Literature Review

–Protective Factors Self-awareness Family cohesion Perception of risk Age of first use –Intervention Programs Substance abuse Prevention Outcome Effectiveness –Substance Abuse Drug & Alcohol –Decision-making Self-efficacy Drug use resistance –Family Family bonding Family Functioning Parenting Practices

Literature Review  Although the link between substance abuse and child maltreatment has been relatively well established, there is a general recognition that this is not a simple cause-effect relationship.  There is a complex interplay of multiple factors best understood within the system of the family.  There is mounting evidence that children reared in chemically dependent families are more likely to be exposed to abuse and neglect than children in the general population.  Childhood abuse has been implicated as a significant risk factor for later substance abuse.  The following outcomes were considered: drug knowledge, drug attitudes, acquirement of personal skills (self-esteem, self-efficacy, decision-making skills, peer pressure resistance, assertiveness), peers/adults drug use, intention to use drugs, and use of drugs Overview

Literature Review  Targeting social and behavioral factors, and active participation of children and parents appears more important than whether the intervention was targeted specifically at parents, was school-based, or involved collaboration between school and home.  Programs which develop individual social skills are the most effective form of school-level intervention for the prevention of the early drug use  Prevention curriculum and activities were aimed at altering psychosocial risk factors believed to initiate or maintain substance use.  Multiple influences and settings were targeted Intervention Programs

Literature Review  Parents Intervention Program Counseling, referral assistance, parent education and nurturance. To create and maintain their own support system, enhance their self- esteem, form more realistic expectations of their children, learn parenting skills (use of positive reinforcement, appropriate discipline techniques), become aware of good nutrition and health habits, and help implement their children’s goals.  Children Intervention Program Skills-based programs, curriculum Knowledge: perception of the risk of drug Affective: self-esteem or self-awareness building interventions (based on psychological factors) Peer-based intervention - Refusal skills: focused on resistance skills or peer role models - Social life skills: inter-personal or intra-personal skills Alternative approaches: aimed at enforcing control abilities

Literature Review  Dissemination of information: (Prior to 1970) -Information-deficit approach -Children lacked adequate knowledge regarding the effects of drug use  Social and Interpersonal influence Model: (During the 1970s through 1980s) -Prevention efforts focused on social and interpersonal influence models -Not fully developed their own internal value system to resist external pressure.  Comprehensive system approach: (1990s) - Comprehensive system approach -Research-based, age-appropriate, culturally relevant interactive resistance model -Promote protective factors while reducing risk factors Universal interventions: a general population, such as a community or school. Selective curricula: selective curricula target an at-risk population Indicated programs: individuals who already demonstrate the problem behavior Prevention Interventions - Harolyn M. E. et al., Pediatr Adolesc Med. (1998) “Substance Abuse in Children Prediction, Protection, and Prevention”-

Literature Review  Efficacy of preschool prevention curricula are largely undocumented  Although much is known about the risk factors that lead to initiation of drug abuse, early intervention strategies targeting preschool and elementary school students are underrepresented in research literature.  Understanding the risk factors that lead to substance abuse is paramount for the early identification and prevention of substance abuse in children. Limitations