The present study examined the impact of a novel intervention for children at risk for substance use or actively using substances that was provided to 783 children between 4 and 18 years of age in Afghanistan. They received the Child Intervention for Living Drug-free (CHILD) protocol while in outpatient or residential treatment. CHILD included age-appropriate literacy and numeracy, drug education, basic living safety, and communication and trauma coping skills. A battery of measures examined multiple child health domains at treatment's start and end and 12 weeks later. For younger children, there were no significant Gender or Gender X Time effects (all p's > .16 and .35, resp.). The time main effect was significant for all outcomes (all p's < .00192, the prespecified per-comparison error rate). Post hoc testing showed significant improvements from residential treatment entry to completion for all scales. For older children, a time main effect was significant for (all p's < .00192, the prespecified per-comparison error rate) all but one outcome. Community follow-up means were significantly lower than residential treatment entry means. CHILD had a positive impact on children, and treatment impact endured from posttreatment to follow-up assessment.
Afghanistan is one of only four countries in the world with the highest proportion of the population under the age of 15 years (48%). By comparison, adults in Afghanistan, ages 65 and older, represent only 3.7% of the population [1]. With a total fertility rate of 5.3 per woman [2], Having a 'youth bulge' creates an opportunity for economic development when youth are provided with an education and skills training; however, this 'bulge' can also be a threat as an insurgent group can readily attract uneducated youth for their purposes. Each year, 400,000 youth enter the Afghanistan
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