High Jump in Preschool Prescription Use

The prescription of psychotropic drugs for preschoolers has rocketed during recent years, according to a study in the Journal of the American Medical Association. Researchers pooled data on 2-4 year olds enrolled in one Midwestern state Medicaid program, one Mid-Atlantic state Medicaid program and one Northwestern health maintenance organization.

The study revealed that the use of stimulants and antidepressants increased significantly between 1991 and 1995, while the use of neuroleptics remained steady. Altogether, 90% of stimulant prescriptions were for the drug methylphenidate (Ritalin ®). Over the five years reviewed, Ritalin prescriptions jumped 3-fold in the Midwestern group, 1.7-fold in the Mid-Atlantic group and 3.1-fold in the Northwestern group.

The report also identified a dramatic increase in off-label prescriptions, such as the stimulant clonidine. The study's authors defined off-label prescriptions as "for treatment indications with little or no proven efficacy and lacking product package insert labeling information approved by the US Food and Drug Administration (FDA)." They caution that the psychotropic drugs given to preschoolers (both on- and off- label) have not been proven safe or effective for long-term use.

Zito JM; Safer DJ; dosReis S; Gardner JF; Boles M; Lynch F   Trends in the prescribing of psychotropic medications to preschoolers   JAMA 2000 (Feb 23);   283 (8):   1025-1030

High "Rep" Weight Training Best for Child Athlete

What type of resistance strength training regimen, if any, is most beneficial for children? To answer that question, investigators looked at 11 girls and 32 boys aged 5.2 to 11.8 years. The children were divided into three groups. One cohort trained using 1 set of 5 to 8 repetitions with a heavy weight. A second set of youngsters engaged in 15 repetitions with a moderate weight. A final control group did not participate in resistance training. Training lasted 8 weeks.

Although both intervention cohorts exhibited increased strength and muscular endurance, the high repetition-moderate load group showed significantly more improvement, compared with the low repetition-heavy load group. The study concluded, "These findings support the concept that muscular strength and endurance can be improved during the childhood years and favor the prescription of higher repetition-moderate load resistance training programs during the initial adaptation period."

Faigenbaum AD, Westcott WL, LaRosa Loud R, Long C.  The effects of different resistance training protocols on muscular strength and endurance development in children   Pediatrics 1999 (Jul);   104 (1):   e5

Radiographic Signs of Spinal Degeneration in Young Football Players

A new report challenges the widely held belief that youths that play football are at an increased risk of radiographic spinal abnormalities.

Investigators examined lumbar radiographs of 104 football players prior to their first season of college play.  They also analyzed lumbar x-rays of 83 age-matched controls.  Researchers found that the rate of spondylolysis did not differ significantly between the two groups. And, football players were less likely to show radiographic signs of degeneration. Specifically, "the control group had a 16.9% incidence of disk space narrowing and spurring and the football players had a 6.7% incidence," researchers report.

Jones DM, Tearse DS, El-Khoury GY, et al.  Radiographic abnormalities of the lumbar spine in college football players. A comparative analysis   Am J Sports Med 1999 (May);   27 (3):   335-338