Problems In Preschool-aged Children Research Articles

Gestational phthalate exposure and behavioral problems in preschool-aged children with increased likelihood of autism spectrum disorder

BackgroundExperimental studies have shown associations between gestational phthalate exposure and behavioral problems among offspring; however, epidemiological evidence is still mixed. This study aims to investigate whether gestational phthalate exposure is associated with behavioral problems in preschool-aged children. MethodsParticipants include 178 mother-child pairs from MARBLES (Markers of Autism Risk in Babies – Learning Early Signs), a cohort with high familial likelihood of autism spectrum disorder (ASD). We quantified 14 phthalate metabolites in multiple maternal urine samples collected during the 2nd and 3rd trimesters. Preschool behavior problems were assessed using the Child Behavioral Checklist (CBCL), a standardized instrument for evaluating behavior problems of children aged 1.5–5 years. To examine associations of CBCL scores with both individual phthalate biomarker concentrations and their mixture, we used negative binomial regression and weighted quantile sum regression. ResultsOverall, maternal phthalate biomarker concentrations were not associated with child behavior problems. Monoisobutyl phthalate (MiBP) concentrations were inversely associated with child anxious/depressed symptoms and somatic complaints. Mono-hydroxy-isobutyl phthalate (MHiBP) and monobenzyl phthalate (MBzP) were also inversely associated with somatic complaints. When assessing trimester-specific associations, more behavior problems were associated with the 2nd trimester biomarker concentrations: mono(3-carboxypropyl) phthalate (MCPP) and monocarboxyisononyl phthalate (MCNP) were positively associated with somatic complaints. All associations became non-significant after false discovery rate correction. No association between a mixture of phthalates and CBCL scores was found. ConclusionsOur study observed no clear evidence of gestational phthalate exposure on child behavior problems. However, our findings based on the biomonitoring assessment of multiple samples per participant could improve our understanding of gestational phthalate exposure in association with behavior problems in preschool-aged children.

Scoping Review: The Relationship between Screen Time and Behavioral Problems in Preschool-Age Children

Scoping Review: The Relationship between Screen Time and Behavioral Problems in Preschool-Age Children

Factors influencing children's emotional and behavioral problems perceived by North Korean refugee mothers: a descriptive study.

The study investigated the relationships between key variables, including the level of parenting knowledge, acculturative stress, depression, and the strengths and difficulties associated with their children's emotions and behavior, among North Korean refugee mothers who faced the challenging task of adapting to Korean society while raising their children. A descriptive study design was used. Data were collected from 130 North Korean refugee mothers between September and November 2023. The participants had very limited parenting knowledge, and 82.3% of them scored 21 or higher on the depression scale used in community epidemiological studies. Higher levels of parenting knowledge and lower levels of depression were associated with lower levels of acculturative stress. Moreover, higher levels of depression were associated with more emotional and behavioral difficulties in children. Maternal depression, age, and employment status were identified as factors that influenced emotional and behavioral problems in preschool-aged children. These findings underscore the importance of providing parent education and mental health support programs for North Korean refugee families in order to improve parents' parenting skills and emotional well-being.

Sleep Habits and Behavioral Problems in Preschool-aged Children with ADHD

Objective: This study aimed to investigate the relationship between sleep habits and behavioral problems in preschool-aged children with ADHD. Materials and Methods: A cross-sectional study was conducted in a child developmental clinic at Siriraj Hospital between October and December 2023. Parents of children aged 4-6 years with ADHD completed the Children’s Sleep Habits Questionnaire (CSHQ) and the Strengths and Difficulties Questionnaire (SDQ). Descriptive analysis, Pearson correlation, and multivariate linear regression analysis were used to examine the association between sleep habits and behavioral problems. Results: This study recruited 80 preschoolers with ADHD and 75% were boys. The mean total CSHQ score was 43.76 ± 7.38 and 40% of the participants had sleep problems. 31.3 % had clinically significant behavioral problems. The most common behavioral problems were hyperactivity (33.8%), emotional problems (16.3%), and conduct behavior (10%). More sleep disturbances were highly correlated with all behavioral problems in SDQ, with a Pearson correlation between 0.78 and 0.90. After multivariate regression analysis, the total CSHQ score remained the strongest predictor of all domains of behavioral problems in preschool-aged children with ADHD (p < 0.05). Conclusion: More than 1/3 of preschool children with ADHD were affected by sleep disturbances. Furthermore, sleep problems in these children can contribute to significant behavioral problems. Therefore, the treatment of ADHD in preschoolers should always include the management of sleep disturbances.

The Relationship Between Parental Education Level And Dental And Oral Health Parenting In Preschool-Aged Children Aisyiyah 1 Pangkajene Kindergarten Maritengngae District Sidenrenng Rappang Regency In 2023

Teeth in preschoolers are generally still deciduous teeth with tooth structure and morphology that are prone to tooth cavities. The prevalence of dental and oral health problems in preschool-age children is still high due to their wrong brushing habits and the habit of frequently consuming karyogenic foods. In addition, this is where children are still very dependent on parents in terms of maintaining cleanliness and dental health. This study aims to determine the relationship between parents' education level and dental and oral health parenting for preschool children of Aisyiyah 1 Pangkajene Kindergarten, Maritengngae District, Sidenreng Rappang Regency in 2023. This type of study is a correlational descriptive and sampling is a total sampling of 43 child samples using univariate data analysis formulas (percentage, distribution and frequency) and bivariate data analysis formulas (chi square test). Using the square test we get a value of 0.008. Therefore the value of p = 0.008 < (0.05) (α). In the research hypothesis that Ho was rejected and Ha was accepted, which means that there is a relationship between parents' education level and children's dental and oral health parenting.

Early and stable difficulties of everyday executive functions predict autism symptoms and emotional/behavioral problems in preschool age children with autism: a 2-year longitudinal study.

Longitudinal studies of autistic children show that autism symptoms and emotional/behavioral problems vary and change over time. However, the factors that affect this variability remain far from certain and very little is known about what take place in the preschool period and the role of executive functions (EF). Here, we test the influence of stable difficulties in everyday executive functioning (EEF) during early childhood across 2 years on autistic symptoms and emotional and behavioral problems. Twenty-nine autistic children (24 males and 5 females) were assessed twice within the space of 2 years. At baseline (M = 29 months, SD =5.6 months), participants were assessed for EEF, cognitive development, autistic symptoms, and emotional/behavioral problems. At follow-up, we repeated the same assessment except for cognitive development. The group with stable difficulties (across 2 years) in EEF during early childhood showed a worsening in the severity of autistic symptoms and emotional and behavioral problems compared with children without EEF difficulties (p < 0.05), and these effects cannot be attributable to cognitive development. Our results suggest that early and stable EEF plays the role of a modifier by interacting with the core domains of autism, in particular with the social affect domain (SA CSS), influencing social cognition and exacerbating or lessening symptom expression and emotional behavioral problems. These short-term longitudinal and preliminary findings underscore the importance of EEF as necessary target for early intervention in children with autism.

Neural and behavioral indicators of cognitive control in preschoolers with and without prenatal opioid exposure

ABSTRACT Prenatal opioid exposure is one consequence of the opioid epidemic, but effects on child development remain poorly understood. There is emerging evidence that children exposed to opioids in utero exhibit elevated emotional and behavioral problems, which may be partially due to alterations in cognitive control. Using multiple methods (i.e., neuropsychological, behavioral, and event-related potential [ERP] assessments), the present study examined differences in emotional, behavioral, and cognitive control difficulties in preschool-aged children with (n = 21) and without (n = 23) prenatal opioid exposure (M age = 4.30, SD = 0.77 years). Child emotional and behavioral problems were measured with a caregiver questionnaire, indicators of cognitive control were measured using developmentally appropriate behavioral (i.e., delay discounting, Go/No-Go) and neuropsychological (i.e., Statue) tasks, and electroencephalogram was recorded to error and correct responses in a Go/No-Go task. ERP analyses focused on the error-related negativity (ERN), an ERP that reflects error monitoring, and correct-response negativity (CRN), a component reflecting performance monitoring more generally. Opioid exposure was associated with elevated difficulties across domains and a blunted ERN, reflecting altered cognitive control at the neural level, but groups did not significantly differ on behavioral measures of cognitive control. These result replicate prior studies indicating an association between prenatal opioid exposure and behavioral problems in preschool-aged children. Further, our findings suggest these differences may be partially due to children with prenatal opioid exposure exhibiting difficulties with cognitive control at the neural level. The ERN is a potential target for future research and intervention efforts to address the sequelae of prenatal opioid exposure.

Sleep and behavioral problems in preschool-age children with Down syndrome

Sleep is a major concern, especially in people with Down Syndrome (DS). Beyond Obstructive Sleep Apnea, a number of other sleep difficulties have been reported in children with DS, such as delayed sleep onset, night-time awakenings, and early morning awakenings. The detrimental effect of sleep difficulties seems to contribute to and exacerbate the cognitive and behavioral outcomes of DS. Although the screening for sleep disorders is recommended early in age in DS, only a few studies have evaluated the sleep profile in preschool-age children with DS. The aim of the current study was to assess the association between sleep disturbances and behavioral problems in a group of preschool-age children with DS, by means of a feasible and easy-to-administer parent-report questionnaires. Seventy-one preschool-age children with DS, ranging in age from 3 to 5.11 years, were included in this retrospective study. Sleep disturbances were evaluated by means of the Sleep Disturbance Scale for Children, while emotional and behavioral problems by means of the Child Behavior Checklist. Sleep breathing disorders were the most frequent sleep difficulties reported by parents. Moreover, children with clinical scores in total sleep problems exhibited elevation of psychopathological symptoms, namely Total problems, Affective problems, Anxiety problems, Pervasive Developmental Problems, and Attention Deficit/Hyperactivity Problems. The identification of the broader connection between sleep difficulties and emotional and behavioral problems in preschool-age children with DS leads to important considerations for intervention.

Affective problems, gastrointestinal symptoms, sleep problems, and challenging behaviour in children and adolescents with autism spectrum disorder

BackgroundPeople with autism spectrum disorder (ASD) can experience affective problems, gastrointestinal (GI) symptoms, sleep problems, and challenging behaviour. This study identified the frequency of affective problems and explored how they related to co-occurring conditions in children and adolescents with ASD. MethodParticipants were children and adolescents diagnosed with ASD using DSM-IV-TR criteria (n = 95), 40 % (n = 38) of whom also had a diagnosis of intellectual disability (ID). The following scales were completed by the participants’ parents or guardians: Child Behaviour Checklist (CBCL), Gastrointestinal Symptoms Inventory, Children’s Sleep Habits Questionnaire (CSHQ), and the Behaviour Problems Inventory-Short Form (BPI-S). Pearson’s correlations and independent sample t-tests were used to examine the relationships between variables. Two hierarchal multiple regressions examined predictors for affective problems in preschool and school-aged children with ASD. ResultsParticipants scored in the clinical range (69.5 %) and borderline range (10.5 %) for affective problems. Significant positive relationships were found between affective problems and sleep problems, GI symptoms, and challenging behaviour. ID and gender predicted affective problems in preschool aged children. In school-aged children, affective problems were predicted by ID, sleep problems, and aggressive/destructive behaviour severity. However, only 25 % of the variance in affective problems was accounted for. ConclusionsFuture research is needed to understand how affective problems are impacted by co-occurring conditions in children and adolescents with ASD. Affective problems are prevalent in this population and the quality of life for individuals may be improved if practitioners consider co-occurring conditions during clinical practice.

Salivary oxytocin after play with parents predicts behavioural problems in preschool children

BackgroundOxytocin (OXT) has attracted research interest for its potential involvement in many of the behavioural problems observed in childhood. Due to its logistical advantages, saliva is an attractive fluid to quantify neuropeptides in children. Salivary OXT has been suggested as a potential biomarker for psychopathology during childhood. However, several questions still remain about the extent to which, and under what conditions, concentrations of OXT in saliva can be reliably measured and are related to behavioural problems in preschool age children. MethodsSeven samples of saliva from 30 preschool children (17 girls) were collected in five different days at their homes. Three of the samples were collected by the children's parents at baseline daily routine conditions, and four of the samples were collected by researchers during two home-visits: before and after two 15-minute dyadic play sessions (one with mothers and one fathers) between each individual parent and the child. Oxytocin concentrations were quantified by Radioimmunoassay with prior extraction. Children's behavioural problems were assessed by the Caregiver-Teacher Report Form (C-TRF) questionnaire, completed by the child's’ preschool teacher. ResultsSalivary OXT measured in baseline samples could not predict any of the behavioural problems measured by the C-TRF. However, when measured after playing with parents salivary OXT showed a stronger pattern of negative correlations, specially with the depression and opposition scales of the C-TRF. Furthermore, salivary OXT was unlikely to be reliably measured using single sampling, but acceptable reliabilities were achieved when averaging several samples. Finally, the single measures of salivary OXT evoked after an episode of play with parents showed better reliabilities than collected at baseline. ConclusionMeasurements of OXT evoked after positive affect interactions with parents seem to capture aspects of the OXT system in young children that might be relevant for understanding the role of this system in children’s social behaviour.

Sleep and social-emotional problems in preschool-age children with developmental delay.

Sleep problems and social-emotional (SE) problems are common in preschooler children and may be affected by culture. However, little is known about the link between sleep and social-emotional problems in non-Western countries. This study aims to compare sleep problems and their association with SE problems in Turkish children with either typical development (TD) or neurodevelopmental delay (NDD). In this case-control study, children with NDD (n = 126) and children with TD (n = 102) were included. Parents completed the Children's Sleep Habits Questionnaire (CSHQ), and the Ages and Stages Questionnaire: Social-Emotional (ASQ:SE). More than half of the TD and NDD groups had sleep problems when assessed by CSHQ (54.4%, 72.2%, respectively). Thecorrelation between CSHQ and ASQ:SE scores in the NDD and TD groups was r = 0.44 and r = 0.352, respectively (both p < 0.001). Children who slept less than 9 h had lower ASQ:SE scores in the NDD (p = 0.003) and TD group(p = 0.023). In the TD group, those who slept after 23:01h had lower ASQ:SE scores compared to early sleepers (p = 0.04). Multivariate analysis revealed associations between SE problems and male gender, lower family income, bedtime resistance, and shorter sleep duration in the NDD group. In the TD group, male gender, sleep onset delay, sleep duration of CSHQ subscale were found to be associated with SE problems. Sleep problems were identified in more than half of all preschooler children, regardless of developmental delay, and were associated with increased SE problems.Interventions to correct sleep problems may have a positive impact on children's emotional development.

Parental Food Beliefs on Pre-School-Aged Children in Kaski District of Nepal: A Qualitative Review

Background: This study explores food beliefs among poor mothers related to feeding their offspring. Mothers’ misconception of a healthy diet is one of the major causes of nutritional problems in preschool-aged children in Nepal and these beliefs and attitudes can result in the inappropriate feeding of young children. Objectives: The main objectives of this study were: • identify major barriers for recommending healthy food that are associated with existing cultures, religions and ethnic divisions; • assess the knowledge, attitudes, and beliefs about nutritious food amongst mothers; • assess health-seeking behaviour for children of low socio-economic status. Methods: Study used a qualitative focus group discussion. Fifty participants took part in seven focus groups to explore their food beliefs. The qualitative focus groups aimed to collect in-depth information around food beliefs and data were thematically analysed. Results: The study identified six key themes: (a) poverty; (b) knowledge; (c) policy; (d) beliefs about breastfeeding; (e) food beliefs: and (f) health-seeking behaviours/cultural influences. Many participants thought that illiterate and underserved populations are generally exposed due to financial scarcity, poor knowledge and strongly rooted in cultural practices, and beliefs. This study found ‘diversified views’ as a major barrier to food and health-seeking behaviours. Some groups recognised the negative effects of existing beliefs and taboos. However, the spiritual healers highlighted the importance of linking beliefs with cultural and religious norms and values. They showed the complex relationships between food and health-seeking behaviours and food recommendations with financial status and the perceived cultural practices of society. Conclusions: This study suggests that a public health approach is needed to address nutrition problems associated with behaviour and revealed major barriers which were associated with poverty, resources, and mothers’ education level.

70.1 PARENTING STRESS AND EMOTIONAL AND BEHAVIORAL DIFFICULTIES IN PRESCHOOLERS: THE IMPORTANCE OF FOCUSING ON PARENT GOALS, VALUES, AND TREATMENT PREFERENCES

Child emotional and behavioral problems are common in primary and community health care settings, with prevalence estimated at 18%. Known psychosocial risk factors for child emotional and behavioral difficulties include low socioeconomic status, parental history of adverse childhood experiences, and parental mental health problems. Modifiable risk factors, such as parenting stress, deserve closer examination as potential targets of intervention. This presentation offers a clinical approach to early identification and management of mental health problems in preschool-aged children from families with few identifiable psychosocial risk factors.

The impact of maternal personality traits on behavioral problems in preschool-aged children: a population-based panel study in South Korea.

The impact of maternal personality traits on offspring behavioral problems has not been well established. In our study, the association between maternal personality traits and behavioral problems in preschool-aged children was investigated. A total of 192 preschoolers with their mothers, who were part of a population-based panel study in South Korea, were included in the present study. Maternal personality traits were assessed by the Personality Assessment Inventory (PAI) when the children were 1year old. The Child Behavior Checklist (CBCL) 1.5-5 was used to identify behavioral problems in the children at 4 and 5years of age. Maternal personality (borderline, somatization) positively correlated with behavioral problems (externalizing, internalizing, and dysregulation) in children. Maternal paranoid personality trait correlated with children's internalizing and dysregulation behavioral problems. Multiple linear regressions showed that maternal borderline trait significantly predicted children's externalizing (B = 0.302, P = 0.001), internalizing (B = 0.211, P = 0.020), and dysregulation problems (B = 0.327, P < 0.001). Similarly, maternal somatization trait predicted children's internalizing problems (B = 0.291, P < 0.001). Maternal borderline and somatization traits showed association with children's behavioral problems. Psychological intervention and support for mothers with these personality traits may be helpful in raising children with behavioral problems.

Reducing Aggression Using a Multimodal Cognitive Behavioral Treatment Approach: A Case Study of a Preschooler With Oppositional Defiant Disorder

Individual cognitive behavioral therapies (CBT) have been shown to be effective in decreasing disruptive behaviors in children and adolescents; however, less is known regarding their efficacy with preschoolers given the developmental limitations accompanying this age range. The current case study extends the use of individual CBT to a preschool aged girl with oppositional defiant disorder (ODD), and is the first to investigate its efficacy in combination with behaviorally-based parent training and classroom teacher consultation. A total of 18 CBT sessions with the child and her parents, in addition to school observations and on-site and phone consultations with teachers, were conducted over a 4-month period. Post-treatment and 2-month follow-up assessments demonstrated significant decreases in physical aggression and property destruction, as well as for parent and teacher reported internalizing and externalizing symptoms. Collectively, results of the case study provide preliminary evidence that a multimodal approach can be applied effectively to treat behavioral problems in preschool-age children.

Meta-Analysis on Parent-Teacher Agreement on Preschoolers' Emotional and Behavioural Problems.

Based on a meta-analysis, this study aimed to examine cross-informant agreement between parents and teachers about Internalizing, Externalizing and Total Problems in preschool children using community and clinical samples and to test the effects of the type of sample, the measure used for assessments, and child sex on agreement between informants. The meta-analysis involved 23 studies assessing cross-informant agreement for preschool children. Informants were parents and teachers. The level of cross-informant agreement tended to be low. Meta-regression analyses showed that the child's sex, the type of sample, and the measure used for assessments did not predict the level of cross-informant agreement on emotional and behavioural problems. The findings were in line with previous research results. Furthermore, the studied variables did not contribute to the prediction of agreement, suggesting the development of further studies that focus on other variables that may interfere with agreement in informants' reports and will contribute to explaining different ratings of internalizing and externalizing problems in preschool-aged children.

Relationship between non-cardiac chest pain and internalizing problems in pre-school aged children.

Non-cardiac chest pain is a common and persistent problem for children; yet, typically, there is no clear medical cause. To date, no behavioural and/or psychological factors have been studied to explain chest pain in a pre-school paediatric sample. We hypothesized that pre-school children with medically unexplained chest pain would have higher rates of behavioural problems compared to healthy controls. We assessed 41 pre-school children with non-cardiac chest pain and 68 age matched children with benign heart murmurs as the control group using the Child Behaviour Check List-1 1/2-5 to evaluate emotional and behavioural problems. Internalizing problem scores comprising emotionally reactive, anxiety/depression, and somatic complaints were higher in children with non-cardiac chest pain than in the control group. Among the possible factors, the factor that is related to behaviour problem scores, in univariate analysis, was a significant and inverse correlation between maternal education and behaviour problem scores. Also, maternal employment status was associated with behavioural problems. Children with a housewife mother were more susceptible to having such behavioural problems. Based on multiple regression analyses, being in the non-cardiac chest pain group was found to be significantly related to internalizing problems in our total sample. These results suggest that pre-school children with non-cardiac chest pain may experience increased levels of certain behavioural comorbidities. Systematic behavioural screening could increase the detection of behavioural problems and improve care for this population. Future studies of non-cardiac chest pain in pre-school children should include larger samples and comprehensive diagnostic assessments as well as long-term follow-up evaluations.

0338 Interactions Between Sleep, Stress Reactivity and Cognition in Early Childhood

Abstract Introduction During early childhood, sleep impacts the development of the cognitive, behavioral and stress systems. Specifically, acute sleep restriction reduces the subsequent cortisol awakening response, predicts self-regulation strategies and moderates correlations between self-regulation strategies and response inhibition. However, little is known about the interaction between sleep, stress reactivity and cognition in early childhood. This preliminary cross over study aimed to determine how acute sleep restriction moderates the relationship between stress reactivity and cognition in 4-year-olds. Methods Healthy children (N=17; 57.4 months +/- 2.1; 10 female) participated in a sleep restriction protocol that included counterbalanced cognitive and behavioral assessments during baseline and sleep restriction conditions. An age appropriate inhibitory control task was administered and salivary cortisol samples (N=6) were collected during the task. Mean processing speed was measured, and stress reactivity was computed as area under the curve with respect to ground (AUCg). Results Two tailed correlation analyses were performed to examine the relationship between AUCg and mean processing speed. Under baseline conditions, AUCg and mean processing speed were positively associated (r=0.45; p=0.05). When children were sleep restricted, there was no association between AUCg and mean processing speed (r=0.05; p=0.83). Although not statistically significant, AUCg was predicted by an interaciton between sleep condition and mean processing speed B=-1.92; p=0.06). Conclusion These results suggest that healthy sleep may promote the coupling of stress and cognitive systems, which is likely adaptive when facing life’s challenges in early childhood. Examining the developmental trajectory of these interactions and incorporating individual difference factors will build upon this model that may eventually be applied in intervention approaches to sleep, stress and behavioral problems in preschool-aged children. Support NIH R01-MH086566 to Dr. Monique LeBourgeois

Sleep Problems Influence Emotional/Behavioral Symptoms and Repetitive Behavior in Preschool-Aged Children With Autism Spectrum Disorder in the Unique Social Context of China.

Sleep disturbances are common in people with autism spectrum disorder (ASD), but research on this topic is still limited in China. In the current study, we evaluated the prevalence of sleep problems in preschool-aged children with ASD and to examine the correlations between sleep disturbances and emotional/behavioral symptoms and repetitive behavior in the unique social context of China. This study recruited 475 preschool-aged children aged 3–6 years old, including 252 children with ASD (mean age 5.13 ± 1.15, 80.6% male) and 223 age-matched typically developing (TD) children (mean age 5.12 ± 0.97, 74.9% male). The parents of all children completed a sociodemographic questionnaire and the Childhood Sleep Habits Questionnaire. The parents of 114 ASD children completed the Strengths and Difficulties Questionnaire (SDQ) and the Repetitive Behavioral Questionnaire-2 (RBQ-2). The prevalence of sleep problems in preschool-aged children with ASD in this study was 81.7%, which was higher than that in TD children (61.0%). The scores for bedtime resistance, sleep anxiety, sleep duration, parasomnias, and sleep onset delay in the ASD group were significantly higher than those in the TD group (t=−7.664, P=0.000; t=−10.477, P=0.000; t=−4.133, P=0.000; Z=−3.916, P=0.000; Z=−7.093, P=0.000; respectively). Sleep onset delay explained 17.3% of the variance (adjusted R2 = 0.173) in the total SDQ score of children with ASD, and bedtime resistance explained a large proportion of total RBQ-2 score variance (adjusted R2 = 0.206). The high rate of sleep disturbances in preschool-aged children with ASD emphasizes the importance of screening for sleep problems in this population. Attention should also be directed toward formulating good sleep hygiene practices for preschool-aged children in the particular social context and cultural setting of China.

White matter microstructure mediates the association between prenatal exposure to phthalates and behavior problems in preschool children

BackgroundPrevious research reports associations between prenatal exposure to phthalates and childhood behavior problems; however, the neural mechanisms that may underlie these associations are relatively unexplored. ObjectiveThis study examined microstructural white matter as a possible mediator of the associations between prenatal phthalate exposure and behavior problems in preschool-aged children. MethodsData are from a subsample of a prospective pregnancy cohort, the Alberta Pregnancy Outcomes and Nutrition (APrON) study (n = 76). Mother-child pairs were included if mothers provided a second trimester urine sample, if the child completed a successful magnetic resonance imaging (MRI) scan at age 3–5 years, and if the Child Behavior Checklist was completed within 6 months of the MRI scan. Molar sums of high (HMWP) and low molecular weight phthalates (LMWP) were calculated from levels in urine samples. Associations between prenatal phthalate concentrations, fractional anisotropy (FA) and mean diffusivity (MD) in 10 major white matter tracts, and preschool behavior problems were investigated. ResultsMaternal prenatal phthalate concentrations were associated with MD of the right inferior fronto-occipital fasciculus (IFO), right pyramidal fibers, left and right uncinate fasciculus (UF), and FA of the left inferior longitudinal fasciculus (ILF). Mediation analyses showed that prenatal exposure to HMWP was indirectly associated with Internalizing (path ab = 0.09, CI.95 = 0.02, 0.20) and Externalizing Problems (path ab = 0.09, CI.95 = 0.01, 0.19) through MD of the right IFO, and to Internalizing Problems (path ab = 0.11, CI.95 = 0.01, 0.23) through MD of the right pyramidal fibers. DiscussionThis study provides the first evidence of childhood neural correlates of prenatal phthalate exposure. Results suggest that prenatal phthalate exposure may be related to microstructural white matter in the IFO, pyramidal fibers, UF, and ILF. Further, MD of the right IFO and pyramidal fibers may transmit childhood risk for behavioral problems.