Girls just wanna have fun! Helping female children and adolescents develop into happy, healthy, successful and sociable adults.

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Pregnant girl

Adolescence can present challenges that are unique to girls.

My last blog (Boys, don’t cry!) addressed the many challenges that can present themselves to boys during childhood and adolescence, and cause them to veer off the road from healthy development. Girls by no means have it easy! When compared to boys, girls are more likely to present with mental health problems (Merikangas, 2010). Furthermore, although both sexes are susceptible to sexually transmitted diseases, the repercussions of forgetting that condom can hold more disastrous consequences for girls, with the risk of an unwanted pregnancy.
Intervention programs can have contrasting outcomes for boys and girls, so it is timely to see the publication of two Child Trends’ Factsheets that deal separately with boys and girls. Each one summarises a separate systematic review investigating the impacts of non-school social intervention programs on improving outcomes for children and adolescentsThis review deals specifically with girls.

What they did

The authors carried out a systematic review of the current literature available from the LINKS Database, which uncovered 106 studies that met the following inclusion criteria:

  • Randomised trials of female children and/or adolescents that include an intention-to-treat analysis
  • Co-ed interventions that provide impact data specifically for female children and adolescents
  • A minimum of 100 girls in each evaluation sample

Nine outcome areas were identified:

Girl hugging teddy

Girls are more likely than boys to report mental health problems.

  • Academic Achievement (e.g. national test results)
  • Delinquency (e.g. violence, crime or arrests)
  • Externalising or Acting out behaviours (e.g. aggression or hyperactivity)
  • Mental Health/Internalising (e.g. depression, anxiety, eating disorder or suicide)
  • Physical Health & Nutrition (e.g.diet, BMI, weight or physical activity)
  • Reproductive Health & Sexuality (e.g. sexual activity, contraceptive use or pregnancy)
  • Self-sufficiency  (e.g. employment, earnings or welfare claims)
  • Social Skills (e.g. relationship building, conflict resolution or empathy)
  • Substance Misuse

The authors categorised the effect of the programs according to their impact on the outcome areas, as either:

  • Found to work
  • Mixed findings
  • Not found to work

What they found

Jump for joy

Almost half of the interventions in the review reported positive outcomes for girls.

Almost half of the programs included in the study had a positive impact on girls’ wellbeing, behaviour or achievement. They did not find any one program that worked across all outcome measures, but some themes came to light. In summary, for female children and adolescents:

  • 51 of the 106 programs had a positive impact on at least one outcome reviewed
  • 27 programs had mixed findings
  • 28 programs had no positive impacts
Table: Showing the impact of a variety of programs/interventions on each of the outcome areas. The fractions in brackets represent the success rates of each program, eg. (Number of studies showing positive outcomes/ number of studies measuring the outcome)
Outcome Area
(Number of relevant studies in the database)
“Found to work”“Mixed Findings”“Not found to work”
Academic Achievement
(29 studies)
1. Programs that target young adults (3/5)1. Gender specific programs
2. Mentoring (2/4)
3. Vocational training/ support (4/11)
1. Social skills training (0/5)
2.Programs with <70 hours contact time (0/5)
Delinquency
(11 studies)
No conclusions could be drawn from the data due to small n numbersNo conclusions could be drawn from the data due to small n numbers1. Mentoring (0/4)
2. School-based programs
Externalising/ acting out
(26 studies)
1. Community-based programs (3/4)
2. Parent training combined with social skills training (2/3)
1. Cognitive behaviour skills training (2/4)
2. Interactive activities (4/11)
1. Targeting group norms or normative beliefs (1/6)
Internalising/ mental health
(21 studies)

1. Cognitive behavioural skills training (3/5)
2. Qualified professional and parent involvement (3/3)
3. Short-term programs (6 weeks or less) (3/4)
1. Parent training (3/8)
2. Life-skills training (3/8)
3. Teacher-provided interventions (1/6, but half had mixed impacts)
1. Home-visiting programs (0/4)
2. Case-management (0/4)
3. Long-term interventions (> 7 weeks) (0/10)
Physical health & nutrition
(27 studies)

1. Social cognitive theory (6/7)
2. Teaching cognitive behavioural skills (4/4)
3. Media literacy & critical thinking (3/4)
4. School-based programs (12/20)
1. Setting goals and monitoring progress (3/6)
2. Life skills training (4/9)
Reproductive health & sexuality
(35 studies)
1. Discussing gender roles (3/4)
2. One-to-one interventions (5/8)
3. Culturally relevant interventions (3/4)
4. Gender specific programs targeted at girls’ needs (3/5)
1. Social cognitive theory-based interventions (4/8)
2. Media literacy & critical thinking (2/4)
3. One-session interventions (3/6)
1. Service learning (1/4)
2. Vocational training/support (2/7)
3. Including parents/ families (1/4)
4. School-based programs (4/14)

Self-sufficiency
(10 studies)
No conclusions could be drawn from the data due to small n numbers1. Vocational training/ support (5/10)
2. Individual counselling/ therapy (2/4)
3. Life skills training (3/6)
No conclusions could be drawn from the data due to small n numbers
Social skills
(20 studies)
1. Individual sessions with families (2/3)1. Social skills training (1/4)1. Mentoring (0/4)
2. School-based programs (1/11)
Substance use
(20 studies)
1. Including parents in program (3/5)
2. Engaging local stakeholders (2/3)
1. Encouraging media literacy
2. Targeting actual/perceived norms (1/4)
1. Teaching social skills (0/4)

The authors concluded

This review of experimental evaluations indicates that social interventions can have positive impacts on the well-being of girls and young women. Interventions in some outcome areas, such as physical health, were generally found to be successful, while for other outcome areas, including reproductive health and problem behaviors, it seems more difficult to achieve positive impacts.

We found that including parents in interventions in some way led to desirable impacts for boys’ and girls’ mental health outcomes. We also found that, for reproductive health outcomes, most school-based programs did not work for boys or girls.

There were also meaningful differences between what worked for girls and for boys in certain outcome areas. For example, while one-on-one interventions often led to positive impacts for girls’ reproductive health outcomes, experiential learning activities that included group activities were often effective for boys. Similarly, while social skills training interventions were not generally successful for boys in reducing delinquency outcomes, these types of interventions were often successful in reducing externalizing behaviors in girls. However, the number of studies is too small for these patterns to be more than suggestive.

Given these findings, continuing to assess which strategies work best for both girls and boys appears to be an important task for future research to undertake.

The Education Elf’s View

The Education ElfThey say, ‘What doesn’t kill you makes you stronger’. To be honest, I have never really subscribed to that theory. In reality, often what doesn’t kill you can have long-term detrimental affects on wellbeing. In an ideal world, maybe we could protect our children and teens from the challenges that can threaten their health, happiness and relationships. Or, maybe life’s obstacles do help us to learn coping strategies for the next time they rear their ugly heads. Oh dear, we are back to the original cliché! Maybe, what doesn’t kill you, and also doesn’t have permanent and serious negative impacts, can teach you and prepare you for future mishaps. Hmm, I may be going round in circles, but one thing I know for sure is that we have a responsibility to provide our young elves and people with coping strategies to give them the very best chance of successful life outcomes.

This review, along with its partner review about boys, only starts to scratch the surface of evidence-based practice in this field. Further research is required to gain deeper insights into what works to improve outcomes for both girls and boys. I’m pretty sure that parents, policy makers and educators will welcome some harder evidence to inform their practice.

My previous blog, ‘Boys, don’t cry!’ provides a discussion about the methodological limitations of the partner systematic review, which is also relevant to this review.

Links

Bell K, Terzian MA and Moore KA What works for female children and adolescents: Lessons from Experimental Evaluations of Programs and Interventions (PDF) Child Trends Fact Sheet Publication (2012)

Merikangas KR, He J, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Study Adolescent (2010) Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry. 49 (10): 980-98

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Leah Tomlin

Leah Tomlin
Leah is Assistant Head of Henleaze Junior School in Bristol. She has over 10 years teaching experience, with a further 10 year background in scientific research. She has first hand experience of the challenges faced by teachers and school leaders who have poor access to the evidence, few skills to read and appraise research and little or no time to spend keeping up to date. Here's hoping this blog can help!

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