Sensitive, stimulating caregiving predicts cognitive and behavioral resilience in neurodevelopmentally at-risk infants

Trajectories of resilience among young children involved with child protective services

Although child maltreatment is associated with short- and long-term maladaptive outcomes, some children are still able to display resilience. Currently, there is a limited understanding of how children's resilience changes over time after experiencing maltreatment, especially for young children. Therefore, the current study used a longitudinal, multidimensional approach to examine trajectories of resilience among very young children involved in child protective services and determine whether placement setting and caregiving behaviors are associated with resilience trajectories. This study used data from National Survey of Child and Adolescent Well-Being I and conducted repeated measures latent class analysis, focusing on children under 2 years old at baseline (n = 1,699). Results suggested that there were three trajectories of resilience: increasing resilience, decreasing resilience, and stable, low resilience. Caregiver cognitive stimulation was related to increasing trajectories of resilience compared to both decreasing and stable, low resilience. These findings illustrate the importance of caregiving behaviors for promoting resilience among a particularly vulnerable population.

Can resilience change over time? Patterns and transitions in resilience among young children involved with the child welfare system

This study examined transitions in resilience profiles and the role of caregiver risk and protective factors in resilience transition probabilities over 18 months among children involved with the child welfare system, using latent profile analysis and latent transition analysis. The sample included 486 children (48% female, baseline Mage  = 3.49). There were three resilience profiles at Time 1 (19.9% low emotional behavioral, 26.1% low cognitive, 54.0% multidomain) and two profiles at Time 2 (18.9% low emotional behavioral, 81.1% multidomain). Caregiver mental health problems were negatively associated with membership in the multidomain resilience group at Time 1. Higher levels of cognitive stimulation were associated with initial and continued membership in the multidomain resilience group. Implications for resilient child development are discussed.

A Pragmatic Clinical Approach to Substance Abuse Prevention

Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care clinicians and child/adolescent behavioral health clinicians are unfamiliar with and/or lack training in evidence-based prevention interventions. However, most clinicians in these settings routinely screen children for developmental delays and skills deficits that increase the risk of developing substance abuse and a broad range of mental health and behavior problems by adolescence. It is hoped that the broader use of these practical evidence-based prevention tools may expand the prevention workforce to address the current youth mental health crisis.

Promoting Temporal Investigations of Development in Context: a Systematic Review of Longitudinal Research Linking Childhood Circumstances and Learning-related Outcomes

Children’s learning and cognitive development have a distinct receptivity to the circumstances of childhood. However, not all children have equal opportunities and learning inequities continue to be influenced by the social and economic circumstances of childhood. Examining factors within the environments that children are growing up in, and the associations of these factors with learning, can help to identify leverage points for change, enabling more children to be supported to reach their potential. Specifically, turning attention to the timing and duration of exposure to specific social and economic factors across childhood can provide essential details to determine who is most susceptible to contextual effects and at what ages. This paper presents a systematic review of 75 longitudinal studies of families and children carried out between 2000 and 2021. These studies tracked social and economic circumstances between pregnancy and early adolescence in relation to educational and cognitive outcomes across the lifespan. The results of the included studies were examined and grouped into themes using reflexive thematic analysis. The findings largely suggest that the degree to which educational and cognitive outcomes are affected by specific social and economic circumstances depends on the duration, timing, and mobility across childhood. In particular, findings relating to the developmental timing of exposure, as well as persistent exposure, revealed distinct evidence of the effects of temporality. These findings provide detail into how much and in what instances temporality should be considered—results which can be used to inform avenues for reducing learning disparities.

A Pragmatic Clinical Approach to Substance Abuse Prevention

Research has led to the development of hundreds of evidence-based prevention interventions, most of which are school-based prevention programs. Most primary care clinicians and child/adolescent behavioral health clinicians are unfamiliar with and/or lack training in evidence-based prevention interventions. However, most clinicians in these settings routinely screen children for developmental delays and skills deficits that increase the risk of developing substance abuse and a broad range of mental health and behavior problems by adolescence. It is hoped that the broader use of these practical evidence-based prevention tools may expand the prevention workforce to address the current youth mental health crisis.

The impact of early-life environment on absence epilepsy and neuropsychiatric comorbidities

This review discusses the long-term effects of early-life environment on epileptogenesis, epilepsy, and neuropsychiatric comorbidities with an emphasis on the absence epilepsy. The WAG/Rij rat strain is a well-validated genetic model of absence epilepsy with mild depression-like (dysthymia) comorbidity. Although pathologic phenotype in WAG/Rij rats is genetically determined, convincing evidence presented in this review suggests that the absence epilepsy and depression-like comorbidity in WAG/Rij rats may be governed by early-life events, such as prenatal drug exposure, early-life stress, neonatal maternal separation, neonatal handling, maternal care, environmental enrichment, neonatal sensory impairments, neonatal tactile stimulation, and maternal diet. The data, as presented here, indicate that some early environmental events can promote and accelerate the development of absence seizures and their neuropsychiatric comorbidities, while others may exert anti-epileptogenic and disease-modifying effects. The early environment can lead to phenotypic alterations in offspring due to epigenetic modifications of gene expression, which may have maladaptive consequences or represent a therapeutic value. Targeting DNA methylation with a maternal methyl-enriched diet during the perinatal period appears to be a new preventive epigenetic anti-absence therapy. A number of caveats related to the maternal methyl-enriched diet and prospects for future research are discussed.

Moderate low birth weight and socioemotional competence among children: The role of parenting factors in early childhood

BACKGROUND

Although the importance of birth weight for socioemotional trajectories among children has become a topic of growing interest for researchers, the majority of prior studies were limited to the more extreme subgroups of low birth weight children.

PURPOSE

The purpose of this study was to examine the longitudinal associations among moderate low birth weight status, parenting factors, and socioemotional competence among at-risk children. This paper also examined the role of parenting factors as a moderator in the associations between birth weight and indicators of socioemotional competence at age 9.

METHODS

Participants include a subsample (N = 1809) of families participating in the Fragile Families and Child Wellbeing Study, a national longitudinal birth cohort study. Birth weight and prenatal data were taken from medical records. Parenting factors were assessed during in-home assessments at ages 3 and 5. Teachers reported on externalizing behaviors and social skills at age 9. Structural equation modeling was used to examine the associations among study variables.

RESULTS

Overall, results indicate that moderate low birth weight was significantly associated with lower levels of teacher-reported socioemotional competence at age 9 even after accounting for a large battery of control variables. Results also showed that maternal warmth, but not parenting stress, moderated the longitudinal association between birth weight and indicators of socioemotional competence.

CONCLUSION

Findings highlight the importance of birth weight and positive parenting processes in socioemotional outcomes among children. The implications of these findings are discussed for targeting positive parenting interventions and developmental outcomes for at-risk children.

The Microbiome-Gut-Brain Axis and Resilience to Developing Anxiety or Depression under Stress

Episodes of depression and anxiety commonly follow the experience of stress, however not everyone who experiences stress develops a mood disorder. Individuals who are able to experience stress without a negative emotional effect are considered stress resilient. Stress-resilience (and its counterpart stress-susceptibility) are influenced by several psychological and biological factors, including the microbiome-gut-brain axis. Emerging research shows that the gut microbiota can influence mood, and that stress is an important variable in this relationship. Stress alters the gut microbiota and plausibly this could contribute to stress-related changes in mood. Most of the reported research has been conducted using animal models and demonstrates a relationship between gut microbiome and mood. The translational evidence from human clinical studies however is rather limited. In this review we examine the microbiome-gut-brain axis research in relation to stress resilience.

Restraint Stress in Mice Alters Set of 25 miRNAs Which Regulate Stress- and Depression-Related mRNAs

In the present study, we aim to identify the effect of restrain stress (RS) on the expression of miRNAs in mouse serum. We used three genotypes of animals (mice with knock-out of the gene-encoding norepinephrine transporter, NET-KO; C57BL/6J, and SWR/J) which had previously been shown to display different sensitivity to RS, and focused on miRNAs which were altered by RS in the serum of all three genotypes. An analysis of miRNAs expression allowed for the identification of a set of 25 differentially expressed miRNAs; 10 were down-regulated compared to an appropriate control group of animals, while 15 were up-regulated. The application of DIANA-miRPath v. 3.0 allowed for the identification of selected pathways (KEGG) and Gene Ontology (GO) categories that were significantly controlled by these miRNAs, while miRWalk v. 3.0-the platform that used the machine learning based algorithm, TaRPmiR-was used to find their targets. The results indicate that 25 miRNAs, identified as altered upon RS in three genotypes of mice, are responsible for regulation of mRNA-encoding proteins that are key for the main hypotheses of depression; therefore, they may help to understand the link between stress and depression at the molecular level.

Developmental Outcomes of Infants Adopted from Foster Care: Predictive Associations from Perinatal and Preplacement Risk Factors

Infants adopted domestically from foster care often present with prenatal substance exposure and risky birth outcomes such as prematurity and low birth weight. Because few longitudinal studies of foster-adoptive infants exist, it is unclear how these preplacement risk factors influence development over time. The present study examined associations between perinatal risk factors and developmental outcomes among an ethnically/racially-diverse sample of 97 infants in foster-care (56% boys) placed into adoptive homes at ages 0-19 months. Relative to population-norms, foster-adoptive infants showed comparable cognitive but lower language and motor functioning at baseline and one-year follow-up. Age-adjusted language scores significantly improved one year following placement, consistent with a developmental "catch-up" effect. Low birth weight uniquely predicted lower language scores at baseline, but this association was no longer significant at follow-up. Prenatal substance exposure was associated with lower baseline cognitive scores, but only for infants placed after six months of age. In contrast, infants with low birth weight and later placement age (>12 months) showed the most accelerated motor development. Sex differences emerged at follow-up when predicting motor and language outcomes, suggesting potential sex-specific pathways of risk. Overall, results support adoption as an early intervention that may buffer vulnerability to perinatal risk on development.

Resilience in Extremely Preterm/Extremely Low Birth Weight Kindergarten Children

OBJECTIVES

Research on developmental outcomes of preterm birth has traditionally focused on adverse effects. This study investigated the prevalence and correlates of resilience in 146 extremely preterm/extremely low birth weight (EPT/ELBW) children (gestational age <28 weeks and/or birth weight <1000 g) attending kindergarten and 111 term-born normal birth weight (NBW) controls.

METHODS

Adaptive competence (i.e., "resilience" in the EPT/ELBW group) was defined by scores within grade expectations on achievement tests and the absence of clinically elevated parent ratings of child behavior problems. The "adaptive" children who met these criteria were compared to the "maladaptive" children who did not on child and family characteristics. Additional analyses were conducted to assess the conjoint effects of group (ELBW vs. NBW) and family factors on adaptive competence.

RESULTS

A substantial minority of the EPT/ELBW group (45%) were competent compared to a majority of NBW controls (73%), odds ratio (95% confidence interval)=0.26 (0.15, 0.45), p<.001. Adaptive competence was associated with higher cognitive skills, more favorable ratings of behavior and learning not used to define adaptive competence, and more advantaged family environments in both groups, as well as with a lower rate of earlier neurodevelopmental impairment in the EPT/ELBW group. Higher socioeconomic status and more favorable proximal home environments were associated with competence independent of group, and group differences in competence persisted across the next two school years.

CONCLUSIONS

The findings document resilience in kindergarten children with extreme prematurity and highlight the role of environmental factors as potential influences on outcome. (JINS, 2019, 25, 362-374).

Developmental trajectories of externalizing behavior from ages 4 to 12: Prenatal cocaine exposure and adolescent correlates

BACKGROUND

Although prenatal cocaine exposure (PCE) has been linked with greater externalizing behavior, no studies have investigated heterogeneity of developmental trajectories in children with PCE to date. The present study aimed to: (1) identify developmental trajectories of externalizing problems in childhood by using a person-oriented analytic approach; (2) examine whether trajectories differ by PCE and other environmental and biological correlates; and (3) investigate how trajectories were associated with adolescent substance use and sexual behavior.

METHODS

Adolescents (N = 386; 197 PCE, 187 non-cocaine exposed (NCE)), primarily African-American and of low socioeconomic status, were prospectively enrolled in a longitudinal study at birth. Externalizing problems were assessed with the Child Behavior Checklist (CBCL) at ages 4, 6, 9, 10, 11, and 12. Substance (tobacco, alcohol, marijuana) use, via self-report and biologic assays, and early (before age 15) sexual intercourse were assessed at age 15.

RESULTS

Latent class growth modeling indicated four distinctive developmental trajectories of externalizing behavior from ages 4 to 12: low-decreasing group (32%); moderate-decreasing group (32%); accelerated risk group (14%); and elevated-chronic group (22%). PCE and maternal psychological distress interactively differentiated developmental trajectories of externalizing behavior, which were related to subsequent adolescent substance use and early sexual behavior differently across gender.

CONCLUSIONS

The two high-risk trajectories (accelerated risk and elevated-chronic groups), comprising 36% of the sample, identified in the present study may reflect multi-causality of early substance use and perhaps greater risk for transition to substance use disorders later in development.

Resilience in young children involved with child protective services

Child maltreatment increases the risk of poor developmental outcomes. However, some children display resilience, meaning they are high-functioning despite their adverse experiences. To date, few research studies have examined protective factors among very young maltreated children. Yet, domains of resilience, and the protective factors that promote resilience among maltreated children, are likely to differ by developmental stage. Drawing on ecological systems theory and life course theory, we examined how protective factors at multiple ecological levels across early childhood were related to social and cognitive resilience among very young children involved with child protective services. The results demonstrated that the buffering effects of protective factors varied by social or cognitive resilience and the cumulative effects of protective factors were more consistently related to later resilience than protective factors at specific time points. In addition, the influence of specific protective factors on resilience slightly varied by initial in-home or out-of-home placement. These findings have important policy and research implications for promoting optimal development among children involved in child protective services.

Promoting the development of resilient academic functioning in maltreated children

This study examined (a) the extent of heterogeneity in the patterns of developmental trajectories of language development and academic functioning in children who have experienced maltreatment, (b) how maltreatment type (i.e., neglect or physical abuse) and timing of abuse explained variation in developmental trajectories, and (c) the extent to which individual protective factors (i.e., preschool attendance, prosocial skills), relationship protective factors (i.e., parental warmth, absence of past-year depressive episode, cognitive/verbal responsiveness) and community protective factors (i.e., neighborhood safety) promoted the development of resilient language/academic functioning trajectories. Longitudinal data analyses were conducted using cohort sequential Growth Mixture Model (CS-GMM) with a United States national representative sample of children reported to Child Protective Services (n=1,776). Five distinct developmental trajectories from birth to age 10 were identified including two resilient groups. Children who were neglected during infancy/toddlerhood or physically abused during preschool age were more likely to be in the poorer language/academic functioning groups (decreasing/recovery/decreasing and high decreasing) than the resilient high stable group. Child prosocial skills, caregiver warmth, and caregiver cognitive stimulation significantly predicted membership in the two resilient academic functioning groups (low increasing and high stable), after controlling for demographics and child physical abuse and neglect. Results suggest that it is possible for a maltreated child to successfully achieve competent academic functioning, despite the early adversity, and identifies three possible avenues of intervention points. This study also makes a significant contribution to the field of child development research through the novel use of CS-GMM, which has implications for future longitudinal data collection methodology.

Maternal Sensitivity: a Resilience Factor against Internalizing Symptoms in Early Adolescents Born Very Preterm?

Compared with full-terms, preterm individuals are more at risk from infancy to adulthood for developing internalizing symptoms. Early maternal interactive behavior, especially maternal sensitivity, has been found to be a resilience factor in the developmental outcome of preterm children. The present longitudinal study aimed at examining whether early interactive parenting behaviors have a long term impact on the internalizing symptoms of preterm-born young adolescents. A total sample of 36 very preterm and 22 full-term children participated in an 11-year follow-up study. Maternal interactive behavior was assessed during a mother-infant interaction when the infant was 18 months old. At 11 years, internalizing symptoms were assessed with the Child Behavior Checklist (CBCL). Hierarchical regression analyses revealed that the interaction between groups (preterm/full-term) and maternal sensitivity at 18 months significantly explained CBCL internalizing symptoms at 11 years (β = -0.526; p < 0.05). Specifically, although prematurity was related to internalizing problems, preterm children with higher maternal sensitivity did not differ from their full-term-born peers on the CBCL internalizing problems domain. These results suggest that maternal sensitivity is a long-term resilience factor preventing the development of internalizing problems at early adolescence in very preterm individuals.

Assessment: The Newborn

Neonatal neurobehavioral assessment has become a standardized component of clinical care provided to newborn infants, guiding neonatal clinical care and subsequent access to early interventions and services. Links between neonatal assessment and neurosensory and motor impairments in high-risk infants have been relatively well established. In contrast, the extent to which newborn neurobehavioral assessment might also facilitate the early identification of infants susceptible to socioemotional impairments in early childhood is less well documented. This review examines longitudinal links between the neonatal neurobehavioral assessment, temperament, and socioemotional outcomes in early childhood.

Resilience

Every child is a unique individual. This individuality is evident in children exposed to psychosocial trauma or adverse childhood experiences. There exists wide variation in the way children respond to toxic stressors in their lives. Some children appear to be relatively unaffected, while others develop a variety of psychological, behavioral, and physical consequences. What is the explanation for this phenomenon? Resiliency has been suggested to explain this variation in pathology expressions in trauma-exposed children. It is vital for pediatric nurse practitioners to understand the concept of resilience. This continuing education offering will define concepts of resilience and stress, explore the neurobiology of resilience, and examine interventions that promote resilience in children.

Risk and protective factors in early child development: Results from the All Our Babies (AOB) pregnancy cohort

BACKGROUND

Understanding factors that protect against early developmental delay among children who are experiencing adversity can inform prevention and early intervention strategies.

AIMS

To identify risk factors for development delay at one year and protective factors for developmental delay in 'at risk' environments (poor maternal mental health and socio-demographic risk).

METHODS AND PROCEDURES

Data was analyzed from 3360 mother-child dyads who participated in the All Our Babies (AOB) pregnancy cohort. Participants completed four questionnaires spanning pregnancy to one year postpartum and provided access to medical records. Risk factors for developmental delay at age one were identified using bivariate methods and multivariable modeling. Protective factors for child development in 'at risk' family environments were identified using bivariate analyses.

OUTCOMES AND RESULTS

At one year, 17% of children were developmentally delayed, defined as scoring in the monitoring zone on at least 2 of the 5 developmental domains of the Ages and Stages Questionnaire. Prenatal depression, preterm birth, low community engagement, and non-daily parent-child interaction increased the risk of delay. Protective factors for children in 'at risk' environments included relationship happiness, parenting self-efficacy, community engagement, higher social support, and daily parent-child interaction.

CONCLUSIONS AND IMPLICATIONS

The study results suggest that maternal and infant outcomes would be improved, even for vulnerable women, through identification and intervention to address poor mental health and through normalizing engagement with low cost, accessible community resources that can also support parent-child interaction.

Operationalising resilience in longitudinal studies: a systematic review of methodological approaches

Over the life course, we are invariably faced with some form of adversity. The process of positively adapting to adverse events is known as ‘resilience’. Despite the acknowledgement of 2 common components of resilience, that is, adversity and positive adaptation, no consensus operational definition has been agreed. Resilience operationalisations have been reviewed in a cross-sectional context; however, a review of longitudinal methods of operationalising resilience has not been conducted. The present study conducts a systematic review across Scopus and Web of Science capturing studies of ageing that posited operational definitions of resilience in longitudinal studies of ageing. Thirty-six studies met inclusion criteria. Non-acute events, for example, cancer, were the most common form of adversity identified and psychological components, for example, the absence of depression, the most common forms of positive adaptation. Of the included studies, 4 used psychometrically driven methods, that is, repeated administration of established resilience metrics, 9 used definition-driven methods, that is, a priori establishment of resilience components and criteria, and 23 used data-driven methods, that is, techniques that identify resilient individuals using latent variable models. Acknowledging the strengths and limitations of each operationalisation is integral to the appropriate application of these methods to life course and longitudinal resilience research.

Association of caregiver quality of care with neurocognitive outcomes in HIV-affected children aged 2-5 years in Uganda

Children affected by HIV are at increased risk of developmental and neuropsychological disturbances due to direct effects of HIV on the brain and direct effects associated with living in poverty. Caregivers can play an important role, through quality caregiving, in mitigating the negative effect of these stressors. This study used baseline data from an ongoing caregiver training intervention trial to evaluate the association between quality of caregiver–child interactions and neurocognitive outcomes in rural HIV-infected and HIV-exposed but uninfected children in Uganda. We also assessed the extent to which caregiver distress moderated this relationship. Data on 329 caregiver–child dyads were collected between March 2012 and July 2014, when the children were between 2 and 5 years of age. Child outcomes include the Mullen Scales of Early Learning to assess general cognitive ability and the Color Object Association Test to assess immediate memory and total recall. Caregiving quality was assessed using the Home Observation for the Measurement of the Environment (HOME) total and subscale scores. Caregiver distress was assessed using the Hopkins Symptom Checklist. General linear regression models assessed the association between the HOME total and subscale scores and child outcomes, with interaction terms used to test moderation by caregiver distress. Total HOME scores were positively and significantly associated with Mullen scores of cognitive ability; HOME acceptance subscale scores were positively and significantly associated with immediate recall scores. No other associations were statistically significant. As hypothesized, there is a strong association between the HOME and Mullen scores of cognitive ability in our study population, such that children who were assessed as living in environments with more stimulation also presented with a higher level of general neurocognitive development. Our results support the view of program guidance for HIV-affected children that suggest family-oriented care with emphasis on parent–child relationships for optimal child development.

Pathways from maternal depressive symptoms to adolescent depressive symptoms: the unique contribution of irritability symptoms

BACKGROUND

The authors tested three possible pathways linking prenatal maternal depressive symptoms to adolescent depressive symptoms. These pathways went through childhood Irritability Symptoms, Anxiety/Depressive Symptoms or Conduct Problems.

METHOD

Data were collected from 3,963 mother-child pairs participating in the Avon Longitudinal Study of Parents and Children. Measures include maternal depressive symptoms (pre- and postnatal); toddler temperament (2 years); childhood (7-13 years) irritability symptoms, anxiety/depressive symptoms, conduct problems, and adolescent depressive symptoms (16 years).

RESULTS

Irritability Symptoms: This pathway linked sequentially - prenatal maternal depressive symptoms, toddler temperament (high perceived intensity and low perceived adaptability), childhood irritability symptoms, and adolescent depressive symptoms. Anxiety/Depressive symptoms: This pathway linked sequentially - prenatal maternal depressive symptoms, toddler temperament (negative perceived mood), childhood anxiety/depressive symptoms, and adolescent depressive symptoms. Childhood conduct problems were not associated with adolescent depressive symptoms, above and beyond irritability symptoms and anxiety/depressive symptoms.

CONCLUSIONS

Results suggest evidence for two distinct developmental pathways to adolescent depressive symptoms that involve specific early and midchildhood features.

Housing mobility and cognitive development: Change in verbal and nonverbal abilities

This study investigates the influence of housing instability on verbal and nonverbal cognitive development among at-risk children and adolescents involved in the child welfare system. Frequent residential changes threaten child mental health, especially among low-income families. Little is known regarding disruptions to cognitive growth, specifically the impact on verbal and nonverbal abilities. The study tests whether developmental timing of housing mobility affects cognitive development beyond individual and family risks. A nationally representative study of families (n=2,442) susceptible to housing and family instability tracked children and adolescents aged 4-14 years (M=8.95 years) over 36 months following investigation by the child welfare system. Youth completed standardized cognitive assessments while caregivers reported on behavior problems and family risk at three time points. Latent growth models examined change in cognitive abilities over time. Housing mobility in the 12 months prior to baseline predicts lower verbal cognitive abilities that improve marginally. Similar effects emerge for all age groups; however, frequent moves in infancy diminish the influence of subsequent housing mobility on verbal tasks. Housing instability threatened cognitive development beyond child maltreatment, family changes, poverty, and other risks. Findings inform emerging research on environmental influences on neurocognitive development, as well as identify targets for early intervention. Systematic assessment of family housing problems, including through the child welfare system, provides opportunities for coordinated responses to prevent instability and cognitive threats.

Out of Control

Family violence is common and brings tremendous costs to individuals, relationships, and society. Victims are vulnerable to negative outcomes across a host of dimensions, including cognitive performance, impulse control, emotion regulation, and physical health. Links between family violence and various problems have been established, yet the specific processes underlying these associations are poorly understood, resulting in the stunted development of effective interventions. This article addresses two key questions: How and why does family violence cause these myriad problems? The self-control strength model of family violence provides novel answers. The model integrates components of existing theories, extending them by pinpointing self-control strength as an explanatory and predictive factor, and can serve as a framework for interventions.

Effects of sensitive parenting on the academic resilience of very preterm and very low birth weight adolescents

PURPOSE

Although sensitive and cognitively stimulating parenting is a powerful predictor of school success, it may not protect against increased neonatal risk resulting from underlying neurological damage.

METHODS

A total of 314 very preterm/very low birth weight (VP/VLBW) and 338 term control children were studied from birth to age 13 years. Socioeconomic status was examined at birth. Neurological and physical impairment was assessed at age 20 months, and sensitive and cognitively stimulating parenting at age 6 years. School success was measured from 6 to 13 years of age.

RESULTS

Very preterm/very low birth weight children had lower school success between 6 and 13 years, after statistically controlling for child disability and socioeconomic status. Cognitively stimulating parenting promoted all children's school success whereas highly sensitive parenting at age 6 years partly protected against the adverse effects of VP/VLBW birth on academic outcomes.

CONCLUSIONS

Very preterm/very low birth weight children's school success to age 13 years may be partly protected with sensitive parenting in middle childhood, despite the neurodevelopmental impairments associated with VP/VLBW birth. This suggests potential avenues for interventions for children born at high neonatal risk.

Resilience in mental health: linking psychological and neurobiological perspectives

OBJECTIVE

To review the literature on psychological and biological findings on resilience (i.e. the successful adaptation and swift recovery after experiencing life adversities) at the level of the individual, and to integrate findings from animal and human studies.

METHOD

Electronic and manual literature search of MEDLINE, EMBASE and PSYCHINFO, using a range of search terms around biological and psychological factors influencing resilience as observed in human and experimental animal studies, complemented by review articles and cross-references.

RESULTS

The term resilience is used in the literature for different phenomena ranging from prevention of mental health disturbance to successful adaptation and swift recovery after experiencing life adversities, and may also include post-traumatic psychological growth. Secure attachment, experiencing positive emotions and having a purpose in life are three important psychological building blocks of resilience. Overlap between psychological and biological findings on resilience in the literature is most apparent for the topic of stress sensitivity, although recent results suggest a crucial role for reward experience in resilience.

CONCLUSION

Improving the understanding of the links between genetic endowment, environmental impact and gene-environment interactions with developmental psychology and biology is crucial for elucidating the neurobiological and psychological underpinnings of resilience.

Biology, genes, and resilience: toward a multidisciplinary approach

Variability in response to stressful environmental exposures is at the core of resilience research. In order to understand why some individuals show resilient functioning in the face of adversity, one needs to understand the mechanisms through which risky environments lead to pathology in some and not others, and the ways in which risk and protective factors affect these processes. Understanding the interplay between genetic and biological processes and different environments is necessary in order to elucidate the causal pathways through which individuals show resilience or vulnerability in the face of adversity.

Routine versus catastrophic influences on the developing child

Exposure to toxic stress accelerates the wear and tear on children's developing bodies and leaves a lasting mark on adult health. Prior research has focused mainly on children exposed to extreme forms of adversity, such as maltreatment and extreme neglect. However, repeated exposure to less severe, but often chronic stressors is likely to play as large, if not larger, of a role in forecasting children's future mental and physical health. New tools from neuroscience, biology, epigenetics, and the social sciences are helping to isolate when and how the foundations for adult health are shaped by childhood experiences. We are now in the position to understand how adversity, in both extreme and more mundane forms, contributes to the adult health burden and to identify features in children's families and environments that can be strengthened to buffer the effects of toxic stressors. We are also positioned to develop and implement innovative approaches to child policy and practice that are rooted in an understanding of how exposure to toxic stressors can become biologically embedded. The stage is set for the creation of new interventions--on both grand and micro scales--to reduce previously intractable health disparities.

Association between maladaptive parenting and child self-control over time: cross-lagged study using a monozygotic twin difference design

BACKGROUND

Harsh parenting practices and negative parental feelings may be environmental risk factors for low self-control in children. Children may also evoke certain parenting reactions.

AIMS

To investigate the longitudinal relationship between parenting and self-control, as well as associated outcomes within the monozygotic (MZ) twin differences framework.

METHOD

Longitudinal MZ twin differences analysis was conducted on a community sample of 5184 twins using data from ages 3, 4, 7 and 9 years. Outcomes related to self-control and parenting were analysed at age 12 years.

RESULTS

Non-shared environmental effects of parenting on the development of self-control and an evocative effect of child self-control on parenting were found. Harsh parenting predicted conduct problems for both boys and girls. Self-control at age 9 predicted conduct problems and emotional difficulties at age 12.

CONCLUSIONS

Parenting and child self-control affect one another, highlighting the potential of early interventions that target parents and children simultaneously.

Relative impact of maternal depression and associated risk factors on offspring psychopathology

BACKGROUND

In general, mothers with depression experience more environmental and family risk factors, and lead riskier lifestyles, than mothers who are not depressed.

AIMS

To test whether the exposure of a child to risk factors associated with mental health adds to the prediction of child psychopathology beyond exposure to maternal depression.

METHOD

In 7429 mother-offspring pairs participating in the Avon Longitudinal Study of Parents and Children in the UK, maternal depression was assessed when the children were aged 1.5 years; multiple risk factor exposures were examined between birth and 2 years of age; and DSM-IV-based externalising and internalising diagnoses were evaluated when the children were 7.5 years of age.

RESULTS

Children of clinically depressed mothers were exposed to more risk factors associated with maternal mental health. Maternal depression increased diagnoses of externalising and internalising disorders, but a substantial portion of these associations was explained by increased risk factor exposure (41% for externalising and 37% for internalising disorders). At the same time, these risk exposures significantly increased the odds of both externalising and internalising diagnoses, over and above the influence of maternal depression.

CONCLUSIONS

Children of clinically depressed mothers are exposed to both maternal psychopathology and risks that are associated with maternal mental health. These results may explain why treating mothers with depression shows beneficial effects for children, but does not completely neutralise the increased risk of psychopathology and impairment.

The impact of prenatal maternal risk, fearless temperament and early parenting on adolescent callous-unemotional traits: a 14-year longitudinal investigation

OBJECTIVE

Proposals have been submitted to the DSM-V for the addition of a callous-unemotional (CU) specifier for conduct problem (CP) youth (CP/CU). While the addition of such a diagnostic category may aid in the identification of homogeneous CP subtypes, evidence on risks for the development of CP/CU remains limited. The present study sought to examine the extent to which CP/CU in early adolescence could be differentiated by family- and child-based risks from pregnancy to age 4 years.

METHOD

Using data from approximately 7,000 mothers and their offspring (51% male) participating in the Avon Longitudinal Study of Parents and Children, the authors examined maternal prenatal risks (psychopathology, criminality, substance use), child's fearless temperament (age 2 years) and harsh and warm parenting (age 4 years) as predictors of CP and CU at age 13; then used follow-back analyses to explore pre- and early post-natal risks in more detail.

RESULTS

Maternal prenatal risks increased fearless temperament and CP and CU. Fearless temperament was also prospectively associated with higher levels of early adolescent CP and CU, above and beyond parenting and prenatal maternal risks. Follow-back analyses showed fearless temperament in boys manifested as lower response to punishment cues, while for girls this temperament was indexed by boldness toward novel situations and strangers, particularly for CP/CU youth.

CONCLUSIONS

The current findings suggest that (i) maternal prenatal risks and fearless temperament showed a dose-response relationship with CP and CU (i.e., higher clustering of risks tended to relate to both higher levels and the co-occurrence of CU with CP), and (ii) intervention programs that aim to improve behavioural outcomes may consider targeting specific temperamental features in both boys and girls.

Do mothers' play behaviors moderate the associations between socioeconomic status and 24-month neurocognitive outcomes of toddlers born preterm or with low birth weight?

OBJECTIVE

We examined whether neonatal risks and maternal scaffolding (i.e., task changes and flexibility) during a 16-month post-term play interaction moderated the association between socioeconomic status (SES), visual-spatial processing and emerging working memory assessed at 24 months post-term among 75 toddlers born preterm or low birth weight.

METHOD

SES and neonatal risk data were collected at hospital discharge and mother-child play interactions were observed at 16-month post-term. General cognitive abilities, verbal/nonverbal working memory and visual-spatial processing data were collected at 24 months.

RESULTS

Neonatal risks did not moderate the associations between SES and 24-month outcomes. However, lower mother-initiated task changes were related to better 24-month visual-spatial processing among children living in higher SES homes. Mothers' flexible responses to child initiated task changes similarly moderated the impact of SES on 24-month visual-spatial processing.

CONCLUSION

Our results suggest that mothers' play behaviors differentially relate to child outcomes depending on household SES.

Attachment behaviour towards support staff in young people with intellectual disabilities: associations with challenging behaviour

BACKGROUND

Attachment research has shown the importance of attachment behaviour for the prevention of dysregulated behaviour due to emotional distress. The support of an attachment figure may be especially important for people with intellectual disability (ID), because they are less adept in dealing with stressful situations on their own. Our purpose was to examine the role of support staff as targets of attachment behaviour for young people with ID by testing the hypothesis that young people who more often engage in attachment interactions with group care staff are less at risk for challenging behaviours. The study design included professional caregivers' report of young persons' attachment behaviour across different relationships to address the relationship-specific nature of attachment behaviour in a group care context.

METHODS

Support staff rated attachment behaviour of 156 young participants with moderate to severe ID who were attending a group care setting. For each participant, we asked two members of the classroom support staff to fill out the Secure Base Safe Haven Observation list. One of them also rated challenging behaviour (Abberant Behavior Checklist).

RESULTS

Young people who showed more secure attachment behaviour towards professional caregivers were less irritable, less lethargic and less stereotypic in their behaviour, even if we controlled for developmental age and Autism Spectrum Disorders. Two results point in the direction of relationship-specific attachment behaviour: the absence of high consistency in a person's attachment behaviour towards two different caregivers and the independent contribution of each of these relationships to explaining differences in lethargy and stereotypies. A certain preference in attachment behaviour towards specific caregivers was not associated with challenging behaviour.

CONCLUSIONS

Findings suggest that attachment behaviour may be part of young persons' adaptation to the stresses and challenges of group care. Furthermore, adaptation may be determined by the integration of relationships with support staff, because each relationship with a care staff member bears uniquely on challenging behaviour.

Families promote emotional and behavioural resilience to bullying: evidence of an environmental effect

BACKGROUND

Bullied children are at risk for later emotional and behavioural problems. 'Resilient' children function better than would be expected given their experience of bullying victimisation. This study examined the role of families in promoting resilience following bullying victimisation in primary school.

METHOD

Data were from the Environmental Risk (E-Risk) Study which describes a nationally representative sample of 1,116 twin pairs and their families. We used mothers' and children's reports to examine bullying victimisation during primary school and mothers' and teachers' reports to measure children's emotional and behavioural adjustment at ages 10 and 12. We used mothers' and interviewers' reports to derive measures of protective factors in the home including maternal warmth, sibling warmth and positive atmosphere at home.

RESULTS

Results from linear regression models showed that family factors were associated with children's resilience to bullying victimisation. Maternal warmth, sibling warmth and a positive atmosphere at home were particularly important in bullied children compared to non-bullied children in promoting emotional and behavioural adjustment. We used a twin differences design to separate out environmental protective factors in twins who are genetically identical. Differences in maternal warmth between twins from genetically identical monozygotic pairs concordant for bullying victimisation were correlated with twin differences in behavioural problems (r = -.23) such that the twin who received the most warmth had fewer behavioural problems. This shows that maternal warmth has an environmental effect in protecting children from the negative outcomes associated with being bullied.

CONCLUSIONS

Warm family relationships and positive home environments help to buffer children from the negative outcomes associated with bullying victimisation. Warm parent-child relationships can exert an environmentally mediated effect on children's behavioural adjustment following bullying victimisation. Identifying protective factors that promote resilience to bullying victimisation could lead to improved intervention strategies targeting the home environment.

Biosocial Influences on the Family: A Decade Review

The past decade brought a remarkable increase in the number and quality of biosocial studies of family processes. The current review summarizes recent advances in biosocial family research by providing key exemplars of emerging research paradigms. Research in the past decade has substantiated the claim in the previous Decade Review (Booth, Carver, & Granger, 2000) that bidirectional influences between all levels of analysis are paramount. There is an emerging consensus that integrating factors at multiple biological and social levels is highly informative. Because ignoring biological factors often will underestimate mediating or moderating mechanisms, the review provides recommendations for biosocial family research. We also highlight the need for researchers who understand complex family environments to lend their expertise to biosocial studies.