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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2014;168(8):689. doi:10.1001/jamapediatrics.2013.3357.
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The actual prevalence of child maltreatment is not clearly known, despite the importance of the problem. Using data from the National Child Abuse and Neglect Data System, Wildeman and colleagues seek to determine the proportion of children who are maltreated by 18 years of age. At 2011 rates, 1 in 8 children will experience maltreatment confirmed by child protections service workers by age 18 years. For black children, the risk is 1 in 5 and for Native American children, 1 in 7. Maltreatment is on the scale of other major public health problems that affect child health and well-being.

The recent spate of school shootings has raised concern about weapon carrying by school-aged youth. Van Geel and colleagues conduct a meta-analysis of studies examining the relationship between bullying and weapon carrying among youth 21 years or younger. Involvement in bullying, as a perpetrator, victim, or both, were all associated with an increased risk of weapon carrying. Studies in the United States found that the odds of carrying weapons were almost 8-fold higher for bully-victims compared with those with no weapon carrying. Interventions for addressing bullying are available and need to be implemented widely in schools.

The overall economic effect of autism spectrum disorders (ASDs) is not well established. Buescher and colleagues use newly available data on prevalence and costs to determine the annual and lifetime costs for individuals with ASDs with and without intellectual disability in the United States and United Kingdom. The cost of supporting an individual with an ASD and intellectual disability during the lifespan was $2.4 million in the United States and $2.2 million in the United Kingdom, with the largest components for children with special education services and for lost parental productivity. In their editorial, Shattuck and Roux discuss the need for a new conversation about innovation and investment for individuals with ASDs.

Animal studies indicate that use of general anesthetic agents in developing animals results in neurocognitive and behavioral deficits. In a cohort study involving 22 academic neonatal intensive care units, Morriss and colleagues study 12 111 infants with birth weight 401 to 1500 g. Infants who underwent surgery had 50% greater odds of death or neurodevelopmental impairment and a 3.3-point lower mean Bayley score than those without surgery. In an accompanying editorial, Williams and colleagues discuss these findings and the implications for clinical care and future research.





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