Developmental Outcomes Of Young Children Research Articles

Coparenting profiles and children's socioemotional outcomes in unmarried parents with low‐income

AbstractObjectiveThis study aimed to examine patterns of mother–father coparenting relationship quality and their associations with child empathy, emotional insecurity, and behavior problems in families with low income.BackgroundGiven the growing number of nonmarital births and the high risk of relationship dissolution among cohabiting couples living with low income, it is important to examine the coparenting relationships among racially diverse unmarried couples from low‐income contexts. To date, little research has assessed patterns of coparenting relationships and their associations with child socioemotional outcomes among this population.MethodsParticipants were 4,266 unmarried couples and their preschool‐aged children from the Building Strong Families study. Latent profile analysis (LPA) was conducted.ResultsLPA of survey data from mothers and fathers revealed four coparenting patterns: Profile 1: low quality, more negative maternal coparenting perceptions (7.2%); Profile 2: moderate‐high quality, high congruence, slightly more negative paternal coparenting perceptions (25.2%); Profile 3: low congruence, severely more negative maternal coparenting perceptions (11.8%); and Profile 4: mutual high‐quality coparenting (55.8%).ConclusionChildren of parents with the mutual high‐quality coparenting profile had the most positive outcomes according to maternal reports of child socioemotional development. Highly congruent and positive perceptions of the other parent as a coparent were found to be significant promotive factors for positive child socioemotional development.ImplicationsFamily strengthening policies and programs for unmarried couples with low income should target and support the development of mutually satisfying, high‐quality coparenting relationships, with the ultimate goal to improve developmental outcomes for young children in such families.

Diaper Need: It’s Time for a Change in Practice and Policy

Over one-third of families in the United States experience diaper need, negatively affecting the health and developmental outcomes of young children. Research has shown that when providers recognize the importance of addressing the social determinants of health (SDOH), including diaper need, critical support is provided to children and families. Early intervention (EI) providers work collaboratively with families to address goals for their children, including SDOH. Through longitudinal partnerships with families, EI providers are ideally positioned to address disparities like diaper need and provide essential supports to families. When diaper need affects children with developmental delays and disabilities, the disparities are often exacerbated due to the extended length of time that may be required for the child to wear diapers. EI providers can address this need by increasing awareness of this issue, connecting families to resources, and advocating for policy changes to effectively address diaper need and optimize outcomes for children.

Child social-emotional and behavioral problems and competencies contribute to changes in developmental functioning during Early Intervention

This study examined how social-emotional and behavioral (SEB) problems and competencies contribute to changes in developmental functioning among children enrolled in Part C Early Intervention (EI), a U.S. program supporting young children with developmental delays and disabilities. The sample included 1,055 children enrolled in EI from 2011-2019 (mean age at EI entry = 17 months; 64% male; 72% marginalized racial and ethnic backgrounds). Standardized developmental assessments, drawn from administrative records, characterized developmental functioning at EI entry and exit and parents reported SEB functioning. Hierarchical regression analyses revealed that SEB problems and competencies interacted in predicting change in developmental functioning from EI entry to exit. Monitoring, identifying, and addressing SEB problems and competencies may optimize developmental outcomes for young children with developmental delays and disabilities.

Early Education Program Racial and Ethnic Composition and Associations with Quality and Children’s Language and Social-Emotional Development

ABSTRACT This study identified patterns of classroom and family experiences and developmental outcomes for young children in segregated early education. This study is based on data from a high-quality early education program serving young children from low-income households in 19 schools across the U.S. The sample included 1,521 children during the 2016–2017 school year. The analysis examined patterns of association between the racial/ethnic composition of Educare sites and family risk factors, classroom quality, and children’s language and social-emotional performance and growth across the academic year. Research Findings: Findings indicated that although classroom quality, measured through traditional tools, did not vary by school racial/ethnic composition, sociodemographic risk factors, children’s language and social-emotional outcomes did vary by this variable. Practice or Policy: We discuss our results in relation to promotive and inhibitive processed within and outside early education programs, as well as the continued impact of structural equities and lack of culturally responsive pedagogy on children’s learning opportunities and development.

Early Developmental Trends in High-Risk Neonates Later Diagnosed With Autism Spectrum Disorder.

We hypothesized that clinical data from a neonatal intensive care unit (NICU) infant developmental follow-up clinic would identify early manifestations of autism spectrum disorder (ASD). One hundred forty-four infants were identified; 72 later diagnosed with ASD and 72 controls. Retrospective chart review provided data from the Test of Infant Motor Performance (TIMP) and the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), between 8 and 26 months of age. Between-group comparisons indicated no significant group difference in TIMP scores; however, Bayley-III scaled scores differed between the groups at 2 administration times. The within-group Bayley-III change scores declined significantly more for the ASD group in cognitive and communication subtests. High-risk neonates, due to prematurity or morbidity, later diagnosed with ASD demonstrated statistically significant differences, including a more precipitous drop in Bayley-III scores over time. Early, longitudinal developmental surveillance for neonates at risk of ASD is critical. What this adds to the evidence: Early identification of ASD is critical to optimize developmental outcomes in young children, including infants born prematurely or with neonatal morbidity, who are perceived to have an increased risk for ASD. Despite these findings, minimal research has been conducted to evaluate the utility of commonly administered norm-referenced developmental surveillance instruments to identify possible early signs of ASD in this high-risk population due to prematurity or neonatal morbidity and not familial association. The present study analyzed retrospectively collected clinical data from a NICU developmental follow-up clinic for 144 infants, 72 of which were later diagnosed with ASD and 72 sex- and gestational age-matched controls. Results demonstrated statistically significant poorer Bayley-III outcomes for the ASD group compared with controls at 2 different study time points, including a more precipitous drop in Bayley-III scaled scores over time. This study highlights the importance of early and longitudinal developmental surveillance for high-risk neonates at risk of ASD.

Early developmental trajectory of children with prenatal alcohol and opioid exposure.

With significant increases in opioid use/misuse and persistent high prevalence of prenatal alcohol exposure (PAE), identifying infants at risk for long-term developmental sequelae due to these exposures remains an urgent need. This study reports on developmental outcomes in young children from a prospective cohort, ENRICH-1, which recruited pregnant women and followed up maternal-infant pairs. Subjects were assigned to four study groups based on prenatal use of medications for opioid use disorder (MOUD), PAE, MOUD+PAE, and unexposed controls (UC). Mixed effects modeling was used to evaluate changes in the Bayley Scales of Infant Development-III (BSID-III) Cognitive, Language, and Motor scores between 6 and 20 months. There was a significant three-way interaction (MOUD-by-PAE-by-Time) with respect to the BSID-III Cognitive (p = 0.045) and Motor (p = 0.033) scales. Significant changes between the two evaluations were observed for MOUD group in Cognitive and Language scores; for PAE group in Cognitive, Language, and Motor scores, and for MOUD+PAE group in Language scores after adjusting for child sex and family socio-economic status. The developmental scores for the UC remained stable. Observed decline in neurodevelopmental scores during the first 2 years of life emphasizes the importance of a longitudinal approach when evaluating children with prenatal polysubstance exposure. BSID-III scores were stable during the first 2 years of life for unexposed children. BSID-III scores declined for children with prenatal exposures to alcohol and/or opioids. Standard developmental tests may not be sensitive enough during the first year of life. Findings emphasize the need for repeated evaluations of children who are at high risk.

Equipping EI Practitioners in Using PBS Strategies to Support Families With Addressing Challenging Behaviors: A Mixed Methods Pilot Study

ABSTRACT Challenging behaviors are linked to negative long-term developmental outcomes for young children with disabilities and remain a primary focus of service delivery for many early intervention practitioners and families. Positive Behavior Interventions and Supports (PBIS) is a tiered prevention framework that recommends evidence-based positive behavior support (PBS) strategies to effectively address young children’s challenging behaviors and promote prosocial skills. However, there is limited research investigating the feasibility of a PBIS approach in Part C early intervention settings, which employ a family-centered approach to serve an increasingly culturally and linguistically heterogeneous population of young children and their families. This article presents findings from a convergent mixed methods study aiming to understand the impact of PBIS approach components implemented in an early intervention context (PBIS-EI) to support diverse families in addressing children’s challenging behaviors at home. EI practitioners’ implementation of PBS strategies is measured over time and practitioner experiences with supporting parents’ use of PBS strategies are explored via qualitative interviews. Findings show increases in EI practitioner confidence and implementation of strategies, as well as practitioner-reported experiences. Implications for practice and future research are discussed.

Mothers’ and Fathers’ Parenting and Other Family Context Variables Linked to Developmental Outcomes in Young Children With Intellectual Disability: A Two-wave Longitudinal Study

Parenting is a key factor for the development of children with intellectual and developmental disabilities. Therefore, early intervention programs should target parenting behaviors to improve children’s developmental outcomes. The present study analyzed the effect of parental behaviors and other family factors on the cognitive and linguistic development of children with an intellectual disability (ID). Participants (n = 87, aged between 20 and 47 months) were recruited from several Spanish Early Intervention Centers. The children’s development was assessed with the Bayley Scales of Infant Development (BSID-III) on two occasions. Besides questionnaires including family factors, 10-min mother–child and father-child interactions during free play were auto-recorded at home. Intensive statistical modeling on the two measurement occasions was used to select relevant predictors as well as their interactions. Child cognitive development models, including predictors such as mother’s responsiveness and affection and father’s teaching, had a predictive capacity between 22 and 26%. The language development models, including the mother’s responsiveness and father’s teaching scores amongst other predictors, yielded adjusted-R2s between 26 and 28%. This study’s findings evidence that parental behaviors during adult–child interaction affect the development of children with intellectual disabilities. The study also provides data that can be used to guide early intervention.

The utility of LENA as an indicator of developmental outcomes for young children with autism.

There is growing understanding of the potential benefits of a multi-method approach to accurately capture language skills of children on the autism spectrum. Tools such as Language ENvironment Analysis (LENA) provide an efficient means of capturing and analysing early child vocalizations (CVs) and the language learning environment. While developed to capture whole-day recordings of child language in naturalistic settings, there is potential utility in capturing, but little knowledge about, primary LENA metrics-including CVs and conversational turns (CTs)-and novel metrics, such as vocalization ratios (VRs), sampled in clinical practice settings where children are often seen. Moreover, recent research indicates that the novel VR may offer a broad indicator of children's developmental level, beyond just their language abilities, a hypothesis yet to be investigated in a large sample of children for whom the LENA was designed (i.e., pre-schoolers). To explore the extent to which primary and novel LENA metrics collected during brief one-to-one clinical interaction was a useful indicator of developmental outcomes for children on the autism spectrum. Participants were recruited as part of an on-going research programme evaluating early intervention outcomes (n = 99; age 14-47 months). Language samples were collected at intake (T1) using the wearable LENA Digital Language Processors during a one-to-one, play-based assessment with a clinician. Direct (Mullen Scales of Early Learning-MSEL) and parent-report (Vineland Adaptive Behavior Scales-VABS) measures of verbal and non-verbal skills were also collected at intake (T1) and again at exit (T2), approximately 12 months later. Few correlations were observed between child measures and CVs, a primary LENA metric. The novel VR metric was associated with concurrent direct assessment (MSEL) (and to a lesser extent parent report; VABS) measures of verbal and non-verbal skills, with moderate positive correlations found between VRs and all directly assessed subscale scores. However, VRs did not uniquely contribute to the prediction of child outcomes when baseline skills were also considered. The novel VR may provide an insight into autistic children's overall development in addition to their language ability, suggesting that even when collected in a short recording format, LENA might be a useful component of a multi-method assessment approach. What is already known on the subject To accurately capture language skills of children on the autism spectrum, multi-method approaches, including natural language sampling, are recommended. Tools such as LENA provide an efficient means of capturing and analysing naturalistic child language and the language learning environment. What this paper adds to existing knowledge This study demonstrates the potential benefits, and limitations, of using LENA to augment assessment of young children on the autism spectrum. Specifically, LENA provides a complementary, and low burden, method for capturing child language samples. What are the potential or actual clinical implications of this work? Novel metrics, such as the VR, collected during brief clinical interactions might be a useful component of a multi-method assessment approach for children on the autism spectrum.

Child and caregiver executive function in trauma-exposed families: Relations with children’s behavioral and cognitive functioning

Children’s executive function (EF) may be negatively affected by their exposure to traumatic events. However, few investigations have examined the relations between EF and the associated developmental outcomes of young children exposed to trauma. Likewise, although growing evidence highlights intergenerational associations between caregiver and child EF, these associations remain unexplored among preschool-aged children exposed to trauma. The current study used a multimethod approach to test the direct and indirect associations of children’s trauma symptomatology, caregiver and child EF, and children’s concurrent behavioral and cognitive functioning in a sample of trauma-exposed, preschool-aged children (N = 109; Mage = 52.11 months, SD = 12.19) and their caregivers. Results indicated positive associations between children’s trauma symptomatology and their behavior problems, positive associations between caregiver and child performance on tasks of EF, and positive associations between children’s EF and a latent factor of cognitive functioning indicated by children’s performance on standardized tests of IQ and receptive vocabulary. However, the hypothesized indirect effects of caregiver and child EF were not supported. Implications for clinical interventions with young children and families exposed to trauma are discussed.

How early intervention practitioners describe family-centred practice: A collective broadening of the definition.

Given the importance of families in supporting the health and developmental outcomes of young children, current recommended practices for early intervention services advocate for a family-centred practice (FCP) approach that recognizes the importance of children's family systems. Though there is consensus in the field on the importance of this approach, there often remains a disconnection between these values and the everyday practice of early intervention practitioners. This study focuses on understanding the ways in which practitioners define FCP as this can provide valuable insight into why these belief-practice disconnections may exist. Early intervention practitioners (n = 203; e.g., special education or child development teachers, therapists, audiologists, etc) were surveyed at a statewide early intervention conference. Qualitative content analyses procedures were used to analyse participants' open-ended responses. Three themes emerged in the analysis, including the following: (a) FCP is a distinct approach to providing early intervention services; (b) there are specific practices for best implementing FCP; and (b) there are provider qualities that are essential in order to use FCP. Practitioners' definitions of FCP were primarily in line with recommended practices; however, they extend beyond the current definition of FCP in the early intervention literature, suggesting that the way this approach is conceptualized may be collectively broadening within the field. Opportunities, difficulties, and practical implications of this broadening definition are discussed.

0719 Does Obstructive Sleep Apnea Affect Development in Children with Down Syndrome?

In typically developing children, obstructive sleep apnea (OSA) is associated with adverse neurocognitive outcomes. Children with Down Syndrome are at increased risk for OSA and have varying degrees of developmental delay, yet minimal data exists on the impact of OSA on the developmental trajectory in children with Down Syndrome. Our objective is to evaluate the relationship between the presence and severity of OSA and developmental outcomes in children with Down syndrome. Retrospective cohort study of pediatric Down Syndrome patients who have been seen in the Oregon Health and Science University Down Syndrome Clinic between 11/2007 and 1/2015. Retrospective review of polysomnogram (PSG) data (Apnea Hypopnea Index, AHI) and developmental screening data, stratified by age: Peabody Fine Motor Quotient, Gross Motor Function Measure, Rosetti Infant-Toddler Language Scale (ages 0-3yo), Peabody Picture Vocabulary Test (ages 3-6yo), and the Expressive Vocabulary Test (ages 6yo and up). The cohort was stratified by degree of delay on these developmental measures compared to published norms for the general pediatric population. ANOVA was used to compare AHI across categories of developmental delay. The relationship between developmental scores and AHI was assessed using linear and logistic regression for continuous and categorical variables respectively. Exclusion criteria include patients without polysomnogram (PSG) data, developmental screening data, or those without developmental screening data within one year of PSG. Total N = 565. 167 (30%) children underwent PSG, and 60 (11%) underwent PSG within one year of their initial developmental testing. Preliminary analysis did not reveal significant associations with AHI when stratified by age group and degree of developmental delay. Descriptive analysis suggests that there may be an association between AHI and developmental delay in the infant/toddler age group with mild degrees of developmental delay. Further subgroup analysis is in progress. OSA may be associated with negative developmental outcomes in young children with Down syndrome. Evaluation of and treatment for obstructive sleep apnea has the potential to impact developmental trajectory of a vulnerable patient population. Repository Sharing Agreement (IRB 00010774). OHSU Redcap.

The Associations of Constructive and Destructive Interparental Conflict to Child Well-Being Among Low-Income Families.

Interparental conflict is a well-established precursor to child maladjustment. However, little is understood of the role of different interparental conflict in shaping the developmental outcomes of young children, especially those from socioeconomically disadvantaged backgrounds. This study uses data from a large and racially diverse sample of low-income, unmarried mothers with young children (n = 1,297) to examine the processes linking parental constructive conflict, destructive conflict, intimate partner violence (IPV) to child behavior problems, and child emotional insecurity as a mediator of these processes. Path analyses were conducted to estimate structural paths between (a) conflict constructs and child behavior problems, (b) conflict constructs and child emotional insecurity, and (c) child emotional insecurity and child behavior problems. Results demonstrated that constructive conflict was associated with decreased levels of both child emotional insecurity and child behavior problems, whereas destructive conflict was associated with increased levels of both child outcomes. IPV was associated with increased levels of child emotional insecurity only. Child emotional insecurity mediated the links between all three conflict constructs and child behavior problems. Such findings suggest the need for clinicians to help raise awareness regarding the consequences of children's exposure to different interparental conflict and educate parents about children's sense of emotional security in the family.

Establishing a protocol for building a pan-Canadian population-based monitoring system for early childhood development for children with health disorders: Canadian Children’s Health in Context Study (CCHICS)

IntroductionHealth disorders early in life have tremendous impact on children’s developmental trajectories. Almost 80% of children with health disorders lack the developmental skills to take full advantage of school-based education...

What implementation evidence matters: scaling-up nurturing interventions that promote early childhood development.

Research in early childhood development (ECD) has established the need for scaling-up multisectoral interventions for nurturing care to promote ECD, for improved socioeconomic outcomes for sustainable societies. However, key elements and processes for implementation and scale-up of such interventions are not well understood. This special series on implementation research and practice for ECD brings together evidence to inform effectiveness, quality, and scale in nurturing care programs; identifies knowledge gaps; and proposes further directions for research and practice. This paper frames the dimensions and components fundamental to the understanding of implementation processes for nurturing care interventions, factors for improving implementation of interventions, and strategies to scale by embedding interventions in delivery systems. We discuss emerging issues in implementation research for ECD, including (1) the role of context in adaptation and implementation, (2) standardized reporting of implementation research, (3) the importance of feasibility studies to inform scale-up and capacity building, (4) fidelity and program quality improvement, and (5) intervention integration into existing systems. Effective implementation of nurturing care interventions is at the heart of achieving positive developmental outcomes for young children. It is pivotal to adapt and implement these interventions based on evidence for high impact, especially in low-resource settings.

Impact of In-Service Professional Development Programs for Early Childhood Teachers on Quality Ratings and Child Outcomes: A Meta-Analysis

High pedagogical quality in early childhood education and care (ECEC) is related to developmental outcomes in young children. This review summarizes findings from (quasi)-experimental studies that evaluated in-service training effects for ECEC professionals on external quality ratings and child development. The aggregation of findings at teacher level (including 36 studies with 2,891 teachers) revealed a medium in-service training effect on process quality (effect size [ES] = 0.68, SE = 0.07, p < .001). Furthermore, a subset of nine studies (including 486 teachers and 4,504 children) that provided data on both quality ratings and child development were analyzed, and they showed a small effect at child level (ES = 0.14; SE = 0.02, p < .001) and a medium effect at the corresponding classroom level (ES = 0.45, SE = 0.11, p < .001). Variance in effect sizes at child level was significantly related to in-service effects on quality ratings (53% explained variance). The results show that quality improvement is a key mechanism to accelerate the development of young children.

Home Visiting Programs: Four Evidence-Based Lessons for Policymakers

Home visiting programs (HVPs) aim to help low-income parents enhance their parenting skills and improve a host of early health and developmental outcomes for young children. Over the past five decades, numerous HVP models have been developed and implemented, albeit with modest or even null results, according to meta-analyses and comprehensive reviews. In 2010, in an effort to advance HVPs’ effectiveness, federal lawmakers vastly expanded funding for HVPs with certain caveats, one being the requirement that the majority of programs be evidence based. Although the new requirement is a policy win, this review presents four main areas that must be addressed and improved upon if this new funding effort is to maximize positive outcomes. Pointedly, HVPs should have built-in flexibility for states to match the specific or unique needs of a family to a program model that has demonstrated effectiveness in meeting those specific needs. Further, program developers should clearly demonstrate what it is specifically about their model that works, in what context, and for whom. Ultimately, not unlike personalized medicine, state policymakers should target delivery of the right HVP model to the right family at the right time.

Improving Cognitive Development in Young Children in Developing Countries

Early developmental intervention (EDI) through home visits by registered nurses has been shown to improve developmental outcomes in young children in

Home Visiting Programs: What the Primary Care Clinician Should Know

Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper.

Home visiting programs: Four evidence-based lessons for policymakers

Home visiting programs (HVPs) aim to help low-income parents enhance their parenting skills and improve a host of early health and developmental outcomes for young children. Over the past five decades, numerous HVP models have been developed and implemented, albeit with modest or even null results, according to meta-analyses and comprehensive reviews. In 2010, in an effort to advance HVPs’ effectiveness, federal lawmakers vastly expanded funding for HVPs with certain caveats, one being the requirement that the majority of programs be evidence based. Although the new requirement is a policy win, this review presents four main areas that must be addressed and improved upon if this new funding effort is to maximize positive outcomes. Pointedly, HVPs should have built-in flexibility for states to match the specific or unique needs of a family to a program model that has demonstrated effectiveness in meeting those specific needs. Further, program developers should clearly demonstrate what it is specifically about their model that works, in what context, and for whom. Ultimately, not unlike personalized medicine, state policymakers should target delivery of the right HVP model to the right family at the right time.