Sleep disturbances are more common among children who watch a great deal of television and in youngsters who view television shortly before bedtime, according to a study by Brown University researchers.

The study involved 495 youngsters, in kindergarten through fourth grade, who attended three public elementary schools in southeastern New England. Parents of the students completed questionnaires about their children's television viewing habits, including how much television was watched daily, children's preferences in television shows and the occurrence of frightening dreams with television-related content. Teachers also filled out questionnaires evaluating the daytime sleepiness of students and their behavior.

The research team, led by physician Judith Owens, reported that most sleeping disturbances were associated with bedtime television viewing, especially the presence of a television set in the child's bedroom. They also found a correlation between sleep disturbances and the amount of television viewed daily.

Children in the study averaged two television sets per household. Nearly all the families owned at least one VCR and 77 percent subscribed to a cable television service. Seventy percent of children in the study watched two hours of television on weekdays. They viewed 2.8 hours on Saturdays and 2.5 hours on Sundays.

Watching television was one of the top three activities for 35 percent of the children in the study. About one-quarter of the children had a television set in their bedroom. Some 76 percent of parents reported that television watching was part of their child's usual bedtime routine. For 16 percent of youngsters, the practice of falling asleep in front of the television occurred at least two nights a week, according to the study in the Sept. 3 electronic journal Pediatrics.

Based on these findings, the authors concluded that television viewing practices should be an important part of routine behavioral screening of children.

"Because television-viewing habits may be a marker for sleep problems, discussion of bedtime television viewing with parents may uncover previously undetected sleep disturbances," they recommended. Such discussion, they said, could also be an opportunity to discuss the potential impact of inadequate sleep on the health, behavior and academic performance of school children.

--Sally Squires


Some of the controversy surrounding the treatment of children with attention deficit hyperactivity disorder (ADHD) stems from concerns that exposure to Ritalin and other stimulant drugs often prescribed for such youngsters might increase their risk of becoming substance abusers as teenagers or adults. But new research suggests instead that the risk of substance abuse is greatly reduced by treating ADHD with medication.

In a long-term study of white boys, those with ADHD who received medication had rates of substance abuse no higher than those seen in children without ADHD, said Joseph Biederman, a professor of psychiatry at Harvard Medical School.

The findings should reassure parents who have been alarmed by previous reports of high rates of drug and alcohol abuse in adults whose ADHD was never diagnosed in childhood, because they suggest that proper treatment can help prevent such problems.

"It's protective in boys [and] it should be protective in girls," Biederman said. Treating ADHD, he added, may help children avoid school failure and social difficulties that could otherwise lead to antisocial behavior and substance abuse.

The research team analyzed data from a longitudinal study of families containing at least one child with ADHD. Included in the research sample were 56 boys with ADHD who had been treated with drugs (for an average of 4.4 years), 19 boys with the disorder who had never received medications, and 137 boys without ADHD. All participants were at least 15 years old at the time of the analysis. Researchers based their conclusions on interviews of each teenager conducted at the beginning of the study, one year later and four years later, including detailed questions about use of alcohol, marijuana, hallucinogens, cocaine and other stimulants.

In the group with ADHD who had never been treated, the rate of substance abuse in adolescence was three times that seen in the boys with ADHD who had received medications. In boys with ADHD who had been treated, the rate was not significantly different from that seen in boys without the disorder.

Biederman said similar studies should be conducted in other populations. However, he said, research so far indicates that girls and African American children with ADHD have symptoms similar to boys with the disorder and respond as well to treatment, so he expects the long-term benefits to be the same.

The study appears in the online version of the August issue of the journal Pediatrics.

--Susan Okie


A global campaign to eradicate polio is on track to eliminate the paralyzing disease by the end of 2000 or shortly thereafter, according a World Health Organization official.

"Our target stands as the year 2000 and we're doing everything we can to reach that target. I think we have reasons to be optimistic," said Harry F. Hull, a senior adviser to the WHO for polio eradication. "If we don't reach it, we're going to be very, very close."

Last month, 8.2 million children in the Democratic Republic of Congo (DRC)--80 percent of that country's children under five years old--were vaccinated against polio during a national immunization campaign. The war-torn nation has had no national immunization program for many years, leaving the majority of children there susceptible to the disease, Hull said.

For the most part, anti-government rebels and government troops laid down their arms during the three-day campaign to allow 75,000 volunteer vaccinators to deliver doses of the oral vaccine to children. When fighting broke out in the city of Kisangani on the third day, Hull said, UN Secretary-General Kofi Annan brokered a cease-fire with the help of the presidents of Uganda and Rwanda. Ultimately, 91 percent of Kisangani's children under five received doses of the vaccine. Additional immunization days have been scheduled to meet the goal of delivering three doses to each child.

Countries with long-running civil wars present the greatest challenge for public health officials seeking to eradicate polio, Hull said.

Elsewhere in the world, "we're making fabulous progress," Hull said. Since 1988, when the WHO set the target of eradicating the disease by 2000, polio cases worldwide have decreased by 85 percent.

--Susan Okie