Background: Inner-city children are frequently exposed to violence; however
, there are few data regarding the psychological and academic correlates of
such exposure in young children at school entry.
Objectives: To document exposure to violence in inner-city children aged 7
years; assess their feelings of distress; and evaluate the relationships of
exposure to violence with school performance, behavior, and self-esteem.
Setting: A study center in an inner-city hospital.
Participants: One hundred nineteen inner-city children evaluated at age 7 y
ears; 119 caregivers (biological and foster).
Design: As part of a longitudinal study, children were administered the fol
lowing by a masked examiner: Things I Have Seen and Heard (TISH) to assess
exposure to violence; Levonn, a cartoon-based interview for assessing child
ren's distress symptoms; and the Culture-Free Self-Esteem Inventory, Second
Edition. School performance was assessed by school reports and child behav
ior by the Child Behavior Checklist (CBCL), the Parent Report Form, and the
Teacher Report Form. Caregivers for children were administered the parent
report version of the Checklist of Children's Distress Symptoms (CCDS-PRV)
as well as the CBCL Parent Report Form.
Main Outcome Measures: Exposure to violence (TISH); feelings of distress (L
evonn); school performance; behavior (CBCL Parent Report Form and CBCL Teac
her Report Form); and self-esteem (Culture-Free Self-Esteem Inventory).
Results: We found that these children were frequently exposed to violence.
For example, 75% had heard gun shots, 60% had seen drug deals, 18% had seen
a dead body outside, and 10% had seen a shooting or stabbing in the home (
TISH). Many showed signs of depression and anxiety; eg, 61% worried some or
a lot of the time that they might get killed or die and 19% sometimes wish
ed they were dead (Levonn). Higher exposure to violence (TISH Total Violenc
e score) was correlated with higher Levonn composite scores for depression
and anxiety and with lower self-esteem (P less than or equal to .04), and w
as also associated with lower grade point average and more days of school a
bsence (P less than or equal to .02). Caregiver assessment of child anxiety
correlated poorly with child report of anxiety (P = .58).
Conclusions: Young inner-city children have a high exposure to violence by
age 7 years; many show signs of distress that frequently are not recognized
by caregivers. Further, higher exposure to violence in children correlates
with poorer performance in school, symptoms of anxiety and depression, and
lower self-esteem.