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- Title
Patterns of Adverse Childhood Experiences and Neurocognitive Development.
- Authors
Yu, Jing; Haynie, Denise L.; Gilman, Stephen E.
- Abstract
Key Points: Question: What are the associations of various patterns of childhood adversities with children's neurocognitive functions? Findings: In a cohort study of 49 853 children, those exposed to certain patterns of adversities (eg, parental harshness and neglect, and crowded housing and poverty) between birth and age 7 years had significantly lower neurocognitive test scores at age 7 years than those with low risk of experiencing any adversity, with standardized mean differences ranging from −0.07 to −0.86. Meaning: These findings suggest that common patterns of adverse experiences in early life are associated with children's neurocognitive development; identifying children most strongly impacted by adversity should, in theory, help minimize the burden of adversity by improving efforts to reduce exposure and by enhancing our understanding of the developmental consequences of adversity. This cohort study examines the associations of various patterns of childhood adversities with children's neurocognitive functions. Importance: Early life adversity is associated with higher risk of many adult health problems, including mental illness, substance abuse, suicide attempt, and chronic diseases. Many previous studies investigated adversities one at a time or investigated the health toll associated with the cumulative number of adversities. Objective: To examine the co-occurrence of adversities among children and how specific patterns of adversities are associated with neurocognitive development. Design, Setting, and Participants: This cohort study used data from the Collaborative Perinatal Project (CPP), which enrolled a national sample of women during pregnancy and followed their offspring to ages 7 to 8 years, between 1959 and 1974. The CPP was a community-based study conducted in 12 US medical centers. The CPP sample was ascertained through prenatal clinics and is diverse with respect to race and socioeconomic status. Data analysis was performed from August 2023 to March 2024. Exposures: A latent class analysis was conducted of 12 adverse childhood experiences that occurred between birth and 7 years to identify common patterns of childhood adversities. Main Outcomes and Measures: Five neurocognitive tests were used to measure children's visual-motor, sensory-motor, auditory-vocal, intelligence quotient, and academic skills. Results: The analysis sample included 49 853 offspring (25 226 boys [50.6%]); 24 436 children (49.0%) had low probability of experiencing any adversity, whereas the remaining half were classified into 5 groups reflecting distinct patterns of childhood adversities: parental harshness and neglect, 1625 children (3.3%); parental separation and poverty, 8731 children (17.5%); family instability, 3655 children (7.3%); family loss, instability, and poverty, 1505 children (3.0%); and crowded housing and poverty, 9901 children (19.9%). Children in 4 of these groups had lower neurocognitive scores than children with a low probability of experiencing adversity, with standardized mean differences ranging from −0.07 (95% CI, −0.11 to −0.03) to −0.86 (95% CI, −1.06 to −0.65). Conclusions and Relevance: These findings suggest that adverse childhood experiences are associated with deficits in children's neurocognitive functions. It is important to understand the complexity in children's exposure to adversity and the resulting developmental consequences, as well as the underlying mechanisms, to help support children exposed to adversity and foster healthier and resilient trajectories of development.
- Subjects
SUICIDE risk factors; MENTAL illness risk factors; SUBSTANCE abuse risk factors; CHRONIC disease risk factors; RISK assessment; PSYCHOLOGICAL resilience; RESEARCH funding; EXECUTIVE function; STRUCTURAL equation modeling; DESCRIPTIVE statistics; LONGITUDINAL method; CHILD development; CONFIDENCE intervals; ADVERSE childhood experiences; COGNITION; SOCIAL classes; POVERTY; CHILDREN
- Publication
JAMA Pediatrics, 2024, Vol 178, Issue 7, p678
- ISSN
2168-6203
- Publication type
Article
- DOI
10.1001/jamapediatrics.2024.1318