ARSH 8: Family life education and counseling: a school based model.

OBJECTIVES: To understand the problems of school going adolescents in selected schools in the first phase and to provide class based family life education in the second phase. METHODS: Step 1: Identification of the study sample, Step 2: Each adolescent was individually administered TSQ-T by trained project staff , Step 3: 'Family life education' sessions were held for the whole class together, Step 4: Queries were collected on a slip of paper without writing their names, Step 5: Those needing medical attention was seen by a medical doctor and psychologist Step 6: Preparation of a guide book named "101 questions", Step 7: Upscaling the project as a service component to Government schools. RESULTS: 4.6% of school going boys and 2.5% of girls were underweight and 4.4% of boys and 7.8% of girls were obese. Less than 5% of adolescents had symptoms suggestive of various mental health disorders, 2.6-8.3% for attention deficit hyperactivity disorder (ADHD), 3% for eliminating disorder, 0.9-2.2% for conduct disorder, 0.9-3.3% for anxiety disorders, 1.7-4.4% for depression and 0.8-1.1% for psychosis. Adolescent school going girls had a mean age of menarche at 12.7 y and 46% of girls did not receive any prior information about menarche. CONCLUSIONS: Screening of adolescents using TSQ-T developed at CDC, Kerala and used extensively in community projects, was found to be useful in identifying adolescents with nutrition and lifestyle issues, scholastic problems, mental health problems and reproductive health problems.

A primary care approach for adolescent care and counseling services.

OBJECTIVE: Adolescents can have mental, emotional, and behavior problems that are a source of stress for the child as well as the family, school and community. These may disrupt the adolescent's ability to function normally. Adolescents also have reproductive concerns especially at menarche. Considering the extent of problems of adolescents and the lack of adolescent care and counseling services, it was felt that community adolescent care counseling services should be made available. This article describes the steps involved in the setting up of Taluk model of adolescent care and counseling services. METHODS: Following steps were involved in setting up a Taluk model of adolescent care counseling service delivery system. Step I: Focus Group Discussions (FGDs) among Stakeholders. Step II: Conceptualization and Strategy planning for service delivery. III: Finalization of service delivery model Step IV: Workshops for finalization of TSQ-T 2008 version the tool to be used for assessing the adolescents in the ARSH clinics. Step V: Training Programme for Medical/Paramedical health staff. Step VI: Awareness programs for mothers of adolescents. Step VII: Setting up of ACS/ARSH clinics at Taluk hospitals. Step VIII: Evaluation of the utilization of services at Taluk hospitals. The clinic has been well utilized with 1,588 adolescents being seen in 2 years. RESULTS: Medical and Reproductive problems among adolescent girls were anemia, underweight, dysmenorrhoea, menstrual irregularities and symptoms of Polycystic Ovarian Syndrome, whereas among boys problems were mostly related to concerns about masturbation and its perceived ill effects. The psychosocial problems ranged from minor anxieties, sadness and adjustment problems to psychiatric disorders. Scholastic problems included poor concentration, poor study habits and low intelligence quotient. CONCLUSIONS: The success of the clinics in these five hospitals can be replicated in other parts of the state as well as the country. These will go a long way to ameliorate the morbidity of adolescents.

Hypoxic ischemic encephalopathy developmental outcome at 12 years.

This study was done to determine the mental and motor development and developmental psychopathology problems at 12 years of age, among term babies with hypoxic ischemic encephalopathy (HIE) at birth. 48 children with HIE at birth were assessed at 12 years of age, to find out the developmental status. Among 41 children, who had grade I HIE at birth, 15 (36 %) had normal intelligence and only 4 (9.8%) had mental retardation. Among the rest of 7 babies who had grade 2 and 3 HIE, 2 children had mental retardation, 3 had borderline IQ and 2 had low average IQ. Hyperkinesis (23%) and somatic disorders (17%) were the commonest developmental psychopathology problems among all the three grades of HIE together. There was also an increased incidence of visual abnormality, cerebral palsy and various psychopathology problems in children who had grade 2 and 3 HIE.