Child Development

for the mental health professionals involved in their
care, the future is looking brighter every day.

See also: BIRTH DEFECTS; PREGNANCY

Bibliography
HIV/AIDS Surveillance Report. 12(1):20. Atlanta. Centers for Dis-
ease Control and Prevention, 2000; Washington, DC: U.S.
Government Printing Office, 2000.
Kaplan, Edward. ‘‘Evaluating Needle-Exchange Programs via Sy-
ringe Tracking and Testing (STT).’’ AIDS and Public Policy
Journal 6, no. 3 (1991):109–115.
Lemp, George F., Susan F. Payne, Dennese Neal, Tes Temelso,
and George W. Rutherford. ‘‘Survival Trends for Patients with
AIDS.’’ Journal of the American Medical Association 263
(1990):402–406.
Lipson, Michael. ‘‘What Do You Say to a Child with AIDS?’’ Has-
tings Center Report 23 (1993):6–12.
Remafedi, Gary. ‘‘The University of Minnesota Youth and AIDS
Projects’ Adolescent Early Intervention Program: A Model to
Link HIV-Seropositive Youth with Care.’’ Journal of Adolescent
Health 23S (1998):115–121.
Stephens Richard C., Thomas E. Feucht, and Shadi W. Roman.
‘‘Effects of an Intervention Program on AIDS-related Drug
and Needle Behavior among Intravenous Drug Users.’’ Ameri-
can Journal of Public Health 81 (1991):568–571.
Wiener, Lori S., Anita Septimus, and Christine Grady. ‘‘Psychologi-
cal Support and Ethical Issues for the Child and Family.’’ In
Philip A. Pizzo and Catherine M. Wilfert eds., Pediatric AIDS:
The Challenge of HIV Infection in Infants, Children, and Adoles-
cents, 3rd edition. Baltimore: Williams and Wilkins, 1998.
World Health Organization. ‘‘Global AIDS Surveillance—Part I.’’
Weekly Epidemiological Report 72 (1997):357–360.
Lori Wiener
Staci Martin

ACTING OUT

Acting out originally referred to the psychodynamic
concept of expressing repressed impulses, but now it
more generally refers to maladaptive behavior exhib-
ited by children and adolescents. Rather than coping
with the resurfacing of negative emotions (i.e., anxi-
ety, fear) associated with past traumatic experiences
or a dysfunctional family environment, the child or
adolescent acts out these emotions by engaging in ex-
ternalizing behaviors. These behaviors range from
the less serious (i.e., disobedience, moodiness) to the
more severe (i.e., suicidal tendencies, violence). Act-
ing out is often associated with the development of
psychopathology, such as antisocial or borderline
personality disorder, or is viewed as evidence of a
mood disorder; it can also refer to rebellious behavior
exhibited by children and, especially, adolescents
attempting to assert independence. The interaction
of several factors, including ineffective parenting,
temperament, and peer rejection can reinforce or ex-
acerbate acting out behavior, leading to delinquency
or psychopathology in adolescence or childhood.

See also: ANGER; MENTAL DISORDERS

Bibliography

Forehand, Rex, and Nicholas Long. ‘‘Outpatient Treatment of the

Acting Out Child: Procedures, Long-Term Follow-Up Data,

and Clinical Problems.’’ Advances in Behavior Research and

Therapy 10 (1988):129–177.

Nielsen, G. Borderline and Acting-Out Adolescents: A Developmental Ap-

proach. New York: Human Sciences Press, 1983.

Patterson, Gerald, Barbara DeBaryshe, and Elizabeth Ramsey. ‘‘A

Developmental Perspective on Antisocial Behavior.’’ American

Psychologist 44 (1989):329–335.

Jeannette M. Alvarez

Gillian S. Garfinkle

ACTIVITY LEVEL

Activity level refers to the relative amounts of motor

behavior produced by children and includes every-

thing from a toddler’s first steps to a middle-school

child’s skillful soccer playing. Activity level is mea-

sured in a number of ways, ranging from parental ob-

servations to computer analysis. Regardless of how it

is measured, activity level is usually related to other

factors, such as gender, age, and individual differ-

ences. Boys are usually more active than girls, and

rates of movement are generally the highest between

the ages of seven and nine. A child’s relative periods

of activity and inactivity have been viewed as a stable

feature of temperament, suggesting that active in-

fants may become active children, and active children

may become extroverted adults. If very high levels of

activity accompany poor concentration, disorganiza-

tion, an inability to ‘‘sit still,’’ high levels of distracta-

bility, impulsiveness, and little sustained attention,

then a diagnosis of hyperactivity with Attention Defi-

cit Hyperactivity Disorder (ADHD) may be indicated.

See also: ATTENTION DEFICIT HYPERACTIVITY

DISORDER

Bibliography

Buss, Arnold H., and Robert B. Plomin. Temperament: Early Develop-

ing Personality Traits. Hillsdale, NJ: Lawrence Erlbaum, 1984.

Janette B. Benson

Leah M. Kelly

ADHD

See: ATTENTION DEFICIT HYPERACTIVITY DIS-

ORDER

ADOLESCENCE

Many people imagine an adolescent as being a gan-

gly, awkward, and troublesome individual. Research-

ADOLESCENCE 7