The influence of participation in leisure activities on quality of life in Spanish children and adolescents with Cerebral Palsy

Participation is an important modifiable quality of life (QOL) determinant and a key outcome measure. The aim of this study was to confirm if participation in leisure activities affects the QOL domains in children and adolescents with Cerebral Palsy (CP) in Spain. A total of 206 children and adolescents with CP (and their parents), 115 boys and 91 girls, mean age of 11.96 years (SD = 3.00; range 8–18 years) participated in the study. Distribution according to the Gross Motor Function Classification System (GMFCS) was 24.3% Level I, 18% Level II, 18% Level III, 12.6% Level IV, and 27.2% Level V. Participation in leisure activities was assessed using the Spanish version of Children's Assessment of Participation and Enjoyment (CAPE) and QOL using the KIDSCREEN parents’ version. Diversity, intensity and enjoyment of participation explained the levels of QOL in the Physical well-being, Psychological well-being, Autonomy, Parent relation & home life and Social support & peers domains, independently of gender, age and level of impairment (motor and intellectual). We also found that intensity and enjoyment of participation in informal activities had more influence on the different QOL domains. The most influenced domain by the enjoyment of participation in all domains and types of CAPE activities was Psychological well-being. The participation in leisure activities had a positive effect on the QOL of the Spanish children and adolescents with CP.     

Description and psychometric properties of the CP QOL-Teen: A quality of life questionnaire for adolescents with cerebral palsy

To assess the measurement properties of a new QOL instrument, the Cerebral Palsy Quality of Life Questionnaire-Teen (CP QOL-Teen), in adolescents with cerebral palsy (CP) aged 13–18 years, examining domain structure, reliability, validity and adolescent-caregiver concordance. Based on age, 695 eligible families were invited to participate by mail. Questionnaires were returned by 112 primary caregivers (71.8% of questionnaires sent). 87 adolescents aged 12–18 years also completed the questionnaires. CP QOL-Teen, generic QOL instruments (KIDSCREEN, Pediatric Quality of Life Inventory), functioning (Gross Motor Function Classification System) and a condition-specific instrument (PedsQL-CP) were used. Principal components analysis produced seven scales: wellbeing and participation; communication and physical health; school wellbeing; social wellbeing; access to services; family health; feelings about functioning. Cronbach's alphas for the derived scales ranged from 0.81 to 0.96 (primary caregiver report) and 0.78 to 0.95 (adolescent report). Test–retest reliability (4 weeks) ranged from 0.57 to 0.88 for adolescent self-report and 0.29 to 0.83 for primary caregiver report. Moderate correlations were observed with other generic and condition specific measures of QOL, indicating adequate construct validity. Moderate correlations were observed between adolescent self-report and primary caregiver proxy report. This study demonstrates acceptable psychometric properties of both the adolescent self-report and the primary caregiver proxy report versions of the CP QOL-Teen.     

Determinants of participation in leisure activities among adolescents with cerebral palsy

Studies have identified restrictions in engagement in leisure activities for adolescents with disabilities. Participation is a complex construct and likely influenced by a variety of factors. These potential determinants have not yet been sufficiently explored in the population of adolescents with cerebral palsy (CP). The objective of this study is to estimate the potential influence of adolescent characteristics and environmental factors as determinants of participation in leisure activities for adolescents with CP. A cross-sectional design was used. Participants were adolescents (12–19 years old) with cerebral palsy. Participants were assessed with the Vineland Adaptive Behavior Scale – II, Gross Motor Function Measure, Gross Motor Function Classification System, Manual Ability Classification System and completed the Self-Perception Profile for Adolescents, Dimensions of Mastery Questionnaire, Strengths and Difficulties Questionnaire, Family Environment Scale, the European Child Environment Questionnaire and the Preferences for Activities of Children. The main outcome measure was the Children's Assessment of Participation and Enjoyment. 187 adolescents (age M = 15.4; SD = 2.2) completed the study. Multivariate models of participation in leisure revealed associations with factors related to the adolescents’ functional characteristics and attitudes, the family environment, socioeconomic status, and contextual factors such as school type, and collectively explained from 28% (diversity of skill-based activities) up to 48% (intensity and diversity of self-improvement activities) of the variance in intensity and diversity in five leisure participation domains (diversity: r² = .33 recreational; r² = .39 active-physical; r² = .33 social activities). Adolescent's mastery motivation, self-perception and behavior were individually associated with participation in different activity domains, but did not strongly predict participation within multivariate models, while preferences for activities were strong predictors of participation in all domains, except for skill-based activities. Engagement in different types of leisure activities is important for adolescents’ development and well-being. Health care professionals should consider adolescents’ and families’ characteristics to promote participation in leisure activities.     

Functioning and health‐related quality of life of adolescents with cerebral palsy: self versus parent perspectives

Aim To determine whether there is a difference between perspectives of functioning and health‐related quality of life (HRQL) of parents and ambulatory adolescents with spastic cerebral palsy (CP). Method A total of 139 parent patient pairs (73 females, 66 males; median age 14y 6mo, age range 11–18y, Gross Motor Function Classification System [GMFCS] levels I–III, with hemiplegia [n=23], diplegia [n=103], triplegia [n=9], and quadriplegia [n=4]) were recruited from outpatient CP clinics at three pediatric orthopaedic hospitals, between 2000 and 2006, from whom Pediatric Outcomes Data Collection Instrument (PODCI) responses were collected. Results Cross‐sectional data, calculated with intraclass correlation coefficients [ICC], showed parents and adolescents agreed more on functioning (ICC=0.488–0.748) than HRQL (ICC=0.242–0.568; PODCI). Parents and adolescents both recognized significant comorbidities (ICC=0.502–0.713), but adolescents saw themselves as less limited (ICC=0.330) than parents. The greatest differences between parents and adolescents were in HRQL scales for male adolescents, with only a small part explained by GMFCS level difference between sexes (effect size 0.002–0.143). Age, parent well‐being, and parent sex had little effect and comorbidities had no effect. GMFCS level was the most common predictor. Interpretation Most scales on health conditions, function, and HRQL agreed between parents and adolescents aged11 to 18 years. Parent proxy is reasonable when necessary, but assessing both parents and adolescents gives additional insight. Adolescents do not consider themselves as limited by health conditions as parents do; parents have greater satisfaction with current level of symptoms than adolescents, and findings vary on expectations for treatment.     

An internet‐based physical activity intervention for adolescents with cerebral palsy: a randomized controlled trial

Aim To determine the effectiveness of an 8‐week internet‐based, lifestyle physical‐activity intervention for adolescents with cerebral palsy (CP). Method A randomized controlled trial using concealed allocation with blinded assessments at baseline, 10, and 20 weeks. Forty‐one adolescents with CP participated (26 males, 15 females; mean age 13y 7mo, SD 1y 8mo, range 11–17y; Gross Motor Function Classification System levels: I, n=21; II, n=17; III, n=3; unilateral distribution n=16, bilateral n=25). Primary outcome was physical activity (NL‐1000 accelerometers and self‐report [Multimedia Activity Recall for Children and Adolescents: MARCA]). Secondary outcomes were exercise knowledge (a purpose‐designed scale), attitudes, intention and self‐efficacy (Lifestyle Education for Activity Program II scales), self‐reported sedentary behaviour (MARCA), and functional capacity (6‐min walk test). Results At 10 weeks the intervention group showed no increased physical activity compared with the comparison group (weekly steps: change of +2420 vs ?12189 steps p=0.06; weekly moderate‐to‐vigorous physical activity: change of +70 vs +8min, p=0.06; weekly distance walked: change of +3 vs ?9.1km, p=0.05) and exercise knowledge (12% vs 1% improvement, p=0.08). There were no statistically significant differences for these outcomes at 20 weeks, or in self‐reported physical activity at 10 or 20 weeks. Interpretation There was a positive short‐term pattern for improvement in physical activity and knowledge. Internet‐based programs may offer an alternative for participants unable to attend regular face‐to‐face physical activity programs.     

Predictors of participation of adolescents with cerebral palsy: A European multi-centre longitudinal study

We investigated whether childhood factors that are amenable to intervention (parenting stress, child psychological problems and pain) predicted participation in daily activities and social roles of adolescents with cerebral palsy (CP). We randomly selected 1174 children aged 8–12 years from eight population-based registers of children with CP in six European countries; 743 (63%) agreed to participate. One further region recruited 75 children from multiple sources. These 818 children were visited at home at age 8–12 years, 594 (73%) agreed to follow-up at age 13–17 years.We used the following measures: parent reported stress (Parenting Stress Index Short Form), their child's psychological difficulties (Strength and Difficulties Questionnaire) and frequency and severity of pain; either child or parent reported the child's participation (LIFE Habits questionnaire). We fitted a structural equation model to each of the participation domains, regressing participation in childhood and adolescence on parenting stress, child psychological problems and pain, and regressing adolescent factors on the corresponding childhood factors; models were adjusted for impairment, region, age and gender.Pain in childhood predicted restricted adolescent participation in all domains except Mealtimes and Communication (standardized total indirect effects β −0.05 to −0.18, 0.01 < p < 0.05 to p < 0.001, depending on domain). Psychological problems in childhood predicted restricted adolescent participation in all domains of social roles, and in Personal Care and Communication (β −0.07 to −0.17, 0.001 < p < 0.01 to p < 0.001). Parenting stress in childhood predicted restricted adolescent participation in Health Hygiene, Mobility and Relationships (β −0.07 to −0.18, 0.001 < p < 0.01 to p < 0.001). These childhood factors predicted adolescent participation largely via their effects on childhood participation; though in some domains early psychological problems and parenting stress in childhood predicted adolescent participation largely through their persistence into adolescence.We conclude that participation of adolescents with CP was predicted by early modifiable factors related to the child and family. Interventions for reduction of pain, psychological difficulties and parenting stress in childhood are justified not only for their intrinsic value, but also for probable benefits to childhood and adolescent participation.     

Impact of intensive upper limb rehabilitation on quality of life: a randomized trial in children with unilateral cerebral palsy

Aim The aim of this study was to determine whether constraint‐induced movement therapy is more effective than bimanual training in improving the quality of life of children with unilateral cerebral palsy (CP). Method Sixty‐three children (mean age 10y 2mo [SD 2y 6mo]; 33 males, 30 females) with CP of the spastic motor type (n=59) or with spasticity and dystonia (n=4) were randomly allocated to two groups. The children were assessed as Manual Ability Classification System level I (n=16), II (n=46), or III (n=1). Each group received 6 hours of daily intervention (either constraint‐induced movement therapy [CIMT] or bimanual training [BIM]) for 10 days over a 2‐week period (total intervention time 60h). Children aged 9 years and older completed the Cerebral Palsy Quality of Life Questionnaire for Children (CPQOL‐Child) and those aged 8 years and older completed the KIDSCREEN‐52. All parents completed proxy versions of each measure. Assessments were made at baseline and at 3, 26, and 52 weeks after the end of the intervention. Results Thirty‐five children completed the CPQOL‐Child and 41 completed the KIDSCREEN‐52. No changes in social or emotional well‐being were reported by children in either group. Children and parents from both groups reported a significant improvement in their or their child’s feelings about functioning as well as participation and physical health on the CPQOL‐Child. The parents of children receiving CIMT reported positive and sustained changes in their child’s social well‐being (CPQOL‐Child). The CIMT group showed significant improvements in physical well‐being, psychological well‐being, and moods and emotions (KIDSCREEN‐52) at 3 weeks post intervention, which were maintained over the study period. Interpretation Intensive goal‐directed upper limb training programmes using either CIMT or BIM achieved domain‐specific changes in quality of life relating to feelings about functioning and participation and physical health. A condition‐specific quality of life compared with a generic measure may be better able to detect changes in quality of life in children with unilateral CP.     

A long-term follow-up study of adolescents with conduct disorder: Can outcome be predicted from self-concept and intelligence?

Background: This study examines Swedish young adults (age 21) with a history of conduct disorder (CD) in adolescence. Research has established CD as a condition for a range of adverse outcomes. Intelligence, aggression, parent–child conflict, parent–child relation and peer-rejection are known factors influencing the outcome. Aim: The aim of this longitudinal study is to find how self-confidence and intelligence in an inpatient group diagnosed with CD are related to health in young adulthood. Methods: The subjects were diagnosed with CD in their adolescence at the inpatient child and adolescent psychiatric unit. Using structured questionnaires as independent variables, this study uses multiple regression analysis to predict health outcomes. Results: The results showed that self-concept and verbal intelligence could significantly predict health outcomes. However, in the multivariate analysis, only self-concept variables significantly predicted the outcome. The predicted outcome was small, but substantial in most models (R²=0.12–0.25). Conclusion: This means that clinicians need to be humble in forecasting individual adult health among adolescents with severe CD. According to this study, it is difficult to separate positive and negative outcomes. We suggest that this structural data has better prediction potential than medical casebook data. If this is the general case, this psychometric data paves the way for more structural ways of assessing child and adolescence psychiatric problems.     

Correlates of decline in gross motor capacity in adolescents with cerebral palsy in Gross Motor Function Classification System levels III to V: an exploratory study

Aim To explore associations between clinical variables and decline in motor capacity in adolescents with cerebral palsy (CP). Method Participants included 76 males and 59 females, whose mean age at the beginning of the study was 14 years 6 months (SD 2.4, range 11.6–17.9); 51 at Gross Motor Function Classification System (GMFCS) level III, 47 at level IV, and 37 at level V. Ninety‐six participants had tetraplegia, 32 had diplegia, and one had hemiplegia. Types of motor disorder were spastic n=98; mixed, n=11; dystonic, n=9; hypotonic, n=7; and ataxic n=3 (seven participants were not classified). Reliable raters collected data annually for 4 years on anthropometric characteristics, the Spinal Alignment and Range of Motion Measure, as well as the Gross Motor Function Measure, 66 items (GMFM‐66); participants or their parents reported on health status (using the Health Utilities Questionnaire), pain, and exercise participation (using measures developed for this study). The predicted drop in GMFM‐66 scores after childhood was calculated using data on the same children from an earlier study. Correlations were calculated between the drop in GMFM‐66 scores and the average and change scores of the clinical variables (the alpha level for statistical significance of this exploratory study was 0.10). Results The drop in GMFM‐66 score was significantly correlated with limitations in range of motion (r=0.42) and spinal alignment (r=0.28), and pain (r=0.16). Increases in triceps skinfold (r=?0.19), mid‐arm circumference (r=?0.23), and the ratio of mid‐arm circumference to knee height (r=?0.23) were associated with less decline. Interpretation Preventing range‐of‐motion limitations and pain experiences and optimizing nutrition might contribute to less decline in the gross motor capacity of adolescents with CP. Further investigation is required to clarify the role other factors that contribute to maintained function over time.     

Empathic accuracy in adolescents with autism spectrum disorders and adolescents with attention-deficit/hyperactivity disorder

In research on theory of mind (ToM) in individuals with an autism spectrum disorder (ASD) mainly static mind-reading tasks were used. In this study both a static (Eyes Test) and a more naturalistic (empathic accuracy task) ToM measure were used to investigate the perspective taking abilities of adolescents with ASD (n = 13), adolescents with attention-deficit/hyperactivity disorder (ADHD; n = 13) and typically developing adolescents (n = 18). An innovative aspect concerns the standard stimulus tapes of the empathic accuracy task, which showed interactions between dyads of one adolescent with ADHD and one adolescent without ADHD. In this way, we were able to compare the ‘readability’ of the thoughts and feelings of adolescents with and without ADHD. The results clearly demonstrate the impairment in perspective taking abilities of adolescents with ASD, both on the static and naturalistic mind-reading task. Moreover, the empathic accuracy task seems to be a useful and promising method to assess ToM abilities in adolescents, with or without clinical problems. Finally, thoughts and feelings of target persons with ADHD seemed to be less easy to read than the thoughts and feelings of typically developing target persons.     

Self-reported and parent-reported quality of life of children and adolescents with new-onset epilepsy

Purpose: To investigate the self‐reported quality of life (QOL) of children and adolescents with new‐onset epilepsy and explore parent’s perceptions of their child’s QOL and the impact of epilepsy on the family. Methods: As part of the Standard and New Antiepileptic Drug (SANAD) trial, 248 children (aged 8–15 years) with new‐onset epilepsy and their parents completed batteries of QOL measures. Children completed the KINDL and subscales of the QOLIE‐AD‐48. Parental questionnaires included the Rutter Parent Scales, Adverse Events Profile, and subscales of the Child Health Questionnaire. Key Findings: Compared with published norms, children with epilepsy had significantly poorer QOL across multiple domains compared with healthy children and children with asthma. Parents, particularly of younger children and those with other long‐term health problems, were affected by their child’s health or behavior, which affected their emotional well‐being and time for their own needs. Significance: Children with new‐onset epilepsy, particularly those with comorbid conditions, are at risk of reduced QOL at the time of diagnosis. It is important that children with epilepsy and their families are assessed for psychosocial problems so that early intervention can be undertaken.     

Mental disorders into adulthood among adolescents placed in residential care: A prospective 10-year follow-up study

BackgroundChild welfare and juvenile justice placed youths show high levels of psychosocial burden and high rates of mental disorders. It remains unclear how mental disorders develop into adulthood in these populations. The aim was to present the rates of mental disorders in adolescence and adulthood in child welfare and juvenile justice samples and to examine their mental health trajectories from adolescence into adulthood.MethodsSeventy adolescents in shared residential care, placed by child welfare (n = 52, mean age = 15 years) or juvenile justice (n = 18, mean age = 17 years) authorities, were followed up into adulthood (child welfare: mean age = 25 years; juvenile justice: mean age = 27 years). Mental disorders were assessed based on the International Classification of Diseases 10th Revision diagnoses at baseline and at follow-up. Epidemiological information on mental disorders was presented for each group. Bivariate correlations and structural equation modeling for the relationship of mental disorders were performed.ResultsIn the total sample, prevalence rates of 73% and 86% for any mental disorder were found in adolescence (child welfare: 70%; juvenile justice: 83%) and adulthood (child welfare: 83%; juvenile justice: 94%) respectively. General psychopathology was found to be stable from adolescence into adulthood in both samples.ConclusionsOur findings showed high prevalence rates and a high stability of general psychopathology into adulthood among child welfare and juvenile justice adolescents in Swiss residential care. Therefore, continuity of mental health care and well-prepared transitions into adulthood for such individuals is highly warranted.     

Object relations in adolescence: a comparison of normal and inpatient adolescents

Aims: We aimed to study the development of object relations in adolescents and their correlation with their mothers' defense styles in inpatient and normal adolescents. Methods: We administered the Thematic Apperception Test to adolescents in the adolescent unit (junior high, n = 16; senior high, n = 22) and normal controls (junior high, n = 16; senior high, n = 16). Results were analyzed using the Complexity of Representations Scale (CRS). We administered the Defense Style Questionnaire (DSQ₄₀) to the subjects' mothers (patients, n = 38; controls, n = 32) to determine whether adolescents' CRS scores correlated with mothers' DSQ scores. Results: There was a nearly significant interaction for group‐by‐school‐year for the children's CRS scores. In the control group, senior high school students' scores (mean [SD] = 3.52 [0.49]) were significantly higher (F [1,66] = 12.3, P = 0.001) than those of junior high school students' (mean [SD] = 3.03 [0.31]). In the patient group, no significant difference was observed between senior high and junior high. For mothers' DSQ₄₀, mature defense scores were significantly higher in the control group than in the patient group (mean [SD] = 10.8 [1.89] vs 9.35 [1.40] in junior high, and 11.8 [1.67] vs 9.36 [1.81] in senior high, F [1,66] = 22.1, P < 0.001, two‐way anova ). A significant, positive correlation (r = 0.37, P = 0.04) was observed between the mothers' mature defense and the children's CRS scores in the control group only. Conclusions: Whatever diagnoses are provided, the problems of adolescents with non‐psychotic pathologies are related to the arrest of object relations development. A patient's mother cannot employ mature mechanisms to alleviate signals of anxiety sent by her child.     

Tibial length growth curves for ambulatory children and adolescents with cerebral palsy

Aim The aim of this study was to generate growth curves for ambulatory children and adolescents with cerebral palsy (CP) using tibial lengths and to determine if they differed according to sex or Gross Motor Function Classification System (GMFCS) level. Method Growth data were studied from a cohort of 750 participants (442 males, 308 females [1199 visits]; mean age 10y 9mo, SD 3y 4mo, range 4–21y) with CP (hemiplegia, n=163; diplegia, n=573; triplegia, n=11; quadriplegia n=2; GMFCS levels I–III), and 165 typically developing children (96 males, 115 females; [211 visits]) mean age 10y 9mo, SD 4y 2mo, range 4–19y). Tibial length measurements calculated from data collected during routine gait analyses were validated using anthropometric tibial length measurements and were used to generate growth curves for males and females classified as GMFCS level I, II, or III. Growth was compared in participants of different sexes and GMFCS levels using the median curves. Results Growth curves for males and females (GMFCS levels I–III) with estimate lines for 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centiles were generated. Mean tibial length was greater in males than in females in all GMFCS levels. Tibial lengths were shorter in participants classified as GMFCS level III than in those classified as GMFCS level I or II. Interpretation To our knowledge this is the first large‐scale investigation of bone growth in ambulatory children and adolescents with CP. The large sample made it possible to generate growth curves and to provide insight into growth trends. The study findings serve as a basis for analysis of the relationships between growth, function, and treatment outcomes.     

Effects of gender,age and diagnosis on perceived parental care and protection in adolescents

To assess whether perceived parental care and protection varied according to age and gender of the child and whether they were associated with psychiatric diagnoses, these constructs were measured with the Parental Bonding Instrument in a cohort of non-referred adolescents (n= 762), in a clinically referred cohort (n= 1299), and in a group of adolescents from the referred cohort (n= 365) for whom DSM-III diagnoses were available. Significant differences in parental care and protection according to clinical status, age, gender and diagnosis were found. However, perceived parental affectionless control was not associated with emotional disorders in adolescents, contrary to reports in adult subjects, but with clinical status.     

Patterns and predictors of participation in leisure activities outside of school in children and adolescents with Cerebral Palsy

This study analyzed the patterns and predictors of participation in leisure activities outside of school of Spanish children and adolescents with Cerebral Palsy (CP). Children and adolescents with CP (n = 199; 113 males and 86 females) participated in this cross-sectional study. Their mean age was 12.11 years (SD = 3.02; range 8–18 years), and they were evaluated using the Spanish version of the Children's Assessment of Participation and Enjoyment (CAPE). Means, standard deviations and percentages were used to characterize the profile of participation, and linear regression analyses were employed to assess associations between the variables (child, family and environmental factors) and the diversity, intensity and enjoyment of participation. Children and adolescents with CP reported low diversity and intensity of participation and high levels of enjoyment. Participation in leisure activities outside of school was determined more by child and environmental factors than by family ones.     

Types and experiences of bullying in adolescents with an autism spectrum disorder

Being victimized by one's peers is a major problem in adolescence, and research has suggested that individuals with autism spectrum disorders (ASD) may experience higher rates of bullying than their typically-developing (TD) peers. However, it is currently unclear whether adolescents with ASD are victimized more by their peers simply because they are ‘different’. This study was designed to examine percentage rates across different types of bullying behaviour in adolescents with an ASD (n = 24), in comparison to a group of special-needs adolescents without an ASD (n = 22), and a group of typically developing peers (n = 24), to determine whether simply being ‘different’ leads to higher rates of victimization. We also examined the agreement between parental and self-reports of bullying behaviour experienced by these groups. Overall, more adolescents with ASD reported victimization than adolescents in the other two groups. In addition, those with ASD reported more social bullying in comparison to the other two groups and more physical bullying than the TD group. No difference was found between parental and self-reports for the bullying experienced by the adolescents with ASD or special needs; however, TD adolescents reported higher levels of victimization than their parents reported for them. Contributing factors for the victimization experienced by adolescents with an ASD are discussed.     

Change in depression across adolescence: The role of early anger socialization and child anger

The purpose of this longitudinal study was to examine the relations of early socialization of anger with change in adolescent depression, and moderation by child anger. Using a sample of low-income, ethnic minority children at familial risk for psychopathology in the United States (n = 92; ages 3–5; 53% female; 65% African American; 27% Latina/o), early anger socialization (i.e., parent response to child anger) was tested as a predictor of change in depression from preadolescence to adolescence [i.e., age 8 (n = 63), 11 (n = 58), and 13 (n = 44)]. A videotaped parent-child interaction was coded for parental socialization of preschooler anger, and psychiatric interviews of depression were conducted three times across preadolescence and adolescence. Major depression diagnoses increased from preadolescence to adolescence. Latent growth modeling indicated parent discouragement of child anger was a significant predictor of an increase in the child's later depression from preadolescence to adolescence, and child anger intensity was a significant moderator.     

Suicide in Austrian children and young adolescents aged 14 and younger

Introduction Research on suicide in childhood and early adolescence is sparse. We investigated suicide cases of children and young adolescents in terms of prevalence, gender differences, suicide methods and monthly distribution during a period of 32 years. Methods Registered suicides aged 14 or younger occurring between 1970 and 2001 (n = 275) in Austria were studied. Results The mean suicide rate for 10 to 14-year-olds was 1.4 per 100,000 with a male–female ratio of 3.1:1. The total child and young adolescent suicide rate and boys’ suicide rates decreased over the study period. However, there was no significant fluctuation in girls’ suicide rates. Hanging was the predominant suicide method in both genders. Use of this method decreased steadily over the study period, whereas the percentage of suicides by other methods, i.e., jumping and firearms suicides increased. Greater number of suicides in children and young adolescents was observed during the months of April/May and October/November. Conclusion Suicide rates of children and young adolescents in Austria are on the decrease, in accordance with a reported decrease in the general suicide rate in Austria.