Early Childhood Poverty Research Articles

A scoping review of early childhood caries, poverty and the first sustainable development goal

BackgroundPoverty is a well-known risk factor for poor health. This scoping review (ScR) mapped research linking early childhood caries (ECC) and poverty using the targets and indicators of the Sustainable Development Goal 1 (SDG1).MethodsWe searched PubMed, Web of Science, and Scopus in December 2023 using search terms derived from SDG1. Studies were included if they addressed clinically assessed or reported ECC, used indicators of monetary or multidimensional poverty or both, and were published in English with no date restriction. We excluded books and studies where data of children under 6 years of age could not be extracted. We charted the publication year, study location (categorized into income levels and continents), children age, sample size, study design, measures of ECC, types and levels of poverty indicators and adjusted analysis. The publications were also classified based on how the relation between poverty and ECC was conceptualized.ResultsIn total, 193 publications were included with 3.4 million children. The studies were published from 1989 to 2023. Europe and North America produced the highest number of publications, predominantly from the UK and the US, respectively. Age-wise, 3–5-year-olds were the most studied (62.2%). Primary studies (83.9%) were the majority, primarily of cross-sectional design (69.8%). Non-primary studies (16.1%) included reviews and systematic reviews. ECC was mainly measured using the dmf indices (79.3%), while poverty indicators varied, with the most common used indicator being income (46.1%). Most studies measured poverty at family (48.7%) and individual (30.1%) levels. The greatest percentage of publications addressed poverty as an exposure or confounder (53.4%), with some studies using poverty to describe groups (11.9%) or report policies or programs addressing ECC in disadvantaged communities (11.4%). In addition, 24.1% of studies requiring adjusted analysis lacked it. Only 13% of publications aligned with SDG1 indicators and targets.ConclusionThe ScR highlight the need for studies to use indicators that provide a comprehensive understanding of poverty and thoroughly examine the social, political, and economic determinants and impact of ECC. More studies in low and middle-income countries and country-level studies may help design interventions that are setting- and economic context-relevant.

Socioeconomic Factors Determining Multidimensional Child Poverty Groups in Central America: A Measurement Proposal from the Wellbeing Approach Using a Comprehensive Set of Children’s Rights

This article aims to show that multidimensional child poverty (MCP) is determined by several socioeconomic factors that influence the formation of stratified groups of poor children under five years of age living in Central America. This study advocates for a comprehensive set of children's rights with the purpose of addressing the different facets of child poverty from the perspective of child well-being, in order to estimate the incidence of MCP, by including multiple childhood deprivations and socioeconomic determinants. Child-specific indicators and household deprivation indicators are considered in the estimation of MCP. The study also states that child poverty is a complex concept, which includes the various types of deprivations experienced by children in the Central American societies and their deprivations are considered as the denial of children’s rights. Therefore, the MCP is estimated based on a conditional latent class analysis that includes not only manifest deprivation variables, but also socioeconomic determinants that help to better predict the incidence and probabilities of children being multidimensionally poor according to different poverty strata. The socioeconomic factors that show high risks of MCP are rural areas, indigenous children, young mothers and low levels of education attained by the head of the household, among others. One of the reasons to investigate the MCP for Belize and El Salvador is because there are few studies that address this problem for these countries and this research sheds light on the characteristics of early childhood poverty. The results indicate that the incidence of MCP is 49% in Belize and 76% in El Salvador. The research work concludes that the International Rights of the Child provide the opportunity to implement comprehensive social policies in Central America to eradicate child poverty.

The impact of poverty and socioeconomic status on brain, behaviour, and development: a unified framework.

In this article, we, for the first time, provide a comprehensive overview and unified framework of the impact of poverty and low socioeconomic status (SES) on the brain and behaviour. While there are many studies on the impact of low SES on the brain (including cortex, hippocampus, amygdala, and even neurotransmitters) and behaviours (including educational attainment, language development, development of psychopathological disorders), prior studies did not integrate behavioural, educational, and neural findings in one framework. Here, we argue that the impact of poverty and low SES on the brain and behaviour are interrelated. Specifically, based on prior studies, due to a lack of resources, poverty and low SES are associated with poor nutrition, high levels of stress in caregivers and their children, and exposure to socio-environmental hazards. These psychological and physical injuries impact the normal development of several brain areas and neurotransmitters. Impaired functioning of the amygdala can lead to the development of psychopathological disorders, while impaired hippocampus and cortex functions are associated with a delay in learning and language development as well as poor academic performance. This in turn perpetuates poverty in children, leading to a vicious cycle of poverty and psychological/physical impairments. In addition to providing economic aid to economically disadvantaged families, interventions should aim to tackle neural abnormalities caused by poverty and low SES in early childhood. Importantly, acknowledging brain abnormalities due to poverty in early childhood can help increase economic equity. In the current study, we provide a comprehensive list of future studies to help understand the impact of poverty on the brain.

Experiences of Adversity and Validity of Baseline Concussion Testing.

Neurocognitive testing is a critical tool in the management of sport-related concussions. Adversity during childhood and adolescence affects cognitive tasks, behavioral outcomes, and academic performance. Adversity may be important in baseline concussion test validity as well; however, the influence of these experiences is not well understood. To examine the relationship between individual-level experiences of adversity and baseline test validity of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). We hypothesized that experiences of poverty, maltreatment, or extreme neighborhood deprivation would be associated with lower odds of baseline test validity. Case-control study. Cuyahoga County, Ohio. A total of 6495 student-athletes born from 1995 through 2005 who completed a baseline ImPACT test between 10 and 18 years old and were identified in the Child-Household Integrated Longitudinal Data system, a comprehensive data system with demographic and social service usage outcomes for children in Cuyahoga County, Ohio. Baseline concussion test validity was determined using the ImPACT built-in validity measure. Experiences of adversity during the sensitive developmental periods of early childhood and adolescence were key independent variables. Our findings suggested that social mobility may play an important role in baseline validity. Youth with upward social mobility (ie, poverty or neighborhood deprivation in early childhood only) were not different from youth without such experiences (odds ratio [OR] = 0.91, P = .74). Youth with persistent adversity across childhood or downward social mobility (ie, poverty or high neighborhood deprivation in adolescence only) had 50% to 72% lower odds of achieving a valid baseline test (persistent poverty, OR = 0.59, P = .05; adolescent poverty only, OR = 0.50, P = .004; adolescent neighborhood deprivation only, OR = 0.28, P < .001). Maltreatment had no significant effect on test validity. These findings indicated that certain patterns of adversity may predispose youth to invalid baseline testing scores, potentially increasing their risk of inappropriate injury management and poor outcomes.

Childhood Factors Associated With Unnatural Death Through Midadulthood

Life expectancy is decreasing in the US. Without national efforts to address factors that support policies and programs directed at children living in areas of concentrated poverty, life expectancy will likely continue to decline while costs and suffering associated with unnatural deaths will increase. To identify which childhood factors are associated with death from unnatural causes through midadulthood. For this cohort study, longitudinal data on childhood characteristics came from a group-randomized intervention trial implemented in Baltimore City Public Schools, Baltimore, Maryland (baseline 1985-1986; all students entering first grade were selected to participate at age 6 years). Participants were followed up to midadulthood with a National Death Index search through December 31, 2020. Data analysis was performed from February to May 2023. Exposures included individual factors (ie, sociodemographic characteristics, teacher-reported aggressive behavior, self-reported depression, anxiety, early alcohol and cannabis use, and assaultive violence exposure), family and peer factors (ie, household structure and education level, deviant peer affiliation, and parental monitoring), and neighborhood factors (ie, rates of neighborhood assault and public assistance). The main outcome was unnatural death, defined as death due to unintentional injury, suicide, and homicide. A National Death Index search ascertained participants who died by age 41 to 42 years and cause of death. Multivariable Cox proportional hazards models were used to identify whether the exposures were independently associated with future mortality by unnatural causes. The initial trial included 2311 children, and longitudinal data were available for 2180 participants (median [IQR] age in first grade, 6.3 [6.0-6.5] years; 1090 female [50.0%]; 1461 Black [67.0%]; 1168 received free or reduced lunch in first grade [53.6%]). A total of 111 male participants (10.2%) and 29 female participants (2.7%) died; among those who died, 96 male participants (86.5%) and 14 female participants (48.3%) died of unnatural causes. Two factors remained significantly associated with mortality from unnatural causes: female sex was associated with reduced risk (hazard ratio, 0.13; 95% CI, 0.08-0.22), and neighborhood public assistance was associated with increased risk (hazard ratio, 1.89; 95% CI, 1.09-3.30). In this urban population-based cohort study, no modifiable risk factors of mortality at the level of the individual (eg, depression or anxiety and substance use) or the family (eg, household education level) were identified. However, the degree of neighborhood poverty in early childhood was significantly associated with death by unnatural causes in early adulthood, suggesting that economic policies are needed to advance health equity in relation to premature mortality.

The mediating role of child delay of gratification in the link between early and prolonged poverty exposure and adolescent allostatic load

Early and prolonged exposure to poverty disrupts biological processes associated with the body’s stress response system, leading to long-term negative health outcomes, including obesity, autoimmune disorders, and cardiovascular disease. Allostatic load (AL), a composite measure of chronic stress on the body, is a robust predictor of subsequent health outcomes. However, developmental research examining the associations of early poverty exposure with AL in adolescence, as well as the underlying mechanisms of influence is limited. Early poverty exposure also impedes healthy development of child self-regulation, which may increase risk for high AL in adolescence, but this mechanistic pathway has not yet been tested. We used data from the national Study of Early Child Care and Youth Development (SECCYD) to examine the longitudinal associations between prolonged poverty exposure in early childhood (0–3 years) and AL in adolescence (age 15). We also tested the mediating role of child delay of gratification, a behavioral measure of self-regulation (at age 54 months), in the potential association between early poverty exposure and adolescent AL. Accounting for model covariates (i.e., child biological sex and race-ethnicity) and individual differences in child delay of gratification, early and prolonged poverty exposure was significantly associated with higher AL at age 15. The indirect effect through child delay of gratification was not significant, but the individual pathways of the indirect effect were significant, and the overall direct association of early poverty exposure with adolescent AL was significant. Our findings show that prolonged exposure to poverty in early childhood (0–3 years) can have significant negative associations with both child delay of gratification (at 54 months) and AL (at age 15). Given that the detrimental impacts of poverty exposure can be detected at an early age, targeted prevention efforts (e.g., anti-poverty programs such as cash assistance programs) may be able to offset some of the risks of early poverty exposure on self-regulation and AL.

Caste-based analysis of multidimensional early childhood poverty in India: Patterns and determinants

Children are among the most vulnerable groups worldwide, bearing a disproportionate share of the burden of poverty. One-third of children, compared to one-sixth of adults, are multidimensionally poor. Experiencing poverty in childhood can have long-term negative consequences across generations. As a result, multidimensional poverty measures have recently been investigated in the child poverty literature. This study analysed multidimensional poverty among children (0–59 months) in India using the Alkire-Foster’s counting approach and looked into how it differs across the country’s well-known social stratification, the Caste system. The determinants of multidimensional child poverty (MCP) have been determined using multiple logistic regression. By using National Family Health Survey, 2019–21 data, the study revealed that the incidence of MCP in India is 32 %; highest among Scheduled Tribes (STs) (50 %), followed by Scheduled Castes (SCs) (37 %), Other Backward Classes (OBCs) (30 %) and ‘Others’ (22 %). Across all the Castes highest rates of deprivation were recorded in the indicators of standard of living and early childhood development (ECD) dimensions; together, they contribute more than 50 % to the MCP index (MCPI). The contribution of the water, sanitation, and hygiene (WASH) dimension in MCPI of STs is also noticeably higher (20.2 %). Of the 15 indicators considered, availability of TV/Radio, followed by immunisation, sanitation, cooking fuel, housing condition, and stunting, are the leading contributors with a combined contribution of more than 55 %. A child being a male, of higher birth order and born to a mother with higher years of schooling was more likely to experience multidimensional poverty. The household head’s sex, age, and years of schooling were significantly associated with MCP. Across all castes, children from nuclear families, 7 + household members, higher number of children per woman, rural areas, central, eastern and north-eastern (except STs) regions were more likely to experience multidimensional poverty.

Poverty in early childhood and future educational achievements

ABSTRACT This study examines whether family income in early childhood is related to achievements of Israeli students in standardized tests at primary school. We analyzed data from the Israeli censuses of 1995 and 2008, which include information on family income and socio-economic background of children along with data pertaining to their achievements in standardized tests taken in fifth-grade. The findings show that belonging to the lowest quintile of family disposable income in early childhood had a negative and significant effect on future educational achievements, controlling for family income in late childhood and other socio-demographic variables. Furthermore, the effect of family income was stronger when measured at birth – age two, than at ages 3–5. These findings are consistent with the claim that child development is most sensitive to environmental influences in the very first years of life.

Associations between early childhood poverty and cognitive functioning throughout childhood and adolescence: A 14-year prospective longitudinal analysis of the Mauritius Child Health Project.

Associations between childhood poverty and cognitive outcomes have been examined from multiple perspectives. However, most evidence is based on cross-sectional data or longitudinal data covering only segments of the developmental process. Moreover, previous longitudinal research has mostly relied on data from Western nations, limiting insights of poverty dynamics in low- and middle-income countries. Here, we use data from the Mauritius Child Health Project, a large-scale prospective longitudinal study conducted in a then low-income country, to examine long-term associations between poverty in early childhood and cognitive performance across childhood and adolescence. Poverty-related factors were assessed at age 3 years and comprised indicators of psychosocial adversity and malnutrition. Cognitive functioning was assessed at ages 3 and 11 years by using standardized intelligence measures and at age 17 years by means of a computerized test battery. Using multiple hierarchical regression models, we found that chronic malnutrition and parental characteristics showed similar-sized, independent associations with initial cognitive functioning at age 3 as well as at age 11 years. For age 17 years, however, associations with early childhood risk factors vanished and instead, cognitive functioning was predicted by performance on prior cognitive assessments. Sex was also found to be a powerful predictor of cognitive trajectories, with boys improving and girls worsening over time, regardless of the level of their initial exposure to risk. The current findings indicate that, to prevent cognitive impairment, interventions tackling poverty and malnutrition should focus on the infancy period and be designed in a gender-sensitive way.

The BabyTok Project: Examining the Feasibility and Acceptability of a Light-Touch Social Media Project for Infant-Toddler Teachers.

The online version contains supplementary material available at 10.1007/s10643-022-01426-y.

Coaching childcare providers to support toddlers’ gesture use with children experiencing early childhood poverty

Coaching childcare providers to support toddlers’ gesture use with children experiencing early childhood poverty

Cortisol across preschool day relates to teacher ratings of executive functioning for children facing economic hardship

Experiences of poverty and racism in early childhood can overburden physiological systems that respond to stress with implications for the development of the prefrontal cortex and related executive functioning. The present study is unique in its examination of basal cortisol output across the preschool day in relation to teacher ratings of executive functioning. Participants were 310 children attending Head Start preschool in the United States, a majority of whom were Black, Hispanic, or Asian Heritage. Salivary cortisol was sampled in duplicate at 4 times across 2 days near the beginning of the school year, resulting in a total of 16 samples per child. Several weeks later, the BRIEF-P teacher rating scale assessed various components of executive functioning. Zero-order correlations suggested that basal cortisol output across the preschool day related to each assessed component of executive functioning, as well as to composite scores. Results of hierarchical linear modeling indicated that higher cortisol across the preschool day related to greater difficulties in overall teacher-reported executive functioning, controlling for child age, birth-assigned sex, race/ethnicity, and family income. Implications concern understanding the impact of stress on executive functioning in the preschool classroom and promoting positive outcomes for children facing adversity.

A-44 Experiences of Adversity and Validity of Baseline Concussion Testing

Abstract Purpose: This study examined the relationship between individual-level experiences of social adversity and baseline computerized concussion testing validity (Immediate Post-Concussion Assessment and Cognitive Testing; ImPACT). Methods: This study involved 6495 student-athletes born between 1995 and 2005 who completed a baseline ImPACT test between 10 and 18 years old and could be identified in the Child-Household Integrated Longitudinal Data (CHILD) System, a continuously updated integrated and comprehensive data system that captures detailed individual-level demographic, social service usage, and educational outcomes on every child born or living in Cuyahoga County, Ohio from 1989 to present. Multivariable logistic regression models were conducted with experiences of SNAP/TANF enrollment, substantiated abuse or neglect incidents, and extreme neighborhood deprivation occurring in the sensitive developmental periods of early childhood and adolescence as key predictors of baseline test validity. Results: Our findings suggest that social mobility may play an important role in baseline validity. Youth with upward social mobility (poverty or neighborhood deprivation in early childhood only) were not significantly different than youth without such experiences (OR = 0.91, p = 0.74). Youth with persistent adversity across childhood or downward social mobility (poverty or high neighborhood deprivation in adolescence only) had 50–72% lower odds of achieving a valid baseline test (persistent poverty: OR = 0.59, p = 0.05; adolescent poverty only: OR = 0.50, p = 0.004; adolescent neighborhood deprivation only: OR = 0.28, p &amp;lt; 0.0001). Conclusions: These findings suggest certain patterns of social adversity may predispose youth to invalid computerized concussion baseline testing scores, potentially increasing their risk of inaccurate injury management and poor outcomes.

Early Childhood Development, Human Capital, and Poverty

Children's experiences during early childhood are critical for their cognitive and socioemotional development, two key dimensions of human capital. However, children from low-income backgrounds often grow up lacking stimulation and basic investments, which leads to developmental deficits that are difficult, if not impossible, to reverse later in life without intervention. The existence of these deficits is a key driver of inequality and contributes to the intergenerational transmission of poverty. In this article, we discuss the framework used in economics to model parental investments and early childhood development and use it as an organizing tool to review some of the empirical evidence on early childhood research. We then present results from various important early childhood interventions, with an emphasis on developing countries. Bringing these elements together, we draw conclusions on what we have learned and provide some directions for future research.

Early childhood hospitalization and problematic behaviors: A propensity score analysis.

Existing research suggests that children who experience poverty and hospitalization in early childhood are at risk of developing behavior problems. We examined whether the association between early childhood hospitalization and children's internalizing and externalizing behaviors were moderated by family poverty status and child sex. Participants included 224 children from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. There was no direct association between hospitalization and problematic behaviors. Poverty status during early childhood, but not child sex, significantly moderated the association between hospitalization and externalizing problems. Findings support the need for community programs that promote an integrative approach to healthcare for families experiencing poverty.

Coaching Childcare Providers to Support Toddlers' Gesture Use With Children Experiencing Early Childhood Poverty.

Purpose The purpose of this study is to examine the impact of an intervention in which childcare providers (CCPs) are coached to support toddlers' gesture use during every day classroom routines. Method This study uses a multiple-baseline across strategies single-case experimental design to examine the impact of a coaching intervention on three CCPs' use of communication strategies with toddlers experiencing early childhood poverty. The CCPs were coached with a systematic framework called Setting the Stage, Observation and Opportunities to Embed, Problem-solving and Planning, Reflection and Review as they learned to implement three strategies to support toddlers' gesture use-modeling gestures with a short phrase, opportunities to gesture, and responding/expanding child gestures. CCPs were coached during book sharing and another classroom routine of their choice. Social validity data on the coaching approach and on the intervention strategies were gathered from postintervention interviews. Results The visual analysis and nonoverlap of all pairs' effect size indicates that the coaching intervention had a functional relation with CCPs' use of modeling gestures and responding/expanding gestures during book sharing, play, and circle time. Social validity data indicate that CCPs found the coaching framework supportive of their learning and feelings of self-efficacy, and that the intervention strategies supported their toddlers' communication. Conclusions The coaching framework was used to increase CCP strategy use during everyday classroom routines with toddlers. CCPs endorsed the coaching approach and the intervention strategies. This study adds to the literature supporting efforts to enhance children's earliest language learning environments. Supplemental Material https://doi.org/10.23641/asha.14044055.

Early childhood poverty and adult executive functioning: Distinct, mediating pathways for different domains of executive functioning.

Executive functioning in adulthood is associated with early-in-life disadvantage. Furthermore, distinct and independent underlying processes account for differences in specific domains of adult executive functioning. The duration of poverty from birth to age 9 is associated with reduced adult inhibitory control assessed by the Flanker task (n=233, M=23.52years). This effect is largely explained by lower levels of maternal responsiveness in adolescence. Early poverty also related to worse working memory in adulthood, and this effect is partially explained by elevated allostatic load during adolescence, an index of chronic physiological stress.

Mechanisms that mitigate the effects of child poverty and improve children's cognitive and social–emotional development: A systematic review

AbstractThe negative effects of poverty on children's development have been examined in many studies. Poverty exerts its influence on children indirectly through mediating pathways, some of which have powerful effects in reducing the impact of early economic deprivation. However, the literature on the mediating mechanisms through which poverty operates and influences children's cognitive and social–emotional development is limited. This review provides a systematic analysis of published and unpublished studies that investigate mediating mechanisms that have been found to be effective in reducing the effects of early childhood poverty and in improving children's cognitive and social–emotional development. The findings of this review suggest that positive parenting and cognitively stimulating home environments have the potential to enhance the developmental outcomes of children living in poverty—in particular, educational materials including books and computers and home learning activities such as reading and counting are salient for the outcomes of children living in poverty. Findings on the effects of early childhood programmes for low‐income children's development and well‐being are also discussed.

Multidimensional Child Poverty in Ghana: Measurements, Determinants, and Inequalities

Early childhood deprivations and inequalities have social and economic implications in adulthood and thus, their elimination is essential for child development. However, child-level estimates of poverty are rare in low income countries. Using data from two recent rounds of the Ghana Demographic and Health Survey, we measure the extent and sources of childhood deprivations in Ghana and examine subgroup differentials in child poverty. In addition, we examine the child quality-quantity by estimating the causal relationship between number of children and child poverty. Finally, we assess the sources of rural-urban inequalities in child poverty. We find that despite declining incidence and intensity of multidimensional child poverty, significant subgroup differentials persist in Ghana. The findings of the paper reveal that living standards is the main contributor to multidimensional poverty in early childhood in Ghana. Our findings also confirm a significant causal relationship between child quality and quantity in Ghana, there exist a positive relationship between the number of children and the intensity of child poverty in Ghana. Finally, we find that rural-urban inequalities in child multidimensional poverty in Ghana are attributable to differences in observed maternal and household characteristics between rural and urban areas. The persistence of subgroup disparities in child poverty may be detrimental to achieving equitable and inclusive growth in the country. There is the need for considerations of equity, fairness and social justice in the distribution and development of social services and economic infrastructure to ensure even distribution of social and economic opportunities and promote social mobility across groups.

Poverty and Food Insecurity Predict Mealtime Structure: Mediating Pathways of Parent Disciplinary Practices and Depressive Symptoms.

Structured, well-organized mealtime routines can provide many physical and mental health benefits for children. Poverty and food insecurity (FI) are socioeconomic risk factors for less effective mealtime routines. However, the specific mechanisms by which these social factors may negatively impact mealtime structure are not well-understood. We test whether poverty and FI are associated with parenting factors (mental health and parent disciplinary practices), and whether these parenting factors in turn associate with less mealtime structure. Low-income families (N = 270), recruited when children were approximately 6-years-old (wave 1), were followed for 2 years (wave 2). Socioeconomic and parenting factors were assessed at W1 via parent-report. Associations of poverty and FI with two measures of mealtime structure (parent-reported and observed mealtime structure at wave 1 and wave 2), mediated by parent factors (depressive symptoms, lax and overreactive parent disciplinary practices) were assessed in separate path analyses. The association between higher depth of poverty and less mealtime structure in early childhood was mediated by greater parent depressive symptoms. FI was associated with less mealtime structure in early childhood, mediated by overreactive parenting, and with less mealtime structure in early and mid-childhood, mediated by lax parenting. Poverty and food insecurity may contribute to suboptimal parent disciplinary practices and poor parent mental health, which may reduce mealtime structure for children. Addressing parent mental health and parent disciplinary practices in the context of socioeconomic adversity may be one way in which interventions can improve mealtime structure for low-income families.