Bulletin - The measure of excellence : Canadian early childhood ...

SPECIAL FEATURE ON RESEARCH: PREGNANCYDECISION-MAKING SWAYED BY WORDS USEDDoes the way in which informationis framed shape people's perceptionsand behaviour? Are we gettingthe same information when it isframed positively or negatively? ACanadian research team recentlydecided to test whether the framingeffect would alter a pregnantwoman's decision to use allergyrelateddrugs during her pregnancy.The team recruited women callersfrom the Motherisk Program, a counselingservice based in Toronto.Motherisk provides evidence-basedinformation about the risks associatedwith drug, chemical, radiation andinfectious exposures during pregnancy.Callers were randomly assigned toone of two groups. In one group,women were told that by taking anallergy-related drug there was a 1% to3% chance that a baby would be bornwith a major birth defect (negativeframing). In the second group, womenwere told that there was a 97% to 99%chance of having a healthy baby (positiveframing). Both groups were toldthat the allergy-related drug did notsignificantly increase the risk of birthdefects in the baby.When contacted a few days later,women who had received the positivelyframed information perceivedthe drug as less risky and were morelikely to say they would take it thanwere women who had been given thenegatively framed information. Theresearchers point out that theseresults concur with the findings of previousstudies on information framing."Framing is a very important issue,and here you have an important findingbecause it appears that negativeand positive framing may have a significantimpact on the decisions peoplemake" says Robin Walker, Professor ofPediatrics at the University of Ottawaand Chief of Neonatology at theChildren's Hospital of Eastern Ontario.The study was well constructed,according to Walker. "It's an elegantpiece of work. Their methodology wascarefully done. They have two wellmatchedgroups and they came up witha significant result." However, JohnLeBlanc, Assistant Professor ofPediatrics, Psychiatry, CommunityHealth and Epidemiology at DalhousieUniversity, points out that the groupswere not representative of the generalpopulation. "Mothers who callMotherisk are already concerned. Itwould be interesting to try this sameapproach with women at doctors'offices or even women who don't getprenatal care."Both Walker and LeBlanc agreedthat the study's conclusions constitutea significant contribution to study inthis field.However,Walker stressed thatmore research is needed. "We need tolook more carefully at how we presentinformation and the impact of thatpresentation. This is a very broad issueand there is a need for more inquiry."Ref.: J. D. Jasper, R. Goel, A. Einarson,M. Gallo and G. Koren. "Effects ofFraming on Teratogenic RiskPerception in Pregnant Women." TheLancet. Vol. 358. October 2001.PROBLEM PREGNANCIES AND INADEQUATE PARENTINGThe links between low socioeconomicbackground, inadequateparenting and criminal behaviourare now widely accepted and wellestablishedin research.However, links between problemswith pregnancy, delivery and adultcriminality have not been as easy toestablish as, to date, findings havebeen contradictory. Now a team ofCanadian and Swedish researchers hasexamined the role played by obstetriccomplications in the development ofcriminal and violent behaviour.The researchers studied 15,117individuals born in Stockholm,Sweden and monitored them untilage 30. Information on obstetric complications(which included problemsduring pregnancy, labour-deliveryand the neonatal period), criminalacts, the socioeconomic status of theirfamilies and inadequate parentingwas obtained from medical, health,social work and police records.Obstetrical complications alonewere not associated with adult criminality.However, obstetrical complicationscombined with inadequate parentingdid slightly increase the risk ofcriminal offences among both menand women, and it more than doubledthe risk of committing violentoffences (i.e., crimes involving threatenedor perpetrated physical violencesuch as rape, assault or robbery)among men.A combination of obstetrical complicationsand inadequate parentingaffected only a small portion of thestudy subjects (3.1 % of the men and4.0% of the women). Inadequateparenting was experienced by 19.1%of the men and 18.1% of women and,as is frequently the case, was associatedwith an increased risk of offending.For Darren Lezubski, ManagingDirector of the Centre of Excellence forChild and Youth-Centered PrairieCommunities in Winnipeg, the study"improves the methodology comparedto previous studies. The researcherscontrolled for possible confoundingfactors, such as mental retardation andmajor psychiatric disorders known toincrease the likelihood of offending."The authors of the study also analyzedthe data by gender, "something that istoo often neglected in this kind ofresearch, despite recognized differencesin the prevalence of criminalbehaviour by gender."Since the study suggests thatobstetrical complications may influencethe development of criminaland violent behaviour, we can wonder"what services can be offered topregnant women to reduce the incidenceof complications at birth?"adds Lezubski. Additionally, it wouldbe interesting to broaden the scopeof environmental variables in order tobetter understand their role indevelopmental pathways that lead tocriminality. Lezubski suggests "thatfuture longitudinal studies should followthrough by investigating withmore scrutiny possible effects of environmentalfactors such as peer grouppressure and the influence of theneighborhood on the likelihood ofbecoming a violent offender".Ref.:S.Hodgins,L.Kratzer,and T.F.McNeil. Obstetric Complications,"Parenting and Risk of CriminalBehavior." Archives of GeneralPsychiatry. Vol. 58. August 2001.VOLUME 1, N O 3 - DECEMBER 2002 BULLETIN OF THE CENTRE OF EXCELLENCE FOR EARLY CHILDHOOD DEVELOPMENT - PAGE 3