Child Cognitive Outcomes Research Articles

Children of War: In-Utero Stress and Child Health in Iraq

This paper combines detailed household-level data on child health with geo-coded incidences of vi- olence in Iraq to estimate the impact of in-utero exposure to violence on biometric, behavioral and cognitive outcomes of children. Rich data on severity (duration and casualties), type (bombings, ex- plosions, gun_re etc.), and perpetrators of violence (coalition, insurgent, or sectarian) on the district level allow me to discriminate between two possible mechanisms: damages to the infrastructure versus violence-induced pre-natal stress for mothers. Comparing siblings within the same household, I find that one single violent incidence during pregnancy significantly increases the risk of stuntedness, malnutrition and weakens major cognitive and behavioral skills. While the type of violence does not seem to play a major role, the perpetrator of violence seems to matter. Violent acts that explicitly target the civilian population, even if they have little e_ect on the general infrastructure, appear to be the driver behind the effect.

Impact of Early Childcare on Immigrant Children’s Educational Performance

This paper investigates the impact of attending early childcare on immigrant children's cognitive outcomes. Our analysis makes use of administrative data on the entire population of students in the fifth grade, collected by the Italian Institute for the Evaluation of the Educational System (INVALSI) for school years 2014/2015 to 2016/2017, matched to unique administrative records on early childcare availability at the municipal level. Our identification strategy exploits cross-sectional and time-series variation in the provision of early childcare services across Italian municipalities as an instrument for individual attendance. Our results point out that the effect of early childcare attendance differs between native and immigrant children. Estimates show a positive and significant effect on the language test scores of immigrant children, with the effect being mostly driven by females, by children with low-educated mothers, and by children who, at home, speak a language highly dissimilar to Italian. Unlike immigrants, native students are negatively impacted by early childcare attendance, as reflected in both language and math test scores. Effects are stronger on math test scores for females and for children with highly educated mothers.

Mental Health Around Pregnancy and Child Development from Early Childhood to Adolescence

We identify the causal effect of mothers' mental health during early - and soon after pregnancy on a range of child psychological, socio-emotional and cognitive outcomes measured between ages 4-16. Results suggest a negative effect on children's psychological and socio-emotional skills in early childhood, but these effects fade-out between the ages of 11-13. We find no significant effect on cognitive outcomes. The fade-out of effects may be partly explained by compensatory behaviour of parents, as we find that mental health during or soon after pregnancy raises breastfeeding and improves measures of interaction between mother and child.

Dietary intake and food sources of one-carbon metabolism nutrients in preschool aged children

Background:It is hypothesised that epigenetic mechanisms including DNA methylation may underlie the relationship between early-life nutrition and child cognitive outcomes. This study aimed to identify dietary patterns associated with the intake of one-carbon metabolism nutrients in children aged 2–3 years.Methods:A validated 120-item semi-quantitative food frequency questionnaires at 2–3 years of age were used to estimate the intake of one-carbon metabolism nutrients (methionine, folate, choline and vitamins B2, B6, B12) and to quantify mean number of serves consumed of the food groups specified by the Australian Guide to Healthy Eating (AGHE). Descriptive statistics were used to analyse the contribution of each food group and food items to the total intake of one-carbon metabolism nutrients. Linear regression was used to test for linear trends in food group servings by nutrient intake quintiles.Results:No child (n = 60) from the Women And Their Children’s Health (WATCH) study consumed the recommended number of serves for all AGHE food groups. Dairy and alternatives (18–44%), discretionary foods (6–33%) and meat and alternatives (6–31%) were the main sources of most one-carbon metabolism nutrients. Most child intakes of one-carbon metabolism nutrients exceeded the nutrient reference values (NRVs), except for the intake of choline, for which the mean intake was 9% below the adequate intake (AI).Conclusion:Dairy and alternatives, discretionary foods and meat and alternatives food groups contributed significantly to the children’s intake of one-carbon metabolism nutrients. The children generally had low intakes of meat and alternative foods, which may explain their inadequate intake of choline.

Childcare Use and Its Role in Indigenous Child Development: Evidence from the Longitudinal Study of Indigenous Children in Australia

We investigate patterns of childcare use and its influence on the cognitive development of Indigenous children. The influence of childcare on Indigenous children's cognitive outcomes is less well understood than for non‐Indigenous children due to a lack of appropriate data. We focus on a cohort of Indigenous children in Australia who have been followed from infancy and for whom rich information on childcare use and cognitive outcomes is observed. Compared to Indigenous children who never participated in childcare, Indigenous children who participated in childcare performed better on several early cognitive outcomes. Using regression and propensity score matching, we show that this difference is driven by selection into childcare, with children from more advantaged families being more likely to attend formal childcare. However, matching analysis results suggest that relatively disadvantaged children might benefit more from attending childcare, as indicated by the positive estimated effects found for those who never attended childcare.

A Matter of Time: Father Involvement and Child Cognitive Outcomes

ObjectiveThis study provides the first systematic account of how father–child time (in total and across activity types) relates to children's cognitive development as well as examining whether paternal education moderates these associations.BackgroundFathers in Western countries allocate progressively more time to child care. However, most research on how parental time inputs affect child development focuses on maternal time. It remains unclear how paternal involvement in the child's upbringing influences child outcomes.MethodThe study uses three waves of unique, longitudinal, time‐diary data from an Australian national sample of children aged 4 to 8 years (Growing Up in Australia: The Longitudinal Study of Australian Children;N= 3,273 children, 6,960 observations). Children's cognitive development is measured using the Peabody Picture Vocabulary Test. The data are modeled using a range of estimation strategies for panel data.ResultsThe total amount of father–child time is associated with, at best, small improvements in children's cognitive functioning. In contrast, the amount of father–child time in educational activities is associated with moderate to large improvements. Such associations are similar for highly and less‐highly educated fathers.ConclusionOur findings are relevant for policy and practice, being indicative that enabling paternal involvement in their children's upbringing should bring moderate to high gains to their children in terms of cognitive functioning, particularly if paternal involvement is directed at educational activities.

Prenatal Fluoride Exposure and Cognitive Outcomes in Children at 4 and 6-12 Years of Age in Mexico

Background: Some evidence suggests that fluoride may be neurotoxic to children. Few of the epidemiologic studies have been longitudinal, had individual measures of fluoride exposure, addressed the impact of prenatal exposures or involved more than 100 participants.Objective: To discuss our recently published as well as key unpublished results of the association of prenatal exposure to fluoride with offspring measures of intelligence.Methods: We studied participants from the Early Life Exposures in Mexico to Environmental Toxicants (ELEMENT) project. An ion-selective electrode technique was used to measure fluoride in archived urine samples taken from mothers during pregnancy and from their children when 6-12 years of age, adjusted for urinary creatinine and specific gravity, respectively. Child intelligence was measured by the General Cognitive Index (GCI) of the McCarthy Scales of Children’s Abilities at age 4 and full scale intelligence quotient (IQ) from the Wechsler Abbreviated Scale of Intelligence (WASI) at age 6-12 years.Results: We had complete data on 299 mother-child pairs, of whom 287 and 211 had data for the GCI and IQ analyses, respectively. Mean (SD) values for urinary fluoride in all of the mothers (n=299) and children with available urine samples (n=211) were 0.90 (0.35) mg/L and 0.82 (0.38) mg/L, respectively. In multivariate models, an increase in maternal urine fluoride of 0.5mg/L (approximately the IQR) predicted 3.15 (95% CI –5.42, –0.87) and 2.50 (95% CI –4.12, –0.59) lower offspring GCI and IQ scores, respectively. Trimester-specific results suggest that exposure during the 1st trimester may have the strongest negative effect.Conclusion: In this study, prenatal fluoride exposure, in the range of exposures reported for other general population samples of pregnant women and non-pregnant adults, was associated with lower scores on tests of cognitive function in the offspring at age 4 and 6–12 years.

Children of Parents with Eating Disorders.

Our primary goal in this article is to review recent findings (from 2015 and on) concerning children of parents with eating disorders. This review addresses the question of whether the offspring of parents with past or present eating disorders have adverse outcomes. This update is timely and informative because recent research includes controlled studies and large cohort designs and earlier reviews relied on case report evidence. Despite substantial diversity in study design, sample size, and parental eating disorder definition, overall, existing research suggests that the children of parents with eating disorders exhibit compromised development: a greater risk of perinatal complications; a tendency toward extremes of growth at birth; greater problems in feeding and eating behaviors and greater incidence of eating disorder symptoms; more psychological and socioemotional difficulties; and more negative qualities to parent-child interactions. Data on children's cognitive outcomes is thus far inconsistent. Given the relatively high incidence of eating disorder history in individuals of childbearing age, research into its potential effects on children is necessary. However, the methodological shortcomings and a limited evidence base caution in drawing conclusions. Nevertheless, mental health services should address the possible problems that these children face and offer tailored programs.

Multilingualism was associated with lower cognitive outcomes in children who were born very and extremely preterm.

AimThis study determined whether cognitive outcomes differed between very preterm (VPT) and extremely preterm (EPT) children who were monolingual or multilingual when they reached the corrected ages of two and five years.MethodsThe data were collected at the Emma Children's Hospital, Amsterdam, The Netherlands, as part of our national neonatal follow‐up programme and comprised 325 VPT/EPT children born between January 1, 2007 and January 1, 2012. The study used the Third Editions of the Bayley Scales of Infant and Toddler Development and the Wechsler Preschool and Primary Scale of Intelligence.ResultsWe compared 234 monolingual children, 65 multilingual children who spoke Dutch and at least one foreign language at home and 26 multilingual children who didn't speak Dutch at home. The best performers on the cognitive scale at two years of age and the verbal subscales at five years of age were the monolingual children, followed by the children who spoke Dutch and at least one foreign language at home, then the children who only spoke foreign languages at home.ConclusionIn our study cohort from The Netherlands, multilingualism lowered the cognitive and verbal outcomes of VPT/EPT children at the corrected ages of two and five years.

The impact of early life shocks on human capital formation: evidence from El Niño floods in Ecuador

This paper investigates the persistent effects of negative shocks in utero and in infancy on low-income children's health and cognitive outcomes and examines whether timing of exposure matters differentially by skill type. Specifically, I exploit the geographic intensity of extreme floods in Ecuador during the 1997–1998 El Niño phenomenon, which provides exogenous variation in exposure at different periods of early development. I show that children exposed to severe floods in utero, especially during the third trimester, are shorter in stature five and seven years later. Also, children affected by the floods in the first trimester of pregnancy score lower on cognitive tests. Additionally, I explore potential mechanisms by studying health at birth and family inputs (income, consumption, and breastfeeding). I find that children exposed to El Niño floods, especially during the third trimester in utero, were more likely to be born with low birth weight. Furthermore, households affected by El Niño suffered a decline in income, total consumption, and food consumption in the aftermath of the shock. Falsification exercises and robustness checks suggest that selection concerns such as selective fertility, mobility, and infant mortality do not drive these results.

Two Case Reports of Neuropsychological Outcomes following Pediatric anti-N-methyl D-aspartate Receptor Autoimmune Encephalitis

ABSTRACTAnti-NMDAR autoimmune encephalitis is a rare neurological condition. Limited existing pediatric case studies have shown mild, but persisting, neuropsychological impairments. This report described neuropsychological functioning in two patients treated for anti-NMDAR autoimmune encephalitis. Patient A is a 16-year-old male (10 months after symptom onset) and Patient B is a 5-year-old female (45 months after symptom onset). Contrary to expectations, their cognitive profiles were largely intact, raising the possibility of minimal cognitive implications for some pediatric patients with this condition. Additional research is needed to identify factors that contribute to better cognitive outcomes in children with anti-NMDAR autoimmune encephalitis.

Casualties of context? Risk of cognitive, behavioral and physical health difficulties among children living in high-incarceration neighborhoods

We examined if residence in high-incarceration neighborhoods is associated with risk of cognitive, behavioral and physical health problems for young children net of individual-level parental incarceration status. We used regression analysis and linked data from Year 9 of the Fragile Families and Child Wellbeing Study and zip code level information on neighborhood prison admission rates from Justice Atlas of Sentencing and Corrections in 2008. Neighborhood incarceration rates appear to have some independent and negative associations with child cognitive outcomes. For behavioral outcomes, individual-level parental incarceration appears to be the most meaningful. For child physical health outcomes as indicated by BMI percentages and overall good health, neither neighborhood incarceration rates nor individual-level parental incarceration experiences show persistent significant associations. Living in a neighborhood with high incarceration may threaten children’s health and wellbeing, suggesting that mass incarceration feeds into a system of inequality that extends beyond those who experience individual-level parental incarceration by exerting a broader public health impact.

Effectiveness of interventions to control screen use and children's sleep, cognitive and behavioral outcomes: a systematic review protocol.

REVIEW QUESTIONS.

The Unequal Impact of Food Insecurity on Cognitive and Behavioral Outcomes Among 5-Year-Old Urban Children

ObjectiveTo examine the associations of food insecurity with children's cognitive and behavioral outcomes using quantile regression. DesignSecondary analysis of the Fragile Families and Child Wellbeing Study dataset. ParticipantsA total of 2,046 children aged 5 years. Main Outcome MeasuresChild behavioral outcomes were measured using externalizing (aggressive) and internalizing (emotional) behavior problems. Child cognitive outcomes were measured using the Peabody Vocabulary test and the Woodcock–Johnson letter–word identification test. Food insecurity was measured using the US Department of Agriculture's Food Security Module. AnalysisUnconditional quantile regressions were employed. Statistical significance was set at P ≤ .05. ResultsNegative associations between food insecurity and child behavior problems (externalizing and internalizing) were largest for children with the most behavior problems. For Peabody Vocabulary scores, the negative association with food insecurity was statistically significant only for children in the top half of the distribution (≥50th percentile). The analysis found mixed evidence of an association between food insecurity and the Woodcock–Johnson letter–word identification test. These associations were similar for boys and girls. Conclusions and ImplicationsBecause children's cognitive skills and behavioral problems have long-lasting implications and effects later in life, reducing the risk of food insecurity might particularly benefit children with greater externalizing and internalizing behavior problems.

Magnetic Resonance Spectroscopy (MRS) predict cognitive outcomes in children after cardiac transplantation (P4.195)

Magnetic Resonance Spectroscopy (MRS) predict cognitive outcomes in children after cardiac transplantation (P4.195)

Cognitive Outcomes In Children With Infantile Spasms: Successful Treatment Response Is Beneficial Regardless Of Etiology (P2.299)

Cognitive Outcomes In Children With Infantile Spasms: Successful Treatment Response Is Beneficial Regardless Of Etiology (P2.299)

Parental executive function and verbal ability matter for scaffolding.

Despite the importance of parental scaffolding for later child cognitive outcomes and academic achievement, sources of individual variation in scaffolding are not fully understood. Scaffolding places extensive demands on cognitive capacity, including planning, flexibly shifting, and inhibition. Executive function (EF) is therefore a parental cognitive ability especially important for effective scaffolding. In this study, parents and preschool-aged children completed a challenging puzzle to assess scaffolding. EF and verbal ability were measured for parents and children. Parental verbal ability was used as an index of global higher-order cognitive function. Higher levels of parental EF related to more effective scaffolding, above and beyond parental verbal ability and independent of child cognitive level. These results highlight the significance of considering parental cognitive capacities in future studies to better understand the sources of individual differences in scaffolding. (PsycINFO Database Record

Parental insightfulness and parenting behavior: a two-dimensional analysis of parent contributions to child cognitive outcomes

ABSTRACTUtilizing a two-dimensional model of parenting emphasizing both (1) proximity seeking and (2) exploration, consistent with a conceptual framework rooted in attachment theory, the relations between parental insightfulness, observed parenting, and child cognitive outcomes were investigated in a low-income sample of 64 of caregivers and their young 3–5-year-old children. Specifically, observed parental sensitivity (proximity seeking) and intrusiveness (exploration) and parental insightfulness assessed dimensionally to capture Positive Insight and Focus on Child were examined in relation to child cognitive outcomes. Parental intrusiveness was negatively correlated with cognitive performance; however, parental sensitivity was not associated with child cognitive outcomes. Parents’ capacity to remain child-focused during the Insightfulness Assessment was negatively correlated with observed intrusiveness and was associated with child cognitive performance. These results suggest unique contributions of dimensions of parental insightfulness and parenting behaviors to child cognitive outcomes – specifically, parents’ capacity to remain focused on children’s experience during the Insightfulness Assessment and nonintrusive parenting behavior, which may reflect strategies to support children’s exploration.

N–3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis

Epidemiologic studies link maternal seafood and n-3 (ω-3) polyunsaturated fatty acid (PUFA) consumption with improved childhood cognitive development; trials show mixed results. We investigated effects of n-3 PUFA supplementation on child cognitive and visual outcomes. We systematically reviewed and meta-analyzed randomized controlled trials of n-3 PUFA supplementation in mothers or infants (age≤2 y) and evaluated standardized measures of cognitive or visual development up to age 18 y. Of 6286 abstracts and 669 full-text articles, 38 trials with 53 intervention arms were included. Data were extracted independently in duplicate. Findings were pooled using random-effects meta-analysis across supplementation periods (maternal, preterm, term infant); we also explored subgroup analyses stratified by supplementation period. Heterogeneity was explored using I2, stratified analysis, and meta-regression. Cognitive development was assessed by Bayley Scales of Infant Development mental and psychomotor developmental indexes (MDI, PDI) and intelligence quotient (IQ); visual acuity was assessed by electrophysiological or behavioral measures. The 38 trials (mothers: n=13; preterm infants: n=7; term infants: n=18) included 5541 participants. When we explored effects during different periods of supplementation, n-3 PUFA supplementation improved MDI in preterm infants (3.33; 95% CI: 0.72, 5.93), without statistically significant effects on PDI or IQ in different intervention period subgroups. Visual acuity [measured as the logarithm of the minimum angle of resolution (logMAR)] was improved by supplementation in preterm (-0.08 logMAR; 95% CI: -0.14, -0.01 logMAR) and term infants (-0.08 logMAR; 95% CI: -0.11, -0.05 logMAR), with a nonsignificant trend for maternal supplementation (-0.02 logMAR; 95% CI: -0.04, 0.00 logMAR). In main analyses pooling all supplementation periods, compared with placebo, n-3 PUFA supplementation improved MDI (n=21 trials; 0.91; 95% CI: 0.005, 1.81; P=0.049), PDI (n=21 trials; 1.06 higher index; 95% CI: 0.10, 2.03; P=0.031), and visual acuity (n=24; -0.063 logMAR; 95% CI: -0.084, -0.041 logMAR; P<0.001) but not IQ (n=7; 0.20; 95% CI: -1.56, 1.96, P=0.83), although few studies assessed this endpoint. Potential publication bias was identified for MDI (Eggers P=0.005), but not other endpoints. Significant differences in findings were not identified by world region, race, maternal education, age at outcome assessment, supplementation duration, DHA or EPA dose, DHA:AA ratio, or study quality score (P-interaction>0.05 each). n-3 PUFA supplementation improves childhood psychomotor and visual development, without significant effects on global IQ later in childhood, although the latter conclusion is based on fewer studies.

Cognitive outcomes in children and adolescents born very preterm: a meta‐analysis

To estimate the association between very preterm birth (<32wks' gestation) and intelligence, executive functioning, and processing speed throughout childhood and adolescence, and to examine the effects of gestational age, birthweight, and age at assessment. Studies were included if children were born at earlier than 32weeks' gestation, aged 4 to 17years, had an age-matched term control group, and if the studies used standardized measures, were published in an English-language peer-reviewed journal, and placed no restrictions on participants based on task performance. We evaluated 6163 children born very preterm and 5471 term-born controls from 60 studies. Children born very preterm scored 0.82 SDs (95% confidence interval [CI] 0.74-0.90; p<0.001) lower on intelligence tests, 0.51 SDs (95% CI 0.44-0.58; p<0.001) lower on measures of executive functioning, and 0.49 SDs (95% CI 0.39-0.60; p<0.001) lower on measures of processing speed than term-born controls. Gestational age and birthweight were associated with study effect size in intelligence and executive functioning of younger children only. Age at assessment was not associated with study effect size. Children born very preterm have medium to large deficits in these cognitive domains. This meta-analysis is centred on very preterm birth and three cognitive domains. The three critical cognitive domains are intelligence, executive functioning, and processing speed.