibility of useful interventions Help families meet their fundamental responsibilities Facilitate the delivery of appropriate services Provide resources-not only money but also people, organization, and technical skills Organize a steady flow of reliable and up-to-date information about what works and for whom in fostering adolescent development The past decade has seen the rapid growth of links between schools and the nation's colleges and universities, business organizations, and a great variety of community organizations. Such partnerships are situations of mutual benefit for the schools and the cooperating organiza- tions, but they are not sufficiently extensive. They do show what can be done by pooling strengths. Crucial components exist all across the country and in other nations as well. We can learn how to put these components together in ways that provide adolescents with the full range of de- velopmental opportunities permitted by today's knowledge and emerging research findings. EPILOGUE 131 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS EXEMPLARY COALITIONS FOR CHILDREN AND YOUTH A variety of innovations involving cooperation among various sectors of American society have arisen in recent years to address adolescent needs in education, health, and the social envi- ronment. Here are a few examples at different levels of organization: state, county, and city. WHAT STATES CAN DO Turning Points marked the beginning of Carnegie Corporation's effort to stimulate nationwide reform of American middle grade schools. The report offered a plan of action for transform- ing middle grade schools into learning environments suited to the needs of young adolescents and equal to the challenges of a rapidly changing world. To date, approximately 86,000 copies of the full report and 185,000 copies of the abridged version have been distributed. In 1990, Carnegie Corporation initiated the Middle Grade School State Policy Initiative (MGSSPI), a program of grants to states to stimulate statewide changes in middle grade educa- tional policy and practice. The MGSSPI is a useful example of what states can accomplish in co- operation with the private sector. The states' work to reform middle grade education has pro- duced impressive results. Fifteen states currently receiving Corporation support are actively implementing comprehensive middle grade policies reflecting Turning Points. Schools in sev- eral states report impressive gains in student achievement over the past few years. The states have employed a variety of sophisticated methods to assist schools. The Corporation has funded two research studies that together serve as an evaluation of the MGSSPI, and the results of the evaluation are encouraging. In general, the more extensive the implementation, the bet- ter the results. State policies and practices can indeed make a constructive difference. WHAT COUNTIES CAN DO A county initiative in North Carolina, called Smart Start, rallies local energy on behalf of chil- dren.¹⁶ Although Smart Start does not deal with adolescents, it demonstrates how such an effort can be effectively organized at the county level. It aims to provide high-quality child care, health care, and other critical services to every child in the state under the age of six. Guided by the North Carolina Partnership for Children, a nonprofit, nonpartisan organization established by the legislature, Smart Start allocates money to selected counties that have achieved a manda- tory first step: bringing together a broad range of individuals in the interest of children. Collaboration is key. The bylaws of the Partnership designate nineteen community members who must serve on local boards, including the superintendent of schools, two business lead- ers, two members of low-income families with preschool children, the president of a local com- munity college, one representative of the religious community, a Head Start representative, and the director of the local health department. The local partnerships have the freedom to create plans that will serve the specific needs of their community. State investment has been substantial and the level of cooperation across sectors has been impressive. Similar efforts could be made on behalf of youth, organized by counties in collaboration with state governments and the pri- vate sector. 132 EPILOGUE EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS WHAT CITIES CAN DO Effective antidrug coalitions draw on the strength of powerful local businesses, churches, uni- versities, and foundations. Kansas City's Metropolitan Task Force on Alcohol and Drug Abuse builds on the success of its comprehensive community prevention program, which engages the city's schools, media, and civic leadership. This program, called STAR, provides financial and technical support for the task force.¹⁷ STAR works with local residents to discourage drinking and drug use among young people; it conducts training sessions for parents, community lead- ers, and concerned citizens. These groups explore their own attitudes toward drugs and study ways in which individuals can make a contribution to preventing substance abuse in the com- munity. Community coalitions channel citizens' concerns into efforts that require active participation, connecting people to one another and to their communities in new ways. These activities gen- erate intense energy as coalition members discover they can have an impact on important and difficult problems. This sense of mission and efficacy is critically important in overcoming the hopelessness and apathy that often inhibit communities. The Kansas City coalition shows the value of strong participation by a critical mass of local leadership-a foundation, academic and business organizations, and civic and religious groups. Although involvement of local governments is useful, these coalitions are largely volunteer efforts. They depend on the commitment of their members and the leadership of a few highly dedicated individuals. Sustaining that commitment over years is a crucial task. Coalitions of- ten respond by creating a small professional staff to organize long-term efforts. Fundamentally, these efforts must engage different sectors of the community in a common cause, led largely by respected volunteers who care deeply about the future of their community. What has happened in Kansas City suggests the potential of community coalitions for youth. A more recent effort has been undertaken in Chicago, where in 1993 the mayor appointed a group of twenty community, corporate, academic, and civic leaders and young people to the Mayor's Youth Development Task Force. Over a year's time, the task force gathered informa- tion from diverse perspectives: community organizations, religious leaders, corporate leaders, youth experts, and young people themselves. The task force decided to concentrate on the op- portunities available to school-age children during non school hours in the spirit of the Coun- cil's report, A Matter of Time. The task force called for rewriting the social contract with youth, spelling out clear roles and responsibilities for various sectors: community groups and religious organizations; businesses and foundations; local, state, and federal agencies; parents; and young people themselves. In its "Chicago for Youth" report, the task force proposed "Blueprints for Change."18 The report was followed by the creation of a Chicago for Youth office to promote coordinated neighbor- hood efforts on behalf of youth and families. Funds were provided to create a strong infra- structure for youth development. Ongoing support and commitment by city government, busi- ness, and community organizations will be critical to the success of this citywide youth development approach. EPILOGUE 133 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS These illustrations are merely suggestive of what might be done. Similar efforts have recently been undertaken in different parts of the United States and in other countries as well. Such in- novations require monitoring, assessment, learning from experience, and upgrading in the years to come. Participants in these efforts can profit from the Carnegie Council's experience of intersectoral collaboration for youth. New Council-like bodies may spring up to stimulate and guide such efforts. WHAT INTERNATIONAL ORGANIZATIONS CAN DO The Council's work has elicited interest in a variety of countries. The Council has cooperated with international organizations to create forums in which leaders from many fields could fo- cus on early adolescence, clarifying the urgency of the problems, the likelihood of exacerba- tion in the midst of drastic ongoing social and economic changes that powerfully affect fami- lies and communities, and opportunities for fostering healthy adolescent development and preventing damage.¹⁹ International organizations involved have included the Johann Jacobs Foundation,20 the World Health Organization, and UNICEF. The distribution of this report, additional grants made by Carnegie, and ongoing activities of the Council members and staff will continue to have stimulating effects on many people in many places. As the importance of adolescence is increasingly understood, many people will collect new data, see new opportunities, and have better ideas. Perhaps the most significant contri- bution of the Council in the long run will be to set in motion an ongoing, far-flung process of building on its work and of moving far beyond it. INVESTING IN OUR FUTURE The United States is suffering heavy casualties during childhood and adolescence- in edu- cational failure, poor health, and very high-risk behavior. Generally, these casualty rates are considerably higher than those of other technically advanced democracies, although similar problems exist in many countries. Given the heavy and growing burdens of disease, disabil- ity, ignorance, incompetence, hatred, and violence, the Council has mobilized a wide range of research evidence and carefully assessed innovations to determine what could be done to reduce the casualties and thereby improve the whole society. In this report, we describe and illustrate a substantial set of experiences, opportunities, and services that could make a large difference in the lives of today's youth-changing the odds favorably for a healthy and pro- ductive adult life. To do so, we have had to make judicious use of existing evidence while wishing that a more extensive base of scientific evidence had been available. Clearly, the low priority in science pol- icy for research on adolescent development has been a costly mistake. If the nation had given this work a priority commensurate with the gravity of the problems and the scope of the op- portunities inherent in adolescent development, we could stand on firmer ground and reach higher in our aspirations. Still, there is no reason to let the perfect become the enemy of the good. The central question is whether we can do better than we are doing now. The social costs of severely damaging con- 134 EPILOGUE EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS ditions that shatter lives in adolescence are terrible not only in their impact on individuals but also in effects that damage the entire society-the costs of disease and disability, ignorance and incompetence, crime and violence, alienation and hatred. These distorted lives are like a virus that knows no boundaries, that cannot be contained unless prevented in the first place. Look- ing back over the range of evidence and experience presented in this report, there is abundant reason to believe that we can do better to provide conditions in which adolescents can grow up healthy and vigorous, inquiring and problem solving, decent and constructive. What will it cost? A constructive sequence of developmental opportunities based on scientific evidence, professional experience, and democratic, humane values will indeed require sub- stantial investment by parents and many others. The first and most crucial investment goes be- yond economics: it deals with decent human relationships that are the essence of human adapt- ability. This profound investment calls for adults to give personal attention, energy, and care to children and adolescents to provide dependable attachment, protection, guidance, stimu- lation, nurturance, and ways of coping with adversity. To a large extent, these are family in- vestments, both personal and economic. But it takes a social support system, a village, a com- munity to raise children effectively and to successfully foster the adolescent's transition from childhood to adulthood. So there will necessarily be expenditures by institutions and indi- viduals beyond the family if we are to provide good life chances for all our youth. The expenditures required for optimal child and adolescent development are not all added ex- penses but can be achieved to a considerable extent by wiser use of existing funds. Large amounts of money are now spent for these purposes. Much of this current spending could re- sult in improved outcomes if redirected by the approaches described in this report. For ex- ample, improving poorly functioning school systems by reducing inflated administrative struc- tures often would cost less than we are now spending. Some new investment certainly will be required, the cost of which must largely be determined on a case-by-case, place-by-place ba- sis. Yet the total economic and social costs associated with present youth-related casualties probably could be greatly reduced. These costs have many facets: economic inefficiency, loss of productivity, lack of skill, high health care costs, growing prison costs, a badly ripped social fabric, and a great deal of human suffering. One way or another, we pay heavily. Preventing the damage now occurring would have a powerful social and economic impact. These vital investments in prevention have to be viewed as a responsibility of the entire soci- ety. It is the task not only of the federal government but also of other levels of government; not only of business but of labor; not only of the public sector but of the private sector, both non- profit and for profit. We are all in this great leaking boat together. Wise investment in human and social capital is the most fundamental and productive invest- ment any society can make. The vitality of any society and the prospects for its future depend in the long run on the quality of its people, on their knowledge, skill, and opportunities, as well as on the decency of their human and social relations. In an era when there is much well-founded concern about losing a vital sense of community, these initiatives on behalf of all our children can have profound collateral benefits of building solidarity, mutual aid, civility, and a reasonable basis for hope. What can bring us together bet- ter than our children? If there is any mission more important, I wonder what it could be. EPILOGUE 135 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS NOTES CHAPTER ONE 10. Hamburg, D.A. (1992). Today's children: Creating Early Adolescence: The Great Transition a future for a generation in crisis. New York: Times Books. 1. Hamburg, D. A. (1986). Preparing for life: The crit- ical transition of adolescence. Presidential Essay. 11. Elliott, 1993. New York: Carnegie Corporation of New York. 12. Dryfoos, 1990; Werner & Smith, 1992. 2. Werner, E. E., & Smith, R.S. (1992). Overcoming the odds: High-risk children from birth to adulthood. CHAPTER TWO Ithaca, NY: Cornell University Press. 3. Dryfoos, J. G. (1990), Adolescents at risk: Prevalence Growing Up in Early Adolescence: and prevention. New York: Oxford University Press. An Emerging View 4. Hamburg, D. A. (1989). Early adolescence: A criti- 1. Feldman, S. S., & Elliott, G. R. (Eds.). (1990). At cal time for interventions in education and health. the threshold: The developing adolescent. Cam- Presidential Essay. New York: Carnegie Corpora- bridge, MA: Harvard University Press. tion of New York. Lerner, R. M. (Ed.). (1993). Early adolescence: Per- 5- Lerner, R.M. (Ed.). (1993). Early adolescence: Per- spectives on research, policy, and intervention. Hills- spectives on research, policy, and intervention. Hills- dale, NJ: Lawrence Erlbaum Associates, Inc. dale, NJ: Lawrence Erlbaum Associates, Inc. 2. Werner, E. E., & Smith, R. S. (1992). Overcoming 6. Elliott, D.S. (1993). Health-enhancing and health- the odds: High-risk children from birth to adulthood. compromising lifestyles. In S. G. Millstein, A. C. Ithaca, NY: Cornell University Press. Petersen, & E. O. Nightingale (Eds.), Promoting 3. Haggerty, R. J., Sherrod, L. R., Garmezy, N., & the health of adolescents: New directions for the Rutter, M. (1994). Stress, risk, and resilience in chil- twenty-first century (pp. 119-145). New York: Ox- dren and adolescents: Process, mechanisms, and in- ford University Press. terventions. New York: Cambridge University Press. Jessor, R., & Jessor, S.L. (1977). Problem behavior and psychosocial development: A longitudinal study Montemayor, R., Adams, G. R., & Gullotta, T.P. of youth. New York: Academic Press. (Eds.). (1990). From childhood to adolescence: A 7. Dryfoos, 1990. transitional period? Newbury Park, CA: Sage. 8. Carnegie Corporation has addressed the needs of 4. Petersen, A.C., & Leffert, N. (1994). What is spe- very young children in its 1994 report Starting cial about adolescence? In M. Rutter (Ed.), Psycho- points: Meeting the needs of our youngest children. social disturbances in young people: Challenges for This report focuses on the first three years of life. A prevention (pp. 3-36). New York: Cambridge Uni- Carnegie Task Force on Learning in the Primary versity Press. Grades is currently synthesizing research and best 5. Ibid. practice to assure that all children in early child- 6. Nolen-Hoeksema, S., & Girgus, J. S. (1994), The hood programs and elementary schools across the emergence of gender differences in depression dur- nation will be well educated. ing adolescence. Psychological Bulletin, 115, 424- 9. The U.S. Congress Office of Technology Assess- 443. ment report was published in three volumes, by the 7. Paikoff, R. L., & Brooks-Gunn, J. (1990). Physio- U.S. Government Printing Office in 1991: Volume I, logical processes: What role do they play during the Summary and policy options; Volume II, Back- transition to adolescence? In R. Montemayor, G.R. ground and the effectiveness of selected prevention Adams, & T.P. Gullotta (Eds.), From childhood to and treatment services; and Volume III, Crosscutting adolescence: A transitional period? (pp. 63-81). issues in the delivery of health and related services. Newbury Park, CA: Sage. 136 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS 8. Brown, B. B. (1990). Peer groups and peer cultures. 3. Goldstein, N. (1993, January). Are changes in work In S.S. Feldman & G. R. Elliott (Eds.), At the and family harming children? Background paper threshold: The developing adolescent (pp. 171-196). prepared for the Task Force on Meeting the Needs Cambridge, MA: Harvard University Press. of Young Children, Carnegie Corporation of New Savin-Williams, R. C., & Berndt, T. J. (1990). York. Friendship and peer relations. In S.S. Feldman & 4. U.S. Department of Education, Office of Educa- G. R. Elliott (Eds.), At the threshold: The develop- tional Research and Improvement, National Center ing adolescent (pp. 277-307). Cambridge, MA: Har- for Education Statistics. (1990). A profile of the vard University Press. American eighth grader: NELS: 88 student descrip- 9. Who's Who among American High School Stu- tive summary. Washington, DC: U.S. Government dents. (1995). A portrait of a generation: 25 years of Printing Office. teen behavior and attitudes. Lake Forest, IL: Edu- 5. Richardson, J. L., Dwyer, K., Hansen, W.B., Dent, cational Communications, Inc. C., Johnson, C. A., Sussman, S. Y., Brannon, B., Louis Harris and Associates, Inc. (1989). Girl Scouts & Flag, B. (1989). Substance use among eighth- survey on the beliefs and moral values of America's grade students who take care of themselves after children. New York: Girl Scouts of the United States school. Pediatrics, 84(3), 556-566. of America. Zelnik, M., & Kantner, J. F. (1977). Sexual and con- 10. Steinberg, L. (1990). Autonomy, conflict, and har- traceptive experience of young unmarried women mony in the family relationship. In S.S. Feldman & in the United States, 1976 and 1971. Family Plan- G. R. Elliott (Eds.), At the threshold: The develop- ning Perspectives 9, 55-71. ing adolescent (pp. 255- 276). Cambridge, MA: Har- 6. U.S. Bureau of the Census. (1994). More education vard University Press. means higher career earnings. [Statistical Brief]. 11. Brown, 1990. Washington, DC: U.S. Department of Commerce. 12. Keating, D. P. (1990). Adolescent thinking. In S.S. 7. Bennett, C. E. (1995). The black population in the Feldman & G. R. Elliott (Eds.), At the threshold: United States: March 1994 and 1993. U.S. Bureau of The developing adolescent (pp. 54-92). Cambridge, the Census, Current Population Reports, P20-480. MA: Harvard University Press. Washington, DC: U.S. Government Printing Office. Fischhoff, B. (1992). Risk taking: A developmental 8. The Alan Guttmacher Institute. (1994). Sex and perspective. In J.F. Yates (Ed.), Risk- Taking Be- America's teenagers. New York: Author. havior. New York: John Wiley & Sons, Ltd. 9. Strasburger, V.C. (1995). Adolescents and the me- Gittler, J., Quigley-Rick, M., & Saks, M.J. (1990). dia: Medical and psychological impact. Newbury Adolescent health care decision making: The law and Park, CA: Sage. public policy. Washington, DC: Carnegie Council 10. Torney-Purta, J. (1990). Youth in relation to social on Adolescent Development. institutions. In S.S. Feldman & G. R. Elliott (Eds.), 13. Millstein, S. G. (1993). A view of health from the At the threshold: The developing adolescent (pp. 457- adolescent's perspective. In S. C. Millstein, A. C. 477). Cambridge, MA: Harvard University Press. Petersen, & E. O. Nightingale (Eds.), Promoting 11. U.S. Bureau of the Census. (1994). Statistical ab- the health of adolescents: New directions for the stract of the United States, 1994. Washington, DC: twenty-first century (pp. 97-118). New York: Ox- U.S. Government Printing Office. ford University Press. 12. O'Hare, W.P. (1992). America's minorities: The de- mographics of diversity. Population Bulletin, 47 (4). CHAPTER THREE 13. Johnston, L. D., O'Malley, P. M., & Bachman, J.G. (1994). National survey results on drug use from the Old Biology in New Circumstances: Monitoring the Future study. Rockville, MD: Na- The Changing Adolescent Experience tional Institute on Drug Abuse. 1. Hernandez, D. (1993). America's children: Re- 14. The Alan Guttmacher Institute, 1994. sources from family, government, and the economy. New York: Russell Sage Foundation. 15. Ibid. 2. Ibid. 16. U.S. Bureau of the Census, Statistical abstract, 1994. NOTES 137 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS 17. U.S. Department of Education, Office of Educa- CHAPTER FOUR tional Research and Improvement, National Center for Education Statistics. (1993). 120 years of Amer- Reducing Risks, Enhancing Opportunities: Es- ican education: A statistical portrait. Washington, sential Requirements for Healthy Development DC: U.S. Department of Education. 1. Dryfoos, J. G. (1990). Adolescents at risk: Prevalence 18. Millstein, S. G., Petersen, A. C., & Nightingale, E. and prevention. New York: Oxford University Press. O. (Eds.). (1993). Promoting the health of adoles- 2. Donovan, J., & Jessor, R. (1985). Structure of prob- cents: New directions for the twenty-first century. lem behavior in adolescence and young adulthood. New York: Oxford University Press. Journal of Consulting and Clinical Psychology, 53, 19. Suicide among children, adolescents, and young 890-904. adults-United States, 1980-1992. (21 April 1995). Jessor, R., & Jessor, S.L. (1977). 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New York: Oxford Uni- cents: New directions for the twenty-first century. versity Press. New York: Oxford University Press. Millstein, S. G., & Litt, I. F. (1990). Adolescent 5. Hamburg, B. A. (1990). Life skills training: Preven- health. In S.S. Feldman & G. R. Elliott (Eds.), At the tive interventions for young adolescents. Washington, threshold: The developing adolescent, (pp. 431-456). DC: Carnegie Council on Adolescent Development. Cambridge, MA: Harvard University Press. 6. Price, R. H., Cioci, M., Penner, W., & Trautlein, B. 21. Dryfoos, J.G. (1990). Adolescents at risk: Prevalence (1990). School and community support programs and prevention. New York: Oxford University that enhance adolescent health and education. Press. Washington, DC: Carnegie Council on Adolescent 22. National Research Council. (1993). Losing genera- Development. tions: Adolescents in high-risk settings. Washington, 7. Nightingale, E. O., & Wolverton, L. (1993). Ado- DC: National Academy Press. lescent rolelessness in modern society. Teachers Col- 23. Wilson, W.J. (1993). Poverty, health, and adoles- lege Record, 94, 472-486. cent health promotion. Promoting adolescent 8. Price, Cioci, Penner, & Trautlein, 1990. health: Third symposium on research opportunities 9. Freedman, M. (1993). The kindness of strangers: in adolescence. Washington, DC: Carnegie Council Adult mentors, urban youth, and the new volun- on Adolescent Development. teerism. San Francisco: Jossey-Bass. 24. Brown, S. S., & Eisenberg, L. (Eds.). (1995). The 10. Hamburg, 1990. best intentions: Unintended pregnancy and the well- being of children and families. Washington, DC: 11. Hedin, D. (1986). Students as teachers: A tool for National Academy Press. improving school climate and productivity. Back- ground paper prepared for the Carnegie Forum on 25. Lynch, B. S., & Bonnie, R.J. (Eds.). (1994). Grow- Education and the Economy. ing up tobacco free: Preventing nicotine addiction in children and youths. Washington, DC: National 12. Hamburg, B. A., & Varenhorst, B. B. (1972). Peer Academy Press. counseling in the secondary schools. American Journal of Orthopsychiatry, 4, 566-581. 13. Hedin, 1986. 14. Hamburg, 1990. 15. Ibid. 16. Ibid. 138 NOTES EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CHAPTER FIVE Collins (Eds.), Development during the transition Reengaging Families with Their Adolescent to adolescence: Minnesota symposium on child psycho- Children logy, Volume 21 (pp. 43-77). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. 1. Princeton Survey Research Associates. Newsweek- Children's Defense Fund Poll. Conducted October 13. Elster, A. B., & Kuznets, N. J. (1994). AMA guide- 18-November 7, 1993. lines for adolescent preventive services (GAPS): Rec- ommendations and rationale. Baltimore: Williams 2. Baumeister, R. F., & Leary, M. R. (1995). The need & Wilkins. to belong: Desire for interpersonal attachments as a fundamental human motivation. Psychological 14. The Carnegie Council's report, A Matter of Time, Bulletin, 117, 497-529. called for partnerships between community pro- grams and families. It cited five constructive ways 3. Who's Who among American High School Stu- to involve family members in the work of youth or- dents. (1995). A portrait of a generation: 25 years of ganizations (p. 88). teen behavior and attitudes. Lake Forest, IL: Edu- cational Communications, Inc. 15. Carnegie Council on Adolescent Development. (1994). Consultation on afterschool programs. Louis Harris and Associates, Inc. (1989). Girl Washington, DC: Author. Scouts survey on the beliefs and moral values of America's children. New York: Girl Scouts of the 16. Small, 1990. United States of America. 4. Elder, G. J., Jr. (1995). Life trajectories in changing CHAPTER SIX societies. In A. Bandura (Ed.), Self-efficacy in changing societies (pp. 46-68). New York: Cam- Educating Young Adolescents for a Changing bridge University Press. World Jarrett, R. L. (1995). Growing up poor: The family 1. Simmons, R. G., & Blyth, D. A. (1987). Moving experiences of socially mobile youth in low-income into adolescence: The impact of pubertal change and African American neighborhoods. Journal of Ado- school context. Hawthorne, NY: Aldine. lescent Research, 10, 111-135. 2. Task Force on Education of Young Adolescents. 5. Small, S. (1990). Preventive programs that support (1992). Turning points: Preparing American youth families with adolescents. Washington, DC: Car- for the twenty-first century. Washington, DC: negie Council on Adolescent Development. Carnegie Council on Adolescent Development. 6. Steinberg, L. (1990). Autonomy, conflict, and har- 3. Slavin, R. E. (1990). Cooperative learning: Theory, mony in the family relationship. In S. S. Feldman research, and practice. Englewood Cliffs, NJ: Pren- & G. R. Elliott (Eds.), At the threshold: The devel- tice-Hall. oping adolescent (pp. 255- 276). Cambridge, MA: (1991). Synthesis of research on coopera- Harvard University Press. tive learning. Educational Leadership, 72-83. 7. Small, 1990. (1994). Educational psychology: Theory 8. Zill, N., & Nord, C.W. (1994). Running in place: into practice. 4th ed. Boston: Allyn & Bacon. How American families are faring in a changing 4. Scales, P. C., & McEwin, K. (1994). Growing pains: economy and an individualistic society. Washington, The making of America's middle school teachers. DC: Child Trends, Inc. Columbus, OH: National Middle School Associa- tion. 9. Epstein, J. L., & Maclver, D. J. (1990). Education in the middle grades: Overview of national practices 5. Zill, N., & Nord, C.W. (1994). Running in place: and trends. Columbus, OH: National Middle How American families are faring in a changing School Association. economy and an individualistic society. 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New York: Carnegie Corporation ington, DC: Author. of New York. 10. U.S. Department of Justice, Bureau of Justice Sta- CHAPTER SEVEN tistics. (1994). Criminal victimization in the United States, 1992. A national crime victimization survey Promoting the Health of Adolescents report. NCJ-145125. Washington, DC: U.S. Govern- 1. Klerman, L.V. (1993). The influence of economic ment Printing Office. factors. In S. G. Millstein, A. C. Petersen, & E.O. 11. Elliott, D.S. (1993). Health-enhancing and health- Nightingale (Eds.), Promoting the health of adoles- compromising lifestyles. In S. G. Millstein, A.C. cents: New directions for the twenty-first century (pp. Petersen, & E. O. Nightingale (Eds.), Promoting 38-57). New York: Oxford University Press. the health of adolescents: New directions for the Wilson, W.J. (1993). Poverty, health, and adolescent twenty-first century (pp. 119-145). New York: Ox- health promotion. Promoting adolescent health: ford University Press. Third symposium on research opportunities in ado- 12. Snyder, H. N., & Sickmund, M. (1995). Juvenile lescence. Washington, DC: Carnegie Council on offenders and victims: A focus on violence. NCJ Adolescent Development. 153570. Washington, DC: U.S. Department of Jus- 2. Millstein, S. G. (1993). A view of health from the tice. adolescent's perspective. In S. G. Millstein, A. C. 13. Earls, F., Cairns, R. B., & Mercy, J. A. (1993). The Petersen, & E. 0. Nightingale (Eds.), Promoting control of violence and the promotion of nonvio- the health of adolescents: New directions for the lence in adolescents. In S. G. Millstein, A. C. Pe- twenty-first century (pp. 97-118). New York: Ox- tersen, & E. O. Nightingale (Eds.), Promoting the ford University Press. health of adolescents: New directions for the twenty- Evans, N., Gilpin, E., Farkas, A.J., Shenassa, E., & first century (pp. 285- 304). New York: Oxford Uni- Pierce, J.P. (1995). Adolescents' perceptions of their versity Press. peers' health norms. American Journal of Public Elliott, 1993. Health, 85, 1064- 1069. 14. Drug Strategies. (1995). Keeping score: What we are 3. Jacobs Quadrel, M., Fischhoff, B., & Davis, W. getting for our federal drug control dollars. Wash- (1993). Adolescent (in)vulnerability. American Psy- ington, DC: Author. chologist, 48, 102-116. 15. Johnston, L. D., O'Malley, P. M., & Bachman, J. G. 4. U.S. Congress, Office of Technology Assessment. (1994). National survey results on drug use from the (1991). Adolescent Health-Volume III: Cross-cutting Monitoring the Future study, 1975-1993: Vol. I: Sec- issues in the delivery of health and related services. ondary school students. Washington, DC: U.S. Gov- OTA-H-467. Washington, DC: U.S. Government ernment Printing Office. Printing Office. 16. Pentz, M.A., Dwyer, J. H., MacKinnon, D. P., Flay, 5. Hamburg, D.A. (1992). Today's children: Creating B. R., Hansen, W.B., Wang, E. Y.I., & Johnson, a future for a generation in crisis. New York: Times C. A. (1989). A multi-community trial for primary Books. prevention of adolescent drug abuse: Effects on 6. Katchadourian, H. (1990). Sexuality. In S.S. Feld- drug use prevalence. Journal of the American Med- man & G. R. Elliott (Eds.), At the threshold: The de- ical Association, 261, 3259-3266. veloping adolescent (pp. 330-351). Cambridge, MA: Elliott, 1993. Harvard University Press. 17. Botvin, G.J., Baker, E., Dusenbury, L., Botvin, E. M., 7. Brown, S. S., & Eisenberg, L. (Eds.) (1995). The & Diaz, T. (1995). Long-term follow-up results of a best intentions: Unintended pregnancy and the well- randomized drug abuse prevention trial in a white being of children and families. Washington, DC: middle-class population. Journal of the American National Academy Press. Medical Association, 273, 1106-1112. 8. Ibid. 18. lbid. 19. Ibid. 140 NOTES EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS 20. Lynch, B. S., & Bonnie, R. J. (Eds.). (1994). Grow- 32. Brooks-Gunn, J., & Paikoff, R.L. (1993). "Sex is a ing up tobacco free: Preventing nicotine addiction in gamble, kissing is a game": Adolescent sexuality children and youths. Washington, DC: National and health promotion. In S.G. Millstein, A.C. Pe- Academy Press. tersen, & E. O. Nightingale (Eds.), Promoting the 21. Kandel, D., & Yamaguchi, K. (1993). From beer to health of adolescents: New directions for the twenty- crack: Developmental patterns of drug involvement. first century (pp. 180-208). New York: Oxford Uni- American Journal of Public Health, 83, 851-855. versity Press. 22. U.S. Department of Health and Human Services. Moore, K. A., Sugland, B. W., Blumenthal, C., (1994). Preventing tobacco use among young people: Glei, D., & Snyder, N. (1995). Adolescent pregnancy A report of the surgeon general. Washington, DC: prevention programs: Interventions and evalua- U.S. Government Printing Office. tions. Washington, DC: Child Trends, Inc. 23. U.S. Congress, Office of Technology Assessment, Brown, S. S., & Eisenberg, L. (Eds.). (1995). The 1991. best intentions: Unintended pregnancy and the well- 24. Ibid. being of children and families. Washington, DC: National Academy Press. 25. Kronick, R. (1989). Adolescent health insurance sta- tus: Analyses of trends in coverage and preliminary estimates of the effects of an employer mandate and CHAPTER EIGHT medicaid expansion on the uninsured. Background Strengthening Communities with Adolescents paper, prepared for U.S. Congress, Office of Tech- nology Assessment. Washington, DC: U.S. Gov- 1. Timmer, S. G., Eccles, J., & O'Brien, I. (1985). How ernment Printing Office. children use time. In F. T. Juster, & F. B. Stafford (Eds.), Time, goods and well-being. Ann Arbor: Uni- U.S. Congress, Office of Technology Assessment, versity of Michigan, Institute for Social Research. 1991. 26. Fox, H. B., & McManus, M. A. (1995). Medicaid Medrich, E. A., & Marzke, C. (1991). Young ado- managed care: A briefing book on issues for chil- lescents and discretionary time use: The nature of life dren and adolescents. In M. R. Solloway & P. P. outside school. Unpublished manuscript prepared Budetti (Eds.), Child health supervision: Analytical for the Carnegie Council on Adolescent Develop- ment, Washington, DC. studies in the financing, delivery, and cost-effective- ness of preventive and health promotion services for 2. U.S. Department of Education, Office of Educa- infants, children, and adolescents (pp. 136-168). Ar- tional Research and Improvement, National Center lington, VA: National Center for Education in Ma- for Educational Statistics. (1990). A profile of the ternal and Child Health. American eighth grader: NELS: 88 Student descrip- tive summary Washington, DC: U.S. Government 27. U.S. General Accounting Office. (1994). Health Printing Office. care: School-based health centers can expand access for children. GAO-HEHS-95-35. Washington, DC: 3. Richardson, J. L., Dwyer, K., Hansen, W.B., Dent, Author. C., Johnson, C. A., Sussman, S. Y., Brannon, B., 28. National Institute of Nursing Research. (1993). & Flag, B. (1989). Substance use among eighth- grade students who take care of themselves after Health promotion for older children and adolescents: school. Pediatrics, 84 (3), 556-566. A report of the NINR priority expert panel on health promotion. NIH Publication No. 93-2420. Washing- 4. Oldenburg, R. (1994). The great good place. New ton, DC: U.S. Department of Health and Human York: Shooting Star, pp. 262-283. Services. 5. Erickson, J. B. (1991). 1992-1993 Directory of Amer- 29. Faigel, H. C., Sznajderman, S., Tishby, O., Turel, ican youth organizations (4th ed.). Minneapolis: M., & Pinus, U. (19950. Attention deficit disorder Free Spirit Publishing. during adolescence: A review. Journal of Adolescent 6. U.S. Department of Education, 1990, pp. 50-54. Health, 16, 174-184. 7. Carnegie Council on Adolescent Development. 30. U.S. General Accounting Office, 1994. (1992). A matter of time: Risk and opportunity in the 31. U.S. Congress, Office of Technology Assessment, nonschool hours. Washington, DC: Author. 1991, p. 45. NOTES 141 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS 8. Carnegie Council on Adolescent Development. world, small screen: The role of television in Ameri- (1994). Consultation on afterschool programs. Wash- can society. Lincoln, NE: University of Nebraska ington, DC: Author. Press. 9. Monks, V. (1994). Giving young people something 4. Ibid. to say yes to, Land and people. The Trust for Public 5. Christenson, P. G., & Roberts, D. F. (1990). Popu- Land Annual Report, 6, 14-19. lar music in early adolescence. Washington, DC: 10. Carnegie Council on Adolescent Development, Carnegie Council on Adolescent Development. 1994. Strasburger, 1995. 11. Mayor's Youth Development Task Force. (1994). 6. Keating, D. P. (1990). Adolescent thinking. In S.S. Chicago for youth: Blueprints for change. Chicago: Feldman & G. R. Elliott (Eds.), At the threshold: Author. The developing adolescent (pp. 54-89). Cambridge, 12. Gardner, J. W. (1992). Reinventing community. MA: Harvard University Press. New York: Carnegie Corporation of New York. 7. Torney-Purta, J. (1990). Youth in relation to social 13. U.S. Department of Education, 1990. institutions. In S.S. Feldman, & G. R. Elliott (Eds.), 14. Carnegie Council on Adolescent Development, At the threshold: The developing adolescent (pp. 1994. 457-477). Cambridge, MA: Harvard University Press. 15. Improved training for youth workers at the commu- nity level is the focus of a series of efforts being un- 8. Dietz, W.H., & Gortmaker, S. L. (1985). Do we fat- dertaken by the Academy for Educational Develop- ten our children at the television set? Obesity and ment's (AED) Center for Youth Development and television viewing in children and adolescents. Pe- Policy Research. Funded by the DeWitt Wallace- diatrics, 75, 807-812. Reader's Digest Fund, AED is assessing the feasibility 9. Brooks-Gunn, J., & Reiter, E. O. (1990). The role of of a staff development initiative to improve training pubertal processes. In S.S. Feldman & G. R. Elliott, for youth workers at the community level by gener- (Eds.), At the threshold: The developing adolescent (pp. ating models and defining the characteristics and 16-53). Cambridge, MA: Harvard University Press. benefits of effective coordinated community-based 10. Strasburger, 1995; Huston et al., 1992. training strategies; creating tools and processes that give communities the capacity to assess their readi- 11. See "Connecting the Media and Adolescent Devel- ness and resources for building coordinated training opment Professionals," in this chapter. strategies; creating a national organization or struc- 12. Huston et al., 1992. ture that has the capacity to coordinate or deliver in- 13. Christenson & Roberts, 1990. formation and technical assistance to communities and to champion the idea of community-based staff 14. Bash, A. (1995 July 10). V-chip: Vital part of vio- lence debate. USA Today, P. 3D. training; and creating short-term and long-term plans for increasing community capacity. In another effort, 15. Lacayo, R. (1995 June 12). Violent reaction. Time, which is funded by the U.S. Department of Justice, 145(24), 24-30. AED is developing a professional training curriculum 16. Hobbs, R. (1994). Teaching media literacy-Yo! Are program for youth workers in community-based you hip to this? Media Studies Journal, 8 (4), 135-145. agencies serving high- risk youth. 17. Roberts, D. F., & Maccoby, E. E. (1985). Effects of mass communication. In G. Lindzey & E. Aronson CHAPTER NINE (Eds.), Handbook of social psychology, volume 2 (pp. 539-598). New York: Random House. Redirecting the Pervasive Power of Media Bauman, K. E., LaPrelle, J., Brown, J. D., Koch, G.G., 1. Strasburger, V.C. (1995). Adolescents and the me- & Padgett, C.S. (1991). The influence of three mass dia: Medical and psychological impact. Newbury media campaigns on variables related to adolescent Park, CA: Sage. cigarette smoking: Results of a field experiment. 2. Ibid. American Journal of Public Health, 81 (5), 597-604. 3. Huston, A. C., Donnerstein, E., Fairchild, H., Fesh- Flora, J. A., Maibach, E.W., & Maccoby, N. (1989). bach, N. D., Katz, P. A., Murray, J. P., Rubinstein, The role of media across four levels of health promo- E. A., Wilcox, B. L., & Zuckerman, D. (1992). Big tion intervention. Annual Review of Public Health, 10, 181-201. 142 NOTES EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS DeJong, W., & Winsten, J. A. (1990). The use of 7. The U.S. Department of Health and Human Ser- mass media in substance abuse prevention. Health vices recently created the Office of Adolescent Affairs, 9, 30-46. Health. Congress passed legislation that enabled 18. Flora, J. A. (1990). Strategies for enhancing adoles- the establishment of this office in October 1992. its'health through music media. Washington, DC: 8. Marshall, R., & Tucker, M. (1992). Thinking for a Carnegie Council on Adolescent Development. living: Education and the wealth of nations. New 19. The Center for Media Education has launched the York: Basic Books. Children and the Information Superhighway Pro- 9. Snowden, C. (1993). Preparing teachers for the de- ject, which will link academic researchers with mands of the twenty-first century: Professional de- policy makers to develop "a solid intellectual base velopment and the NBPTS vision. Detroit: National for policymaking." In addition, the Project will cre- Board for Professional Teaching Standards. ate a Children's Media Policy Network to monitor 10. American Association for the Advancement of Sci- the development of information superhighway pol- ence. (1989). Science for all Americans: A project icy and will produce a quarterly publication, the 2061 report on literacy goals in science, mathemat- Children's Media Policy Bulletin, which will also be ics, and technology. Washington, DC: Author. published on line. 11. See Appendix C. 12. Snowden, 1993. EPILOGUE 13. In 1987, the American Medical Association estab- Looking to the Future: Sustaining the Council's lished the National Coalition on Adolescent Health Perspective to bring together 35 organizations from various dis- 1. Carnegie Corporation of New York. (1990). Ado- ciplines concerned with adolescent health. The lescence: Path to a productive life or a diminished coalition is comprised of representatives from the future? Carnegie Quarterly, 35 (1,2). health professions, private foundations, public health associations, and federal agencies that di- Hamburg, D. A. (1989). Early Adolescence: A Crit- rectly affect adolescent health policy. The Coalition ical Time for Interventions in Education and has sponsored compendia on adolescent health re- Health. Presidential Essay. New York: Carnegie lating to three topics: tobacco, alcohol, and other Corporation of New York. drugs; confidential health services; and violence, in- Hamburg, D. A. (1986). Preparing for Life: The jury, and abuse. Critical Transition of Adolescence. Presidential Es- 14. The National Commission on the Role of the say. New York: Carnegie Corporation of New York. School and the Community in Improving Adoles- 2. Task Force on Meeting the Needs of Young Chil- cent Health. (1990). Code blue: Uniting for health- dren. (1994). Starting points: Meeting the needs of ier youth. Alexandria, VA: National Association of our youngest children. New York: Carnegie Corpo- State Boards of Education. ration of New York. 15. Gardner, J. (1994). American renewal. New York: 3. See Appendix B. Carnegie Corporation of New York. 4. Task Force on Education of Young Adolescents. 16. Task Force on Meeting the Needs of Young Chil- (1989). Turning points: Preparing American youth dren, 1994, p. 95. for the twenty-first century. Washington, DC: 17. Falco, M. (1992). The making of a drug-free Amer- Carnegie Council on Adolescent Development. ica: Programs that work. New York: Times Books. 5. The American Business Collaboration for Quality 18. Chicago Mayor's Youth Development Task Force. Dependent Care is a consortium of corporations (1994). Chicago for youth: Blueprints for change. that work together to find suitable alternatives for Chicago: Author. employees who care for children or elderly parents. See "American Businesses Invest in Young Ado- 19. Takanishi, R., & Hamburg, D.A. (Eds.). (in press). lescents," in chapter five, for more details. Preparing young adolescents for the 21st century: Challenges facing Europe and the United States. 6. Committee for Economic Development. (1991). The New York: Cambridge University Press. unfinished agenda: A new vision for child develop- ment and education. New York: Author. 20. Johann Jacobs Foundation. (1995). Annual Report, 1995. Zurich: Author. NOTES 143 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS ACKNOWLEDGMENTS If the Carnegie Council on Adolescent Development is able to leave a rich legacy, it will be due in large measure to the many people who have made a long-term commitment to enhancing the life chances of American adoles- cents. These individuals have made substantial contributions to the Council's work during the nine years of its existence. In so doing, they have fulfilled the aim of this intersectoral body: to make connections across disci- plinary and professional boundaries for the benefit of all young people. It is no easy task to accord each of them the recognition they so well deserve. We deeply appreciate the efforts of the extraordinary twenty-six members of the Council whose biographical sketches can be found in Appendix D. None of the Council's major reports nor their impact over the years could have been achieved without each of these members. From the outset of this experiment, they have guided all of the Council's initiatives, offered strategic advice on emerging issues that required the Council's involvement, and provided steady leadership in designing and bringing projects to successful fruition. Some Council members assumed key responsibilities as chairs of its task forces and working groups. David Hornbeck was the chair of the Task Force on Education of Young Adolescents, bringing his continuing passion for education reform to the effort. Billie Tisch co-chaired the Task Force on Youth Development and Commu- nity Programs, with Carnegie Corporation Trustee and honorary Council member, James Comer. It was she who had the foresight to urge the Council to focus on the then-unrecognized potential of voluntary, community, and youth organizations in adolescents' lives. Michael I. Cohen, a leader in the development of adolescent medicine, served as the vice-chair of the Adoles- cent Health Advisory Panel, which guided a joint project of the Council and the U.S. Congress Office of Tech- nology Assessment (OTA) that resulted in the first national, comprehensive report on adolescent health. Sena- tors Daniel K. Inouye and Nancy Landon Kassebaum, both members of the Council, and a bipartisan group from both houses of Congress had the foresight to initiate the request for this study. Fred M. Hechinger, the dean of American education writers, produced the Council's publication, Fateful Choices, aimed at reaching a general audience about crucial opportunities to promote the health of adolescents. Beatrix A. Hamburg chaired a working group on life skills training during adolescence, which resulted in a ma- jor analytical resource on the subject. Eleanor E. Maccoby chaired the Science Policy Working Group, which brought together researchers and federal science administrators to discuss research gaps and opportunities. We are deeply grateful to these members of the Council for their important contributions. We are also thankful to Richard Price, who chaired the Council's Working Group on Social Support Networks. To sustain the work of the Council between its meetings, a staff working group within the Corporation met on a monthly basis. Over the years, the core group included Vivien Stewart and Elena O. Nightingale, who retired from the Corporation in December 1994. As the major initiatives of the Council changed, the working group also changed to include Susan G. Millstein, an associate director of the Council from 1987 to 1990, and Jane Quinn, project director for the Task Force on Youth Development and Community Programs from 1990 to 1993. From 1994 to 1995, Susan V. Smith joined the working group. We thank our colleagues for their insights and dedication in translating the Council's wise counsel into specific activities. The special contributions of Vivien Stewart and Elena Nightingale in supporting the Council's efforts through the Corporation's grant making program should be recognized. Under their leadership, follow-up and other grants were made in research syntheses, middle schools reform, adolescent health, substance abuse, and youth violence. Gloria Primm Brown also handled grants related to adolescent health and youth violence, as well as those related to youth organizations and the media. The Council sponsored two volumes that synthesized research in key areas. Both informed the adolescent health research and promotion initiatives of the National Institutes of Health. Shirley Feldman and Glen Elliott edited At the Threshold: The Developing Adolescent on normal adolescent development. Susan G. Millstein, Anne Petersen, 144 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS and Elena Nightingale co-edited Promoting the Health of Adolescents: New Directions for the twenty-first Cen- tury. We are grateful to these editors and to the authors of the chapters for their contributions to identifying re- search opportunities and stimulating research funding on adolescent development and health. Martha Zaslow was a valued consultant who produced cogent overviews for the Council's research symposia. Their contribu- tions are likely to keep adolescent health and development on the science policy agenda for years to come. Several members of Carnegie Corporation staff contributed substantial time, energy, and wisdom to the work of the Council and its concluding report. Avery Russell brought her remarkable editorial and writing talents to bear on the earlier versions of the report, as did members of the staff working group. Anthony W. Jackson, who served as the Council's project director for the Task Force on Education of Young Adolescents and now heads the Corporation's grant making program to stimulate implementation of Turning Points recommendations, wrote most of the chapter on schools. Staff of the Carnegie Council were responsible for the program descriptions and charts and graphs of the re- port. Allyn Mortimer was irreplacable in researching and drafting the descriptions of programs and supervising the development of charts and graphs. It was her energy, attention to all of the details of producing a report, and good humor that kept the Council staff in good spirits throughout. Timothy McGourthy researched and pro- duced the computer-generated graphics for these materials, while being responsible for the administrative sup- port that is essential for the production of a report to flow smoothly. Jenifer Hartnett was the manuscript man- ager, research assistant, and proofreader. Elliott Milhollin provided office support to all of us. Katharine Beckman secured photographs for the report and as with all previous Council reports was the liaison with the designers during the production process. We are exceedingly grateful to each of the Council staff for their devotion to see- ing that every aspect of the report's production was seriously addressed and consistent with high standards. As in all our Council activities, Carnegie Corporation staff were helpful in maintaining communications with the New York office. We are especially grateful to Jeanne D'Onofrio, Annette Dyer, and Bernadette Michel for forming a human web of support. We thank the reviewers of several drafts of the report: the members of the Carnegie Council plus Gloria Primm Brown, James Comer, Joy Dryfoos, Delbert Elliott, Mathea Falco, Susan G. Millstein, Kathryn Montgomery, Elena Nightingale, and Jane Quinn. We appreciate very much the generosity of their time and advice that made this report more accurate and well informed. Special thanks go to Lynne Constantine and Suzanne Scott of Community Scribes for their careful editing of the manuscript under tight timelines. They came through with professional aplomb. As with all of the Coun- cil's major reports, Marc Meadows of Meadows Design Office, produced a lively and imaginative design under rigorous deadlines. The concluding report of the Council was released at a national meeting in Washington, D.C. Julia C. Chill served as conference coordinator for this final convening of the Council, attending to all the details that are re- quired for a successful meeting. The Council on Adolescent Development has been a nearly decade long activity. Change and continuity in key staff, listed on page 166, naturally occurred. Allyn Mortimer and Katharine Beckman were there when we first opened the Council's offices in Washington in October 1986. They are the trustees of the Council's history. We owe both of them an enormous debt for their commitment, integrity, and behind-the-scenes activity over the years. They are truly the glue that has held the Council's operation together. Throughout the life of the Council, our families have been an ever constant source of loving support. David would not have met his responsibilities without the unfailing encouragement of Betty, Eric, and Peggy. Ruby thanks Louis L. Knowles and Marika Takanishi Knowles, who became an adolescent during the Council's life, for reminding her about what really counts in all of life's great transitions. D.A.H. New York, New York R.T. Washington, D.C. ACKNOWLEDGMENTS 145 Sm 1 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS APPENDIX A TASK FORCE ON EDUCATION OF YOUNG ADOLESCENTS CHAIR Renee R. Jenkins Roberta Simmons* Titles and affiliations David W. Hornbeck Associate Professor of Pediatrics Professor of Psychiatry reflect dates of service Of Counsel, Hogan and Hartson Director of Adolescent Medicine and Sociology as Task Force members. Washington, D.C. Howard University School University of Pittsburgh of Medicine Pittsburgh, Pennsylvania Washington, D.C. Marshall S. Smith MEMBERS Nancy L. Kassebaum Dean Bill Clinton United States Senator School of Education Kansas Governor Stanford University State of Arkansas Stanford, California Hernan LaFontaine Little Rock, Arkansas Superintendent of Schools Admiral James D. Watkins** James P. Comer Hartford, Connecticut U.S. Navy, Retired Maurice Falk Professor of Deborah W. Meier Washington, D.C. Child Psychiatry Principal Yale University Central Park East Secondary Child Study Center School *Deceased, 1993. New Haven, Connecticut New York, New York **Served as a member of the Alonzo A. Crim Amado M. Padilla Task Force until his designation Benjamin E. Mays Chair of Professor by President Bush as Secretary Urban Educational School of Education of Energy on January 26, 1989. Leadership Stanford University Department of Educational Stanford, California Administration Georgia State University Anne C. Petersen Atlanta, Georgia Dean College of Health and Human Jacquelynne Eccles Development Professor Pennsylvania State University Department of Psychology State College, Pennsylvania University of Colorado Boulder, Colorado Jane Quinn Director of Program Services Lawrence W. Green Girls Clubs of America Vice President New York, New York Henry J. Kaiser Family Foundation Mary Budd Rowe Menlo Park, California Professor College of Education Fred M. Hechinger University of Florida President Gainesville, Florida New York Times Company Foundation, Inc. New York, New York 147 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS TASK FORCE ON YOUTH DEVELOPMENT AND COMMUNITY PROGRAMS CO-CHAIRS William H. Gray III Karen Johnson Pittman President Director James P. Comer Maurice Falk Professor of United Negro College Fund Center for Youth Development New York, New York and Policy Research Child Psychiatry Academy for Educational Yale University C. Anne Harvey Development Child Study Center Director of the Programs Washington, D.C. New Haven, Connecticut Division American Association of Hugh B. Price Wilma S. Tisch Retired Persons Vice President Chairman of the Board Washington, D.C. The Rockefeller Foundation WNYC Foundation New York, New York Member of the Executive Thomas J. Harvey Committee President Stephanie G. Robinson United Way of New York City Catholic Charities U.S.A. Assistant to the Superintendent New York, New York Alexandria, Virginia for Funding-Development and Special Initiatives Leah Cox Hoopfer Kansas City School District MEMBERS Program Director Kansas City, Missouri Extension, Children, Youth, Raymond G. Chambers and Family Programs Timothy Sandos Chairman Michigan State University At-Large Representative Amelior Foundation East Lansing, Michigan Denver City Council Morristown, New Jersey Denver, Colorado David S. Liederman Philip Coltoff Executive Director Christen G. Smith Executive Director Child Welfare League of America Executive Director The Children's Aid Society Washington, D.C. American Association for New York, New York Leisure and Recreation Dagmar E. McGill Reston, Virginia Jane L. Delgado Deputy National Executive President and CEO Director Kenneth B. Smith National Coalition of Hispanic Big Brothers/ Big Sisters of President Health and Human Services America Chicago Theological Seminary Organizations (COSSMHO) Philadelphia, Pennsylvania Chicago, Illinois Washington, D.C. Milbrey W. McLaughlin Judith Torney-Purta Joy G. Dryfoos Director, Center for Research Professor of Human Independent Researcher on the Context of Secondary Development Hastings-on-Hudson, New York School Teaching University of Maryland Stanford University College Park, Maryland Judith B. Erickson Stanford, California Director of Research Services Jo Uehara Indiana Youth Institute Thomas W. Payzant Assistant Executive Director for Indianapolis, Indiana Superintendent Member Association Services San Diego City Schools YWCA of the U.S.A. John W. Gardner San Diego, California New York, New York Miriam and Peter Hass Centennial Professor of Federico Peña Roberta Van Der Voort Public Service President and CEO Executive Director Stanford University Peña Investment Advisors United Way of King County Stanford, California Denver, Colorado Seattle, Washington 148 APPENDIX A EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS WORKING GROUP ON LIFE SKILLS TRAINING CHAIR Thomas Cook Joan Schine Titles and affiliations Professor Early Adolescent Helper Beatrix A. Hamburg reflect dates of service Center for Urban Affairs Program as Task Force members. Professor of Psychiatry and Pediatrics Northwestern University National Helpers Network, Inc. Evanston, Illinois New York, New York Director of the Division of Child and Adolescent Psychiatry Martin Covington Robert Selman Mount Sinai School of Medicine Professor of Psychology Professor New York, New York University of California, Harvard University Berkeley Cambridge, Massachusetts Berkeley, California MEMBERS Roger Weissberg Baruch Fischhoff Associate Professor Gilbert Botvin Professor Department of Psychology Associate Professor Department of Social and Yale University Cornell University Medical Decision Sciences New Haven, Connecticut Center Carnegie-Mellon University Renee Wilson-Brewer New York, New York Pittsburgh, Pennsylvania Senior Project Director James P. Connell Jane Quinn Center for Health Promotion Associate Professor in Education Project Director and Education and Psychology Carnegie Council on Adolescent Education Development University of Rochester Development Center, Inc. Rochester, New York Washington, D.C. Newton, Massachusetts WORKING GROUP ON SOCIAL SUPPORT NETWORKS CHAIR Beatrix A. Hamburg David Olds Professor of Psychiatry and General Pediatrics and Richard H. Price Pediatrics Adolescent Medicine Professor of Psychology Director of the Division of Child University of Rochester Director and Adolescent Psychiatry Rochester, New York Michigan Prevention Research Mount Sinai School of Medicine Center Karen Rook New York, New York Institute for Social Research Program in Social Ecology University of Michigan Kenneth Heller University of California, Irvine Ann Arbor, Michigan Psychological Clinic Irvine, California Department of Psychology Robert Selman Indiana University MEMBERS Bloomington, Indiana Judge Baker Guidance Center Harvard University Vanella Crawford Judith Musick Cambridge, Massachusetts Congress of National Black Department of Education and Churches Social Policy Washington, D.C. Northwestern University Evanston, Illinois APPENDIX A 149 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS ADVISORY BOARD FOR PROMOTING THE HEALTH OF ADOLESCENTS Albert Bandura Denise V. Kandel Frederick C. Robbins Department of Psychology Department of Psychiatry University Professor Stanford University Columbia University Epidemiology and Biostatistics Stanford, California New York, New York Case Western Reserve University Cleveland, Ohio Michael I. Cohen Lorraine V. Klerman Chairman School of Public Health Robert Selman Department of Pediatrics University of Alabama Judge Baker Guidance Center Montefiore Medical Center Birmingham, Alabama Harvard University Albert Einstein College of Cambridge, Massachusetts Medicine Julius B. Richmond Bronx, New York Division of Health, Policy, Research, and Education Richard Jessor Harvard University Institute of Behavioral Science Cambridge, Massachusetts University of Colorado Boulder, Colorado I....... 150 APPENDIX A EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS APPENDIX B PUBLICATIONS REPORTS WORKING PAPERS These pupers are no A matter of time: Risk and opportunity in the Consultation on afterschool programs longer available from nonschool hours Carnegie Council on Adolescent Development. (1994). the offices at Carnegie Task Force on Youth Development and Community Council. To receive " Programs. (1992). Washington, DC: Carnegie Coun- Schooling for the middle years: Developments in eight copy. please contact the cil on Adolescent Development. Abridged version european countries Educational Resources and executive summary available free from the Carnegie D. Hirsch. (1994). Information Center Council on Adolescent Development. Promoting adolescent health: Third symposium on re- at 1-800-143-3712 Fateful choices: Healthy youth for the 21st century search opportunities in adolescence F. M. Hechinger. (1992). New York, NY: Hill and Carnegie Council on Adolescent Development. (1993). Wang. Executive summary available free of charge Depression in adolescence: Current knowledge, research from the Carnegie Council on Adolescent Develop- directions, and implications for programs and policy ment. A. C. Petersen, B. E. Compas, and J. Brooks-Gunn. Turning points: Preparing american youth for the 21st (1992).* century Violence prevention for young adolescents: The state of Task Force on Education of Young Adolescents. the art of program evaluation (1989). Washington, DC: Carnegie Council on Ado- S. Cohen and R. Wilson-Brewer. (1991).* lescent Development. Abridged version available free from of Carnegie Council on Adolescent Develop- Violence prevention for young adolescents: A survey of ment. the state of the art R. Wilson-Brewer, S. Cohen, L. O'Donnell, and I.F. Goodman. (1991).* BOOKS Adolescent health care decision making: The law and Adolescence in the 1990s: Risk and opportunity public policy R. Takanishi (Ed.). (1993). New York, NY: Teachers J. Gittler, M. Quigley-Rick, and M.J. Saks. (1991). College Press. Life-skills training: preventive interventions for young Promoting the health of adolescents: New directions for adolescents the twenty-first century B. A. Hamburg. (1990).* S.G. Millstein, A. C. Petersen, and E.O. Nightingale Popular music in early adolescence (Eds.). (1993). New York, NY: Oxford University P.G. Christenson and D.F. Roberts. (1990). Press. Executive Summary available free from the Carnegie Council on Adolescent Development. Preventive programs that support families with adolescents At the threshold: The developing adolescent S.A. Small. (1990). S.S. Feldman and G. R. Elliott (Eds.). (1990). Cam- bridge, MA: Harvard University Press. Risk taking in adolescence: A decision-making perspective L. Furby and R. Beyth-Marom. (1990). School and Community Support Programs that Enhance Adolescent Health and Education R. H. Price, M. Cioci, W. Penner, and B. Trautlein. (1990). 151 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Strategies for enhancing adolescents' health through Overview of youth recreation programs in the United music media States J. A. Flora. (1990). C. Smith. Teaching decision making to adolescents: A critical Overview of youth sports programs in the United States review V. Seefeldt, M. Ewing, and S. Walk. R. Beyth-Marom, B. Fischhoff, M. Jacobs, and L. Furby. (1989). Professional development of youthworkers (Summary report of the May 1991 Consultation) Adolescent rolelessness in modern society Carnegie Council on Adolescent Development. E.O. Nightingale and L. Wolverton. (1988). The quiet revolution: Elder service and youth develop- The potential of school-linked centers to promote ado- ment in an aging society lescent health and development M. Freedman, A. C. Harvey, and C. Ventura-Merkel. S. G. Millstein. (1988). Racial, ethnic, and cultural differences in youth devel- Preventing abuse of drugs, alcohol, and tobacco by ado- opment programs lescents L. A. Camino. M. Falco. (1988).* A rationale for enhancing the role of the non-school vol- Issues in adolescent health: An overview untary sector in youth development K. Hein. (1988). K. Pittman and M. Wright. AIDS in adolescence: A rationale for concern A synthesis of the research on, and a descriptive over- K. Hein. (1988). view of Protestant, Catholic, and Fewish religious youth programs in the United States K. C. Dean. COMMISSIONED PAPERS What young adolescents want and need from out-of- Adult Service Clubs and Their Programs for Youth school programs: A focus report A. K. Fitzgerald and A. M. Collins. S. W. Morris & Company. Building supportive communities for youth: Local ap- Young adolescents and discretionary time use: The Report WGTT commis- proaches to enhancing youth development nature of life outside school sioned by the Carnegic R. O'Brien, K. Pittman, and M. Cahill. E. Medrich. Task Force on Youth Development and Community-based youth services in international Community Programs perspective OCCASIONAL PAPERS and CITY available M. Sherraden. only by calling the Adolescent health: Safeguarding a generation at risk Educational Resources Evaluation of youth development programs (Summary F. M. Hechinger. Based on a speech delivered at the Information Center report of the January 1992 Consultation) conference "Crossroads: Critical Choices for the De- at 1-500-443-3742 Carnegie Council on Adolescent Development. velopment of Healthy Adolescents," in Washington, Funding patterns of non-profit organizations that pro- DC, April 12-14, 1992, sponsored by Carnegie Cor- vide youth development services: An exploratory study poration of New York and the Carnegie Council on L.W.Stern. Adolescent Development. Gender issues in youth development programs Business and adolescent health: How to succeed by H.J. Nicholson. really trying J.A. Califano. Based on a speech delivered at the con- ference "Crossroads: Critical Choices for the Devel- opment of Healthy Adolescents," Washington, DC, April 12-14, 1992, sponsored by Carnegie Corpora- tion of New York and the Carnegie Council on Ado- lescent Development. 152 APPENDIX B EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Reinventing community JOURNAL ARTICLES AND J. W. Gardner. Based on a speech delivered at the con- COLLABORATIVE WORKS ference "A Matter of Time: Risk and Opportunity in the Nonschool Hours," Washington, DC, December "Promoting the Healthy Development of Adoles- 10-11, 1992, sponsored by Carnegie Corporation of cents." S. G. Millstein, E.O. Nightingale, A. C. Pe- New York and the Carnegie Council on Adolescent tersen, A. M. Mortimer, and D.A. Hamburg. (1993). Development. Journal of the American Medical Association, 269 (11):1413-1415. The case for comprehensive upgrading of American education "Crucial Opportunities for Adolescent Health." D. A. O. B. Butler. Based on a speech delivered at the con- Hamburg. (1993). Journal of Adolescent Health, 14, ference "Turning Points: Education in America in 495-498. the 21st Century," Washington, DC, June 20, 1989. "The Urban Poverty Crisis: An Agenda for Children The education crisis and the future of our economy and Youth." D. A. Hamburg. (1993). The Western R. Marshall. Based on a speech delivered at the con- Journal of Medicine, 159, 692-697. ference "Turning Points: Education in America in "The Role of Social Support and Social Networks in the 21st Century," Washington, DC, June 20, 1989. Improving the Health of Adolescents." D. A. Ham- burg, E.O. Nightingale, and A. M. Mortimer. (1991). In W.R. Hendee (Ed.), The Health of Adolescents, pp. ESSAYS BY DAVID A. HAMBURG, 526-542. San Francisco: Jossey-Bass Publishers. PRESIDENT, CARNEGIE "Preparing for Life: The Critical Transition of Ado- CORPORATION OF NEW YORK lescence." D.A. Hamburg and R. Takanishi. (1989). Children of urban poverty: Approaches to a critical American Psychologist, 44 (5), 825-827. american problem "Facilitating the Transitions of Adolescence." D.A. Reprinted from the 1992 Annual Report of Carnegie Hamburg, E.O. Nightingale, and R. Takanishi. (1987). Corporation of New York. Journal of the American Medical Association, 257 Early adolescence: A critical time for interventions in (24):3405-3406. education and health WITH THE U.S. CONGRESS OFFICE OF TECHNOLOGY Reprinted from the 1989 Annual Report of Carnegie ASSESSMENT (1991): Corporation of New York. Adolescent health-Volume 1: Summary and policy op- Preparing for life: The critical transition of adolescence tions. Washington, DC: U.S. Government Printing Reprinted from the 1986 Annual Report of Carnegie Office. Corporation of New York. Adolescent health-Volume 2: Background and the effec- tiveness of selected prevention and treatment services. CARNEGIE QUARTERLIES Washington, DC: U.S. Government Printing Office. Saving Youth from Violence, Winter 1994 Adolescent health-Volume 3: crosscutting issues in the delivery of related services. Washington, DC: U.S. Turning points revisited: A new deal for adolescents, Government Printing Office. Spring 1993. Adolescent health: A generation at risk, Fall 1992. Adolescence: Path to a productive life or a diminished future? Winter/Spring 1990. APPENDIX B 153 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS APPENDIX C MEETINGS AND WORKSHOPS SYMPOSIA ON RESEARCH MEDIA LINKAGES: COUNCIL- OPPORTUNITIES IN ADOLESCENCE SPONSORED SPEAKERS AND FOURTH SYMPOSIUM THEIR TOPICS The Development of Interethnic Group Relations Louis Butler, California Tomorrow During Childhood and Adolescence, September 1994 Changing Populations, Emerging Audiences Cosponsor: Women in Film/Film Festival THIRD SYMPOSIUM Promoting Adolescent Health, June 1993 Peter Christenson, Lewis and Clark College Children, Teens, and Popular Music SECOND SYMPOSIUM Cosponsor: Billboard magazine Opportunities in the Health and Education of Ado- lescents, November 1991 James Comer, Yale University Medical School Education FIRST SYMPOSIUM Cosponsors: Education 1st! and the National Council Opportunities in Adolescent Development, October for Families and Television 1990 Delbert Elliott, Institute of Behavioral Science, University of Colorado MEETINGS IN CONJUNCTION Adolescent Violence and the Media Cosponsor: Caucus for Producers, Writers, and WITH JOHANN JACOBS Directors FOUNDATION, SWITZERLAND David Hayes-Bautista, Chicano Studies Research Frontiers in Education: Schools as Health-Promoting Center, University of California at Los Angeles Environments, February 1995, Geneva, Switzerland Voices from the Front Lines: Behind the School House Door Frontiers in the Education of Young Adolescents, No- vember 1994, Marbach Castle, Germany Cosponsor: National Council on Families and Television Changing Audience Demographics MEETINGS OF THE COUNCIL Cosponsor: Education 1st! ON ADOLESCENT Richard Louv, San Diego Union DEVELOPMENT The World of Today's Adolescent Cosponsor: Academy of Television Arts and Sciences Ninth Council Meeting, October 13, 1995 Eighth Council Meeting, June 24-25, 1993 Eleanor Maccoby, Department of Psychology, Stanford University Seventh Council Meeting, November 14-15, 1991 Parenting and Co-Parenting before and after Divorce Sixth Council Meeting, October 15-16, 1990 Cosponsor: National Council on Families and Television Fifth Council Meeting, October 12-13, 1989 Fourth Council Meeting, September 29-30, 1988 Ray Marshall, Departments of Economics and Public Policy, University of Texas at Austin Third Council Meeting, February 1-2, 1988 The Economic Crisis and Its Impact on Families, Second Council Meeting, June 29-30, 1987 Education, and Society First Council Meeting, January 11-12, 1987 Cosponsor: Show Coalition 154 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Deborah W. Meier, Central Park East Secondary COUNCIL WORKSHOPS School Assessing Promising Prevention Interventions: Life Turning Points Cosponsor: National Council on Families and Skills Training Working Group, May 1988, July 1988, March 1989 Television Assessing Promising Prevention Interventions: Social Rosemary Lee Potter, middle school teacher and author of Positive Use of Commercial TV for Kids Support Networks Working Group, June 1988, No- vember 1988, February 1989 Television, the Accidental Educator Cosponsor: Education 1st! Supporting Families with Adolescents, September 1988 Donald Roberts, Stanford University, author of Popular Music in Early Adolescence Consultation on Health Services and Health Promo- Violence and the Media tion in Middle Grade Schools, June 1988 Cosponsor: American Film Institute Popular Music in Early Adolescence Consultation on School-Linked Adolescent Health Cosponsor: Billboard Magazine Centers, November 1987 Children, Teens, and Popular Music Creating New Television Programs for and about Ado- Cosponsor: Recording Industry Association of America lescents, June 1987 Laurence Steinberg, Center for Research in Human Youth at Risk in the Middle Schools, May 1987 Development and Education, Temple University Conflict and Harmony in the Parent-Teen Relationship Consultation on Adolescent Violence, May 1987 Cosponsor: National Council on Families and Toward Healthy Adolescent Development: The Po- Television tential of Effective Interventions, April 1987 Renee Wilson-Brewer, Violence Prevention Project, Working with the Media to Promote Healthy Adoles- Education Development Center cent Development, April 1987 Violence and the Media Cosponsor: American Film Institute Adolescent Violence and the Media Cosponsor: Caucus for Producers, Writers, and Directors Linda Wong, California Tomorrow Minority Education Cosponsor: National Council on Families and Television APPENDIX C 155 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS APPENDIX D BIOGRAPHIES OF MEMBERS THE COUNCIL H. Keith H. Brodie H. Keith H. Brodie is president emeritus of Duke University, where he is the James B. Duke Professor of Psy- chiatry and Behavioral Sciences, professor of law, and professor of experimental psychology. Before these po- sitions, he was acting provost and chancellor. Dr. Brodie also served as chief of the psychiatry service at Duke University Hospital and as chairman of the university's department of psychiatry. Before his tenure at Duke, he was assistant professor in the department of psychiatry at Stanford University. Among Dr. Brodie's numerous honors and awards is the 1994 William C. Menninger Memorial Award from the American College of Physi- cians. He has been president and secretary of the American Psychiatric Association and was an associate editor of the American Journal of Psychiatry. He is a member of the National Academy of Sciences-Institute of Med- icine, where he has chaired a number of committees. Dr. Brodie is a fellow of the Royal College of Psychiatrists as well as of the Royal Society of Medicine. His most recent publication is AIDS and Behavior: An Integrated Ap- proach (1994), which he edited with J.D. Auerbach and C. Wypijewska. Dr. Brodie earned an A.B. from Prince- ton University and an M.D. from Columbia University College of Physicians and Surgeons. Michael 1. Cohen Michael I. Cohen, chairman of the department of pediatrics at Albert Einstein College of Medicine-Montefiore Medical Center in New York City, was instrumental in the development of adolescent medicine as a medical spe- ciality. Among his numerous honors are the Society for Adolescent Medicine Award for Outstanding Achieve- ment and the Montefiore Medical Center Staff and Alumni Association Distinguished Physician Award. The author of more than one hundred publications, he holds membership in a number of professional societies, in- cluding the Society for Developmental and Behavioral Pediatrics; the Eastern Society for Pediatric Research, where he served on the Executive Council; and the National Academy of Sciences-Institute of Medicine. Dr. Cohen's work has focused on the health needs of adolescents. He served as vice-chair of the advisory panel for the U.S. Congress Office of Technology Assessment's landmark study of adolescent health in 1991. He has held lectureships at several universities, including the University of Colorado and Cornell University Medical Col- lege. He is a board member for many nonprofit agencies and has served on the editorial and publication advi- sory boards of a variety of professional publications. Dr. Cohen earned his B.A. and M.D. from Columbia Uni- versity and was a postdoctoral fellow at Albert Einstein College of Medicine. Alonzo A. Crim Alonzo A. Crim is a professor in the department of education and special assistant to the president on college and school partnerships at Spelman College. He was the Benjamin E. Mays Professor of Urban Educational Leadership in the department of educational administration at Georgia State University. As superintendent of the predominantly black and low-income public schools of Atlanta, Georgia, for fifteen years, Dr. Crim intro- duced many innovative programs that resulted in a dramatic increase in the number of students completing high school and continuing to postsecondary education. One of these innovations was a districtwide requirement of community service for a high school diploma. A widely published educator, Dr. Crim began his career as a seventh- and eighth-grade science and mathematics teacher and later served as a principal and district superin- tendent in Chicago and superintendent of the Compton, California, Unified School District. His numerous hon- ors and awards include honorary doctorate degrees from Princeton, Harvard, Tuskegee, and Columbia Uni- versities. Dr. Crim earned a B.A. in sociology from Roosevelt College in Chicago, an M.A. in educational administration from the University of Chicago, and an Ed.D. from the Harvard Graduate School of Education. 156 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Michael S. Dukakis Michael S. Dukakis, former governor of the Commonwealth of Massachusetts, is a visiting distinguished pro- fessor in the political science department at Northeastern University in Boston. Governor Dukakis served for two years in the United States Army, spent in part with the support group to the UN delegation to the Military Armistice Commission in Munsan, Korea. He began his political career as an elected town meeting member in Brookline, Massachusetts. Elected chairman of the town's Democratic organization in 1960, he soon won a seat in the legislature and served four terms. Winning the Massachusetts gubernatorial election in 1974, he served one term in office but was defeated in the 1978 state Democratic primary. Governor Dukakis won election again in 1982 and was reelected to an unprecedented third four-year term in 1986. In 1986, his colleagues in the Na- tional Governors' Association voted him the most effective governor in the nation. In 1988, Governor Dukakis won the Democratic nomination for the U.S. presidency but was defeated in the general election by George Bush. Since 1991, he has taught courses in the American presidency, public management, health care reform, public policy, and state and local government at Northeastern University. Governor Dukakis earned a B.A. from Swarthmore College and a J.D. from Harvard Law School. William H. Gray, III William H. Gray III is president and chief executive officer of the United Negro College Fund (UNCF). As head of America's oldest black higher education assistance organization, Mr. Gray has led the UNCF to new fund- raising records. Mr. Gray served in the U.S. Congress from 1978 until 1991. The first African American to chair the House Budget Committee, he was a leading advocate for strengthening America's educational systems. As chairman of the Democratic Caucus and later as majority whip, he was the highest ranking African American ever to serve in Congress. For more than twenty years, Mr. Gray has been pastor of the five thousand member Bright Hope Baptist Church in Philadelphia. He has been a faculty member and professor of history and reli- gion at St. Peter's College, Jersey City State College, Montclair State College, Eastern Baptist Theological Sem- inary, and Temple University. He earned his B.A. from Franklin and Marshall College, a master's degree in di- vinity from Drew Theological Seminary, and a master's degree in theology from Princeton Theological Seminary. He also has been awarded more than fifty honorary degrees from American colleges and universities. Beatrix A. Hamburg Beatrix A. Hamburg is president of the William T. Grant Foundation and professor of psychiatry and pediatrics at the Mount Sinai School of Medicine, where she was director of the division of child and adolescent psychi- atry. Her prior professorial appointments were in the psychiatry departments at the Stanford University School of Medicine and Harvard Medical School. Dr. Hamburg has researched normal adolescence, adolescent psycho- pathology, and endocrine-behavior interactions. She is noted for her work on peer counseling, studies of dia- betic children and adolescents, and studies of the health and mental health status of minority populations. Ac- tive in public policy and public service in areas that affect children and youth, she is a member of the Public Health Council of the New York State Department of Health and of the New York Governor's Task Force on Life and the Law. She is also a member of the National Advisory Mental Health Council for the National Insti- tute of Mental Health and of the Institute of Medicine of the National Academy of Sciences. Dr. Hamburg earned a B.A. from Vassar College and an M.D. from the Yale University School of Medicine. David A. Hamburg David A. Hamburg has been president of Carnegie Corporation of New York since 1983. Formerly, he served as president of the Institute of Medicine of the National Academy of Sciences. He has been a member of the President's Committee of Advisers on Science and Technology since its formation in 1994. For a decade, Dr. Hamburg was on the Advisory Committee on Medical Research of the World Health Organization. He was a trustee and vice chairman of the board of Stanford University, and was a member of the board of The Federal Reserve Bank of New York, where he was also deputy chairman. He serves on the boards of The Rockefeller University; The Mount Sinai Medical Center, New York; The American Museum of Natural History; and The Johann Jacobs Foundation, Zurich. Dr. Hamburg is the author of Today's Children: Creating a Future for a Generation in Crisis (1992). He is chairman of the Carnegie Council on Adolescent Development, founder of the Carnegie Commission on Science, Technology and Government, and co-chairman of the Carnegie Com- APPENDIX 0 157 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS mission on Preventing Deadly Conflict. Dr. Hamburg's professorial appointments have included chairman- ship of the department of psychiatry and behavioral sciences at Stanford University, Stanford's Reed-Hodg- son Professor of Human Biology, and John D. MacArthur Professor of Health Policy at Harvard University. Dr. Hamburg earned his A.B. and M.D. degrees from Indiana University. David E. Hayes-Bautista David E. Hayes-Bautista is the director of the Center for the Study of Latino Health at the University of Cali- fornia at Los Angeles, where he is also a professor in the School of Medicine. Dr. Hayes-Bautista began his ca- reer directing La Clínica de la Raza in Oakland, California. Since then, he has been affiliated with numerous public and private organizations that promote public health, including the American Public Health Associa- tion's Task Force on Latin American Health Workers, the National Center for Health Services Research, and the State of California's Tobacco Education Oversight Committee. Dr. Hayes-Bautista has written numerous articles and books on Latino health policy, demographics, and inner-city youth and co-authored The Burden of Support, which examines the role of Latino youth in an aging society. Dr. Hayes-Bautista has received several awards, among them the Hispanic Business Magazine Hispanic Influential Award, the Chicanos for Creative Medicine Humanitarian Award, and the Outstanding Researcher Award from the Chicano/Latino Medical As- sociation of California. He earned a B.A. from the University of California at Berkeley and an M.A. and Ph.D., both in medical sociology, from the University of California's San Francisco Medical Center. Fred M. Hechinger Fred M. Hechinger is senior adviser at Carnegie Corporation of New York. As a reporter, columnist, editor, au- thor, and foundation executive, he has devoted much of his career to issues of education and policies affecting children and society. Mr. Hechinger began his career with The New York Times as education editor, later be- coming deputy editor of the editorial page. He became president of The New York Times Company Founda- tion and of The New York Times Neediest Cases Fund, and he began writing a weekly column, "About Edu- cation." Mr. Hechinger has authored or co-authored with his wife, Grace, a number of books about American education and youth, including A Better Start and Growing Up in America. He is a former education editor of Parents' Magazine and also a former president of the Education Writers Association, from which he has received a number of awards for his writing. Mr. Hechinger received the George Polk Memorial Award, and he holds the British Empire Medal. He joined the staff of Carnegie Corporation after serving on the Corporation's board for six years. Mr. Hechinger attended New York University and City College of New York, from which he was grad- uated magna cum laude. He undertook graduate studies at the University of London. David W. Hornbeck David W. Hornbeck is the superintendent of schools for the school district of Philadelphia. Mr. Hornbeck chaired the Carnegie Council on Adolescent Development's Task Force on Education of Young Adolescents. He has since worked with several jurisdictions nationwide as an education advisor to develop school restruc- turing processes. As a partner with Hogan & Hartson in Washington, D.C., Mr. Hornbeck worked with private, nonprofit, and government institutions interested in educational restructuring, including the State of Kentucky, whose reform legislation he designed. From 1976 to 1988, Mr. Hornbeck was the state superintendent of schools for Maryland. He also has served as deputy counsel to the Governor of Pennsylvania, and as the Executive deputy secretary of education for the Commonwealth of Pennsylvania. He currently serves on the advisory boards and on the boards of directors of several organizations devoted to improving education, among them the National Center on Education and the Economy, the Pew Forum on Education Reform, and the Southern Education Foundation. He is chairman of the Children's Defense Fund board of directors. Mr. Hornbeck earned a B.A. and an LL.D. from Austin College, a Diploma in Theology from Oxford University, a B.D. from Union Theo- logical Seminary, and a J.D., cum laude, from the University of Pennsylvania Law School. Daniel K. Inouye Daniel K. Inouye is the fifth-ranking member of the United States Senate. As a senator, he has championed im- proved education for all youth and better health care for all Americans. From 1989 to 1994, Senator Inouye was the chairman of the Committee on Indian Affairs and is a leader in advancing the rights of Indian people in the 151 APPENDIX D EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS United States including American Indians and Native Hawaiians. Currently, he is the Committee's vice chair- man. He also is a member of the Senate committees on Appropriations; Commerce, Science, and Transporta- tion; and Rules and Administration; and of the Senate Democratic Steering Committee. In World War II, Sen- ator Inouye served in the all-Japanese American 442nd Infantry Regimental Combat Team, the most highly decorated unit of its size in that war. He was discharged an army captain, with a Distinguished Service Cross, Bronze Star, Purple Heart with cluster, and twelve other medals and citations. He began his career as deputy public prosecutor for the City and County of Honolulu. In 1954, he was elected to the Territorial House of Rep- resentatives, where he served two consecutive terms, and, in 1958, he was elected to the Territorial Senate. Sen- ator Inouye became Hawaii's first Congressman in 1959, when he was elected to the U.S. House of Represen- tatives. He served in the House until his election to the U.S. Senate in 1962. Senator Inouye earned a B.A. from the University of Hawaii and a J.D. from the George Washington University Law School. James M. Jeffords James M. Jeffords, a Republican Senator from Vermont, is the chairman of the Education, Arts, and the Hu- manities Subcommittee of the Committee on Labor and Human Resources. Senator Jeffords was first elected to Congress in 1975 as a member of the U.S. House of Representatives, where he was a member of the Agricul- ture Committee and the ranking Republican member on the Education and Labor Committee. Elected to the Senate in 1989, he sits on a number of Senate Committees including Labor and Human Resources, Appropri- ations, and Energy and Natural Resource. He has devoted his public life to education, health, and environmental issues. Senator Jeffords served on active duty with the U.S. Navy from 1956 to 1959, retiring from the U.S. Naval Reserve as a captain in 1990. He was president of the Young Lawyers Section of the Vermont Bar Association from 1966 to 1968. He received his B.S in international affairs from Yale University in 1956 and his LL.B. from Harvard Law School in 1962. Richard Jessor Richard Jessor has been a member of the faculty at the University of Colorado-Boulder for the past forty-three years. He is a professor in the department of psychology and the director of the Institute of Behavioral Science. For the past seven years, Dr. Jessor has directed the MacArthur Foundation Research Network on Successful Adolescent Development among Youth in High-Risk Settings. His areas of research include adolescent and young adult development, the social psychology of problem behavior, and psychosocial aspects of poverty. Dr. Jessor has been consultant to numerous organizations, including the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, the National Academy of Sciences, Health and Welfare (Canada), and the World Health Organization. He served on the National Research Council Committee on Child Development Research and Public Policy and on the National Academy of Sciences Panel on High-Risk Youth. Dr. Jessor has authored or edited more than one hundred publications, including seven books. His most recent book is Ethnography and Human Development: Context and Meaning in Social Inquiry (forthcoming), edited with A. Colby and R.A. Shweder. Dr. Jessor earned his B.A. from Yale University, an M.A. from Columbia Uni- versity, and a Ph.D. in clinical psychology from Ohio State University. Helene L. Kaplan Helene L. Kaplan is Of Counsel to the firm of Skadden, Arps, Slate, Meagher & Flom. She has practiced law for more than twenty-five years. Mrs. Kaplan has served in the not-for-profit sector as counsel or trustee of many scientific, arts, charitable and educational institutions and foundations, including The American Mu- seum of Natural History; The Committee for Economic Development; The Commonwealth Fund; Carnegie Corporation of New York; The J. Paul Getty Trust; The Mount Sinai Hospital, Medical School, and Medical Center; and Barnard College, where she was chairman of the board. She also served as chairman of the Board of Trustees of Carnegie Corporation of New York. She was a member of the U.S. Secretary of State's Advisory Committee on South Africa, and she served on New York Governor Mario Cuomo's Task Force on Life and the Law, which was concerned with the legal and ethical implications of advances in medical technology. Mrs. Kaplan is a director of Chemical Banking Corporation and Chemical Bank, The May Department Stores Com- pany, Metropolitan Life Insurance Company, Mobil Corporation, and NYNEX Corporation. She is a fellow of the American Academy of Arts and Sciences and a member of the American Philosophical Society. Mrs. Ka- plan earned her A.B. from Barnard College and a J.D. from New York University. APPENOIX D 159 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Nancy Landon Kassebaum Nancy Landon Kassebaum, a Republican Senator from Kansas, is the chairman of the Committee on Labor and Human Resources. She also is a member of the committees on Foreign Relations and Indian Affairs. The daugh- ter of Alfred M. Landon, governor of Kansas from 1933 to 1937 and the Republican presidential nominee in 1936, she was introduced to politics at an early age. While raising her four children on a farm in Maize, Kansas, Sen- ator Kassebaum was a member of the Maize School Board, Kansas Governmental Ethics Commission, and the Kansas Committee for the Humanities. In 1975, she accepted a position in Washington as an aide to Republi- can Senator James Pearson of Kansas. In 1978, she was elected to the seat opened upon Senator Pearson's re- tirement. Respected as a coalition builder, Senator Kassebaum is serving her third term in the U.S. Senate. An advocate of fiscal responsibility, she is known as a social moderate with strong interests in education and health care. She has also focused her efforts on international affairs, including foreign aid programs and African issues. Senator Kassebaum earned a B.A. in political science from the University of Kansas and an M.A. in diplomatic history from the University of Michigan. Thomas H. Kean Thomas H. Kean is president of Drew University and former governor of the State of New Jersey. As univer- sity president, he has stressed the primacy of teaching for all faculty, the creative use of technology in the lib- eral arts, and the growing importance of international education. He created new awards and scholarships for faculty and students. As governor, he instituted a federally replicated welfare reform program and more than thirty education reforms. Governor Kean delivered the keynote address at the 1988 Republican National Con- vention. He served on the President's Education Policy Advisory Committee under George Bush and as chair of the Education Commission of the States and the National Governors' Association's Task Force on Teach- ing. Governor Kean is chairman of Educate America and former chairman of the National Environmental Ed- ucation and Training Foundation. He is on the board of a number of organizations, including Carnegie Cor- poration of New York, the Robert Wood Johnson Foundation, and United Health Care Corporation. His most recent book is The Politics of Inclusion, published by The Free Press. Governor Kean earned a B.A. from Princeton University and an M.A. from Columbia University Teachers College and holds honorary degrees from twenty-five colleges and universities. Ted Koppel Ted Koppel, a thirty-one-year veteran of ABC News, is anchor of "Nightline," television's first late-night network news program. As anchor of "Nightline," he is the principal on-air reporter and interviewer. Mr. Koppel also is the program's managing editor. In its fifteen year on the air, "Nightline" remains an innovation in broadcast news. Mr. Koppel also has worked as a foreign and domestic correspondent and as bureau chief for ABC News. He has won every major broadcasting award, including twenty-three Emmy Awards, five George Foster Peabody Awards, eight duPont-Columbia Awards, nine Overseas Press Club Awards, two George Polk Awards, and two Sigma Delta Chi Awards, the highest honor bestowed for public service by the Society of Professional Journal- ists. He recently received the Goldsmith Career Award for Excellence in Journalism by the Joan Shorenstein Barone Center on the Press, Politics and Public Policy at Harvard University. He has received fifteen honorary degrees. Mr. Koppel co-authored the bestseller In the National Interest with Marvin Kalb, formerly of CBS News. Mr. Koppel earned a B.A. from Syracuse University and an M.A. in mass communications research and politi- cal science from Stanford University. Hernan LaFontaine Hernan LaFontaine is professor of administration and supervision in the educational leadership department of the Graduate School of Education at Southern Connecticut State University. As a former science teacher and principal in the New York City schools and later as the head of the Office of Bilingual Education at the New York City Board of Education, Mr. LaFontaine was instrumental in establishing bilingual education in the city. In 1979, Mr. LaFontaine assumed the post of superintendent of schools for the Hartford public school system, where he led major efforts to improve the conditions of the school system. As superintendent, he sought to im- prove standardized achievement test scores, institute a citywide standardized curriculum, and establish a com- 160 APPENDIX D EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS prehensive computer-based education program. He actively consulted with parents, community, and business through groups he established early in his tenure, such as the Parents Association President's group and the School/Business Collaborative. Mr. LaFontaine has served as a consultant on bilingual education to the federal Office of Education, the New York Department of Education, and many school systems. He has taught as an ad- junct professor at Fordham and New York Universities and has lectured widely throughout the United States. Mr. LaFontaine earned B.S. and M.A. degrees from City College of New York and a Professional Diploma in Education Administration from Fordham University. Eleanor E. Maccoby Eleanor E. Maccoby is Barbara Kimball Browning Professor of Psychology Emerita at Stanford University, where she has been on the faculty since 1958. Her primary field of interest is the development of children's social be- havior, particularly as it relates to family functioning and child-rearing methods. She is the co-author (with R.H. Mnookin) of Dividing the Child: The Social and Legal Dilemmas of Custody, for which she was awarded the William J. Goode Award from the American Sociological Association in 1993, and is the author of Social De- velopment: Psychological Growth and the Parent-Child Relationship, in addition to numerous articles and mono- graphs. Dr. Maccoby is the recipient of several distinguished awards in her field, among them the American Psy- chological Association Award for Distinguished Scientific Contribution and the Kurt Lewin Memorial Award from the Society for the Psychological Study of Social Issues. A pioneer in the psychology of sex differences, Dr. Maccoby was elected to the National Academy of Sciences in 1993. She has been a member of the Institute of Medicine since 1977 and of the American Academy of Arts and Sciences since 1974. Dr. Maccoby earned a B.S. from the University of Washington, where she was elected to Phi Beta Kappa. She earned an M.A. and Ph.D. in psychology from the University of Michigan. Ray Marshall Ray Marshall is the Audre and Bernard Rapoport Centennial Chair in Economics and Public Affairs at the Lyn- don B. Johnson School of Public Affairs at the University of Texas at Austin. The author or co-author of more than thirty books and monographs and 175 articles, Dr. Marshall has done extensive research on the economics of education, minority business development programs, school-to-work transitions, workplace learning systems, and private pension reform, among other topics. Dr. Marshall, who was U.S. Secretary of Labor under Presi- dent Jimmy Carter, has received several distinguished honors, among them the Sullivan Distinguished Service Award, the Sydney Hillman Book Award (for Thinking for a Living), and the Lewis-Murray-Reuther Social Justice Award from the AFL-CIO Industrial Union Department. Dr. Marshall was a Fulbright Research Profes- sor in Finland and has been a fellow at The Rockefeller Foundation, Harvard University, and the Ford Founda- tion. He was Wayne Morse Chair in Law and Public Policy at the University of Oregon. Dr. Marshall earned a B.A. in economics and business administration from Millsaps College, an M.A. in economics from Louisiana State University, and a Ph.D. in economics from the University of California at Berkeley. Julius B. Richmond Julius B. Richmond is John D. MacArthur Professor of Health Policy Emeritus in the division for health policy research and education at Harvard Medical School. Dr. Richmond directed Head Start in the program's early years. As Assistant Secretary for Health in the U.S. Department of Health and Human Services and Surgeon General of the United States Public Health Service during the Carter administration, he directed the publica- tion of "Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention." Dr. Richmond has served as chair of the pediatrics department and dean of the medical school at the State Univer- sity of New York at Syracuse. He also was a professor of child psychiatry and human development at Harvard Medical School and became the director of the Judge Baker Guidance Center and chief of psychiatry at Chil- dren's Hospital in Boston. Dr. Richmond's published work spans pediatrics, child health, child development, and public health policy. He has received several distinguished awards, including the Aldrich Award of the Amer- ican Academy of Pediatrics, the Howland Award of the American Pediatric Society, the Gustave Lienhard Award of the Institute of Medicine, and the Sedgwick Medal of the American Public Health Association. Dr. Richmond earned an M.S. and an M.D. from the University of Illinois at Chicago. APPENOIX 0 161 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Frederick C. Robbins Frederick C. Robbins, university professor emeritus at Case Western Reserve University and dean emeritus of the Case Western Reserve University School of Medicine, currently is the director of the Center for Adolescent Health at Case Western. With Dr. John Enders and Dr. Thomas Weller, Dr. Robbins received the 1954 Nobel Prize in Physiology and Medicine for the development of techniques for the growth of poliovirus in cultures of nonnervous tissue. Dr. Robbins was director of the department of pediatric and contagious diseases at Cleve- land City Hospital. During World War II, he served as the U.S. Army's chief of the virus and rickettsial disease section of the Fifteenth General Medical Laboratory. Dr. Robbins is a charter member of the Technology As- sessment Advisory Committee of the U.S. Office of Technology Assessment and was president of the Institute of Medicine of the National Academy of Sciences. He currently serves on the Board of International Health of the Institute of Medicine and co-chairs the Vaccine Action Program between the United States and India. He received the Abraham Flexner Award for Medical Education from the Association of American Medical Col- leges. Dr. Robbins earned a B.A. from the University of Missouri, completed a two-year program at the Uni- versity of Missouri School of Medicine, and earned an M.D. from Harvard Medical School. Kenneth B. Smith Kenneth B. Smith is president and associate professor of ministry at the Chicago Theological Seminary and an ordained minister of the United Church of Christ. Reverend Smith was a senior minister at the Church of the Good Shepherd in Chicago for sixteen years before he assumed the presidency at the seminary. During his tenure at the Church of the Good Shepherd, the congregation initiated programs in preschool education, af- ter-school care and recreation, nutritional and recreation programs for retired persons, and a program for ado- lescents with special needs. Reverend Smith currently serves on several local and national voluntary boards and committees, including the board of trustees of National Youth Advocates and the United Way of Chicago. From 1980 to 1981, he was president of the Chicago Board of Education. Among numerous awards, he has re- ceived the Educational Award from Operation PUSH and the Humanitarian Award from the Plano Chicago De- velopment Center. His publications include the Lenten Book of Meditation and The United Church of Christ- Issues in Its Quest for Denominational Identity, edited with Dorothy C. Bass. Reverend Smith earned a B.A. from Virginia Union University in Richmond, Virginia, and a Bachelor of Divinity from Bethany Theological Seminary in Oak Brook, Illinois. Wilma S. Tisch Wilma S. Tisch, a civic leader, is chairman emeritus of the board of WNYC (New York Public Broadcasting). She is a trustee of the United Way of New York City, as well as a member of its executive committee. She is vice pres- ident of the Jewish Communal Fund; trustee of the Federation of Jewish Philanthropies of New York; member of the Council of Advisors, Hunter College School of Social Work; a trustee of Carnegie Corporation of New York; and a member of the American Jewish Joint Distribution Committee. Ms. Tisch was president of the Fed- eration of Jewish Philanthropies of New York and was vice president of the Council of Jewish Federations. She also is a former trustee of Blythedale Children's Hospital. In 1993, she was a member of the Mayor's Transition Advisory Council, New York City. Ms. Tisch received the Louis D. Marshall Medal from the Jewish Theolog- ical Seminary and an honorary Doctor of Humane Letters from Skidmore College and from the Mount Sinai School of Medicine of the City University of New York. Brandeis University named her Milender Fellow in 1981. Born in Asbury Park, New Jersey, Ms. Tisch earned a B.S. from Skidmore College. P. Roy Vagelos P. Roy Vagelos is chairman of the board of Regeneron Pharmaceuticals Inc. and former chairman of the board and chief executive officer of Merck & Company, Inc. An authority on lipids and enzymes, Dr. Vagelos began his career as a researcher at the National Institutes of Health, where he became head of the section on compar- ative biology. He joined the faculty of Washington University in St. Louis, Missouri, and became chairman of the department of biological chemistry of the school of medicine. He later served as director of the university's division of biology and biomedical sciences. Dr. Vagelos held several research and business positions in twenty years at Merck & Company, Inc. The author of more than one hundred scientific papers, Dr. Vagelos received the Enzyme Chemistry Award of the American Chemical Society. He is a member of the National Academy of 162 APPENDIX D EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Sciences, the American Academy of Arts and Sciences, and the American Philosophical Society. He is chair- man of the board of trustees of the University of Pennsylvania and a trustee of The Danforth Foundation. Dr. Vagelos earned an A.B. from the University of Pennsylvania, where he was elected to Phi Beta Kappa, and an M.D. from the College of Physicians and Surgeons of Columbia University. James D. Watkins James D. Watkins, retired admiral of the U.S. Navy, is president of the board of governors of the Joint Oceano- graphic Institutions (JOI) Inc. He is founder and president of the board of governors of Consortium for Oceano- graphic Research and Education (CORE). Under President George Bush, Admiral Watkins served as Secretary of Energy. He has worked throughout his career to improve the education of young people, especially in math- ematics and science. Admiral Watkins served as chairman of the Federal Coordinating Council for Science, En- gineering, and Technology's Committee on Education and Human Resources, which produced the first federal government-wide strategic plan for mathematics and science education programs. Admiral Watkins served as chairman of the Presidential Commission on the Human Immunodeficiency Virus (AIDS) Epidemic under Pres- ident Ronald Reagan. His naval career was capped by his assignment as Chief of Naval Operations. His military decorations include several Distinguished Service and Legion of Merit medals and the Bronze Star. Admiral Watkins is member of the Knights of Malta, an international order of leading Catholic laymen dedicated to hu- manitarian service and a trustee of Carnegie Corporation of New York. Admiral Watkins is a graduate of the U.S. Naval Academy, earned an M.S. in mechanical engineering from the U.S. Naval Post-Graduate School, and is a graduate of the reactor engineering course at the Oak Ridge National Laboratory. William Julius Wilson William Julius Wilson is the Lucy Flower University Professor of Sociology and Public Policy and the director of the Center for the Study of Urban Inequality at the University of Chicago. Professor Wilson is noted for his work on urban poverty and issues of race. He is author of Power, Racism, and Privilege: Race Relations in The- oretical and Sociohistorical Perspectives; The Declining Significance of Race: Blacks and Changing American In- stitutions, and The Truly Disadvantaged: The Inner City, The Underclass, and Public Policy. A MacArthur Prize Fellow, Professor Wilson is a past fellow at the Center for Advanced Study in the Behavioral Sciences at Stan- ford University. He is past president of the Consortium of Social Science Associations and of the American So- ciological Association. Professor Wilson is a fellow of the American Academy of Arts and Sciences and of the American Association for the Advancement of Science and is a member of the National Academy of Sciences, American Philosophical Society, and National Academy of Social Insurance. Among many awards and honorary degrees, he received the Burton Gordon Feldman Award, given for outstanding contributions in the field of pub- lic policy from the Brandeis University Gordon Public Policy Center. Professor Wilson earned a B.A. from Wilberforce University, an M.A. from Bowling Green State University, and a Ph.D. in sociology/anthropology from Washington State University. APPENDIX 0 163 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS APPENDIX E INDEX OF PROGRAMS CITED IN THE REPORT Advocates for Youth ASPIRA Association, Inc. Center for Media Education 1025 Vermont Avenue, N.W. 1112 16th Street, N.W., Suite 340 1511 K Street, N.W., Suite 518 Suite 200 Washington, DC 20036 Washington, DC 20005 Washington, DC 20005-3516 Contact: Ronald Blackburn- Contact: Kathryn C. Contact: Mary Pruitt Clark, Moreno, National Executive Montgomery, President President Director Telephone: (202) 628-2620 Telephone: (202) 347-5700 Telephone: (202) 835-3600 Fax: (202) 628-2554 Fax: (202) 347-2263 Fax: (202) 223-1253 Page 117 Pages 119, 120 Page 109 Center for Media Literacy Advocates for Youth Media Association of Science- 1962 South Shenandoah Project Technology Centers (ASTC) Los Angeles, CA 90034 3733 Motor Avenue, Suite 204 Youth Alive! Initiative Contact: Elizabeth Thoman, Los Angeles, CA 90034 1025 Vermont Avenue, N.W. Executive Director Contact: Jennifer Daves, Suite 500 Telephone: (800) 226-9494 Director Washington, DC 20005-3516 Fax: (310) 559-9396 Telephone: (310) 559-5700 Contact: DeAnna B. Beane, Page 119 Fax: (310) 559-5784 Project Director Page 119 Telephone: (202) 783-7200 Center for Youth Development Fax: (202) 783-7207 and Policy Research American Business Page 109 Academy for Educational Collaboration for Quality Development Dependent Care Boy Scouts of America 1255 23rd Street, N.W., Suite 400 c/o Work/Family Directions 1325 West Walnut Hill Lane Washington, DC 20037 93° Commonwealth Ave., West P.O. Box 152079 Contact: Richard Murphy, Vice Boston, MA 02215-1274 Irving, TX 75015-2079 President, AED, and Director, Contact: Mary Kay Leonard, Contact: Jere Ratcliffe, Chief CYDPR Vice President Scout Executive Telephone: (202) 884-8000 Telephone: (617) 278-4000 Telephone: (214) 580-2000 Fax: (202) 884-8404 Fax: (617) 566-2806 Fax: (214) 580-2502 Page 113 Pages 70, 71 Page 106 Center for the Study and American Library Association Boys & Girls Clubs of America Prevention of Violence Young Adult Services Division (Programs in Public Housing Institute of Behavioral Science 50 East Huron Street Projects) University of Colorado at Boulder Chicago, IL 60611 1230 West Peachtree Street, N.W. 910 28th Street, Frontage Road Contact: Linda Waddle, Deputy Atlanta, GA 30309 Campus Box 422 Executive Director Contact: Judith Carter, Senior Boulder, CO 80309-8479 Telephone: 1-800-545-2433, Vice President Contact: Laura Ross Greiner, extension 439° Telephone: (404) 815-5758 Project Coordinator Fax: (312) 664-7459 Fax: (404) 815-5789 Telephone: (303) 492-1032 Page 110 Pages 108, 109 Fax: (303) 449-8479 Page 96 164 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS Children's Aid Society Stanford University National Urban League 105 East 22nd Street Stanford, CA 94305 500 East 62nd Street New York, NY 10010 Contact: H. Craig Heller New York, NY 10021 Contact: Philip Coltoff, Telephone: (415) 723-1509 Contact: Hugh B. Price, Executive Director Fax: (415) 725-5356 President and CEO Telephone: (212) 949-4917 Pages 78, 79 Telephone: (212) 310-9000 Fax: (212) 460-5941 Fax: (212) 755-2140 Page 82 MediaScope Page 109 12711 Ventura Boulevard, Suite 250 City Youth Studio City, CA 91604 Quantum Opportunity Constitutional Rights Contact: Marcy Kelly, President Program Foundation Telephone: (818) 508-2080 1415 North Broad Street 601 South Kingsley Drive Fax: (818) 508-2088 Philadelphia, PA 19122 Los Angeles, CA 90005 Pages 119, 120, 121 Contact: Debbie Scott, Office of Contact: Eleanor Kim, Associate National Helpers Network, Inc. National Literacy Programs Director Telephone: (215) 236-4500 Telephone: (213) 487-5590 (Early Adolescent Helper Fax: (215) 236-7480 Fax: (213) 386-0459 Program) Pages 56, 57 Pages 109, III 245 Fifth Avenue, Suite 1705 New York, NY 10016-8728 School-Based Youth Services The Congress of National Contact: Alice L. Halsted, Program Black Churches, Inc. / President New Jersey Department of Project SPIRIT Telephone: (212) 679-2482 Human Services 1225 Eye Street, N.W., Suite 75° Fax: (212) 679-7461 222 South Warren Street Washington, DC 20005-3914 Pages 109, 111 Trenton, NJ 08625-0700 Contact: B.J. Long, Acting Contact: Edward Tetelman, Project Director National Coalition of Hispanic Health and Human Service Director, Office of Legal and Telephone: (202) 371-1091 Regulatory Affairs Fax: (202) 371-0908 Organizations (COSSMHO) Telephone: (609) 292-1617 Pages 109, 112 1501 16th Street, N.W. Fax: (609) 984-7380 Washington, DC 20036 Girl Scouts of the USA Pages 51, 52 Contact: Jane L. Delgado, 420 Fifth Avenue President and Chief Executive YMCA of the USA New York, NY 10018-2202 Officer 101 North Wacker Drive Contact: Mary Rose Main, Telephone: (202) 387-5000 14th Floor National Executive Director Fax: (202) 797-4353 Chicago, IL 60606-7386 Telephone: (212) 852-8000 Page 109 Contact: David Mercer, National Fax: (212) 852-6517 Executive Director Page 119 National 4-H Council 7100 Connecticut Avenue Telephone: (312) 977-0031 Girls Incorporated Fax: (312) 977-9063 Chevy Chase, MD 20815 Page 106 30 East 33rd Street Contact: Richard Sauer, New York, NY 10016 President YWCA of the USA Contact: Isabel Carter Stewart, Telephone: (301) 962-2820 726 Broadway National Executive Director Fax: (301) 961-2894 New York, NY 10003 Telephone: (212) 689-3700 Page 106 Contact: Prema Mathai-Davis, Fax: (212) 683-1253 National Executive Director National Network of Violence Page 119 Prevention Practitioners Telephone: (212) 614-2821 Human Biology Middle Grades Fax: (212) 979-6829 Education Development Center Life Science Curriculum Page 106 55 Chapel Street HUMBIO Curriculum Newton, MA 02160 Program in Human Biology Contact: Gwendolyn J. Department of Biological Dilworth, Project Coordinator Sciences Telephone: (617) 969-7100 Building 80-2160 Fax: (617) 244-3436 Page 96 APPENDIX E 165 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CARNEGIE COUNCIL ON ADOLESCENT DEVELOPMENT STAFF Ruby Takanishi Julia C. Chill Wanda M. Ellison Executive Director Program/Administrative Administrative Assistant Assistant Allyn M. Mortimer Jenifer Hartnett Program Associate Timothy J. McGourthy Staff Assistant Program/Administrative Katharine Beckman Assistant Elliott Milhollin Office Administrator Office Clerk FORMER STAFF Winnie Bayard Anthony W. Jackson Jane Quinn Project Assistant, 1990-93 Project Director Project Director Task Force on Education of Task Force on Youth Bronna Clark Young Adolescents, Administrative Secretary, Development and Community 1987-90 Programs, 1990-93 1986-89 Susan G. Millstein Linda L. Schoff Annette Dyer Associate Director, 1987-90 Administrative Assistant, Program/Administrative Assistant, 1991-94 1988-91 Elena O. Nightingale Senior Advisor to the Council, Andrea Solarz 1986-94 Program Associate, 1988-90 166 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS CREDITS PHOTOGRAPHS Page 1: Boy plays on a swing, Danny Lyon © 1988, Magnum Photos. This section to be completed. QUOTES AND POEMS Page 16, part I opener: From Voices from the future: Our children tell us about violence in America, by Children's Express, edited by Susan Goodwillie, 1993, New York: Crown Publishers, Inc. Reprinted by permission. This section to be completed. UNCORRECTED PAGE PRO The world's blind, neglecting its land. The human race has turned on itself, destruction's loud but the world's deaf! Change can be found if it's truly being searched for; we as one need to communicate, guide our youth, because what we do today is setting the path for our children! GEORGE T., 17 EMBARGOED UNTIL 10 AM, OCTOBER 12, 1995 UNCORRECTED PAGE PROOFS