The International Journal of the Addictions, 27( 12). 147551483. 1992
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Note
Alcohol and Other Drug Use among Adolescents with Disabilities Donna L. Elmquist,'9' Daniel P. Morgan,' and Pamela K. Bolds2
'
Department of Special Education, Logan, Utah 84322-2865 'Granite School District, Salt Lake City, Utah 841 15
ABSTRACT This study assessed the incidence rates of alcohol and other drug (AOD) use among a sample of five groups of adolescents: (1) nondisabled students, (2) learning disabled students, (3) behaviorally disordered/less aggressive students, (4) behaviorally disordered students, and (5) behaviorally disordered/self-contained students. The learning disabled, behaviorally disorderedAess aggressive, and nondisabled students reported similar AOD use rates. The behaviorally disordered/self-containedstudents reported substantially more AOD use than the other groups. The behaviorally disordered students reported higher usage of some AODs, but the differences were not as dramatic as those of the behaviorally disordered/self-containedgroup.
INTRODUCTION The results of the most current surveys of American youth indicate that alcohol and other drug (AOD) use among high school seniors is at its lowest level since 1975 (Cavazos, 1989). However, rates are still alarmingly high, and *To whom correspondence should be addressed at Boston Bldg., Suite 31 1, Nine Exchange Place, Salt Lake City, Utah 841 11. Telephone: (801) 521-8041. 1475 Copyright 01992 by Marcel Dekker, Inc.
ELMQUIST. MORGAN, A N D BOLDS
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
1476
many view AOD use problems as a critical threat to the health and education of children and youth. Estimates of adolescent AOD use are probably low because many students who use AODs often are not included in the surveys. These students may be absent, may have dropped out of school, or may attend alternative programs (Rhodes and Jason, 1988). It is generally acknowledged that these students have higher than average rates of AOD use (Johnston et al., 1989; U.S. Department of Education, 1989). Another group for whom AOD use data are not available is adolescents with disabilities. These students often do not attend the mainstream classes where most students are surveyed. If adolescents with disabilities are surveyed, they usually are not specifically identified or differentiated as disabled. Consequently, little evidence is available which pinpoints their rates of AOD use (Pendergast et al., 1990). Only one study (Leone et al., 1989) has been located which assessed AOD use among disabled students. In this study of secondary students, one group classified as behaviorally disordered (BD) attended special residential or day treatment schools. Another group, primarily learning disabled (LD), attended special education classes within a junior high or high school. A nondisabled comparison group in the same school system was also included in the survey. The LD students reported no greater AOD use than the nondisabled students. However, the BD students enrolled in special schools reported a higher incidence and a wider range of AODs used than either the other special education students or the nondisabled students. The Leone et al. (1989) study provides important information about the incidence of AOD use among school-age disabled students. However, given the magnitude of the AOD use problem and the paucity of accurate information regarding its impact on students with disabilities, more data about the scope of the problem are necessary to assist policymakers and program developers to make informed judgments about future directions in this area. Therefore, the purpose of this study was to further assess the extent of AOD use among BD and LD students.
METHOD Participants We conducted this survey in 1988 in a large suburban school district in Utah. The sample of students was selected from two middle schools (Grades 6-8), three high schools (Grades 9-12), and a special self-contained school. Five distinct groups of students comprised the final sample: (1) a comparison group of nondisabled students, (2) students with learning disabilities attending self-contained classrooms within one of the middle schools or high schools (LD), (3) behaviorally disordered/less aggressive students (i.e., withdrawn, phobic students) attending self-contained classrooms within one of the middle
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
DRUG USE AMONG ADOLESCENTS WITH DISABILITIES
1477
schools or high schools (BD/LA), (4) behaviorally disordered students attending self-contained classrooms within one of the middle schools or high schools (BD), and (5) behaviorally disordered/special school students attending a separate self-contained school (BD/SS). The primary difference between the behaviorally disordered students in Groups 4 and 5 was one of degree. Students in both groups displayed the characteristic behavior patterns often associated with this handicapping condition; e.g., aggression, noncompliance, social skill deficits, poor school survival skill, academic skill deficits. However, the problems of the BD students in Group 5 were deemed so significantly discrepant from the norm that they could not be adequately or appropriately educated within the confines of a regular school building and, thus, required special school placement. We attempted to survey all the students in each setting. However, several students were absent, declined to participate, or did not have a signed permission form. Thus, of the total number of students in each group, 42% of nondisabled, 40% of LD, 55% of BD/LA, 32% of BD, and 54% of BD/SC comprised the final sample. The ethnic composition of the sample was essentially comparable to that found in the school district as a whole and the state of Utah at large; i.e., approximately 96.8 % Caucasian, 1.6% Asian-American, 1 . 1 % Hispanic, 0.5 % Native American, and 0.2 % African-American. Table 1 describes the sample in terms of gender, age, grade, and sample size of each group.
Instrumentation The questionnaire used was “Version B” of an instrument developed for and used in the evaluation of the Utah K-12 prevention curriculum (Hass, 1988). Prior field tests had established adequate reliability for the purposes of this research. The questionnaire was designed to obtain information in each of the following areas: (a) Knowledge; (b) Peer Influence; (c) Future Tobacco, Alcohol, and Other Drug Use; (d) Tobacco, Alcohol, Marijuana, and Other Drug History; (e) Frequency of Tobacco, Alcohol, Marijuana, and Other Drug Use; (f) Quantity of Tobacco, Alcohol, Marijuana, and Other Drug Use; (g) Self-Esteem; and (h) Degree of Rebelliousness.
Procedure The third author briefly explained to the participating students the reason for the survey. Students were told that there was a great interest in assessing the extent to which the state’s efforts to combat alcohol and other drug use among students were successful and that their answers to the questionnaire would help in that effort. She told each group to circle one answer to each
ELMQUIST, MORGAN, AND BOLDS
1478
Table 1. Sample of Students Completing Survey
( n = 68)
Group 2 , LD ( n = 15)
Group 3, BD/ less aggressive ( n = 12)
Group 4, BD ( n = 12)
Group 5, BD/ self-contained ( n = 13)
27 41
12 3
8 4
7 5
10 3
2 I 3
I
0
8 3
5
0
0
0
I
0 3
0 0 4 4 4 1
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Group 1, Nondisabled
Gender: Male Female Age: 11-12 13-14 15-16 17-18
Grade: 6 7 8 9 10 11
5
2
25 37 1
9
0
I
1 4 5 2
37 0
2 1
15 15
3 0
4 4 2 0 1
6 0 3 1
8
question, and ensured them of anonymity. No names or code numbers were used. She then gave each student a questionnaire and read aloud the entire questionnaire to all groups. The time required to complete the questionnaire ranged from 30 to 65 minutes, dependent on how much clarification was needed. After completing the survey, the students sealed their questionnaires inside blank envelopes and returned them to the third author.
Data Analysis In anticipation of some dishonest reporting-either exaggeration or understatement-validity checks were incorporated into the survey instrument. However, all questionnaires were used for data analysis because of no evidence of dishonest reporting. Frequency tabulations and a One Way Analysis of Variance was performed on all the variables to determine whether AOD use rates differed among the five groups of students in this sample.
RESULTS Table 2 presents the reported incidence of AOD use for each group. The use rates of BD/SS students and the students in the other four groups are strik-
1479
DRUG USE AMONG ADOLESCENTS WITH DISABILITIES Table 2.
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Reported Incidence of Substance Use (in Yo)
Tobacco: Ever used tobacco in any form (e.g., cigarettes, chewing tobacco) Used in any form in the past 30 days Daily cigarette smokers Alcohol: Ever had a drink Drank in the past 30 days 5 or more drinks per occasion Marijuana: Ever used Used in the past 30 days Illegal drugs other than marijuana: Ever used
Nondisabled
LD
BD/LA
BD
BD/SS
38
40
8
92
100
16
1
8
58
92
4
1
8
58
92
53 21 10
60 40 13
42 8 8
61 42 25
85 85 62
10 3
13 0
0 0
34 34
92 92
7
13
0
34
71
ingly different. The BD/SS students reported more use of all AODs than the other groups. Although the BD students reported AOD use was not as great as the BD/SS students, the BD students also reported more use than the nondisabled, LD, and BD/LA students. The LD students’ use rates were similar to the nondisabled students except 2 times more LD students reported drinking in the past 30 days than did nondisabled students. The BD/LA students reported overall less use than any of the other groups in this survey. Table 3 displays the results of the Analysis of Variance. For each variable, the group means (in parentheses) are ranked from highest to lowest; beside the parenthesis is the group’s identifying number. When statistically significant differences are present, the group number and mean is underlined. This indicates that the group’s mean is statistically significantly different from the group(s) not underlined. For example, on the variable “Knowledge,” the nondisabled students (Group 1) had statistically significantly higher knowledge than the other four groups. On the variable Marijuana History, the BD/SS students’ (Group 5) reported use rates were statistically significantly greater than the other four groups. On this same variable, the BD/LA (Group 3) and nondisabled (Group 1) students’ reported use rates were statistically significantly less than the BD/SS (Group 5 ) , BD (Group 4),or LD (Group 2) students.
I480
ELMQUIST, MORGAN, AND BOLDS
Table 3.
Group Means and Ranks" -
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Knowledge:
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Note
Alcohol and Other Drug Use among Adolescents with Disabilities Donna L. Elmquist,'9' Daniel P. Morgan,' and Pamela K. Bolds2
'
Department of Special Education, Logan, Utah 84322-2865 'Granite School District, Salt Lake City, Utah 841 15
ABSTRACT This study assessed the incidence rates of alcohol and other drug (AOD) use among a sample of five groups of adolescents: (1) nondisabled students, (2) learning disabled students, (3) behaviorally disordered/less aggressive students, (4) behaviorally disordered students, and (5) behaviorally disordered/self-contained students. The learning disabled, behaviorally disorderedAess aggressive, and nondisabled students reported similar AOD use rates. The behaviorally disordered/self-containedstudents reported substantially more AOD use than the other groups. The behaviorally disordered students reported higher usage of some AODs, but the differences were not as dramatic as those of the behaviorally disordered/self-containedgroup.
INTRODUCTION The results of the most current surveys of American youth indicate that alcohol and other drug (AOD) use among high school seniors is at its lowest level since 1975 (Cavazos, 1989). However, rates are still alarmingly high, and *To whom correspondence should be addressed at Boston Bldg., Suite 31 1, Nine Exchange Place, Salt Lake City, Utah 841 11. Telephone: (801) 521-8041. 1475 Copyright 01992 by Marcel Dekker, Inc.
ELMQUIST. MORGAN, A N D BOLDS
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
1476
many view AOD use problems as a critical threat to the health and education of children and youth. Estimates of adolescent AOD use are probably low because many students who use AODs often are not included in the surveys. These students may be absent, may have dropped out of school, or may attend alternative programs (Rhodes and Jason, 1988). It is generally acknowledged that these students have higher than average rates of AOD use (Johnston et al., 1989; U.S. Department of Education, 1989). Another group for whom AOD use data are not available is adolescents with disabilities. These students often do not attend the mainstream classes where most students are surveyed. If adolescents with disabilities are surveyed, they usually are not specifically identified or differentiated as disabled. Consequently, little evidence is available which pinpoints their rates of AOD use (Pendergast et al., 1990). Only one study (Leone et al., 1989) has been located which assessed AOD use among disabled students. In this study of secondary students, one group classified as behaviorally disordered (BD) attended special residential or day treatment schools. Another group, primarily learning disabled (LD), attended special education classes within a junior high or high school. A nondisabled comparison group in the same school system was also included in the survey. The LD students reported no greater AOD use than the nondisabled students. However, the BD students enrolled in special schools reported a higher incidence and a wider range of AODs used than either the other special education students or the nondisabled students. The Leone et al. (1989) study provides important information about the incidence of AOD use among school-age disabled students. However, given the magnitude of the AOD use problem and the paucity of accurate information regarding its impact on students with disabilities, more data about the scope of the problem are necessary to assist policymakers and program developers to make informed judgments about future directions in this area. Therefore, the purpose of this study was to further assess the extent of AOD use among BD and LD students.
METHOD Participants We conducted this survey in 1988 in a large suburban school district in Utah. The sample of students was selected from two middle schools (Grades 6-8), three high schools (Grades 9-12), and a special self-contained school. Five distinct groups of students comprised the final sample: (1) a comparison group of nondisabled students, (2) students with learning disabilities attending self-contained classrooms within one of the middle schools or high schools (LD), (3) behaviorally disordered/less aggressive students (i.e., withdrawn, phobic students) attending self-contained classrooms within one of the middle
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
DRUG USE AMONG ADOLESCENTS WITH DISABILITIES
1477
schools or high schools (BD/LA), (4) behaviorally disordered students attending self-contained classrooms within one of the middle schools or high schools (BD), and (5) behaviorally disordered/special school students attending a separate self-contained school (BD/SS). The primary difference between the behaviorally disordered students in Groups 4 and 5 was one of degree. Students in both groups displayed the characteristic behavior patterns often associated with this handicapping condition; e.g., aggression, noncompliance, social skill deficits, poor school survival skill, academic skill deficits. However, the problems of the BD students in Group 5 were deemed so significantly discrepant from the norm that they could not be adequately or appropriately educated within the confines of a regular school building and, thus, required special school placement. We attempted to survey all the students in each setting. However, several students were absent, declined to participate, or did not have a signed permission form. Thus, of the total number of students in each group, 42% of nondisabled, 40% of LD, 55% of BD/LA, 32% of BD, and 54% of BD/SC comprised the final sample. The ethnic composition of the sample was essentially comparable to that found in the school district as a whole and the state of Utah at large; i.e., approximately 96.8 % Caucasian, 1.6% Asian-American, 1 . 1 % Hispanic, 0.5 % Native American, and 0.2 % African-American. Table 1 describes the sample in terms of gender, age, grade, and sample size of each group.
Instrumentation The questionnaire used was “Version B” of an instrument developed for and used in the evaluation of the Utah K-12 prevention curriculum (Hass, 1988). Prior field tests had established adequate reliability for the purposes of this research. The questionnaire was designed to obtain information in each of the following areas: (a) Knowledge; (b) Peer Influence; (c) Future Tobacco, Alcohol, and Other Drug Use; (d) Tobacco, Alcohol, Marijuana, and Other Drug History; (e) Frequency of Tobacco, Alcohol, Marijuana, and Other Drug Use; (f) Quantity of Tobacco, Alcohol, Marijuana, and Other Drug Use; (g) Self-Esteem; and (h) Degree of Rebelliousness.
Procedure The third author briefly explained to the participating students the reason for the survey. Students were told that there was a great interest in assessing the extent to which the state’s efforts to combat alcohol and other drug use among students were successful and that their answers to the questionnaire would help in that effort. She told each group to circle one answer to each
ELMQUIST, MORGAN, AND BOLDS
1478
Table 1. Sample of Students Completing Survey
( n = 68)
Group 2 , LD ( n = 15)
Group 3, BD/ less aggressive ( n = 12)
Group 4, BD ( n = 12)
Group 5, BD/ self-contained ( n = 13)
27 41
12 3
8 4
7 5
10 3
2 I 3
I
0
8 3
5
0
0
0
I
0 3
0 0 4 4 4 1
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Group 1, Nondisabled
Gender: Male Female Age: 11-12 13-14 15-16 17-18
Grade: 6 7 8 9 10 11
5
2
25 37 1
9
0
I
1 4 5 2
37 0
2 1
15 15
3 0
4 4 2 0 1
6 0 3 1
8
question, and ensured them of anonymity. No names or code numbers were used. She then gave each student a questionnaire and read aloud the entire questionnaire to all groups. The time required to complete the questionnaire ranged from 30 to 65 minutes, dependent on how much clarification was needed. After completing the survey, the students sealed their questionnaires inside blank envelopes and returned them to the third author.
Data Analysis In anticipation of some dishonest reporting-either exaggeration or understatement-validity checks were incorporated into the survey instrument. However, all questionnaires were used for data analysis because of no evidence of dishonest reporting. Frequency tabulations and a One Way Analysis of Variance was performed on all the variables to determine whether AOD use rates differed among the five groups of students in this sample.
RESULTS Table 2 presents the reported incidence of AOD use for each group. The use rates of BD/SS students and the students in the other four groups are strik-
1479
DRUG USE AMONG ADOLESCENTS WITH DISABILITIES Table 2.
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Reported Incidence of Substance Use (in Yo)
Tobacco: Ever used tobacco in any form (e.g., cigarettes, chewing tobacco) Used in any form in the past 30 days Daily cigarette smokers Alcohol: Ever had a drink Drank in the past 30 days 5 or more drinks per occasion Marijuana: Ever used Used in the past 30 days Illegal drugs other than marijuana: Ever used
Nondisabled
LD
BD/LA
BD
BD/SS
38
40
8
92
100
16
1
8
58
92
4
1
8
58
92
53 21 10
60 40 13
42 8 8
61 42 25
85 85 62
10 3
13 0
0 0
34 34
92 92
7
13
0
34
71
ingly different. The BD/SS students reported more use of all AODs than the other groups. Although the BD students reported AOD use was not as great as the BD/SS students, the BD students also reported more use than the nondisabled, LD, and BD/LA students. The LD students’ use rates were similar to the nondisabled students except 2 times more LD students reported drinking in the past 30 days than did nondisabled students. The BD/LA students reported overall less use than any of the other groups in this survey. Table 3 displays the results of the Analysis of Variance. For each variable, the group means (in parentheses) are ranked from highest to lowest; beside the parenthesis is the group’s identifying number. When statistically significant differences are present, the group number and mean is underlined. This indicates that the group’s mean is statistically significantly different from the group(s) not underlined. For example, on the variable “Knowledge,” the nondisabled students (Group 1) had statistically significantly higher knowledge than the other four groups. On the variable Marijuana History, the BD/SS students’ (Group 5) reported use rates were statistically significantly greater than the other four groups. On this same variable, the BD/LA (Group 3) and nondisabled (Group 1) students’ reported use rates were statistically significantly less than the BD/SS (Group 5 ) , BD (Group 4),or LD (Group 2) students.
I480
ELMQUIST, MORGAN, AND BOLDS
Table 3.
Group Means and Ranks" -
Subst Use Misuse Downloaded from informahealthcare.com by University of Toronto on 12/25/14 For personal use only.
Knowledge:
