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Methods: Data were drawn from the National Longitudinal Survey of Youth, 1997. Of the 8984 youth interviewed, 3855 also had a sibling interviewed who met the selection criteria. School problem outcomes measured were suspension occurrence, poor grades and highest grade completed low for age. Independent variables of interest were self-reported frequency of family dinner, fun and religious activities in a typical week. Multivariable logistic models were estimated for each outcome, and multivariable linear probability models were estimated adjusting for family fixed effects.

Results: Adjusting for family connectedness, there were significant associations between certain family activities and adolescent school problem measures. However, these results did not remain significant in models with family fixed effects, suggesting that associations could be driven by family-level confounders.

Discussion: This study did not find strong evidence of a protective relationship between family activities and school problems. Therefore, it suggested that programme and policymakers be cautious in overstating the importance of family activities in preventing adolescent risk outcomes until true causal relationships can be determined.

In this article we address this latter question by looking at a unique set of questions that were asked to three waves of the National Longitudinal Survey of Youth 1997 (NLSY97). Teenage children (we use the terms youth, teenager, and child/children as synonyms throughout this article to describe these individuals) were asked about how the parent or parent-figures in their household treated each other. Teenage children were also asked how much these figures knew about the child's own friends and behavior. Additionally, the teenagers were asked about their own behavior with regard to a number of undesirable activities, including (but not limited to) smoking tobacco, drinking alcohol, using marijuana, stealing, destroying property, and physical fighting. We combine this information to examine how the likelihood of undesirable juvenile behavior is affected by both family structure and the quality of the relationships among the household's members.

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AIMS OF STUDY: This study investigate the relationship between prenatal substance use and subsequent children's behavior problems in early childhood (4-6.5 years) and in later childhood (8-10.5 years). The datasets used are the Children of the National Longitudinal Survey (CNLSY), linked with the National Longitudinal Survey of Youth (NLSY79).

METHODS: Prenatal substance use is measured by binary indicators of smoking during pregnancy and alcohol-use during pregnancy. The outcome of interest is the age and gender specific standardized Behavior Problem Index (BPI) scale that is constructed using 32 mother-reported items on the child's behavior, as well as six sub-scales of problem behavior. Initially OLS regressions are estimated to verify the positive association between prenatal substance use and higher-levels of behavior problems. Thereafter, maternal fixed effects, maternal household fixed effects, propensity score matching, and propensity score inclusive regressions are all employed to obtain estimates of the effects of prenatal smoking and alcohol-use after reducing bias from unobserved confounding factors.

RESULTS: Initial OLS results find very strong associations between prenatal smoking and alcohol-use and higher levels of behavioral problems among both younger and older children. Howeve r, when we use fixed-effects, propensity-score matching and propensity-score inclusive regressions, prenatal alcohol use continues to be significant related with increases in behavior problems, but prenatal smoking by and large ceases to have any significant effects. DISCUSSION: While prenatal smoking has many deleterious outcomes for children, mostly related to low birthweight, it appears that the association between prenatal smoking and behavioral problems among children is largely driven by other confounding factors. On the other hand, results of this study suggest that prenatal alcohol-use may have true physiological/biological effects on the fetus that eventually exacerbate behavior problems. However, it should be noted that none of the methods used can account for all potential confounding factors -- especially time-variant ones -- hence, there may still remain some estimation bias. It should also be noted that the study suffers from certain shortcomings -- namely, behavioral problems as well as prenatal substance-use are all based on mother-reported data, and thus there are concerns about the accuracy of these measures. Hence, there remains scope for further research into this topic using alternate datasets. IMPLICATIONS FOR POLICY: The 1999 United States Surgeon General's Report stated that almost one in five children and adolescents in the U.S. exhibit signs of mental and behavioral disorder. This study suggests that policies aimed at reducing alcohol-use among pregnant women might contribute to reducing the prevalence of such disorders. However, while reducing cigarette use among pregnant women has numerous other health benefits for their children, it may not help reduce the incidence of behavior problems.