Child Behavioral Outcomes Research Articles

Is maternal diabetes during pregnancy associated with neurodevelopmental, cognitive and behavioural outcomes in children? Insights from individual participant data meta-analysis in ten birth cohorts

BackgroundGrowing evidence shows that dysregulated metabolic intrauterine environments can affect offspring’s neurodevelopment and behaviour. However, the results of individual cohort studies have been inconsistent. We aimed to investigate the association between maternal diabetes before pregnancy and gestational diabetes mellitus (GDM) with neurodevelopmental, cognitive and behavioural outcomes in children.MethodsHarmonised data from > 200 000 mother-child pairs across ten birth cohorts in Europe and Australia were available. Mother-child pairs were included for analysis to determine whether GDM was recorded (yes or no) and whether at least one neurodevelopmental, cognitive and behavioural outcome was available in children aged 3 to 13 years. Confounder-adjusted regression models were used to estimate associations between maternal diabetes and child outcomes using two-stage individual participant data (IPD) meta-analysis. Model 1 included a crude estimate. The full adjustment model (model 2) included adjustment for child sex, maternal age, pre-pregnancy BMI, pregnancy weight gain, maternal smoking during pregnancy, plurality, parity and maternal education.ResultsChildren (aged 7–10 years) born to mothers with GDM had higher attention-deficient hyperactive disorder (ADHD) symptoms compared to non-exposed controls (model 2, regression coefficient (β) 3.67 (95% CI 1.13, 6.20), P = 0.001). Moreover, children (aged 4–6 years) born to mothers with GDM exhibited more externalising problems than those born to mothers without GDM (model 2, β 2.77 (95% CI 0.52, 5.02), P = 0.01). A pre-existing maternal history of type 1 and type 2 diabetes mellitus was associated with ADHD symptoms at 4–6 years (model 1, β 8.82 (95% CI 2.21, 15.45, P = 0.009) and β 7.90 (95% CI 0.82, 14.98, P = 0.02), respectively). The association was no longer apparent in further adjustments.ConclusionsThis study found that children between 4 - 6 and 7–10 years of age born to mothers with GDM have a greater likelihood of developing externalising problems and ADHD symptoms, respectively. Externalising problems often co-exist with ADHD symptoms and precede formal ADHD diagnosis. Overall, this large-scale multi-cohort study suggested that a dysregulated metabolic environment during pregnancy may contribute to ADHD symptoms and externalising problems in young children.

Early bedtime routines and behavioral outcomes among children from low-income families: Mediating role of emotion regulation.

The establishment of early bedtime routine is essential for children's emotion and behavioral outcomes. Less is known, however, about the longitudinal effects and mechanisms predicting behavioral outcomes through early bedtime routine and emotion regulation in school-age children from low-income families. Thus, the present study examined emotion regulation at age three as a potential mediator in the longitudinal links between early bedtime routine and behavioral outcomes among racially diverse school age children from low-income families. Participants include a subsample of families (n = 2977) participating in the Early Head Start Research and Evaluation Project (EHSRE). Structural equation modeling with bootstrapping techniques was used to examine the models. The early bedtime routine index was created from parents' reports at 14, 24, and 36 months. Children's emotion regulation was drawn from interviewer assessments at 36 months and problem behaviors were reported by mothers when the child was approximately at age 10. Results indicated that children with consistent early bedtime routine were better able to regulate their emotions at age three. Also, emotion regulation at age three mediated the associations between early bedtime routine at 14-36 months and internalizing and externalizing behaviors among fifth-grade children. Findings indicated that consistent early bedtime routine helps children to regulate their emerging emotions which in turn has long-term benefits on their emotional and behavioral outcomes. These findings have important implications for pediatricians, nurse practitioners, nurses, and early childhood educators who can provide education and resources to support families in establishing consistent bedtime routine for their young children.

How does family functioning contribute to child externalizing and internalizing behavior problems after childhood TBI? Evidence from a prospective cohort study.

Despite a well-documented association between childhood traumatic brain injury and elevated risk for internalizing and externalizing behavior problems, the mechanisms through which family functioning contributes to individual variation in these behavioral outcomes remains poorly understood. This prospective cohort study aimed to assess the respective contribution of family functioning and child emotion regulation (ER) to post-injury behavior problems at 1-year follow-up, with a specific focus on evaluating the role of emotional dysregulation in mediating the effects of familial affective responsiveness and communication on child behavioral outcomes. The study included 129 participants, comprising 86 children with medically confirmed mild-to-severe TBI, identified from consecutive hospital admissions, and 43 typically developing (TD) control children, of similar age and sex. Participants ranged in age from 6 to 15 years (mean age = 11.2 years). Parents completed validated assessments of post-acute family functioning and child emotion regulation difficulties at 6 months post-injury, as well as measures of child behavior problems at 1-year post-injury. Although group differences in internalizing behaviors did not reach statistical significance, the TBI group exhibited significantly higher overall externalizing symptoms and was significantly more likely to display clinically elevated symptoms than TD controls at 1-year post-injury. Compared to TD controls, the TBI group displayed significantly greater ER problems, which mediated the effects of lower familial affective responsiveness and communication on child behavior problems 1-year-post-injury. Evidence for these robust, prospective associations suggests that child emotional dysregulation plays a key role in mediating the effect of post-acute family functioning on long-term behavior problems in children with TBI. Early assessment and screening for relevant risk factors may help identify those children and families who could benefit from therapeutic interventions designed to address emotional dysregulation and mitigate risk for post-injury behavioral problems. Importantly, these findings underscore the value of adopting family-centred care approaches in rehabilitation, where involving families in therapeutic processes and addressing family dynamics may enhance child emotion regulation and improve long-term behavioral outcomes.

Community Implementation and Evaluation of the Chicago Parent Program.

The purpose of this study was to describe and evaluate the implementation of the Chicago Parent Program (CPP) in a community setting. Included are details of the co-designed implementation by academic and community partners, and parenting and child behavior outcomes. Two hundred eighty caregivers of children aged 2-5 years participated in the CPP in seven community sites. Measures of parenting and child behavior were administered at pre-intervention, post-intervention, and 3-month follow-up. Caregivers reported broad improvements in parenting and child behavior from pre-intervention through 3-month follow-up. No effects were found for attendance, COVID-19 exposure, and remote versus in-person delivery. The CPP was successfully implemented in a community setting and demonstrated significant changes in parenting and child behavior.

Associations between prenatal caffeine exposure and child development: Longitudinal results from the Adolescent Brain Cognitive Development (ABCD) Study

ObjectiveThough caffeine use during pregnancy is common, its longitudinal associations with child behavioral and physical health outcomes remain poorly understood. Here, we estimated associations between prenatal caffeine exposure, body mass index (BMI), and behavior as children enter adolescence. MethodLongitudinal data and caregiver-reported prenatal caffeine exposure were obtained from the ongoing Adolescent Brain and Cognitive Development (ABCD)SM Study, which recruited 11,875 children aged 9–11 years at baseline from 21 sites across the United States starting June 1, 2016. Prenatal caffeine exposure was analyzed as a 4-level categorical variable, and further group contrasts were used to characterize “any exposure” and “daily exposure” groups. Outcomes included psychopathology characteristics in children, sleep problems, and BMI. Potentially confounding covariates included familial (e.g., income, familial psychopathology), pregnancy (e.g., prenatal substance exposure), and child (e.g., caffeine use) variables. ResultsAmong 10,873 children (5686 boys [52.3 %]; mean [SD] age, 9.9 [0.6] years) with nonmissing prenatal caffeine exposure data, 6560 (60 %) were exposed to caffeine prenatally. Relative to no exposure, daily caffeine exposure was associated with higher child BMI (β = 0.08; FDR-corrected p = 0.02), but was not associated with child behavior following correction for multiple testing. Those exposed to two or more cups of caffeine daily (n = 1028) had greater sleep problems than those with lower/no exposure (β > 0.92; FDR-corrected p < 0.04). ConclusionDaily prenatal caffeine exposure is associated with heightened childhood BMI, and when used multiple times a day greater sleep problems even after accounting for potential confounds. Whether this relationship is a consequence of prenatal caffeine exposure or its correlated factors remains unknown.

One is Good, but are Two Really Better? Outcomes for Dual versus Individual Attendees in a Behavioral Parent-Training Program for Caregivers of Young Children

ABSTRACT Background The Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS) BPMT program utilizes positive behavior support principles to help caregivers of children birth-5 years address early childhood disruptive behaviors and common developmental challenges experienced by many young children. Objective The present study examined whether there were differences in child outcomes, attendance rates, homework completion rates, levels of caregiver stress, and treatment satisfaction for individual versus dual caregiver participation in the HOT DOCS BPMT. Method Using a quasi-experimental design, caregivers of children ages 0–5 years were assigned to two non-equivalent groups: individual attendee (n = 141) and dual attendee (n = 123). Independent samples t-tests were utilized to compare means between individual and dual attendee groups for number of sessions attended and homework completion. Paired samples t-tests were calculated to compare means between individual and dual attendee groups on HOT DOCS program outcomes, including child behavior, parenting stress, and treatment satisfaction. Results There were no significant differences in outcomes between individual and dual attendee groups. Child behavior outcomes, parenting stress, treatment satisfaction, attendance, and homework completion were similar across both groups. Conclusions Individual caregiver engagement in the HOT DOCS BPMT program might be sufficiently potent to result in desirable outcomes. Future directions should include examining family structure and treatment modality on BPMT outcomes, maintenance of intervention gains, and perceived child behavior outcomes of BPMT non-attending caregivers.

Child Well-Being, Family Functioning, and Contextual Strain: A Study of Multi-Assisted Low-Income Families.

This study aimed to examine the effects of poverty on child well-being and family functioning among low-income families. Specifically, it explored the role of parental stress, family dynamics, and contextual strain on children's behavioral and emotional outcomes. Using a sample of families receiving welfare support, the research sought to assess the impact of conditional cash transfer programs and the involvement of Child Protective Services on child development and family well-being. This cross-sectional study involved 99 children aged 8-12 from low-income, welfare-assisted families recruited from the Porto Metropolitan Area. Parental stress, parenting attitudes, family functioning, and child outcomes were assessed using standardized questionnaires. Families with and without Child Protective Services involvement were compared, and a cumulative index of contextual strain was developed to measure the multidimensional impact of stressors on child outcomes. The results revealed that 53% of children exhibited clinical or borderline internalizing behaviors, 47% showed externalizing behaviors, and 39% experienced low psychological well-being. High levels of parental stress, low parenting competence, and significant contextual strain were associated with poorer child outcomes. Families involved with Child Protective Services showed no significant differences in parent or family characteristics, but children from these families exhibited fewer behavioral problems. The study highlights the pervasive impact of poverty and contextual strain on child development, emphasizing the need for more comprehensive interventions. Family functioning and parental stress are critical factors influencing child well-being, pointing to the importance of addressing these areas through targeted welfare and support programs to reduce the intergenerational transmission of poverty and improve child outcomes.

Early Family Conflict and Behavioral Outcomes in Children from Low-Income Families: The Indirect Effects of Parental Depression and Parenting Practices.

Family conflict has been demonstrated as a risk factor impacting children's mental health and behaviors; however, the mechanisms underlying these connections are unclear. Focusing on 1622 children from low-income families (51.4% boys, 38.3% White, 35.5% Hispanic/Latino, 22.1% African American, 4.1% other), the current study examines the role that maternal depression and parenting behaviors play in the associations between family conflict in early childhood and children's internalizing and externalizing behaviors in early adolescence. Family conflict was positively associated with maternal depression at age 3 and detached parenting at age 5; however, maternal depression was linked to increased child internalizing and externalizing behaviors, and detached parenting was associated with decreased behavioral outcomes. Maternal depression at age 3 and intrusive parenting at age 5 successively mediated the association between family conflict and child externalizing. Multi-group analysis indicated different indirect paths of parenting behaviors in boys and girls. Specifically, in boys, the indirect effect of detached parenting on the links between family conflict and externalizing and internalizing behaviors was sustained. In girls, maternal depression and intrusive parenting sequentially explained the link between family conflict and externalizing behaviors. The findings highlighted the importance of addressing family well-being and parenting support, especially for children from low-income families.

Testing the Mediational Role of Classroom Interactions in the Dynamic Interplay Between Teacher Emotional Exhaustion and Children’s Disruptive Behavior

ABSTRACT Research Findings: Teacher emotional exhaustion and classroom-level disruptive child behaviors are prominent risk factors influencing teacher and child social-emotional and behavioral outcomes. Additionally, theoretical perspectives position links between teacher emotional exhaustion and children’s disruptive classroom behavior as influenced by other proximally occurring teacher-child interactive processes. The purpose of the study is twofold: 1) examine longitudinal bi-directional relationships between teachers’ emotional exhaustion and children’s disruptive classroom behaviors, and 2) examine teachers’ classroom interactions (i.e. emotional support, instructional support, and classroom organization) as mediators of this potentially longitudinal bi-directional relationship. A total of 756 preschool-aged children and 101 preschool teachers across 17 schools serving children from primarily low-income families within the southeastern United States were examined. Data were collected through a multiple-methods approach. Multi-level path models examined the bi-directional associations between teachers’ emotional exhaustion and classroom-level child disruptive behaviors and the mediating role of teacher-facilitated classroom interactions. No bi-directional or mediational links were found; however, teachers’ emotional exhaustion was linked to children’s disruptive classroom behavior, and classroom disruptive behaviors were linked with teachers’ emotional support and classroom organization. Practice or Policy: Facilitating support for teachers’ well-being is critical for school personnel to continue to promote children’s classroom behaviors and maintain effective classroom interactions.

Psychological interventions for parents of children with intellectual disabilities to enhance child behavioral outcomes or parental well-being: A systematic review, content analysis and effects.

The aim of this review was to identify the type, content, and effectiveness of psychological parenting interventions for parents of children with intellectual disabilities to enhance child behavior and/or parental well-being. A systematic search yielded 21 studies involving 1825 participants. Studies were evaluated according to intervention content, pre- and post-treatment and follow-up effect sizes, and risk of bias. We categorized the interventions into those targeting 'Child or interaction' (child behavior, interaction and learning, understanding disability), and those targeting 'Parent' (parental well-being) or both themes. All these interventions had positive effects on parental well-being or child behavior. Parental outcomes were improved by interventions targeting 'Parental well-being', as well as 'Child or interaction'. Child behavior showed improvements in programs focusing on 'Child or interaction', and in a mindfulness-based parental well-being program. During follow-up, most effects were sustained or further increased, but some studies showed no improvements over the control group.

Helping the Noncompliant Child and Child Behavior Outcomes: An Exploratory Examination of Financial Strain.

Theoretical models and empirical research have highlighted the impact of economic disadvantage on children's psychosocial development broadly and the onset, maintenance, and treatment of early-onset (3-8 years) behavior disorders (BDs) more specifically. In the context of intervention, evidence suggests that economic disadvantage may pose risk for diminished parent-mediated treatment efficacy (e.g., Behavioral Parent Training [BPT]) given its impact on salient factors in the family system. Though, studies have shown significant variability in BPT outcomes within families experiencing economic disadvantage, suggesting that additional influences may further contribute to disparities in the trajectory of treatment and maintenance of treatment gains for this population. To address this gap in existing knowledge, financial strain, or the inability to meet financial needs, was examined in families (N = 54) of young children (3-8 years old) with low-income and clinically elevated behavior problems participating in one BPT program, Helping the Noncompliant Child (HNC). Results demonstrated that families who experienced greater levels of financial strain prior to engaging in HNC exhibited diminished maintenance of parent reported child behavior gains following treatment. Financial strain did not significantly influence rate of change or maintenance of treatment gains for HNC clinician-coded child compliance. Clinical implications and directions for future research are discussed. ClinicalTrials.gov Identifier: NCT02191956, registered on 6/18/2014.

Associations Between Sleep Health and Child Behavior at Age 6 Years in the INSIGHT Study.

Suboptimal sleep is associated with disruptive behaviors in childhood. We evaluate associations of mean and variability (SD) of sleep duration, quality, and timing with emotion regulation, impulsivity, and prosocial and antisocial behavior in children. Intervention Nurses Start Infants Growing on Healthy Trajectories, a randomized controlled trial designed for obesity prevention, compared a responsive parenting intervention delivered in the first 2.5 years after birth with a home safety control group. At age 6 years, children wore an actigraphy device for 7 days and participated in behavioral tasks evaluating behavioral control, emotion regulation, and prosocial and antisocial behaviors. Separate linear regression models examined associations between sleep and behavioral variables, adjusting for study group, child sex, and household income. Moderation analysis investigated whether the study group moderated relationships between sleep and positive age-appropriate behavior. Children (N = 143, age 6.7 ± 0.3 years) were predominantly non-Hispanic White (95%). Mean actigraphic sleep duration, quality, and timing were not associated with behavioral variables. By contrast, greater variability in sleep onset timing was associated with greater impulsivity (B = 0.85, p = 0.004) and poorer emotion regulation (B = -0.65, p = 0.01). Greater variability in sleep midpoint timing was associated with greater impulsivity (B = 0.80, p = 0.03). The study group moderated the effect of sleep onset variability on behavior; only the home safety control group exhibited a significant negative relationship between variability in sleep onset timing and emotion regulation (B = -1.28, p = 0.0002). Findings support the importance of consistency in sleep timing and how this may play a greater role in children's behavioral and emotional outcomes than mean actigraphic sleep duration and quality.

Maternal support in preschool and child behavior problems: The mediating role of childhood emotion knowledge.

Children's emotion knowledge encompasses abilities to recognize and label emotions in the service of positive adaptation. Drawing on a sociodemographically diverse sample of 250 children (50% female sex assigned at birth; Mage_W1 = 49.02 months, SD = 2.99) and their maternal caregivers (55.6% Latina; 37.6% poverty), this study evaluated a multiple mediation model to integrate heretofore distinct bodies of research examining (a) parenting effects on the development of emotion knowledge and (b) emotion knowledge effects on socioemotional adaptation. Observations of maternal supportive presence at age 4 predicted increases in children's emotion recognition and labeling from ages 4 to 8. However, only emotion labeling skills explained children's behavioral adjustment outcomes with a significant pathway from supportive parenting at age 4 to fewer externalizing and internalizing behavior problems at age 10 via improved emotion labeling skills. These findings suggest that emotion knowledge, particularly labeling skills, partially explains the protective impact of supportive parenting on behavioral adaptation across childhood. Prevention and intervention efforts should target both supportive parenting practices and emotion knowledge skill development to support children's socioemotional functioning and reduce behavior problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Father-child attachment on children’s screen time: mediating role of ego resilience

BackgroundChildren spend a significant amount of time engaging in sedentary behaviors, defined as activities that do not increase energy expenditure significantly above resting levels, such as watching TV and playing PC/video games. Increased screen time is a significant public health concern because children are in a developmental stage where lifestyle behaviors predict various health outcomes in adulthood and beyond. This study explores the links between parent-child attachment, ego resilience, and children’s screen time.MethodsThis cross-sectional correlation study uses 1,163 parents and their children data from the 12th Panel Survey of Korean Children. The study instruments were a modified Armsden and Greenberg scale of parent-child attachment and modified the children’s ego resilience scale of the Block and Kremen. Children’s screen time was classified as more than 2 h per day spent watching television, playing on computers, or playing video games in their leisure time.ResultsStudy results show a negative association between father-child attachment and children’s screen time (ß = -0.43, p < .001) and a positive association between father-child attachment and ego resilience (ß = 0.24, p < .001). Ego resilience showed a negative link to children’s screen time after adjusting for parental attachment (ß =- 0.03, p = .009). Father-child attachment link to children’s screen time (ß = -0.36, p < .001) continued even though the association was slightly reduced in magnitude after adjusting for ego resilience.ConclusionsOur findings show the mediating role of ego resilience on a negative path of father-child attachment to children’s screen time. This finding emphasizes the importance of fostering solid father-child relationships and enhancing children’s psychological resilience as critical strategies for reducing excessive screen time. By addressing emotional support and resilience-building, interventions can more effectively promote healthier behavioral outcomes in children.

Socioeconomic status, linguistic skills and language background differentially relate to preschoolers' emotional and behavioural profile.

Proximal and distal factors interact to shape children's development and well-being. The present study aimed to examine socioeconomic status (SES), linguistic skills, and language background as concurrent predictors of socio-emotional and behavioural outcomes in heritage bilingual and monolingual children attending preschool. Parents of 1810 children (mean age = 63.42 months ± 7.36), attending preschool in Italy, completed the Four Factor Index of SES and the Strengths and Difficulties Questionnaire (SDQ). Teachers (n = 99) completed a questionnaire on children's linguistic skills and emotional and behavioural profiles. A subsample of 995 children was administered an expressive vocabulary task in Italian. Regression analyses showed that linguistic skills were the only concurrent predictor of conduct problems, as well as the dominant predictor of hyperactivity/impulsivity, peer problems, and better prosocial behaviour. SES was negatively related to ADHD traits, peer problems, and prosocial behaviour. Finally, heritage bilingualism background was associated, although not as a primary predictor, with increased emotional problems, peer relationship problems, and lower teacher-rated emotional and behavioural skills. However, it was the main factor positively associated with prosocial behaviour. The implications of these findings for research in this area and for educational policy are discussed, highlighting the need for a multidimensional perspective that includes linguistic skills and SES in the assessment of children's emotional and behavioural outcomes.

Latino Family Engagement and Student Outcomes in Early Elementary School: Evidence from Two National Datasets

ABSTRACT Family engagement in children’s schooling is important. Research indicates that Latino families often utilize home-based practices (e.g. reading, telling stories, singing, counting) over school-based involvement (e.g. participating in school events and committees, volunteering in the classroom). Using an assets-based approach, the present study considers both school- and home-based forms of engagement for Latino families. Drawing upon data from two large, nationally representative datasets, the Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 (ECLS-K:2011; N = 4,590) and the Head Start Impact Study (HSIS; N = 1,670), this study seeks to examine national patterns of Latino family school- and home-based engagement in kindergarten, and how such engagement relates to child academic, cognitive, and behavioral outcomes in early elementary school. Descriptive findings show high levels of Latino family participation in a variety of both home-based academic activities and school-based activities. Regression analyses indicate an association between Latino family engagement and child outcomes, most evident in school-based engagement. Implications for educators, schools, and research are discussed.

Study Of Psychological And Behavioral Outcomes In Children Admitted In PICU

Study Of Psychological And Behavioral Outcomes In Children Admitted In PICU

Maternal Nutrition during Pregnancy and Offspring Brain Development: Insights from Neuroimaging.

Maternal nutrition during pregnancy is known to be important for offspring growth and health and has also been increasingly recognized for shaping offspring brain development. On the other hand, recent advancements in brain imaging technology have provided unprecedented insights into fetal, neonatal, and pediatric brain morphometry and function. This review synthesizes the current literature regarding the impact of maternal nutrition on offspring brain development, with a specific focus on findings from neuroimaging studies. The diverse effects of maternal nutrients intake or status during pregnancy on neurodevelopmental outcomes in children are discussed. Neuroimaging evidence showed associations between maternal nutrition such as food categories, macronutrients, and micronutrients including vitamins and minerals during pregnancy and child brain imaging features measured using imaging techniques such as ultrasound, magnetic resonance imaging (MRI), electroencephalography (EEG), and magnetoencephalography (MEG). This review demonstrates the capability of neuroimaging in characterizing how maternal nutrition during pregnancy impacts structure and function of the developing brain that may further influence long-term neuropsychological, cognitive, and behavioral outcomes in children. It aims to inspire future research utilizing neuroimaging to deepen our understanding of the critical impacts of maternal nutrition during pregnancy on offspring brain development.

Transgenerational impact of maternal adverse childhood experiences on children's mental health among families experiencing homelessness

BackgroundAdverse childhood experiences (ACEs) threaten the livelihood of individuals and their families. This may be particularly detrimental for mothers facing homelessness and their children's behavioral adjustment. ObjectiveThis study compared two models to examine the impact of maternal ACEs on children's internalizing and externalizing symptoms. Rather than using the cumulative approach to conceptualize ACEs, we analyzed a model that assessed the effect of each maternal ACE individually (i.e., specificity model) and another model that categorized them into two subtypes of maltreatment and household dysfunction (i.e., dimensional model). Participants and settingWe evaluated a sample of 164 children and their mothers in a residential vocational training program in Northern California. MethodsACEs for both mother and children and children's behavioral outcomes were collected via questionnaires completed by the mothers with the assistance of trained researchers. Additional demographic data was collected via trained case managers at the residential facility. Two models (i.e., specificity model; dimensional model) were utilized to better understand how to best assess adversity in settings with limited resources. ResultsResults of the specificity ACE model identified maternal childhood physical abuse and parental incarceration as predictors of internalizing problems and parental substance problems as a predictor of externalizing behaviors. The dimensional ACE model indicated that only the broad category of maltreatment predicted internalizing behavioral difficulties. The individual ACE model demonstrated a better fit for the data and highlighted specific events relevant to children's outcomes. ConclusionsThese results suggest that programs focusing on ending generational trauma may benefit from screening participants for individual ACE and tailoring services for mothers and children accordingly.

Interpregnancy intervals and behavioural outcomes in children: A population-based longitudinal study

BackgroundWhile the physical health consequence of short interpregnancy intervals (IPIs) is well documented, its mental health impact is not well explored. This study aimed to examine the associations between IPIs and behavioural outcomes in children born following the interval at four developmental time points between ages 7 and 16. MethodsOur study sample comprised participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort, an ongoing population-based longitudinal birth cohort in Bristol, Avon, United Kingdom. Behavioural problems, including total behavioural difficulties, hyperactivity, emotional symptoms, conduct problems, peer-problems, and problems of pro-social behaviour, were assessed using the Strengths and Difficulties Questionnaire (SDQ). Over 2300 mothers and their singleton children were included in this study. Generalized Estimating Equations (GEE) were used to estimate odds ratios for the associations. ResultsChildren born to mothers with short IPI (<6 months) were 1.54 (95%CI: 1.12–2.11), 1.42 (95% CI: 1.12–1.81) and 1.37 (95%CI: 1.04–1.79) times more likely to have total behavioural difficulties, conduct problems and hyperactivity/inattention problems across the child's age, respectively, compared with children of mothers with IPIs of 18–23 months. We found no evidence of associations between short IPI (<6 months) and emotional symptoms, peer-relationship problems and pro-social behaviour problems. ConclusionShort IPI (<6 months) was associated with externalising (conduct and hyperactivity/inattention) but not internalising (emotional and peer-relationship problems) problems. Further studies are needed to confirm this association and elucidate the underlying mechanisms.