Child Advocacy, Part II

I wanted to comment on another experience I had while on the Child Advocacy rotation, specifically going to the Boys and Girls Club in Gardena. The kids and teens there were like any other in the country, but I came to realize the pressures they often faced and how the often lack of education/support from parents influenced their growth, development and futures.

At "the club", kids were kids...children were doing their math and spelling homework, teens were playing video games and pool and gossiping. I came to understand from talking to the director that even kids who were smart, hardworking and "good" were at high risk for gang involvment, drug use and dropping out of school largely because there was a lot of pressure by gang members in the community and the "bad" to choose that route in life. I am paraphrasing the director, but he essentially said that kids can be protected and supported in the club but cannot be protected by what they face outside of the club. The club did offer a refuge from exposure to gangs/drugs/lack of supervision for the after school period however, in hopes of helping to prevent kids from the risks they were predisposed to simply because of the environment in which they lived.

I also spoke to the director about his role in speaking to parents whose children may be displaying signs of poor school performance or other risky behaviors. Sadly, he said that he essentially gave up on parent meetings because so often the parents don't feel overly concerned about such things. He had a few theories of where this came from including lack of education and therefore value of school by the parents or the parents themselves being involved in gangs/drugs and not seeing the problem with their kids involved or exposed to such lifestyles. Obviously these theories may be wrong and certianly not all parents feel this way.

It just made me realize the important role that Pediatricians and those working with children have to ensure the safety, well-being and support of kids at high risk and also that if parents don't enforce our advice or recommendations, then it makes it much harder to expect more from kids. I guess it just brought the idea of HEADDSS exam for example and it's importance as a screening tool to a higher level and made me realize how I must really evaluate my patients from a psycho-social point of view, not just medical.

Additionally,if children do show signs of poor school performance or high risk behaviors, that as pediatricians we must do our best to directly intervene and hold our patients accountable through frequent follow-up visits to follow them, most especially when parents may not do so. Parents must be educated and informed along with kids because we can advise but we need the cooperation of parents to follow our advice.