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Survey of risky behavior by middle schoolers is necessary, appropriate

In his op-ed on Sunday, David Bittle characterizes the Maryland State Department of Education's Youth Tobacco and Risk Behavior questionnaire of middle schoolers as inappropriate probing by state sanctioned bureaucrats ("Sex survey too risque for middle schoolers," Nov. 9). He is concerned that the questions are inappropriate for his 12-year-old 8th grader and "99.9 percent of students who needn't worry about such subject matter."

Unfortunately, Mr. Bittle is completely mistaken about the purpose and benefit of this survey and its Centers for Disease Control counterpart, the Youth Risk Behavior Surveillance System (YRBSS). Both of these surveys consistently demonstrate that children in Maryland and nationally begin to use tobacco, alcohol and drugs in middle school. Data from the 2011 YRBSS from kids in the state of Maryland demonstrate that by the age of 13, 11 percent of children have tried smoking cigarettes, 23 percent have tried alcohol, and 8.5 percent have tried marijuana. Those numbers are substantially higher than the 0.1 percent of children Mr. Bittle feels are at risk.

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Unfortunately, our middle schoolers not only need to worry about these questions, they need education and guidance on how to make healthy decisions to avoid using alcohol, tobacco and other drugs. The only way to gauge effectiveness of public health and school interventions is to use a validated method to assess what they are doing, and these questionnaires are such a method. As a pediatrician who talks to teenagers and pre-teens about substance use regularly, I have found that the children do not get offended about these questions, even when they aren't using alcohol or drugs. Continuing to survey our children (and adults for that matter) through anonymous risk factor surveys is a vital public health measure to reduce risks, not an inappropriate intrusion into our children's lives.

Dr. Scott Krugman, Baltimore

The writer is chairman of the Department of Pediatrics at MedStar Franklin Square Medical Center.

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