Study Finds Additional Problems in Preschoolers With a Deployed Parent

It's tough to say goodbye: For some children, the pain of separation from a parent deployed overseas is followed by behavioral and psychological problems and elevated distress.
It's tough to say goodbye: For some children, the pain of separation from a parent deployed overseas is followed by behavioral and psychological problems and elevated distress. (By Andrew Nenque -- Associated Press)
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By Sandra G. Boodman
Special to The Washington Post
Tuesday, December 16, 2008

It's well known that spouses of military personnel serving in Iraq and Afghanistan are severely stressed by wartime separations -- but is the same true of their kids?

New research by developmental pediatricians, believed to be the first to study children so young, has found that preschoolers with a deployed parent display more behavioral and psychological problems, such as depression and anxiety, than their peers whose parents are stateside.

The difficulties confronting military families are likely to get increased attention in the next administration: Michelle Obama has indicated she will focus on the needs of military families as first lady.

The study, published last month in the Archives of Pediatric and Adolescent Medicine, involved 169 children ages 18 months to 5 years who were enrolled in 2007 in a day care center on a large, unnamed Marine base in the United States. Researchers led by Air Force Lt. Col. Molinda M. Chartrand asked the remaining parent (nearly always the mother) and a day care teacher to independently complete two widely used behavioral checklists. After controlling for the mother's depression and stress, Chartrand and her colleagues from the Boston University School of Public Health and the Portsmouth Naval Medical Center found that children between 3 and 5 with a deployed parent showed significantly more distress than military children without a parent overseas.

More than 2 million children have a parent who has been or is serving in Iraq or Afghanistan; 40 percent of these children are younger than 5, the authors note.

"These kids are really the tip of the iceberg," said Chartrand, interviewed by telephone from Spangdahlem Air Base in Germany, where she is now stationed. The extent of the distress, she said, is probably greater than researchers found, in part because the study excluded several sorts of children: those whose parents were in the National Guard or Reserves and therefore did not live on base with the benefits of community support; those who were not enrolled in day care; and those with a preexisting disability or behavioral problem.

Overall, 55 children in the study had a deployed parent. The average length of deployment at the time of the study was short: less than four months. And although distress was clear among the older children, it was not seen among those between 18 months and 3 years.

"What we see here is striking and highly concerning," said physician David J. Schonfeld, director of the division of developmental and behavioral pediatrics at Cincinnati Children's Hospital. In a companion editorial, Schonfeld noted that the study found that one in five children showed signs of difficulty, despite what he called the authors' "very conservative" interpretations, which may have understated the extent of distress. Problem behaviors seen among the 3- to 5-year-olds include disrupted eating and sleeping, increased anxiety or sadness, acting out and an inability to concentrate.

"We can't pretend anymore that kids are not suffering," Schonfeld added in an interview. "I think there's a tendency to think that young children are unaware of or not impacted" by a parent's deployment, unlike older children or teenagers. "But it's not just the mothers who are stressed."

Child psychologist Robin Gurwitch, who co-wrote the editorial and was involved in developing a support program for military families, agrees. "The study is a great first step," said Gurwitch, an expert in childhood trauma who has worked with survivors of the 1995 Oklahoma City bombing and Hurricane Katrina.

There has been a growing interest in the effect of deployment on children and an increase in programs for military families, Gurwitch said. Earlier this yearhttp://Sesame Workshop unveiled free bilingual programming (http://archive.sesameworkshop.org/tlc) that parents can download. The videos, music and printed guides are part of the "Deployments, Homecomings, Changes" series for young children. In one episode, the character Rosita talks with Elmo about her father's return from war in a wheelchair.

Chartrand said that previous studies of military children have not uncovered higher levels of psychological dysfunction than among the civilian population. Studies of school-age children whose parents were deployed in 1990 and 1991 as part of the Gulf War found increased but not clinically significant levels of symptoms. But that conflict, Schonfeld said, lasted a matter of weeks, far shorter than the war in Afghanistan, which began in 2001, or Iraq, which was launched more than five years ago.

In Chartrand's view, the findings of her study underscore the continued importance of taking care of military families.

"The most important circle is the family," she said. "If the family isn't functioning well, the child isn't functioning well, no matter how many resources or how much therapy we throw at them."

Comments: boodmans@washpost.com.


© 2008 The Washington Post Company

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