What Children and Adolescents Know and Need to Learn about Cancer.

Despite cancer's devastating effects on health and longevity, and the critical role of health habits formed during childhood and adolescence in its prevention, children's knowledge of contributors to cancer is understudied. In this paper, the first developmental analysis of the literature, we outline relevant theoretical perspectives and three early emerging intuitions about illness evident among preschool children-contagion/germ, contamination, and unhealthy lifestyle theories-and then review research on elementary and secondary school students' awareness of risk factors for cancer in light of these early intuitive theories. Our analysis centers on the 16 studies we could locate, done in seven countries, that allowed calculating the percentages of children of different age groups who mentioned various risk factors in response to open-ended questions or endorsed them in response to structured questions.

Characterizing Children's Intuitive Theories of Disease: The Case of Flu.

To advance the study of children's knowledge and understanding of disease, we devised a methodology for assessing key features of intuitive theories laid out by Wellman and Gelman (1998). We then assessed a disease-relevant biological ontology, causal propositions involving unobservables, and coherence in explanations of influenza offered by children aged 8 to 13. Use of disease-relevant terms and mention of propositions in a biological theory of flu causality, although not coherence or connectedness of ideas, increased with age.

Development and Coherence of Beliefs About Disease Causality and Prevention.

Guided by a naïve theories perspective on the development of thinking about disease, this study of 188 children aged 6 to 18 examined knowledge of HIV/AIDS causality and prevention using parallel measures derived from open-ended and structured interviews. Knowledge of both risk factors and prevention rules, as well as conceptual understanding of AIDS causality, increased with age. Younger children displayed more advanced knowledge in response to structured questions than in response to open-ended questions.

Gender differences in preschool children's commentary on self and other.

To examine gender differences in commentary about self and others in same- and mixed-gender contexts, the authors analyzed dyadic conversations involving 78 children in 5 preschool facilities. Compared to girls talking to girls, boy talking to boys made more statements with negative connotations for others and less often pointed out self-other similarities. No gender differences were observed in mixed-gender contexts.

Rich man, poor man: developmental differences in attributions and perceptions.

In an examination guided by cognitive developmental and attribution theory of how explanations of wealth and poverty and perceptions of rich and poor people change with age and are interrelated, 6-, 10-, and 14-year-olds (N=88) were asked for their causal attributions and trait judgments concerning a rich man and a poor man. First graders, like older children, perceived the rich man as more competent than the poor man. However, they had difficulty in explaining wealth and poverty, especially poverty, and their trait perceptions were associated primarily with their attributions of wealth to job status, education, and luck.

Age and ethnic differences in cold weather and contagion theories of colds and flu.

Age and ethnic group differences in cold weather and contagion or germ theories of infectious disease were explored in two studies. A cold weather theory was frequently invoked to explain colds and to a lesser extent flu but became less prominent with age as children gained command of a germ theory of disease. Explanations of how contact with other people causes disease were more causally sophisticated than explanations of how cold weather causes it.

Differences between Black and White elementary school children's orientations toward alcohol and cocaine: a three-study comparison.

To trace the origins of race differences in substance use, this study examined differences between Black and White elementary school children's knowledge of alcohol and cocaine, beliefs about their short- and long-term effects, and attitudes toward and intentions to use them across three independent samples (N = 181, N = 287, N = 234). Black children were more negatively oriented toward alcohol and cocaine than White children from an early age. Most notably, in all samples Black children had less positive attitudes toward adult alcohol use and lower intentions to use alcohol.

Teaching a coherent theory of drug action to elementary school children.

This study examined whether two versions of a drug and alcohol curriculum explaining how substances affect behavior and health, one version more causally coherent than the other, were more effective than a control curriculum on disease in changing school-age children's (N=327) beliefs and attitudes regarding cocaine and alcohol. Few differences were found between the two drug and alcohol curricula. Compared to children receiving the control curriculum, however, both treatment groups demonstrated greater understanding of the circulation of alcohol and cocaine throughout the body, the true long-term effects of these substances, and the stimulant effects of cocaine.

Biological background knowledge and learning from a drug and alcohol education program.

The authors asked whether having a base of relevant biological knowledge put school children in a better position to understand the effects of alcohol and cocaine and to learn about these effects when exposed to a curriculum presenting a physiological theory of drug action. Participants were 337 ethnically diverse 3rd- through 6th-grade students who were pretested, trained, and posttested. Multiple regression analyses revealed that knowledge of the basic functions of the heart, blood, and brain predicted certain drug-knowledge variables.

Age differences in alcohol and cocaine expectancies and attitudes.

Positive and negative expectancies regarding the behavioral effects of alcohol and cocaine were assessed and used to predict attitudes toward their use across four age groups (5-7, 8-10, 11-14, and 18-25, N = 121). Regardless of gender and minority status, children and early adolescents appeared to overgeneralize their beliefs about alcohol to a less familiar drug, cocaine, perceiving the effects of the two drugs similarly. Only college students differentiated between drugs, perceiving cocaine as less likely than alcohol to produce drunkenness and more likely to have stimulant and elation/empowerment effects.

Children's beliefs about long-term health effects of alcohol and cocaine use.

Objective: To assess age differences in children's beliefs about the long-term health effects of alcohol and cocaine, to use such beliefs to predict attitudes toward and intentions to use these substances, and to establish whether accurate beliefs are more predictive than inaccurate ones.

Methods: Children ages 6 to 12 (N: = 217) responded to an open-ended question about the effects of long-term alcohol and cocaine use and to 12 structured questions asking whether each produces alcohol-like, cocaine-like, and tobacco-like effects.

Results: Differentiation among alcohol, cocaine, and tobacco effects was limited but increased with age.

Parental drug use and the socialization of AIDS knowledge and attitudes in children.

Children aged 6 to 18 who had a parent enrolled in drug treatment were matched on the child's age, sex, and ethnicity and on the parent's level of education with children from a community sample. They were compared with respect to parents' knowledge of HIV transmission, parents' efforts to teach their children (ages 6 to 18) about HIV and AIDS, and children's knowledge and attitudes regarding AIDS. Children of drug-abusing parents had more direct and indirect experience with people affected by AIDS than other children, and they demonstrated more knowledge of HIV transmission, once other variables were controlled.

Social implications of behavioral interventions for persons with mental retardation.

The influence of type of behavioral program and program outcome on university students' perceptions of a hypothetical 17-year-old boy with mental retardation who exhibited severe self-injury was examined. A positive program was viewed as more acceptable and effective than were other programs (extremely aversive, mildly aversive, positive combined with extremely aversive, and control). Successful programs were also judged more acceptable and effective than were unsuccessful ones.

The role of germs and viruses in children's theories of AIDS (or, AIDS are not Band-Aids).

The development of knowledge of germs and viruses in relation to AIDS and flu was examined in a predominantly Mexican American sample of children aged 8-9, 10-11, and 12-13. Children progressed with age from identifying the disease agent for these diseases as a nondescript germ or something other than a germ to implicating a disease-specific germ or virus. Parallel age trends in mastery of the two diseases were observed; gender and ethnic differences were minimal.

Factors associated with disclosure of diagnosis to children with HIV/AIDS.

Disclosure of the diagnosis of human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) to a child is a controversial and emotionally laden issue. To understand the factors that affect the process of disclosure and its consequences, we studied 99 parent-child dyads recruited from patients being treated at the National Cancer Institute (NCI). Parents and HIV-infected children were interviewed and administered several standardized measures.

Intuitive theories of human immunodeficiency virus transmission: their development and implications.

Explored the use of cluster analysis to characterize the development of intuitive theories of HIV transmission and examined relationships between children's theories and their attitudes regarding AIDS. In Study 1, analyses of interviews with 188 children and adolescents led to the identification of three relatively immature theories (undifferentiated thinking in which anything can cause AIDS, uncertainty about its causes, and a hybrid theory emphasizing germs as well as any form of drug use) and two relatively mature ones (both emphasizing true AIDS risk factors but differing in their understanding of blood exchange as a cause). Unwillingness to interact with persons with AIDS and worry about AIDS decreased with age and the former in particular was most closely associated with the belief that AIDS is spread through casual contact.

Collective identity and intergroup prejudice among Jewish and Arab students in the United States.

Relationships between indicators of collective identity (collective self-esteem, religious involvement, and involvement in ethnic organizations) and prejudice toward the other-group were examined in a sample of Jewish and Arab students in the United States. Contrary to expectations, collective identity variables were largely unrelated to prejudice among the Jewish students, although the Jewish students who expressed the least amount of anti-Arab sentiment were those who were the most religious. As expected, the Arab students who (a) had low public collective self-esteem and (b) were highly involved in religious and ethnic organizations tended to be the most prejudiced.

Mexican-American and Anglo-American children's responsiveness to a theory-centered AIDS education program.

Third, fifth, and seventh graders, most of them Mexican-American, were exposed to an empirically based and culturally sensitive AIDS curriculum designed to replace their intuitive theories with a coherent, scientific account of the causal processes that lead from risk behavior to AIDS symptomatology. Compared to students in control classes, experimental students knew more about AIDS risk factors and AIDS generally, displayed more conceptual understanding of the causes of AIDS and flu, and were more willing to interact with people who have AIDS (although not less worried about AIDS) at posttest and typically at follow-up 10-11 months later. The findings point to the potential value of adopting an intuitive theories approach in assessing and modifying children's concepts of health and illness and suggest, contrary to Piagetian formulations, that even relatively young children can, with appropriate instruction, grasp scientific theories of disease.

Response biases in interviews of individuals with limited mental ability.

The validity of responses by individuals with mental retardation during interviews is threatened by a number of biases. Acquiescence (the disposition to answer 'yes' regardless of the question asked) is a commonly observed response bias committed by respondents to questionnaires and interviews, and this disposition is significantly more pronounced when persons of low status are questioned by high-status interviewers. Research on the acquiescence bias suggests that it can be reduced in mentally retarded respondents by replacing the usual 'yes/no' question format with an 'either/or' format.

Parents' contributions to children's knowledge and attitudes regarding AIDS: another look.

Attempted to determine, using a sample of students in Grades 3, 5, and 7, whether parent-child communication about AIDS and parent knowledge of AIDS predict children's knowledge, social attitudes, and worry regarding AIDS, partially replicating tests by Sigelman, Derenowski, Mullaney, and Siders (1993) of main effects, interaction, and potentiation models of parent-child socialization. Most parents had talked to their children about AIDS but many were susceptible to myths about HIV transmission. Child age was the strongest predictor of accurate knowledge and positive attitudes, but gender, ethnicity, and parent education also made modest contributions.

Parents' contributions to knowledge and attitudes regarding AIDS.

Examined, in a sample of 170 students in Grades 1-12, relationships between parental background and socialization variables and children's knowledge of AIDS risk factors and willingness to interact with people who have AIDS. Most parents had talked to their children about AIDS and supported early AIDS education, but were susceptible to common transmission myths. Age was the strongest predictor of a child's knowledge and attitudes, but parent ethnicity, education, and occupational status also contributed.

Age differences in understanding of disease causality: AIDS, colds, and cancer.

The development of concepts of disease causality was explored by asking 9-, 11-, and 13-year-olds and college students about risk factors for AIDS, colds, and cancer. Their knowledge became more accurate and differentiated with age. Although younger children knew a good deal about what causes each of the diseases, they lacked knowledge of what does not cause them, often inferring that risk factors for one disease, especially AIDS, cause other diseases as well.

Do you believe in magic? The impact of "Magic" Johnson on adolescents' AIDS knowledge and attitudes.

A group of young people ages 10 to 18, interviewed after basketball star Earvin "Magic" Johnson announced that he had tested positive for the human immunodeficiency virus (HIV), were asked for their reactions to the news. Their knowledge of and attitudes regarding AIDS were also compared to those of similar young people interviewed before the announcement. Reactions to the announcement were varied and were accompanied by only isolated changes in knowledge and attitudes, suggesting that news of this celebrity's HIV infection served primarily to reinforce or make temporarily more salient knowledge and attitudes that predated the announcement.

Views of problem drinking among Native American, Hispanic, and Anglo children.

Native American, Hispanic, and Anglo sixth graders reacting to an example of teenage problem drinking expressed similar beliefs and attitudes in many respects. However, Native American children viewed the problem as less serious, subscribed more to a disease theory of alcoholism, attributed less causal responsibility to the individual, and adopted a less aggressive approach toward treatment than did Hispanic, and especially Anglo, children. Their less conventional value orientations accounted for all these differences except their stronger endorsement of a disease theory of problem drinking.