Developmental Trajectories Of Children Research Articles

Trajectories of early childhood development in children experiencing homelessness

IntroductionThe experience of homelessness early in life can potentially disrupt childhood development. Enrollment in early education has been identified as a buffer to promote adequate development. Nevertheless, there has not yet been a quantitative assessment of the developmental trajectories of children experiencing homelessness receiving early education. MethodsWe compared the development of children from birth to 6 years old enrolled at a high-quality early education center, against a US representative sample and the acceptable ranges of developmental indicators. Further, we studied predictors of developmental trajectories in children exposed to homelessness. A total of 459 children enrolled at an early education center, Horizons for Homeless Children (HHC), between 2017 and 2022, between birth to 6 years old, were included in the analysis, with an average follow-up time of 22 months. We assessed the development in six domains, including Socio-emotional, Motor, Language, Literacy, Cognitive, and Mathematics, using the scaled scores from the Teaching Strategies GOLD system. The scores of children at HHC were compared with the norm scores from a US representative sample and the expected scores for different ages. We assessed developmental trajectories and included child and family covariates in a linear mixed model to examine developmental differences over time. ResultsThe scores of HHC students on Teaching Strategies GOLD assessments were lower than those of a US representative sample and frequently did not meet age group expectations. Within the HHC cohort, boys scored lower than girls. Socioeconomic characteristics remained a factor associated with development; specifically, having older primary caregivers and having parental education below High School were associated with worse developmental trajectories. Earlier enrollment into HHC was associated with higher scores for all domains and faster developmental progress for the Literacy domain over time. Discussion and conclusionEven in the context of a high-quality early education program, the developmental delays of children who experienced homelessness did not attenuate in the first six years of life compared with a normative sample. Furthermore, within a population experiencing homelessness, there are developmental differences associated with socioeconomic status, including parental education. Early enrollment in education centers may reduce the developmental delays of children experiencing homelessness. This actionable determinant of development supports enrollment into schooling as early as possible.

Особенности развития и психическое здоровье близнецов раннего возраста: обзор отечественных и зарубежных исследований

<p style="text-align: justify;"><strong>Objectives. </strong>Due to the increasing birth rate of twins and the high risk of delayed physical, cognitive, and psychosocial development in twins at an early age, there is a need to identify factors that contribute to the mental health and developmental trajectory of children.</p> <p style="text-align: justify;"><strong>Methods. </strong>We conducted a review and analysis of recent domestic and international research from 183 articles published between 2009 and 2024, and available in the Scopus, Semantic Scholar, PubMed, Bielefeld Academic Search Engine, Russian Science Citation Index (RSCI) and Crossref databases. The search used the keywords “infant twins”, “twins at early age”, “twins early development”, “twins interaction”.</p> <p style="text-align: justify;"><strong>Results. </strong>The interest of researchers in different aspects of the mental health and development of children born from monozygotic and dizygotic twin pregnancies is shown. The main factors affecting the health and development of twins are genetic factors, congenital defects, gestational age and birth weight, the presence of trauma during birth, as well as the somatic health of children in the first months of life. The early development of twins is closely related to the features of the care organization and parenting, interaction with the mother, as with a caring adult, a set of environmental factors and conditions for the education. At an early age, twins are at high risk of lagging in general physical, cognitive and speech impairment development compared with singleton, which should be taken into account in monitoring the need for early help for children.</p> <p style="text-align: justify;"><strong>Conclusions. </strong>There is a need for relevant domestic research on the features of the development of twins at an early age. The study of the individual trajectory of early development of each child from twins should be carried out taking into account the factor of discordance in a twin pair.</p>

Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method

PurposeThis work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. Method: In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. Results: Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. Conclusions: Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.

Developmental trajectory of children’s epistemic and interpersonal trust decision for acting and testifying informants

ABSTRACT The purpose of the study is to examine children’s (5-to 10-year-old) epistemic and interpersonal trust decisions when they watched testifying and acting informants. Epistemic and interpersonal trust decision data were gathered from separate groups. Children in epistemic trust study responded to three ask questions. Children in interpersonal trust study responded to three interpersonal trust questions. Epistemic trust findings showed that children preferred testifying informant significantly higher than acting informant, children’s families’ SES and age did not affect their preference. For epistemic trust, girls preferred testimony informant significantly higher than acting informant. Interpersonal trust findings revealed that children preferred testifying informant significantly higher than acting informant. For interpersonal trust fourth graders (10 year-olds) preferred acting informant significantly more than other groups. The study suggests that as age increases children started to consider acting as a more important source of evidence than testimony for evaluating trustworthiness of person’s for interpersonal trust decisions.

Place du pédopsychiatre auprès de l’enfant négligé

Neglect is the most common form of child abuse. It can also have the most serious impact on a child's development, with an increased and accompanying risk of the emergence of psychiatric disorders from adolescence to adulthood. Child neglect is under-recognized today, due to a lack of training for professionals, the orientation of child psychiatry, and difficulties in understanding what this vague concept refers to. After proposing definitions of neglect, its characteristics, and its effects, we present the possible actions of the child psychiatrist in the ecosystem of the neglected child. Neglect is neither a legal nor a medical term. It is, however, used by doctors and social workers, with a loose definition as the absence of appropriate care for a child's development. Neglect is multifactorial. The French consensus approach to the basic needs of the child has highlighted a meta-need for security, emphasizing attachment and the particular qualities of the caregiver. In light of this report, we understand that affective or emotional neglect is the most problematic form of neglect. The effects of neglect are early, depending on the child's age. They can manifest as developmental delays, sleep disorders, tonus disorders in infants, intellectual disorders, and various internalized and externalized disorders in adolescence. Mortality and morbidity are increased in cases of neglect, and developmental sequelae have been described. Neglect has a greater impact on development than physical abuse. The child psychiatrist can take three types of action to treat the neglected child. Firstly, he or she must identify neglect and alert the appropriate instances so as to protect the child. Identification involves being aware of indicators of neglect and a particular clinical pattern that varies according to age, requiring the exploration of the different lines of development. Three clinical patterns seem to be linked to extreme neglect: anaclitic depression, post-traumatic stress disorder, particularly complex developmental trauma, and attachment disorders. When faced with symptoms suggestive of neglect, the child psychiatrist should try to rule out a sensory or neurodevelopmental cause, sometimes seeking the advice of a specialist. He or she will observe the child's behavior alone and with his or her parents, as well as parent-child relationships, and will consider the child outside the family microsystem in an ecosystemic approach. The child psychiatrist can use available standardized tools that explore the various dimensions of neglect. This multi-consultation assessment should not delay the child psychiatrist's initial actions, given the narrow developmental windows. In particular, the child psychiatrist may be required to report the child's situation to the administrative and judicial authorities. The care provided to the neglected child will then take place within the child's own ecosystem. Interventions must be early, participative and in partnership with social services, educators, and staff at the placement site. Care will seek to compensate for the negative developmental effects of neglect, in order to correct the child's developmental trajectory. It must take into account the child's psychopathology. Psychotherapy, the framework of which will need to be adapted, will help the child to assume ownership of his or her history. Child psychiatrists can also take part in innovative initiatives to help children at risk, such as mobile teams. The final action to be developed by the trained child psychiatrist is preventative. It is important that child psychiatrists be informed and trained to deal with neglect and its effects. Today's neglected children will be tomorrow's adults with the most psychiatric disorders.

Impact of epilepsy surgery on developmental trajectories of children under 3 years of age.

To investigate the developmental effects of epilepsy surgery in young children. This study retrospectively reviewed 315 consecutive children under 3 years of age, and ultimately included 89 children (48 males, 41 females) with pre- and postsurgery developmental evaluations. The mean general quotient before surgery was 46.7 (SD 24.7). Before surgery, the general quotient decreased in 77.6% of patients, while after surgery it increased in 55.1%. Furthermore, 70% of those 20 patients whose presurgical general quotient decreased by more than 10 points experienced positive changes. General quotient scores decreased in 15 out of the 22 patients classified in the normal/marginal presurgical category. Children who underwent surgery before the age of 12 months had a median gain in general quotient score by 7.6. Short-term general quotient scores were highly correlated with long-term scores (r = 0.909, p < 0.001). Surgical intervention was more inclined to positively impact developmental trajectories within a short postsurgical period, particularly among those affected by severe epileptic activity. However, in children with relatively typical development, certain developmental setbacks may arise. Postsurgical short-term developmental outcomes could predict longer-term outcomes.

Role of narcissism in parental alienation phenomenon. A narrative review.

Parental Alienation Syndrome (PAS) is a term addressed to describe negative, psychopathological feelings, thinking and behaviours, including hostility and fear, exhibited by children who have been alienated from one parent by the other parent. Despite its relevance in the clinical psychology field, theoretical and empirical contributions to understanding and deepening the many facets of this concept are still few. In particular, literature aimed at disentangling the alienating parent's psychological characteristics is scarce and fragmented. Our contribution encompasses a narrative review of scientific literature since the term PAS was coined in 1987 by Gardner, to delineate narcissistic proneness in alienating parents. Namely, considering the narcissistic drift the western society is going toward, we hypothesised that narcissism has a pivotal role in parents' alienating behaviours against the alienated ones. Firstly, the elements that emerged from our literature search confirmed our theoretical hypothesis, in terms of the likely role of narcissism/narcissistic marked traits in alienating parents. In the second section, we contextualised the phenomenon in a psychodynamic/psychoanalytic theoretical framework. Finally, based on previous findings/considerations, the developmental trajectories of children with PAS have been traced. An improved theoretical knowledge of this phenomenon, also in terms of the psychopathology associated with its genesis, means to refine the diagnostic and treatment tools to prevent it.

Developmental changes in drawing production under different memory demands in a U.S. and Chinese sample.

Children's drawings of common object categories become dramatically more recognizable across childhood. What are the major factors that drive developmental changes in children's drawings? To what degree are children's drawings a product of their changing internal category representations versus limited by their visuomotor abilities or their ability to recall the relevant visual information? To explore these questions, we examined the degree to which developmental changes in drawing recognizability vary across different drawing tasks that vary in memory demands (i.e., drawing from verbal vs. picture cues) and with children's shape-tracing abilities across two geographical locations (San Jose, United States, and Beijing, China). We collected digital shape tracings and drawings of common object categories (e.g., cat, airplane) from 4- to 9-year-olds (N = 253). The developmental trajectory of drawing recognizability was remarkably similar when children were asked to draw from pictures versus verbal cues and across these two geographical locations. In addition, our Beijing sample produced more recognizable drawings but showed similar tracing abilities to children from San Jose. Overall, this work suggests that the developmental trajectory of children's drawings is remarkably consistent and not easily explainable by changes in visuomotor control or working memory; instead, changes in children's drawings over development may at least partly reflect changes in the internal representations of object categories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Early life growth and developmental trajectory in children with biliary atresia undergoing primary liver transplantation.

To clarify the early growth and developmental characteristics of children with biliary atresia (BA) undergoing primary liver transplantation (pLT). A prospective cohort study, which specifically focused on BA-pLT children, was conducted after the diagnosis of BA by following the children at the time of pLT and 1, 3, 5, 7 months and 1 year after pLT for growth and developmental monitoring. The growth parameters were calculated according to the WHO standard, and the developmental status was assessed using Denver Developmental Screening Tests. A total of 48 BA children who received pLT at the age of 5.00 ± 0.94 months were analyzed. The weight-for-age Z-value (ZW) and length-for-age Z-value (ZL) were higher than the head circumference-for-age Z-value (ZHC) at pLT (P = 0.002 and 0.02), but they were all lower than the WHO growth standard (Z = 0) (P < 0.001). The ZW and ZHC decreased first and then returned to the population level at 1 year after pLT, while the ZL only returned to the preoperative status and was lower than the ZW and ZHC (P < 0.001). Developmental screening showed that 35% (17/48) of the children were defined as suspicious and 15% (7/48) were abnormal at 1-4 months after pLT, the most likely time to be suspected of developmental delay. At 1 year after pLT, gross motor skill delay still existed (12/45, 27%), and language skill delay began to appear (4/45, 9%). BA-pLT children suffer from growth and developmental problems. Low ZHC is the main growth problem before pLT, while low ZL is the problem after pLT. Developmental delays are significant after pLT, especially in motor and language skills. The current study suggested that further studies are warranted to clarify the long-term growth and developmental outcomes of BA-pLT children, to compare them with children undergoing the Kasai procedure and to explore their influencing factors and possible mechanisms.

Differential longitudinal effects of frequent sweetened food consumption at different exposure ages on child cognitive, language, and motor development

BackgroundEvidence reveals frequent sugar consumption worsens cognition in animal models, and similar effects on child development are probable. We aimed to investigate the influence of sweetened foods (SFs) on child developmental trajectories. MethodsThe prospective cohort recruited 3-month-old children in Taiwan from 1st April 2016 to 30th June 2017. Developmental inventories including cognitive, language, and motor domains, were measured at the age of 3-,12-, 24-, and 36 months old via in-person interviews. We constructed latent growth models with covariates to estimate the influence of SFs on child development. ResultsUltimately, 4782 children (50.7% boys) were included in the statistical analysis. In the cognitive domain, consumption at one year of age significantly affected the intercept, but not the linear slope and quadratic term (intercept: estimate = −0.054, p < .001); consumption at two years of age significantly affected the intercept and quadratic term (intercept: estimate = −0.08, p < .001; quadratic term: estimate = −0.093, p = .026), but not the linear slope. In the language domain, only consumption at two years of age significantly affected the intercept (estimate = −0.054, p < .001). In the motor domain, consumption at two years of age significantly affected the linear slope and quadratic term (estimate = 0.080, p = .011 and estimate = −0.082, p = .048, respectively). ConclusionWe found SFs exposure at different times has different negative effects on child development. Early exposure to SFs harmed children's cognitive function. Relatively late exposure to SFs not only deteriorated children's cognitive and language abilities but also decelerated developmental velocity in cognitive and motor domains.

Explore the mechanisms by which prenatal stress can lead to the emergence of neurodevelopmental and psychiatric disorders among children

IntroductionMaternal stress experienced during pregnancy has potential lasting consequences on child development. One mechanism that can explain certain links between the activity of the maternal stress axis during pregnancy and the developmental trajectory of children is the maternal hypothalamic pituitary-adrenal (HPA) axis. Nevertheless, further exploration is needed as there are methodological limits in the existing literature, such as the lack of longitudinal data.ObjectivesTo fill this gap, this DEVSTRESS research project was created with the aim of increasing our understanding of the mechanisms linking prenatal maternal stress to child development using longitudinal data from the EDEN cohort study.MethodsIn this sample, various bio-psycho-social data were collected: (1) maternal stress was measured during pregnancy via questionnaires assessing childhood adversity, major life events, work-related stress, anxiety, and depressive symptoms; (2) children’s emotional and behavioural problems were reported at 3, 5, 8 and 11 years, and cognitive development was assessed by psychologists at 5 years of age; (3) maternal and child hair samples provided data on the level of cortisol in the hair, which were used as a biological marker of stress and were collected at birth for both mother and child, as well as 1, 3, and 5 years after birth from children.ResultsVarious statistical analyses have been conducted using this data to explore the longitudinal links between self-reported maternal prenatal stress and child outcomes.ConclusionsThis research project will be concluded in 2023, thus findings from the overall DEVSTRESS project and practical recommendations will be provided.Disclosure of InterestNone Declared

Intimations of Infanticide in Little Women

Abstract: This article reads Louisa May Alcott's Little Women (1868) against nineteenth-century mothering manuals and the psychoanalytic object-relations theory to argue that the novel links maternal rage with infanticide. Feminist scholars have noted how Little Women , though ostensibly a story of family harmony, conceals a deep vein of anger. Jo March's trajectory, like that of other nineteenth-century sentimental heroines, stages a transformation from rebellious tomboy to self-controlled angel-in-the-house. Attending to the ways in which the text persistently links anger to infanticide, this article shows how the idealized angel-in-the-house functioned as an idealized solution to guard against the imagined dangers of female rage. Moreover, the binary between angel mothers and infanticidal ones was inflected with racial meaning that served to distinguish who was and wasn't included under the umbrella of national belonging. In recovering the spectre of infanticide subtending Little Women , this article asks us to re-evaluate the ways that cultural texts transmitted messages about love and rage and the political implications of how such relationships to affect determined the lives and developmental trajectories of children.

Describing the communicative profiles of young children with a significant cognitive and motor developmental delay

The communicative behavior of young children with significant cognitive and motor developmental delays is generally considered to be limited, idiosyncratic and non-intentional. At present, changes between and within children over time regarding their communicative behavior are hard to detect. This article describes an exploratory observational study that draws on data from the first data point of 38 children who are participating in a longitudinal project on the developmental trajectories of children with significant cognitive and motor developmental delays. The aims of this study were to (a) describe the participants’ communicative behavior in detail with communication-related variables that reflect differences across individuals, (b) create summarizing variables and (c) explore whether subgroups of children can be detected. A self-developed coding scheme and descriptive statistics combined with correlational analyses were used, followed by a principal component analysis and visual inspection of the outcome of this analysis. The within-group differences related to communicative behavior was characterized using 16 variables. Based on these variables, three overarching components were formulated: communication proficiency, Expressions of Discomfort and Rejection and Differentiation According to Focus. All participating children were found to be unique in terms of their component scores and the relationship among their component scores.

Mother-child cohesion, friendship quality, and depressive symptoms in children: Direct and indirect associations between developmental trajectories

BackgroundMother-child cohesion and friendship quality have been shown to be protective factors against the development of children's depressive symptoms. However, the possible direct and indirect pathways from these two important interpersonal relationships to children's depressive symptoms need to be further elucidated. Moreover, these associations have not been examined from a developmental perspective. Therefore, this study examined the direct and indirect relations among developmental trajectories of mother-child cohesion, friendship quality, and depressive symptoms in children. MethodsA total of 4078 Chinese children (45.2 % girls, Mage = 9.90 years, SD = 0.73) participated in assessments at five time points across 2.5 years, employing six-month intervals. Latent growth curve modeling was conducted to examine the direct and indirect relations among the developmental trajectories of mother-child cohesion, friendship quality, and depressive symptoms. ResultsThe developmental trajectories of both mother-child cohesion and friendship quality were negatively and directly associated with the developmental trajectory of children's depressive symptoms. The developmental trajectory of friendship quality was indirectly associated with the developmental trajectory of depressive symptoms through the mediating role of mother-child cohesion. LimitationsThis study did not investigate father-child cohesion and other important psychological mechanisms linking interpersonal relationships to depressive symptoms. ConclusionsThe findings documented the direct and indirect relations among mother-child cohesion, friendship quality, and depressive symptoms from a developmental perspective, which suggested that prevention and intervention efforts target improving mother-child cohesion and friendship quality to reduce children's depressive symptoms.

Developmental trajectories of children’s sibling jealousy after the birth of a sibling: Strict parental control, parenting stress and parental depression as pre-birth predictors

This longitudinal research identified the developmental trajectories of sibling jealousy in firstborn children (M age = 49.9 months; 55% boys) among 107 Chinese families from 1 to 12 months after the birth of a younger sibling. Four sibling jealousy trajectories were identified: (a) low-increasing, (b) middle-stable, (c) high-stable, and (d) sharp-increasing. Trajectory group membership varied as a function of pre-birth parental factors including strict parental control (i.e., tiger parenting), parenting stress, and parental depression. These results highlight the benefit of examining the development of sibling jealousy over the transition to siblinghood and the importance to recognize pre-birth parental characteristics, especially paternal factors, as determinants when identifying children who may be at greater risk of adjustment difficulties following the birth of a younger sibling.

Toward feeling, understanding, and caring: The development of empathy in young autistic children.

Empathy is a highly valued human capacity. Yet, autistic people are often portrayed as lacking in empathy. Recent research, which views empathy as a complex construct emerging from multiple interrelated emotional and cognitive processes, argues that, although many autistic people do have difficulty understanding others' emotions, and this may hinder them from responding to others in a prosocial manner, they are not indifferent to other people's feelings. Hoping to contribute to a better understanding of the unique challenges that autistic children face in their empathy development, we followed the development of four empathy abilities: emotion contagion, attention to others, emotion acknowledgment, and prosocial actions, in 1- to 6-year-old autistic children, in comparison with non-autistic children. Once a year, for 4 consecutive years, children's empathy abilities were evaluated by experimenters who acted out emotional episodes to provoke empathy in children, and by parents who filled out empathy questionnaires. We found that autistic children experienced indeed more difficulty attending to others, acknowledging others' emotions, and initiating prosocial actions toward others. However, according to parents, they did not differ from their non-autistic peers in feeling along with others' negative emotions. This indicates that it might not be the case that autistic children did not want to act empathetically toward others. Rather, they might not know how to do so. Notably, despite these difficulties, when looking at children's developmental trajectories, autistic children showed similar improvements over time as non-autistic children. This provides evidence that autistic children have the potential to learn and to improve their empathy skills.

Being an adult sibling of an individual with autism spectrum disorder may be a predictor of loneliness and depression - Preliminary findings from a cross-sectional study.

BackgroundThe aim of this study is to compare depression and loneliness among adult siblings of people on the autism spectrum, adult siblings of normotypic individuals, and adults raised alone (only child). In recent years, an increasing interest in the perspective of siblings of children diagnosed with autism has been observed, with studies among this population particularly concerned with the developmental trajectories of children and adolescents at “high risk” for ASD, rarely focusing on their mental well-being.MethodsThe respondents filled out: the survey on sociodemographic data designed by the authors, Beck Depression Inventory II (BDI, measure of depression), and De Jong Gierveld Loneliness Scale (DJGLS, assessment of loneliness).ResultsA rise in BDI and an increase in the DJGLS score were predicted by having a sibling diagnosed with ASD. Those effects were independent of subjects’ sex, educational status, place of residence, or a number of siblings.ConclusionThe results underline a fundamental need for the development of mental hygiene programs for families where children with autism spectrum are accompanied by healthy siblings.

Young children’s understanding of the epistemic and deontic meanings of ask and tell

The verbs ask and tell can be used both epistemically, referring to the flow of information, and deontically, referring to obligations through polite requests or commands. Some researchers suggest that children’s understanding of deontic modals emerges earlier than their understanding of epistemic modals, possibly because theory of mind is required to understand epistemic modals. In the current study, 184 children aged 3–6 years were presented with vignettes depicting epistemic and deontic asking and telling and were asked whether the speaker asked or told, followed by first-order theory-of-mind tasks. An emergence of both epistemic and deontic understanding was found at 5 years of age, and both were correlated with children’s theory-of-mind understanding. These findings are consistent with arguments that both epistemic and deontic understanding implicate theory-of-mind awareness and provide insight into the developmental trajectory of children’s understanding.

Expedited epilepsy surgery prior to drug resistance in children: a frontier worth crossing?

Epilepsy surgery is an established safe and effective treatment for selected candidates with drug-resistant epilepsy. In this opinion piece, we outline the clinical and experimental evidence for selectively considering epilepsy surgery prior to drug resistance. Our rationale for expedited surgery is based on the observations that (i) a high proportion of patients with lesional epilepsies (e.g. focal cortical dysplasia, epilepsy-associated tumours) will progress to drug resistance; (ii) surgical treatment of these lesions, especially in non-eloquent areas of brain, is safe; and (iii) earlier surgery may be associated with better seizure outcomes. Potential benefits beyond seizure reduction or elimination include less exposure to antiseizure medications, which may lead to improved developmental trajectories in children and optimize long-term neurocognitive outcomes and quality of life. Further, there exists emerging experimental evidence that brain network dysfunction exists at the onset of epilepsy, where continuing dysfunctional activity could exacerbate network perturbations. This in turn could lead to expanded seizure foci and contribution to the comorbidities associated with epilepsy. Taken together, we rationalize that epilepsy surgery, in carefully selected cases, may be considered prior to drug resistance. Last, we outline the path forward, including the challenges associated with developing the evidence base and implementing this paradigm into clinical care.

Intergenerational Continuity of Risk: Examining Pathways From Parental Mental Health to Children’s Behavioral Health Problems Among Families Investigated for Maltreatment

Objective: Children exposed to maltreatment are a vulnerable population with disproportionately high rates of adverse outcomes, including internalizing and externalizing behavior problems. Parental risk characteristics, such as poor mental health, may help to explain the health and developmental trajectories of children who have experienced maltreatment. This study examined the hypothesis that specific parenting behaviors mediate the association between parental mental health and children’s behavioral health outcomes among families investigated for maltreatment. Method: We used data from parent interviews from Waves 1 and 3 of the National Survey of Child and Adolescent Well-Being II (N = 1,192) to measure parenting behavior pathways from parental mental health to children’s behavioral health. Results: Path analyses indicated statistically significant direct effects of poor parental mental health on neglectful, psychologically aggressive, and physically assaultive parenting and on children’s internalizing and externalizing behavior problems. We found statistically significant indirect effects from poor parental mental health to internalizing behavior problems through neglectful and psychologically aggressive parenting, and from poor parental mental health to externalizing behavior problems through psychologically aggressive parenting. Conclusion: Results suggest that specific parenting behaviors partially mediate the relationship between parental mental health and children’s behavioral health outcomes. Findings suggest the need to target specific parenting behaviors to reduce children’s internalizing and externalizing behavior problems and promote health and development across generations.