The Home Inventory: review and reflections

Young mother risk-taking moderates doula home visiting impacts on parenting and toddler social-emotional development

This longitudinal randomized controlled trial examined the impact of a doula home visiting intervention for young, low-income mothers on parenting and toddler social-emotional development and tested whether intervention effects were moderated by maternal emotional and behavioral health characteristics. 156 mothers were offered home visits from a home visitor starting in mid-pregnancy through several years postpartum, with a community doula also working with the mother during pregnancy and after the birth. 156 received case management. Interviews, video recordings of mother-child interactions, and toddler assessments were conducted at 3 weeks, 3 months, 13 months, and 30 months of age. Intent-to-treat analyses conducted with the full sample showed some intervention effects. Moderation analyses, however, showed that most effects were concentrated among mothers engaged in high levels of risk-taking (delinquent behaviors, school suspensions, smoking, alcohol use, sexual risk-taking). Among higher risk-taking mothers, the intervention was related to less intrusiveness during early infancy, less psychological and physical aggression during toddlerhood, more sensitive parenting attitudes, and greater toddler social relatedness. Maternal depressive symptoms were only a moderator for toddler behavior problems. These findings suggest that doula home visiting may be a particularly effective model for enhancing sensitive, non-aggressive parenting among young mothers with a history of risk-taking behavior.

Design-redesign, implementation, and evaluation of effectiveness of maternal nutrition and responsive parenting program on child development at 2 years of age from rural India: a cluster RCT

Background

To promote early childhood development (ECD), we require information not only on what needs to be addressed and on what effects can be achieved but also on effective delivery methods that can be adapted to local context. We describe design, implementation, and evaluation of a complex intervention to strengthen nurturing environment for young children.

Methods

Study participants were pregnant women and their children from birth to 2 years. We used design and redesign, implementation, and evaluation approaches for the study. We co-created curriculum and delivery plan with stakeholders, based on the theoretical framework, findings from formative research, and our preliminary work. We recruited 656 pregnant women and newborns, 326 (49.69%) from intervention and 330 (50.30%) from the control group. We conducted a cluster randomized controlled trial to evaluate the program's effectiveness. The outcomes of children were assessed at 12 and 24 months.

Findings

At recruitment, study participants from both the study arms were similar in sociodemographic characteristics. We conducted 6,665 home visits, 25 toy-making workshops, and 65 caregiver-meetings. The initial examination of program data revealed gaps in quality and coverage of interventions. The intervention was redesigned based on feedback from stakeholders in community meetings. At recruitment, participants in both study groups had similar socio-demographics. We conducted 6,665 home visits, 25 toy workshops, and 65 caregiver meetings. Initial program data showed intervention quality and coverage gaps, leading to a redesign program based on community and stakeholder feedback. Post-re-designing, session quality improved, with program coverage rising from 32 to 98%. Male participation in home visits increased from 4.3 to 32.65%, and data errors reduced from 270 to 140 per month on average. At 24 months, program showed moderate-mild impact on ECD - cognitive (0.31, 95%CI: 0.13-0.48), language (0.2, 95%CI: 0.01-0.39), and socioemotional-development (0.19, 95%CI: 0.01-0.37), moderate effect on home-environment and mother-child interaction. 96% of women initiated breastfeed within one-hour of delivery, and exclusive-breastfeeding rate of 89.80%.

Interpretations

The study provides an evidence-based community centered ECD curriculum and implementation strategies to enhance service providers, and caregivers' knowledge and skills for promoting ECD in low-resource settings with the potential to scale within existing Government Program.

Funding

The trial was funded by the Saving Brains Round 5 Initiative of Grand Challenges Canada (Grant no. SB-1707-05084), and we are grateful for their ongoing support through online sessions and orientation workshops. The trial was also supported by the Indian Council of Medical Research (File No: 5/7/1693/CH/Adhoc/RBMCH-2020).

The association between prenatal exposure to polycyclic aromatic hydrocarbons and childhood intelligence: a systematic review of observational studies

Exposure to polycyclic aromatic hydrocarbons (PAHs) during pregnancy has been associated with many adverse child health. However, the evidence on such associations with child brain development was not reviewed systemically. Therefore, in this study, we systemically reviewed the observational studies on prenatal exposure to PAHs and childhood intelligence quotient (IQ). The Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines were applied to perform this review. We systematically searched Scopus, PubMed, and Web of Science for all relevant articles published in English until 15 October 2022. The quality of retrieved studies was evaluated based on the Gascon et al. method. We retrieved a total of 351 citations through the initial search, of which an overall of six articles ([Formula: see text] participants) were included in our final review. The quality assessment indicated that four studies had excellent and two studies had good quality. Three reviewed studies reported a significant negative association between prenatal exposure to PAHs and children's IQ. One study reported that exposure to PAHs combined with material hardship was associated with lower child IQ and one study indicated lower child IQ through lower LINE1 DNA methylation-related maternal exposure to PAHs. However, another study did not observe a significant association between prenatal PAH exposure and child IQ. Overall, our review indicated that exposure to PAHs during pregnancy has an adverse impact on childhood IQ.

Prenatal exposure to air pollution is associated with altered brain structure, function, and metabolism in childhood

BACKGROUND

Prenatal exposure to air pollution disrupts cognitive, emotional, and behavioral development. The brain disturbances associated with prenatal air pollution are largely unknown.

METHODS

In this prospective cohort study, we estimated prenatal exposures to fine particulate matter (PM_2.5 ) and polycyclic aromatic hydrocarbons (PAH), and then assessed their associations with measures of brain anatomy, tissue microstructure, neurometabolites, and blood flow in 332 youth, 6-14 years old. We then assessed how those brain disturbances were associated with measures of intelligence, ADHD and anxiety symptoms, and socialization.

RESULTS

Both exposures were associated with thinning of dorsal parietal cortices and thickening of postero-inferior and mesial wall cortices. They were associated with smaller white matter volumes, reduced organization in white matter of the internal capsule and frontal lobe, higher metabolite concentrations in frontal cortex, reduced cortical blood flow, and greater microstructural organization in subcortical gray matter nuclei. Associations were stronger for PM_2.5 in boys and PAH in girls. Youth with low exposure accounted for most significant associations of ADHD, anxiety, socialization, and intelligence measures with cortical thickness and white matter volumes, whereas it appears that high exposures generally disrupted these neurotypical brain-behavior associations, likely because strong exposure-related effects increased the variances of these brain measures.

CONCLUSIONS

The commonality of effects across exposures suggests PM_2.5 and PAH disrupt brain development through one or more common molecular pathways, such as inflammation or oxidative stress. Progressively higher exposures were associated with greater disruptions in local volumes, tissue organization, metabolite concentrations, and blood flow throughout cortical and subcortical brain regions and the white matter pathways interconnecting them. Together these affected regions comprise cortico-striato-thalamo-cortical circuits, which support the regulation of thought, emotion, and behavior.

Portable HEPA filter air cleaner use during pregnancy and children's autistic behaviors at four years of age: The UGAAR randomized controlled trial

BACKGROUND

Developmental exposure to airborne particulate matter (PM) may increase children's risk of developing autism spectrum disorder. We quantified the impact of reducing PM exposure during pregnancy on the development of autistic traits in children. We also assessed associations between indoor fine PM (PM2.5) concentrations during pregnancy and autistic traits.

METHODS

In this parallel-group randomized controlled trial, we randomized 540 non-smoking pregnant women to receive HEPA filter air cleaners or to a control group, which did not receive air cleaners. We administered the Social Responsiveness Scale (SRS-2) to caregivers when children were a median of 48 months (range: 48 to 51 months). Our primary outcome was the SRS-2 total T-score. We imputed missing data using multiple imputation with chained equations and our primary analysis was by intention to treat. In secondary analyses, we estimated associations between full pregnancy and trimester-specific indoor PM2.5 concentrations and T-scores.

RESULTS

We enrolled participants at a median of 11 weeks' gestation. Our analysis included 478 children (233 control, 245 intervention). The intervention reduced average indoor PM2.5 concentrations by 29 % (95 % CI: 21, 37 %). The mean SRS-2 total T-score was 0.5 units lower (95 % CI: -2.5, 1.5) among intervention participants, with evidence of larger benefits for children at the high end of the T-score distribution. An interquartile range (9.6 µg/m3) increase in indoor PM2.5 during pregnancy was associated with 1.8-unit (95 % CI: 0.3, 3.2) increase in mean SRS-2 total T-score. Effect estimates for PM2.5 concentrations by trimester were smaller and confidence intervals spanned no effect.

CONCLUSION

Reducing indoor PM during pregnancy had little impact on mean autism-related behavior scores in children. However, indoor PM2.5 concentrations during pregnancy were associated with higher scores. Exposure to particulate matter during pregnancy may influence the development of autistic traits in childhood.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01741051.

The development of a scale to assess children's and adolescents' sleep environments

STUDY OBJECTIVES

To develop a measure of children's sleep environments and to assess its initial reliability and validity.

METHODS

This cross-sectional study consisted of an online survey for parents of children ages 5-18 years across the United States. A total of 840 parents/caregivers (Mage = 40.6 years, standard deviation = 8.6; 72.0% female) completed surveys regarding a target child (Mage = 10.4 years, standard deviation = 3.8). The items on the scale that was developed were evaluated with exploratory and confirmatory factor analyses in separate random sample halves of the dataset. Cronbach's alpha coefficients were calculated to assess internal consistency across multiple demographic groups. We explored convergent and discriminant validity by examining associations with measures from the nomological net of constructs surrounding the children's sleep environment. Finally, we examined incremental/unique predictive validity of the full scale and its subscales through regression analyses.

RESULTS

The Children's and Adolescents' Sleep Environment Scale (13 items) produced 3 factors: general environmental hazards (7 items), availability of bedding materials (2 items), and presence of electronics (4 items). The full scale and its subscales showed strong discriminant validity, and analyses suggested that the Children's and Adolescents' Sleep Environment Scale and its subscales were generalizable across diverse demographic groups. Finally, after controlling for children's sleep hygiene, sleep disturbances, behavioral problems, and family functioning, the full-scale Children's and Adolescents' Sleep Environment Scale significantly predicted children's sleepiness, as did the general environmental hazards and presence of electronics subscales in a separate regression analysis.

CONCLUSIONS

The Children's and Adolescents' Sleep Environment Scale shows strong psychometric properties and has emerged as both a reliable and valid indicator of children's and adolescents' sleep environments and their potential impact on children's sleep and sleep-related behavior.

CITATION

Peltz JS, Rogge RD, Elmore-Staton L, Spilsbury J, Buckhalt JA. The development of a scale to assess children's and adolescents' sleep environments. J Clin Sleep Med. 2022;18(10):2353-2365.

Multimodal assessments of preterm temperament across the first year of life: Continuity, stability, and moderation by country of origin and infant age

There is limited research regarding the continuity, stability, and role of country of origin in preterm infant temperament across the first year of life. This prospective longitudinal study examined patterns of mean-level continuity and individual-differences stability of select scales of temperament at 6 and 12 months in preterm infants from three countries, Chile (n = 47), United Kingdom (n = 44), and United States (n = 50). Temperament was assessed with the Infant Behavior Questionnaire and observed using the Bayley Behavior Rating Scale. Continuity and stability across infant age, country effects, and interactions of country and age on preterm infant temperament were examined. Chilean mothers rated infants higher in soothability, duration of orienting, and orientation/engagement compared with mothers from the United Kingdom and/or United States. Continuity of temperament from 6 to 12 months varied by country: Chilean mothers reported increasing smiling and laughter and activity level from 6 to 12 months, and mothers from the United Kingdom reported decreasing smiling and laughter and increasing fear from 6 to 12 months. Infant temperament was stable in all three countries. Correlations evidenced low concordance between maternal reports and examiner observations of infant temperament at 12 months. However, among Chilean infants, higher maternal reported activity level was associated with higher examiner observed orientation/engagement score.

Prenatal exposure to air pollution is associated with childhood inhibitory control and adolescent academic achievement

BACKGROUND

Prenatal air pollution exposure is associated with reductions in self-regulation and academic achievement. Self-regulation has been separately linked with academic achievement. Understudied, however, are the contributions of pollution exposure to inhibitory control, a facet of self-regulation, and whether pollution-related inhibitory control deficits are associated with impairment in academic achievement.

METHODS

Participants were recruited from a prospective birth cohort. Measures of prenatal airborne polycyclic aromatic hydrocarbons (PAH) during the third trimester of pregnancy, inhibitory control (NEPSY Inhibition) at mean age = 10.4 years, and Woodcock-Johnson Tests of Achievement-III at mean age = 13.7 were available for N = 200 participants. Multiple linear regression examined sex-dependent and sex independent associations among prenatal PAH, childhood inhibitory control, and academic achievement during adolescence, and whether childhood inhibitory control mediated associations between prenatal PAH and academic achievement during adolescence, controlling for ethnicity, maternal country of birth, language of prenatal interview, maternal marital status, maternal years of education, material hardship, quality of home caregiving environment, and early life stress.

RESULTS

Across all participants, higher prenatal PAH was significantly associated with worse spelling skills (WJ-III Spelling, β = -0.16, 95%Confidence Interval [CI]: 0.30, -0.02, p = .02). Trend level associations between higher prenatal PAH and worse reading comprehension (WJ-III Passage Comprehension, β = -0.13, 95%CI: 0.28, 0.01, p = .07) and math skills (WJ-III Broad Math, β = -0.11, 95%CI: 0.25, 0.03, p = .11) were detected. Across all participants, higher PAH was significantly associated with worse inhibitory control (β = -0.15, 95%CI: 0.29,-0.01 p = .03). Better inhibitory control was significantly associated with better reading comprehension (WJ-III Passage Comprehension, β = 0.22, 95%CI: 0.09, 0.36, p < .002) and math skills (WJ-III Broad Math Index, β = 0.32, 95%CI: 0.19, 0.45, p < .001), and trend level associations with better spelling skills (WJ-III Spelling, β = 0.12, 95%CI: 0.02, 0.26, p = .10). Inhibitory control significantly mediated PAH-related achievement effects for Passage Comprehension (β = -0.61, 95%CI: 1.49, -0.01) and Broad Math Index (β = -1.09, 95%CI: 2.36, -0.03).

CONCLUSIONS

Higher prenatal PAH exposure and lower childhood inhibitory control were associated with worse spelling, passage comprehension, and math in adolescence. Notably, childhood inhibitory control mediated PAH exposure-related effects on achievement in adolescents. Identifying these potential exposure-related phenotypes of learning problems may promote interventions that target inhibitory control deficits rather than content specific deficits.

Portable HEPA filter air cleaner use during pregnancy and children's behavior problem scores: a secondary analysis of the UGAAR randomized controlled trial

BACKGROUND

Developmental exposure to particulate matter (PM) air pollution may impair children's behaviors. Our objectives were to quantify the impact of reducing indoor PM using portable HEPA filter air cleaners during pregnancy on behavioral problems in children and to assess associations between indoor fine PM (PM_2.5) concentrations during pregnancy and children's behavior.

METHODS

This is a secondary analysis of a single-blind parallel-group randomized controlled trial in which we randomly assigned 540 non-smoking pregnant women to receive 1 or 2 HEPA filter air cleaners or no air cleaners. We administered the Behavior Assessment System for Children (BASC-3) to caregivers when children were a mean age of 23 months, and again at a mean age of 48 months. Primary outcomes were the four BASC-3 composite scales: externalizing problems, internalizing problems, adaptive skills, and the behavioral symptoms index. We imputed missing data using multiple imputation with chained equations. The primary analysis was by intention-to-treat. In a secondary analysis, we evaluated associations between BASC-3 composite indices and modeled trimester-specific PM_2.5 concentrations inside residences.

RESULTS

We enrolled participants at a median of 11 weeks gestation. After excluding miscarriages, still births and neonatal deaths, our analysis included 478 children (233 control and 245 intervention). We observed no differences in the mean BASC-3 scores between treatment groups. An interquartile increase (20.1 µg/m³) in first trimester PM_2.5 concentration was associated with higher externalizing problem scores (2.4 units, 95% CI: 0.7, 4.1), higher internalizing problem scores (2.4 units, 95% CI: 0.7, 4.0), lower adaptive skills scores (-1.5 units, 95% CI: -3.0, 0.0), and higher behavior symptoms index scores (2.3 units, 95% CI: 0.7, 3.9). Third trimester PM_2.5 concentrations were also associated with some behavioral indices at age 4, but effect estimates were smaller. No significant associations were observed with PM_2.5 concentrations during the second trimester or for any of the BASC indices when children were 2 years old.

CONCLUSION

We found no benefit of reducing indoor particulate air pollution during pregnancy on parent-reported behaviors in children. Associations between indoor PM_2.5 concentrations in the first trimester and behavioral scores among 4-year old children suggest that it may be necessary to intervene early in pregnancy to protect children, but these exploratory findings should be interpreted cautiously.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT01741051.

Within-person changes in basal cortisol and caregiving modulate executive attention across infancy

One pathway by which environments of socioeconomic risk are thought to affect cognitive development is through stress physiology. The biological systems underpinning stress and attention undergo a sensitive period of development during infancy. Psychobiological theory emphasizes a dynamic pattern of context-dependent development, however, research has yet to examine how basal cortisol and attention dynamically covary across infancy in ecologically valid contexts. Thus, to address these gaps, we leveraged longitudinal, multilevel analytic methods to disentangle between- from within-person associations of hypothalamic-pituitary-adrenal (HPA) axis activity and executive attention behaviors across infancy. We use data from a large longitudinal sample (N = 1,292) of infants in predominantly low-income, nonurban communities at 7-, 15-, and 24-months of age. Using multilevel models, we investigated longitudinal associations of infant attention and basal cortisol levels and examined caregiving behaviors as moderators of this relationship. Results indicated a negative between- and within-person association between attention and cortisol across infancy and a within-person moderation by caregiver responsiveness. In other words, on the within-person level, higher levels of cortisol were concomitantly associated with lower infant attention across the first 2 years of life. However, variation in the caregiver's level of responsiveness either buffered or sensitized the executive attention system to the negative effects of physiological stress.

Does Kinship vs. Foster Care Better Promote Connectedness? A Systematic Review and Meta-Analysis

Internationally, there is an increasing trend toward placing children in kinship vs. foster care. Prior research suggests that children in kinship care fare better compared to children in foster care; however, the reasons for this remain unclear. We conducted a systematic review and meta-analysis to examine the hypothesis that kinship care better preserves children's connectedness to caregiver, birth family, culture, and community; which, in turn, is associated with more optimal child outcomes. Thirty-one studies were reviewed that compared children aged 0-18 years in kinship care vs. foster care on levels of connectedness, three of which had outcomes that permitted meta-analysis. Findings indicated that children in kinship vs. foster care were more likely to feel connected to family in general; however, there was not a clear advantage for kinship vs. foster care for caregiver, birth parent, cultural, and community connectedness. While levels of connectedness were generally associated with more adaptive child outcomes for children in both kinship and foster care, no reviewed studies examined the hypothesis that children's connectedness may mediate the relationship between placement type and child well-being and placement outcomes. Results are discussed with respect to limitations and policy implications of the current evidence-base and the need for more rigorous research to help identify how to improve child well-being in home-based care.

The Relationship Between Maternal Domestic Violence and Infant and Toddlers' Emotional Regulation: Highlighting the Need for Preventive Services

In an effort to further understand the impact of domestic violence (DV) on infant and toddlers' development, this research utilized data from the second cohort of National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the relationship between maternal DV and infant and toddlers' emotional regulation, and determine whether mothers' receipt of DV services mediated this relationship. The sample was limited to children aged 0 to 3 years and included (a) infants less than 1 year old (n = 603), (b) infants 1 to less than 2 years old (n = 310), and (c) toddlers 2 to 3 years old (n = 268). Infant/toddlers' emotional regulation was measured using mothers' response on the How My Infant/Toddler/Child Usually Acts questionnaire. In addition, data were collected to assess whether (a) active DV was present during the time of the Child Protective Services (CPS) investigation and (b) mothers received DV services during the past year. Study research questions were examined using a series of multiple regression analyses. Mediation was tested based on Baron and Kenny's recommended model for establishing mediation. The mediational model was not found to be significant; however, a positive relationship existed between maternal DV and emotional regulation among infants aged less than 1 year old (β = 1.61, p = .039). There were no statistically significant relationships between DV and emotional regulation in the other age groups. These findings highlight the need to provide CPS-involved families victimized by DV with services that focus on preventing poor infant emotional regulation.

Assessing the play and learning environments of children under two years in peri-urban Lima, Peru: a formative research study

BACKGROUND

Home-based interventions have potential for improving early child development (ECD) in low-resource settings. The design of locally acceptable strategies requires an in-depth understanding of the household context. In this formative research study, we aimed to characterize the home play and learning environments of children 6-23 months of age from low-income households in peri-urban Lima, Peru.

METHODS

Drawing on the developmental niche framework, we used quantitative and qualitative methods to understand children's physical and social settings, childcare practices, and caregiver perspectives. We conducted interviews, unstructured video-recorded observations, and spot-checks with 30 randomly selected caregiver-child dyads, 10 from each child age group of 6-11, 12-17, and 18-23 months of age, as well as key informant interviews with 12 daycare instructors. We analyzed the data for key trends and themes using Stata and ATLAS.ti and employed an adapted version of the Indicator of Parent-Child Interaction to evaluate the observations.

RESULTS

Children's social settings were characterized by multi-generational homes and the presence of siblings and cousins as play partners. Access to books and complex hand-eye coordination toys (e.g., puzzles, building blocks) in the home was limited (30.0 and 40.0%, respectively). Caregivers generally demonstrated low or inconsistent levels of interaction with their children; they rarely communicated using descriptive language or introduced novel, stimulating activities during play. Reading and telling stories to children were uncommon, yet 93.3% of caregivers reported singing to children daily. On average, caregivers ascribed a high learning value to reading books and playing with electronic toys (rated 9.7 and 9.1 out of 10, respectively), and perceived playing with everyday objects in the home as less beneficial (rated 6.8/10). Daycare instructors reinforced the problems posed by limited caregiver-child interaction and supported the use of songs for promoting ECD.

CONCLUSIONS

The features of the home learning environments highlighted here indicate several opportunities for intervention development to improve ECD. These include encouraging caregivers to communicate with children using full sentences and enhancing the use of everyday objects as toys. There is also great potential for leveraging song and music to encourage responsive caregiver-child interactions within the home setting.

Prenatal exposure to polycyclic aromatic hydrocarbons modifies the effects of early life stress on attention and Thought Problems in late childhood

BACKGROUND

Risk for childhood psychopathology is complex and multifactorial, implicating direct and interacting effects of familial and environmental factors. The role of environmental neurotoxicants in psychiatric risk is of growing concern, including polycyclic aromatic hydrocarbons (PAH), common in air pollution. Prenatal PAH exposure is linked to adverse physical, behavioral, and cognitive outcomes as well as increasing psychiatric risk. It is unclear whether environmental exposures, like PAH, magnify the effects of exposure to early life stress (ELS), a critical risk factor for psychopathology. The current work aimed to test potential interactions between prenatal PAH exposure and psychosocial/socioeconomic stress on psychiatric symptoms in school-age children.

METHODS

Data were from the Columbia Center for Children's Environmental Health Mothers and Newborns longitudinal birth cohort study. Prenatal PAH exposure was ascertained though air monitoring during pregnancy and maternal PAH-DNA adducts at delivery. Mothers reported on ELS (child age 5) and on child psychiatric symptoms across childhood (child age 5, 7, 9, and 11) using the Child Behavior Checklist (CBCL).

RESULTS

Significant prenatal airborne PAH × ELS interactions (FDR-corrected) predicted CBCL Attention (β = 0.22, t(307) = 3.47, p < .001, p_fdr  = .003) and Thought Problems T-scores (β = 0.21, t(307) = 3.29, p = .001, p_fdr  = .004) at age 11 (n = 319). Relative to those with lower exposure, children with higher prenatal PAH exposure exhibited stronger positive associations between ELS and CBCL Attention and Thought Problem T-scores. This interaction was also significant examining convergent ADHD measures (Conners, DuPaul) and examining maternal PAH-DNA adducts (β = 0.29, t(261) = 2.48, p = .01; n = 273). A three-way interaction with assessment wave indicated that the PAH × ELS interaction on Attention Problems was stronger later in development (β = 0.03, t(1,601) = 2.19, p = .03; n = 477).

CONCLUSIONS

Prenatal exposure to PAH, a common neurotoxicant in air pollution, may magnify or sustain the effects of early life psychosocial/socioeconomic stress on psychiatric outcomes later in child development. This work highlights the critical role of air pollution exposure on child mental health.

Construct-Specific and Timing-Specific Aspects of the Home Environment for Children's School Readiness

Prior evidence supports that the home environment is related to children’s development of school readiness skills. However, it remains unclear how construct- and timing-specific aspects of the home environment are related to children’s school readiness skills, unique from overall, stable aspects of home quality. Unpacking associations due to specific constructs and timing of the home environment may provide insights on the theoretical processes that connect the home environment to school readiness. Using data from the NICHD Study of Early Child Care and Youth Development (N = 1,364), the current study examines how timing (36 and 54 months) and constructs (educational stimulation and socio-emotional responsivity) of the home environment, relative to overall levels across time, relate to children’s language skills, math skills, and externalizing behaviors. The overall, stable aspects of the home environment were significantly associated with children’s language skills and externalizing problems. Additionally, there were significant paths from the stimulation construct at 54 months to math skills, language skills, and externalizing problems. These findings provide evidence that although the overall home environment is predictive of school readiness, the stimulation construct of the home environment at 54 months has additional concurrent relations to children’s school readiness. Implications for the role of the home environment and children’s school readiness are discussed.

Skill-experience transactions across development: Bidirectional relations between child core language and the child's home learning environment

The transaction of children's core language skill and their home learning environment was assessed across 5 waves from infancy (15 months) up to adolescence (11 years) in 1,751 low-socioeconomic status families. Child core language skill and the quality of the home learning environment were each stable across waves, and the two covaried at each wave. Over and above these stabilities and concurrent correlations, and net child social competence and maternal education, higher quality stimulation and support in the home learning environment at each wave advanced children's core language skill at each subsequent wave, and reciprocally children with more advanced core language skill at each wave stimulated a higher quality home learning environment at each subsequent wave. These transactions were robust across child gender, ethnicity, birth order, and developmental risk. This bidirectionality shows that children consistently affect their environments from infancy to adolescence and underscores that the home learning environment is a worthy intervention target for improving core language skill in children regardless of age. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

INFLUENCE OF FAMILY ENVIRONMENT ON DEVELOPMENTAL OUTCOMES IN CHILDREN WITH COCHLEAR IMPLANTS: A MATCHED CASE STUDY

This case study analyzes and describes the language, executive function, and psychosocial outcomes of two 6-year-old children with cochlear implants in the context of their respective family environments. Despite having nearly identical audiological histories, their language abilities and social skills are markedly different from one another, exemplifying the variability in outcomes of children with cochlear implants. Families play a critical role in child development. Including analyses of the family environment serves to draw attention to the importance of expanding the variables of potential influence beyond child characteristics to more fully encompass the factors that influence children's performance in future studies.

Adverse Childhood Experiences in Infancy and Toddlerhood Predict Obesity and Health Outcomes in Middle Childhood

BACKGROUND

The Adverse Childhood Experiences (ACEs) study articulated the negative effects of childhood trauma on adult weight and health. The purpose of the current study is to examine the associations between ACEs in infancy and toddlerhood and obesity and related health indicators in middle childhood.

METHODS

We used data collected from a sample of low-income families enrolled in the national evaluation of Early Head Start (EHS). Data come from 1335 demographically diverse families collected at or near children's ages 1, 2, 3, and 11. An EHS-ACE index was created based on interview and observation items from data collected at ages 1, 2, and 3, which were averaged to represent exposure across infancy and toddlerhood. At age 11, children's height and weight were measured and parents were asked about their child's health.

RESULTS

Children were exposed at rates of 30%, 28%, 15%, and 8% to one, two, three, and four or more EHS-ACEs, respectively. Logistic regressions revealed significant associations between EHS-ACEs in infancy/toddlerhood and obesity, respiratory problems, taking regular nonattention-related prescriptions, and the parent's global rating of children's health at age 11. Across all outcomes examined, children with four or more ACEs had the poorest health. Compared with children with no ACE exposure, the odds of each of the examined health outcomes were over twice as high for children who experienced four or more ACEs.

CONCLUSIONS

Findings highlight that ACEs experienced very early in development are associated with children whose health is at risk later in childhood.

Effects of socioeconomic status and executive function on school readiness across levels of household chaos

Isolating child attributes and familial characteristics that support school readiness in children on the upper half of the socioeconomic spectrum can complement existing research on lower-socioeconomic status (SES) children and facilitate a more complete understanding of how children's performance varies across the full SES spectrum. This study examined if relations between SES, two components of executive function (EF; set-shifting and inhibitory control), and school readiness vary as a function of household chaos in 564 four-year-old children, primarily from middle-to upper-middle class families in the Northeast Region of the United States. Structural equation modeling of direct and indirect effects revealed three major findings: 1) higher levels of EF were related to better school readiness regardless of level of household chaos; 2) SES had an indirect effect on school readiness through set-shifting; and 3) household chaos was negatively associated with school readiness.

Frühkindliche Prädiktoren externalisierender Verhaltensauffälligkeiten

Zusammenfassung. Externalisierende Verhaltensauffälligkeiten sind mit hohen gesellschaftlichen Kosten verbunden. Damit wirksame Präventions- und frühe Therapieprogramme entwickelt werden können, ist es notwendig, bereits in den ersten Lebensjahren Risiken für einen externalisierenden Entwicklungsverlauf zu identifizieren. In einer systematischen Literaturrecherche konnten aus 21 Publikationen zu 12 längsschnittlichen Geburtskohorten mit insgesamt 55 077 Kindern frühe Risiken bezogen auf eine elterliche Psychopathologie, einen niedrigen sozio-ökonomischen Status und ungünstige Eltern-Kind-Interaktionen identifiziert werden. Insbesondere eine mütterliche Depression, ein niedriger sozio-ökonomischer Status und ein harsches Erziehungsverhalten in den ersten Lebensjahren waren prädiktiv für externalisierende Verhaltensauffälligkeiten im Kindergarten und bei Schuleintritt. Implikationen für die klinische Praxis werden vorgestellt.

A Combined Dietary and Cognitive Intervention in 3⁻5-Year-Old Children in Indonesia: A Randomized Controlled Trial

Early childhood nutritional interventions typically combine nutritional and psychosocial stimulation. Such combined interventions result in long-lasting improvements of cognitive abilities in children who are malnourished. Here, we investigated potential cognitive abilities in normally developing children in Indonesia who were, however, at risk for suboptimal cognitive development due to little psychosocial stimulation in their home environment. In a randomized controlled intervention, children of the experimental group received nutritional supplementation combined with cognitive stimulation. Pre- and post-intervention measurements included cognitive development and functioning, behavior, and mother–child interaction. The experimental and control group received nutritional supplementation in the form of a fortified or unfortified milk powder, respectively. Additionally, the children and parents of the experimental group jointly engaged in daily learning activities at home and performed iPad-based tasks designed to foster cognitive abilities. The experimental group compared to the control group displayed a significantly higher increase in intelligence quotient as well as a significantly larger reduction in attentional problems after the intervention. These results indicate that low-level cognitive stimulation in combination with nutritional supplementation during early childhood can be an effective intervention that improves global cognitive functioning in healthy developing children. ClinicalTrials.gov Identifier: NCT02359669.

Early Life Socioeconomic Disparities in Children's Sleep: The Mediating Role of the Current Home Environment

Despite identified concurrent socioeconomic disparities in children's sleep, little research has examined pathways explaining such associations. This study examined the quality of the home environment as a direct predictor of sleep and potential mediator of associations between early life socioeconomic status and objective and subjective indicators of sleep in middle childhood. A socioeconomically and ethnically diverse sample of 381 twin children (50% female; 46.6% lower middle class or living at or below the poverty line; 26% Hispanic/Latino) were assessed at 12 months for SES and eight years using gold-standard home environment interviews and actigraphy-measured sleep. Multilevel mediation path models indicated that lower early SES and lower quality concurrent home environments were associated with shorter sleep durations, longer sleep latencies, and greater sleep timing variability. The home environment significantly mediated associations with sleep duration and sleep timing variability. The findings illustrate an important target in the prevention of poor childhood and adolescent sleep.

Adverse experiences in infancy and toddlerhood: Relations to adaptive behavior and academic status in middle childhood

Findings from the Adverse Childhood Experiences (ACE) study articulated the negative effects of childhood trauma on long-term well-being. The purpose of the current study is to examine the associations between ACEs experienced in infancy and toddlerhood and adaptive behavior and academic status in middle childhood. We used data collected from a sample of low-income families during the impacts study of Early Head Start (EHS). Data were collected by trained interviewers demonstrating at least 85% reliability with protocols. Data come from 1469 socio-demographically diverse mothers and children collected at or near ages 1, 2, 3, and 11. At ages 1, 2, and 3, an EHS-ACEs index was created based on interview and observation items. The EHS-ACEs indices were averaged to represent exposure across infancy and toddlerhood. At age 11, parents were asked about school outcomes and completed the Child Behavior Checklist. Across development, children were exposed to zero (19%), one (31%), two (27%), and three or more ACEs (23%). Logistic regression analyses, controlling for EHS program assignment, and parent, school, and child characteristics, showed ACEs were significantly associated with parental report of the child: having an individualized educational program since starting school and in the current school year, having been retained a grade in school, and problems with externalizing and internalizing behavior, as well as attention. Findings suggest that ACEs influence children's behavioral and academic outcomes early in development.

The Effect of Intimate Partner Violence on the Psychosocial Development of Toddlers

This study used data from the National Survey of Child and Adolescent Well-Being II to examine the effects of intimate partner violence (IPV) on child-welfare-involved toddlers' psychosocial development. The sample was limited to toddlers aged 12 to 18 months with mothers who did ( n = 102) and did not ( n = 163) report IPV physical victimization. Multiple linear regression analyses showed, when compared with mothers who did not report IPV physical victimization, mothers who reported IPV physical victimization were more likely to have toddlers with higher levels of socioemotional and behavioral problems ( B = 5.06, p < .001). Conversely, delayed social competence was not associated with IPV ( B = -1.33, p > .05). Further analyses examining only toddlers with mothers who reported IPV physical victimization revealed, when compared with IPV-exposed toddlers who had a child welfare report of physical abuse as the primary maltreatment type, those with IPV as the primary maltreatment type were at lower risk of having socioemotional and behavioral problems ( B = -12.90, p < .05) and delayed social competence ( B = 3.27, p < .05). These findings indicate a significant concern regarding toddler psychosocial development when a mother has experienced IPV. This concern is even greater among IPV-exposed toddlers who experience physical abuse. We recommend child welfare workers assess for IPV. Once identified, early prevention and intervention services should be offered and tailored to the specific needs of IPV-affected families.

METHODOLOGICAL CONSIDERATIONS FOR HOME-VISITING RESEARCH IN TRIBAL COMMUNITIES

Drawing on previous studies and the collective experience of conducting rigorous evaluations as part of the Tribal Maternal, Infant, and Early Childhood Home Visiting grants, we outline methodological considerations that will inform future research in tribal communities, particularly in the area of home visiting. The methodological issues we discuss are study design choices, measurement and data collection, and including community members in all aspects of the research.

Combined effects of prenatal exposure to polycyclic aromatic hydrocarbons and material hardship on child ADHD behavior problems

IMPORTANCE

Polycyclic aromatic hydrocarbons (PAH) are carcinogenic and neurotoxic combustion by-products commonly found in urban air. Exposure to PAH is disproportionately high in low income communities of color who also experience chronic economic stress.

OBJECTIVE

In a prospective cohort study in New York City (NYC) we previously found a significant association between prenatal PAH exposure and Attention Deficit Hyperactivity Disorder (ADHD) behavior problems at age 9. Here, we have evaluated the joint effects of prenatal exposure to PAH and prenatal/childhood material hardship on ADHD behavior problems.

MATERIALS AND METHODS

We enrolled nonsmoking African-American and Dominican pregnant women in New York City between 1998 and 2006 and followed their children through 9 years of age. As a biomarker of prenatal PAH exposure, PAH-DNA adducts were measured in maternal blood at delivery and were dichotomized at the limit of detection (to indicate high vs. low exposure). Maternal material hardship (lack of adequate food, housing, utilities, and clothing) was self-reported prenatally and at multiple time points through child age 9. Latent variable analysis identified four distinct patterns of hardship. ADHD behavior problems were assessed using the Conners Parent Rating Scale- Revised. Analyses adjusted for relevant covariates.

RESULTS

Among 351 children in our sample, across all hardship groups, children with high prenatal PAH exposure (high adducts) generally had more symptoms of ADHD (higher scores) compared to those with low PAH exposure. The greatest difference was seen among the children with hardship persisting from pregnancy through childhood. Although the interactions between high PAH exposure and hardship experienced at either period ("persistent" hardship or "any" hardship) were not significant, we observed significant differences in the number of ADHD symptoms between children with high prenatal PAH exposure and either persistent hardship or any hardship compared to the others. These differences were most significant for combined high PAH and persistent hardship: ADHD Index (p < 0.008), DSM-IV Inattentive (p = 0.006), DSM-IV Hyperactive Impulsive problems (p = 0.033), and DSM-IV Index Total (p = 0.009).

CONCLUSION

The present findings add to existing evidence that co-exposure to socioeconomic disadvantage and air pollution in early life significantly increases the risk of adverse neurodevelopmental outcomes. They suggest the need for multifaceted interventions to protect pregnant mothers and their children.

Foundations for screening adverse childhood experiences: Exploring patterns of exposure through infancy and toddlerhood

Adverse childhood experiences (ACEs) have lifetime consequences for health and development. Identification of ACEs early in childhood provides the potential to intervene before health and development are impaired. This study examined the timing and duration of exposure to ACEs experienced by children from low-income families from ages one to three years to identify whether there were patterns of exposure when infants and toddlers were most vulnerable. We were able to confirm the early negative consequences on cognitive, health, and behavior outcomes previously reported in young children using a national, longitudinal data set of parents and children from low-income households (N=2250). Using Finite Mixture Models, five classes of exposure were identified for children, Consistently Low (63.8%), Decreasing (10.3%), High at Age 2 (11.4%), Increasing (10.4%), and Consistently High (4%). The Consistently Low and Consistently High classes had the most and least optimal development across all domains, respectively. When examining child development outcomes among children with variable exposures to adversities, we found that for cognitive, language, and physical development, the most proximal ACEs were more robust for predicting child outcomes. For socioemotional health, exposure at any time from one to three to ACEs had negative consequences. As a whole, findings from this study highlight the need to consider ACEs screening tools that are both time-sensitive and permit a lifetime report.

Bisphenol A exposure and symptoms of anxiety and depression among inner city children at 10-12 years of age

BACKGROUND

Experimental and epidemiological studies suggest that gestational exposure to Bisphenol A (BPA), an ubiquitous endocrine disrupting chemical, may lead to neurobehavioral problems in childhood; however, not all results have been consistent. We previously reported a positive association between prenatal BPA exposure and symptoms of anxiety/depression reported by the mother at child age 7-9 years in boys, but not girls.

OBJECTIVES

Here, in the same birth cohort, we investigated the association of prenatal BPA exposure with symptoms of depression and anxiety self-reported by the 10-12 year olds, hypothesizing that we would observe sex-specific differences in anxiety and depressive symptoms.

METHODS

African-American and Dominican women living in Northern Manhattan and their children were followed from mother's pregnancy through children's age 10-12 years. BPA was quantified in maternal urine collected during the third trimester of pregnancy and in child urine collected at ages 3 and 5 years. Children were evaluated using the Revised Children's Manifest Anxiety Scale (RCMAS) and Children's Depression Rating Scale (CDRS). We compared the children in the highest tertile of BPA concentration to those in the lower two tertiles. Associations between behavior and prenatal (maternal) BPA concentration or postnatal (child) BPA concentration were assessed in regression models stratified by sex.

RESULTS

Significant positive associations between prenatal BPA and symptoms of depression and anxiety were observed among boys. Postnatal BPA exposure was not significantly associated with outcomes. There was substantial co-occurrence of anxiety and depressive symptoms in this sample.

CONCLUSION

These results provide evidence that prenatal BPA exposure is associated with more symptoms of anxiety and depression in boys but not in girls at age 10-12 years.

What IQ Tests Test

As we approach the centenary of the first practical intelligence test, there is still little scientific agreement about how human intelligence should be described, whether IQ tests actually measure it, and if they don't, what they actually do measure. The controversies and debates that result are well known. This paper brings together results and theory rarely considered (at least in conjunction with one another) in the IQ literature. It suggests that all of the population variance in IQ scores can be described in terms of a nexus of sociocognitive-affective factors that differentially prepares individuals for the cognitive, affective and performance demands of the test—in effect that the test is a measure of social class background, and not one of the ability for complex cognition as such. The rest of the paper shows how such factors can explain the correlational evidence usually thought to validate IQ tests, including associations with educational attainments, occupational performance and elementary cognitive tasks, as well as the intercorrelations among tests themselves.

The Africentric Home Environment Inventory: An Observational Measure of the Racial Socialization Features of the Home Environment for African American Preschool Children

The sociocultural context of the home is one of the most important socializing environments for young children. In this study, the authors describe an observational measure for racial socialization features of the home environment. Data were collected during home visits to 200 socioeconomically diverse urban African American families with preschool children, and a principal axis factor analysis revealed a single factor with an internal reliability of .88. The scale varied significantly by socioeconomic status and was significantly correlated with parent involvement and enrichment behaviors and child achievement and problem-solving ability. This inventory is an important complement to parent-report measures for the study of racial socialization and the development of preschool African American children and will contribute to the understanding of the importance of culturally anchored socialization practices for the optimal development of children of color.

Cost-effectiveness of preventive case management for parents with a mental illness: a randomized controlled trial from three economic perspectives

Background

The children of parents with a mental illness (COPMI) are at increased risk for developing costly psychiatric disorders because of multiple risk factors which threaten parenting quality and thereby child development. Preventive basic care management (PBCM) is an intervention aimed at reducing risk factors and addressing the needs of COPMI-families in different domains. The intervention may lead to financial consequences in the healthcare sector and in other sectors, also known as inter-sectoral costs and benefits (ICBs). The objective of this study was to assess the cost-effectiveness of PBCM from three perspectives: a narrow healthcare perspective, a social care perspective (including childcare costs) and a broad societal perspective (including all ICBs).

Methods

Effects on parenting quality (as measured by the HOME) and costs during an 18-month period were studied in in a randomized controlled trial. Families received PBCM (n = 49) or care as usual (CAU) (n = 50). For all three perspectives, incremental cost-effectiveness ratios (ICERs) were calculated. Stochastic uncertainty in the data was dealt with using non-parametric bootstraps. Sensitivity analyses included calculating ICERs excluding cost outliers, and making an adjustment for baseline cost differences.

Results

Parenting quality improved in the PBCM group and declined in the CAU group, and PBCM was shown to be more costly than CAU. ICERs differ from 461 Euros (healthcare perspective) to 215 Euros (social care perspective) to 175 Euros (societal perspective) per one point improvement on the HOME T-score. The results of the sensitivity analyses, based on complete cases and excluding cost outliers, support the finding that the ICER is lower when adopting a broader perspective. The subgroup analysis and the analysis with baseline adjustments resulted in higher ICERs.

Conclusions

This study is the first economic evaluation of family-focused preventive basic care management for COPMI in psychiatric and family services. The effects of the chosen perspective on determining the cost-effectiveness of PBCM underscore the importance of economic studies of interdepartmental policies. Future studies focusing on the cost-effectiveness of programs like PBCM in other sites and studies with more power are encouraged as this may improve the quality of information used in supporting decision making.

Trial registration

NTR2569, date of registration 2010-10-12.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-016-1498-z) contains supplementary material, which is available to authorized users.

Caring for children around the world: A view from HOME

This review examines cultural and socioeconomic variations in parenting as represented by the original and adapted versions of the HOME Inventory. There was specific focus on three aspects of the family environment where cultural models of parenting and access to resources are thought to be operative and for which there is evidence of impact on child well-being: parental responsiveness, discipline practices, and exposure to stimulating materials and experiences. Findings revealed meaningful impacts of culture and SES in all three areas. Not only did mean differences emerge across countries but different alliances between indicators, presumably representing the same parenting construct, also emerged. The review also revealed a tendency for researchers to modify the HOME consistent with local beliefs and practices concerning what children need, what families need, and the role of parents in fostering particular aspects of development. Despite differences in cultural models of parenting around the world, the studies showed rather consistent relations between exposure to stimulation and parental responsiveness and children's adaptive functioning. Associations with physical punishment were somewhat less clear.

Parenting and Preschool Self-Regulation as Predictors of Social Emotional Competence in 1st Grade

The current longitudinal study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) to examine a model of development that emphasizes early caregiving environments as predictors of social emotional competence (including classroom competence). This path analysis model included features of parenting, emotion regulation, preschool language skills, and attention to predict child outcomes in 1st grade. Early caregiving environments were directly predictive of peer relationship satisfaction, oppositional behavior, social skills, and classroom competence over and above significant mediated effects through preschool self regulation (language, inattention, and anger/frustration). These results suggest that the characteristics of supportive and stimulating caregiving shift in valence over time, such that qualities of the infant-child relationship that are significant in predicting early childhood outcomes are not the same as the caregiving qualities that move to the foreground in predicting primary school outcomes. Implications for school-readiness programming are discussed, including interventions in the early caregiving system to encourage sensitive and supportive parent child interactions to bolster school readiness via the development of social-emotional competence.

Prenatal exposure to polycyclic aromatic hydrocarbons/aromatics, BDNF and child development

OBJECTIVES

Within a New York City (NYC) birth cohort, we assessed the associations between polycyclic aromatic hydrocarbon (PAH) and other aromatic DNA adducts and brain derived neurotrophic factor (BDNF) concentrations in umbilical cord blood, and neurodevelopment at age 2 years and whether BDNF is a mediator of the associations between PAH/aromatic-DNA adducts and neurodevelopment.

METHODS

PAH/aromatic-DNA adduct concentrations in cord blood were measured in 505 children born to nonsmoking African-American and Dominican women residing in NYC, and a subset was assessed for neurodevelopment at 2 years using the Bayley Scales of Infant Development Mental Development Index (MDI). A spectrum of PAH/aromatic-DNA adducts was measured using the (32)P-postlabeling assay; DNA adducts formed by benzo[a]pyrene (B[a]P), a representative PAH, were measured by High Performance Liquid Chromatography (HPLC)/fluorescence. BDNF mature protein in cord blood plasma was quantified by an ELISA. Multivariate regression analysis, adjusting for potential confounders, was conducted.

RESULTS

PAH/aromatic-DNA adduct concentration measured by postlabeling was inversely associated with BDNF concentration (p=0.02) and with MDI scores at 2 years (p=0.04). BDNF level was positively associated with MDI scores (p=0.003). Restricting to subjects having all three measures (PAH/aromatic-DNA adducts by postlabeling, MDI, and BDNF), results were similar but attenuated (p=0.13, p=0.05, p=0.01, respectively). Associations between B[a]P-DNA adducts and BDNF and B[a]P-DNA adducts and MDI at age 2 years were not significant. At age 3 years, the positive association of BDNF with MDI was not observed.

CONCLUSIONS

The results at age 2 suggest that prenatal exposure to a spectrum of PAH/aromatic pollutants may adversely affect early neurodevelopment, in part by reducing BDNF levels during the fetal period. However, the same relationship was not seen at age 3.

Bisphenol A exposure and behavioral problems among inner city children at 7-9 years of age

BACKGROUND

Bisphenol A (BPA) is a ubiquitous endocrine disrupting compound. Several experimental and epidemiological studies suggest that gestational BPA exposure can lead to neurodevelopmental and behavioral problems in early-life, but results have been inconsistent. We previously reported that prenatal BPA exposure may affect child behavior and differently among boys and girls at ages 3-5 years.

OBJECTIVES

We investigated the association of prenatal and early childhood BPA exposure with behavioral outcomes in 7-9 year old minority children and hypothesized that we would observe the same sex-specific pattern observed at earlier ages.

METHODS

African-American and Dominican women enrolled in an inner-city prospective cohort study and their children were followed from mother's pregnancy through children's age 7-9 years. Women during the third trimester of pregnancy and children at ages 3 and 5 years provided spot urine samples. BPA exposure was categorized by tertiles of BPA urinary concentrations. The Child Behavioral Checklist (CBCL) was administered at ages 7 and 9 to assess multiple child behavior domains. Associations between behavior and prenatal (maternal) BPA concentrations and behavior and postnatal (child) BPA concentration were assessed via Poisson regression in models stratified by sex. These models accounted for potential confounders including prenatal or postnatal urinary BPA concentrations, child age at CBCL assessment, ethnicity, gestational age, maternal intelligence, maternal education and demoralization, quality of child's home environment, prenatal environmental tobacco smoke exposure, and prenatal mono-n-butyl phthalate concentration.

RESULTS

The direction of the associations differed between boys and girls. Among boys (n=115), high prenatal BPA concentration (upper tertile vs. lower two tertiles) was associated with increased internalizing (β=0.41, p<0.0001) and externalizing composite scores (β=0.40, p<0.0001) and with their corresponding individual syndrome scales. There was a general decrease in scores among girls that was significant for the internalizing composite score (β=-0.17, p=0.04) (n=135). After accounting for possible selection bias, the results remained consistent for boys. Conversely, high postnatal BPA concentration was associated with increased behaviors on both the internalizing composite (β=0.30, p=0.0002) and externalizing composite scores (β=0.33, p<0.0001) and individual subscores in girls but fewer symptoms in boys. These results remained significant in girls after accounting for selection bias.

CONCLUSION

These results suggest BPA exposure may affect childhood behavioral outcomes in a sex-specific manner and differently depending on timing of exposure.

Combined effects of prenatal polycyclic aromatic hydrocarbons and material hardship on child IQ

IMPORTANCE

Polycyclic aromatic hydrocarbons are common carcinogenic and neurotoxic urban air pollutants. Toxic exposures, including air pollution, are disproportionately high in communities of color and frequently co-occur with chronic economic deprivation.

OBJECTIVES

We examined whether the association between child IQ and prenatal exposure to polycyclic aromatic hydrocarbons differed between groups of children whose mothers reported high vs. low material hardship during their pregnancy and through child age 5. We tested statistical interactions between hardships and polycyclic aromatic hydrocarbons, as measured by DNA adducts in cord blood, to determine whether material hardship exacerbated the association between adducts and IQ scores.

DESIGN

Prospective cohort. Participants were recruited from 1998 to 2006 and followed from gestation through age 7 years.

SETTING

Urban community (New York City)

PARTICIPANTS

A community-based sample of 276 minority urban youth EXPOSURE MEASURE: Polycyclic aromatic hydrocarbon-DNA adducts in cord blood as an individual biomarker of prenatal polycyclic aromatic hydrocarbon exposure. Maternal material hardship self-reported prenatally and at multiple timepoints through early childhood.

MAIN OUTCOME MEASURE

Child IQ at 7 years assessed using the Wechsler Intelligence Scale for Children.

RESULTS

Significant inverse effects of high cord PAH-DNA adducts on full scale IQ, perceptual reasoning and working memory scores were observed in the groups whose mothers reported a high level of material hardship during pregnancy or recurring high hardship into the child's early years, and not in those without reported high hardship. Significant interactions were observed between high cord adducts and prenatal hardship on working memory scores (β = -8.07, 95% CI (-14.48, -1.66)) and between high cord adducts and recurrent material hardship (β = -9.82, 95% CI (-16.22, -3.42)).

CONCLUSION

The findings add to other evidence that socioeconomic disadvantage can increase the adverse effects of toxic physical "stressors" like air pollutants. Observed associations between high cord adducts and reduced IQ were significant only among the group of children whose mothers reported high material hardship. These results indicate the need for a multifaceted approach to prevention.

Infant Movement Motivation Questionnaire: development of a measure evaluating infant characteristics relating to motor development in the first year of life

This paper highlights the development and testing of the Infant Movement Motivation Questionnaire (IMMQ), an instrument designed to evaluate qualities of infant characteristics that relate specifically to early motor development. The measurement development process included three phases: item generation, pilot testing and evaluation of acceptability and feasibility for parents and exploratory factor analysis. The resultant 27-item questionnaire is designed for completion by parents and contains four factors including Activity, Exploration, Motivation and Adaptability. Overall, the internal consistency of the IMMQ is 0.89 (Cronbach's alpha), with test-retest reliability measured at 0.92 (ICC, with 95% CI 0.83-0.96). Further work could be done to strengthen the individual factors; however it is adequate for use in its full form. The IMMQ can be used for clinical or research purposes, as well as an educational tool for parents.

Do the effects of head start vary by parental preacademic stimulation?

Data from the Head Start Impact Study (N = 3,185, age = 3-4 years) were used to determine whether 1 year of Head Start differentially benefited children from homes with high, middle, and low levels of parental preacademic stimulation on three academic outcome domains-early math, early literacy, and receptive vocabulary. Results from residualized growth models showed positive impacts of random assignment to Head Start on all three outcomes, and positive associations between parental preacademic stimulation and academic performance. Two moderated effects were also found. Head start boosted early math skills the most for children receiving low parental preacademic stimulation. Effects of Head Start on early literacy skills were largest for children receiving moderate levels of parental preacademic stimulation. Implications for Head Start are discussed.

Parenting dimensions and styles: a brief history and recommendations for future research

Over the last decade, researchers have uncovered relationships between general parenting styles and children's obesity. This is an emerging area of research, and there currently is a great deal of interest in the parent's role. This review was written to provide researchers entering this area with a historical introduction to parenting research and to point to some directions for future inquiry. Over the last 75 years, considerable insight has been gained into individual differences in parenting behavior, especially regarding the dimensions underlying individual differences in general parenting approach, and parenting styles resulting from individual differences on these dimensions. The history of empirical attempts to identify parenting dimensions and styles is reviewed briefly, followed by a review of more recent studies of parenting styles. Next is a discussion of data analytic approaches to measuring parenting, with a particular emphasis on variable-centered versus person-centered approaches. Because investigators have often disagreed about which of these approaches is the most appropriate, the advantages and disadvantages of each are considered, along with recommendations for future research.

Economic disadvantage and young children's emotional and behavioral problems: mechanisms of risk

This study aimed to establish potential mechanisms through which economic disadvantage contributes to the development of young children's internalizing and externalizing problems. Prospective data from fetal life to age 3 years were collected in a total of 2,169 families participating in the Generation R Study. The observed physical home environment, the provision of learning materials in the home, maternal depressive symptoms, parenting stress, and harsh disciplining practices were all analyzed as potential mediators of the association between economic disadvantage and children's internalizing and externalizing problem scores. Findings from structural equation modeling showed that for both internalizing and externalizing problems, the mechanisms underlying the effect of economic disadvantage included maternal depressive symptoms, along with parenting stress and harsh disciplining. For internalizing but not for externalizing problem scores, the lack of provision of learning materials in the home was an additional mechanism explaining the effect of economic disadvantage. The current results suggest that interventions that focus solely on raising income levels may not adequately address problems in the family processes that emerge as a result of economic disadvantage. Policies to improve the mental health of mothers with young children but also their home environments are needed to change the economic gradient in child behavior.

Environmental opportunities questionnaire: development of a measure of the environment supporting early motor development in the first year of life

PURPOSE

The development and testing of a measure evaluating the quality and variability in the home environment as it relates to the motor development of infants during the first year of life.

METHODS

A sample of 112 boys and 95 girls with a mean age of 7.1 months (SD 1.8) and GA of 39.6 weeks (SD 1.5) participated in the study. The measurement development process was divided into three phases: measurement development (item generation or selection of items from existing measurement tools), pilot testing to determine acceptability and feasibility to parents, and exploratory factor analysis to organize items into meaningful concepts. Test-retest reliability and internal consistency were also determined.

RESULTS

The environmental opportunities questionnaire (EOQ) is a feasible 21-item measure comprised of three factors including opportunities in the play space, sensory variety and parental encouragement. Overall, test-retest reliability was 0.92 (CI 0.84-0.96) and the internal consistency is 0.79. The EOQ emphasizes quality of the environment and access to equipment and toys that have the potential to facilitate early motor development.

CONCLUSION

The preliminary analyses reported here suggest more work could be done on the EOQ to strengthen its use for research or clinical purposes; however, it is adequate for use in its current form. Implications for Rehabilitation New and feasible 21-item questionnaire that enables identification of malleable environmental factors that serve as potential points of intervention for children that are not developing typically. Therapeutic tool for use by therapists to inform and guide discussions with caregivers about potential influences of environmental, social and attitudinal factors in their child's early development.

A brief observational instrument for the assessment of infant home environment: development and psychometric testing

The present paper reports on the development and the psychometric properties of a brief observational assessment of home environments for use in large-scale investigations with young infants. We generated observational items conceptually relevant for child development by two methods. First, we adapted the Infant Toddler Home Observation for Measurement of the Environment (IT-HOME) inventory for use in an exclusively observational context. Second, we added new observational items following a review of relevant literature and consulting professionals. The quality of the instrument was first evaluated in a pilot study (n = 926). In our study sample of 3406 families and their children (median age = 3.1 months, range = 1.6-6.0), exploratory factor analysis was used to identify latent constructs, Cronbach's alpha was used as a measure of internal consistency, and convergent validity was evaluated against family socio-demographic characteristics. Inter-observer agreement was investigated in a sub-sample of the respondents (n = 124). The results supported good psychometric properties of the instrument based on: (a) exploratory factor analysis yielding three meaningful latent constructs, (b) Cronbach's alphas ranging from α = 0.66 to α = 0.90, (c) inter-observer agreement ranging from r = 0.75 to r = 0.91, and (d) associations between the instrument and socio-demographic characteristics in the expected direction [e.g. Odds Ratio for low income = 15.24, 95% confidence interval (11.60, 20.01)].

Prenatal bisphenol a exposure and child behavior in an inner-city cohort

BACKGROUND

Experimental laboratory evidence suggests that bisphenol A (BPA), an endocrine disruptor, is a neurodevelopmental toxicant. However, there have been limited and inconclusive results with respect to sex-specific BPA effects on child behavior.

OBJECTIVE

We examined the association between prenatal BPA exposure and child behavior, adjusting for postnatal BPA exposure and hypothesizing sex-specific effects.

METHODS

We followed African-American and Dominican women and their children from pregnancy to child's age 5 years, collecting spot urine samples from the mothers during pregnancy (34 weeks on average) and from children between 3 and 4 years of age to estimate BPA exposure. We assessed child behavior between 3 and 5 years of age using the Child Behavior Checklist (CBCL) and used generalized linear models to test the association between BPA exposure and child behavior, adjusting for potential confounders.

RESULTS

The analysis was conducted on 198 children (87 boys and 111 girls). Among boys, high prenatal BPA exposure (highest quartile vs. the lowest three quartiles) was associated with significantly higher CBCL scores (more problems) on Emotionally Reactive [1.62 times greater; 95% confidence interval (CI): 1.13, 2.32] and Aggressive Behavior syndromes (1.29 times greater; 95% CI: 1.09, 1.53). Among girls, higher exposure was associated with lower scores on all syndromes, reaching statistical significance for Anxious/Depressed (0.75 times as high; 95% CI: 0.57, 0.99) and Aggressive Behavior (0.82 times as high; 95% CI: 0.70, 0.97).

CONCLUSION

These results suggest that prenatal exposure to BPA may affect child behavior, and differently among boys and girls.

Prenatal polycyclic aromatic hydrocarbon (PAH) exposure and child behavior at age 6-7 years

BACKGROUND

Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban air pollutants from fossil fuel burning and other combustion sources. We previously reported that a broad spectrum of combustion-related DNA adducts in cord blood was associated with attention problems at 6-7 years of age in the Columbia Center for Children's Environmental Health (CCCEH) longitudinal cohort study.

OBJECTIVES

We evaluated the relationship between behavioral problems and two different measures of prenatal exposure--both specific to PAH--in the same cohort.

METHODS

Children of nonsmoking African-American and Dominican women in New York City (NYC) were followed from in utero to 6-7 years. Prenatal PAH exposure was estimated by personal air monitoring of the mothers during pregnancy as well as by the measurement of DNA adducts specific to benzo[a]pyrene (BaP), a representative PAH, in maternal and cord blood. At 6-7 years of age, child behavior was assessed using the Child Behavior Checklist (CBCL) (n = 253). Generalized linear models were used to test the association between prenatal PAH exposure and behavioral outcomes.

RESULTS

In multivariate analyses, high prenatal PAH exposure, whether characterized by personal air monitoring (greater than the median of 2.27 ng/m³) or maternal and cord adducts (detectable or higher), was positively associated with symptoms of Anxious/Depressed and Attention Problems (p ≤ 0.05).

CONCLUSION

These results provide additional evidence that environmental levels of PAH encountered in NYC air can adversely affect child behavior.

Evolution of obesity in a low birth weight cohort

OBJECTIVE

The objective of this study was to determine the evolution of obesity status (OS) in a longitudinal cohort of low birth weight preterm (LBWPT) infants to an age of 8 years, and to determine whether rapid weight gain in the first year of life independently predicts 8-year OS.

STUDY DESIGN

In total, 985 infants (birth weight ≤2500 g, gestation age ≤37 weeks) were recruited from the nursery in an eight-site intervention research program and were evaluated at an age of 3, 5, 6.5 and 8 years. Weight and height were measured by standard protocol at each visit and body mass index was calculated. Obesity status is ≥95% for age and sex. Multiple logistic analyses were performed on 8-year OS with predictor variables including infant race, gender, small for gestational age status, birth weight category, neonatal health index, treatment group and first-year weight gain; maternal education and weight status before conception; and HOME Inventory.

RESULT

Overall, 2.3% were OS at an age of 3 years, 6.1% at an age of 5 years, 7.7% at age 6.5 years and 8.7% at an age 8 years. OS varied by birth weight category at each visit. The infants born ≤1500 g had the lowest prevalence of OS at each age. In the logistic regression, maternal race (Hispanic) (adjusted odds ratio=2.8, confidence interval=1.2 to 6.8), maternal obese status (adjusted odds ratio 3.4, confidence interval=1.5 to 7.8) and first-year weight gain (adjusted odds ratio=2.7, confidence interval=1.9 to 3.9), significantly predicted 8-year OS.

CONCLUSION

OS is common in LBWPT infants during childhood, and prevalence varies by birth weight category. High weight gain in the first year of life is an important predictor of the development of OS in LBWPT children.

Polycyclic aromatic hydrocarbons-aromatic DNA adducts in cord blood and behavior scores in New York city children

BACKGROUND

Airborne polycyclic aromatic hydrocarbons (PAH) are widespread urban pollutants that can bind to DNA to form PAH-DNA adducts. Prenatal PAH exposure measured by personal monitoring has been linked to cognitive deficits in childhood in a prospective study conducted by the Columbia Center for Children's Environmental Health.

OBJECTIVES

We measured PAH-DNA and other bulky aromatic adducts in umbilical cord white blood cells using the 32P-postlabeling assay to determine the association between this molecular dosimeter and behavioral/attention problems in childhood.

METHODS

Children born to nonsmoking African-American and Dominican women residing in New York City (NYC) were followed from in utero to 7-8 years of age. At two time points before 8 years of age (mean ages, 4.8 years and 7 years), child behavior was assessed using the Child Behavior Checklist (CBCL). To estimate and test the association between adducts and behavioral outcomes, both CBCL continuous raw scores and dichotomized T-scores were analyzed.

RESULTS

Higher cord adducts were associated with higher symptom scores of Anxious/Depressed at 4.8 years and Attention Problems at 4.8 and 7 years, and with Diagnostic and Statistical Manual of Mental Disorders, 4th edition-oriented Anxiety Problems at 4.8 years.

CONCLUSIONS

These results suggest that PAH exposure, measured by DNA adducts, may adversely affect child behavior, potentially affecting school performance.

The effect of family processes on school achievement as moderated by socioeconomic context

This longitudinal study examined a model of early school achievement in reading and math, as it varies by socioeconomic context, using data from the NICHD Study of Early Child Care and Youth Development. A conceptual model was tested that included features of family stress, early parenting, and school readiness, through both a single-group analysis and also a multiple-group analysis. Latent profile analysis was used to identify subgroups of more advantaged and less advantaged families. Family stress and parenting were shown to operate differently depending on the socioeconomic context, whereas child-based school readiness characteristics were shown to operate similarly across socieodemographic contexts. Implications for intervention are discussed.

Adolescents with and without gestational cocaine exposure: Longitudinal analysis of inhibitory control, memory and receptive language

Preclinical studies of gestational cocaine exposure (GCE) show evidence of changes in brain function at the anatomical, physiological, and behavioral levels, to include effects on developing dopaminergic systems. In contrast, human studies have produced less consistent results, with most showing small effects or no effects on developmental outcomes. Important changes in brain structure and function occur through adolescence, therefore it is possible that prenatal cocaine exposure has latent effects on neurocognitive (NC) outcome that do not manifest until adolescence or young adulthood. We examined NC function using a set of 5 tasks designed to tap 4 different systems: inhibitory control, working memory, receptive language, and incidental memory. For each NC task, data were collected longitudinally at ages 12, 14.5 and 17 years and examined using generalized estimating equations. One hundred and nine children completed at least two of the three evaluations. Covariates included in the final model were assessment number, gender, participant age at first assessment, caregiver depression, and two composites from the Home Observation for Measurement of the Environment (HOME), Environmental Stimulation and Parental Nurturance. We found no cocaine effects on inhibitory control, working memory, or receptive language (p=0.18). GCE effects were observed on incidental face memory task (p=0.055), and GCE by assessment number interaction effects were seen on the incidental word memory task (p=0.031). Participant performance on inhibitory control, working memory, and receptive language tasks improved over time. HOME Environmental Stimulation composite was associated with better receptive language functioning. With a larger sample size smaller differences between groups may have been detected. This report shows no evidence of latent effects of GCE on inhibitory control, working memory, or receptive language. GCE effects were observed on the incidental face memory task, and GCE by assessment number interaction effects was seen on the incidental word memory task.