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Two studies this week bust some myths about sensitive topics and kids. This is Healthcare Triage News.

For those of you who want to read more, go here: http://theincidentaleconomist.com/wordpress/?p=60691

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

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 Introduction


Two studies this week bust some myths about sensitive topics in kids. This is Healthcare Triage News.

(Intro music plays)

 Foster Care and Academic Achievement


A number of studies have found that kids in foster care suffer from a number of adverse outcomes, including poor academic achievement. This has led many people to believe that being placed in foster care causes poor academic achievement. In other words, foster care can't live up to regular care and you see that in school performance.

But a recent study in the journal Pediatrics questions this assumption in the aptly titled paper, "Children's Academic Achievement and Foster Care". Researchers looked at a large data set to try and understand this better. They found, in a simple bivariate analysis, meaning that they didn't control for other things, that kids in foster settings did have test scores more than half of a standard deviation below average. That's the kind of simple but flawed analysis that gives foster care a bad rap.

But these researchers went further. They also found that academic deficit was associated not only with current and past foster placement but also with future foster placement. And something that takes place in the future can't cause something in the past. Moreover, in the model that was preferred by the authors, which was also the most robust model because it controlled for child-specific fixed effects, foster placement had no effect at all on academic achievement. In other words, foster placement is associated with poor academic achievement but likely not causing it. Something else which is associated with foster placement is likely the cause.

This means that while we should be concerned about children in foster care, and recognize that it is perhaps a marker for kids at risk for lower academic achievement, it's not an independent predictor of school troubles. Many have often viewed it negatively for this reason, likely mistakenly so.

 Effect of Sexual Abuse on Future Outcomes


Our second story helps to dispel a myth about sexual abuse. For a long time, people have assumed that being sexually abused as a child increases the chance that that child will grow up to be a sexual offender. As you can imagine, anecdotes fuel this belief. There's not a lot of good data to go on. But there is some. In a recent study in JAMA Pediatrics, researchers got into it. They examined a cohort of kids in the Midwest, some of whom had been physically or sexually abused before the age of 11 years old. They matched them to kids who had not been abused but who were the same age, sex, race or ethnicity, and social class. There were 908 cases and 667 controls. Both groups were followed until they were, on average, 51 years old - that's no small feat! The court cases were all between 1967 and 1971, and follow-up was through to 2013. The main outcome of interest was whether as adults they were arrested for a sex crime. Here's the gist of their findings.

Overall, those who were abused or neglected as kids were significantly more likely to be arrested for a sex crime than those who had not been abused, even after controlling for other factors. Adults arrested for a sex crime comprised 8.3% of those who were abused or neglected but only 4.5% of those who were not. But specifically, those who were either physically abused or who were neglected were at increased risk for committing a sex crime.

But here's the surprising part: those who were sexually abused were not significantly more likely to commit a sex crime later in life. It also turned out that the significant relationships were true for men only - not women. In general, men were much more likely to be arrested for sex crimes than women, no matter what their history.

What does this mean? We should absolutely continue to provide assistance to children who are physically abused or who are neglected to reduce their risk of future sexual crimes. But those who've been sexually abused? We should still do everything we can to help them but the stigma of concern that they're an increased risk for future sex crimes may be unwarranted.