University of Washington

" Pre-Teen Health I think this is an age group where it's important to underscore culturally and spiritually what it is to be an Indian person because this is where they lose it. This is such an important age group, if they're not involved in their culture as an Indian person, it's very easy for them to walk away from it and forget it and who they are." SUMMARY Participants stressed the importance of ensuring that this age group, 10-13 year olds, doesn't "fall through the cracks." Many concerns about "tween" youth in local Native communities were expressed. These included (1) the reality that first time drug/alcohol use is reported at as early as 8 years old; (2) that middle school aged children are often more vulnerable, as there is "nothing for them to do" and they are excluded from activities for teens and younger children; (3) the disproportionate number of AIAN children in the foster care system; (4) older kids being a negative influence on this age group — for example having younger kids inhale gasoline because they think it's funny; (5) the lack of parental guidance at a time when parental influence is key; and (6) the devastating effect of domestic violence and sexual assault on this age group. A number of community strengths regarding pre-teens were identified as well: (1) this age is a good time to strengthen cultural teachings, and tribal communities have teachings to offer; (2) Native families and communities are resilient and innovative, the current revitalization of culture will help youth; (3) many communities offer programs that keep youth busy after school and during weekends and holidays; (4) communities are full of aunties and uncles who can support youth when they make good choices and provide consequences for negative choices; and (5) communities can support youth as they explore their passions and skills. Summit participants identified specific needs for pre-teens, including the need for connection to culture and community, and involvement in activities. Clear, respectful sex education is very important, as is providing resources to help parents and families talk with pre-teens about difficult and personal topics. In general, it would be helpful to provide solid education, mentoring and support for parents, to help improve parenting 14 skills. Also, communities would benefit from service providers who can support families of children with mental health and behavioral issues, like ADHD (Attention Deficit Hyperactive Disorder) and ODD (Oppositional Defiance Disorder). Lastly, participants talked about the importance of providing positive role models for this age group, particularly if youth don't have parents who can model healthy life skills and behaviors. Many suggestions were offered for meeting pre-teen needs. Suggestions included more cultural activities and community events for this age group, integrating culture into evidencebased practices and programs, and developing youth councils to mentor pre-teens. Another suggestion was for tribal communities to collaborate more closely with middle schools, where pre-teens spend much of their time. Communities can also work harder to step in when children are at risk, and help parents identify what needs to be changed. Education was stressed, specifically in regards to healthy intimate relationships, computer safety, appropriate boundaries and leadership skills. It was suggested that communities continue to develop and offer programs that group youth by age — as the needs of pre-teens are different from adolescents and younger children. And lastly, participants suggested increased use of current technologies, such as social media (Facebook) and texting, as a way to engage pre-teen youth. Participants acknowledged that there were some challenges in meeting Native pre-teen needs. (1) Communities have lost cultural teachers due to government practices — it's hard to bring back cultural teaching; (2) leadership isn't always responsive to needed changes; (3) communities experience many losses, deaths and violence — trauma is difficult for this age group; (4) some families have low expectations for their children; (5) there are often tensions between programs that work with all age youth and those that are age-specific, with Washington Tribes & Recognized American Indian Organizations (RAIOs) Health Priorities Summit

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