Maternal major depression during early pregnancy is associated with impaired child executive functioning at 4.5 years of age.

BACKGROUND: Maternal depression is a serious condition that affects up to 1 in 7 pregnancies. Despite evidence linking maternal depression to pregnancy complications and adverse fetal outcomes, there remain large gaps in its identification and treatment. More work is needed to define the specific timing and severity of depression that most urgently requires intervention, where feasible, to protect maternal health and the developing fetus. OBJECTIVE: This study aimed to examine whether the timing and severity of maternal depression and/or anxiety during pregnancy affect child executive functioning at age 4.5 years. Executive functioning in the preschool years is a strong predictor of both school readiness and long-term quality of life. STUDY DESIGN: This longitudinal observational pregnancy cohort study included a sample of 323 mother-child dyads taking part in the Ontario Birth Study, an open pregnancy cohort in Toronto, Ontario, Canada. Maternal symptoms of depression and anxiety were assessed at 12 to 16 and 28 to 32 weeks of gestation and at the time of child testing at age 4.5 years using the 4-item Patient Health Questionnaire. Child executive functioning was measured during a home visit using standardized computerized administration of the Flanker test (a measure of attention) and the Dimensional Change Card Sort (a measure of cognitive flexibility). Stepwise linear regressions, controlling for possible confounding variables, were used to assess the predictive value of continuous measures of maternal depression and/or anxiety symptoms at each assessment time on the Flanker test and Dimensional Change Card Sort. Posthoc general linear models were used to assess whether maternal depression severity categories (no symptom, mild symptoms, or probable major depressive disorder) were helpful in identifying children at risk. RESULTS: Across all children, after controlling for potential confounds, greater maternal depressive symptoms at weeks 12 to 16 weeks of gestation predicted worse performance on both the Flanker test (ΔR2=0.058; P<.001) and the Dimensional Change Card Sort (ΔR2=0.017; P=.018). Posthoc general linear modeling further demonstrated that the children of mothers meeting the screening criteria for major depression in early pregnancy scored 11.3% lower on the Flanker test and 9.8% lower on the Dimensional Change Card Sort than the children of mothers without maternal depressive symptoms in early pregnancy. Mild depressive symptoms had no significant effect on executive function scores. There was no significant effect of anxiety symptoms or maternal antidepressant use in early pregnancy or pandemic conditions or maternal symptoms in later pregnancy or at the time of child testing on either the Flanker or Dimensional Change Card Sort results. CONCLUSION: This study demonstrated that fetal exposure to maternal major depression, but not milder forms of depression, at 12 to 16 weeks of gestation is associated with impaired executive functioning in the preschool years. Child executive functioning is crucial for school readiness and predicts long-term quality of life. This emphasizes an urgent need to improve the recognition and treatment of maternal major depression, particularly in early pregnancy, to limit its negative effects on the patient and on child cognitive development.

Linking early maternal input during shared reading to later theory of mind through receptive language and executive function: A within- and between-family design.

This study explored whether early maternal input during shared reading predicted later theory of mind (ToM) understanding through children's receptive language and executive function (EF). Maternal input plays a prominent role in the development of children's language skills, which are crucial for both EF and ToM development. There is also an abundance of behavioral evidence suggesting a directional link from EF to ToM. This relation raises the possibility of a cognitive cascade in which maternal input during shared reading promotes ToM development sequentially through receptive language and EF. The sample included 656 children clustered within 328 ethnically and sociodemographically diverse families. The shared reading sessions occurred when the younger and older siblings were 1.5 and 4 years old, respectively. Receptive language, EF, and ToM were measured when the siblings were approximately 5 years old to account for age differences. Multilevel modeling using Bayesian estimation was used to account for the effect of family-wide confounds (i.e., shared between the siblings in the family) while isolating child-specific processes (i.e., unique to each child within the family). The results supported two indirect paths from shared reading to children's ToM: one through receptive language alone and another that operated sequentially through receptive language and EF. These paths were observed only at the family level. These findings emphasize the importance of maternal input during early shared reading for cognitive development and suggest a cascade from maternal input to ToM via language and EF during the preschool period.

Do Mothers or Children Lead the Dance? Disentangling Individual and Influence Effects During Conflict.

Are mother-child conflict discussions shaped by time-varying, reciprocal influences, even after accounting for stable contributions from each individual? Mothers were filmed discussing a conflict for 5 min, separately with their younger (ages 5-9, N = 217) and older (ages 7-13, N = 220) children. Each person's conflict constructiveness was coded in 20-s intervals and data were analyzed using dynamic structural equation modeling, which separates individual and influence effects. Children influenced their mothers' behavior under certain conditions, with evidence for developmental differences in the magnitude and direction of influence, whereas mothers did not influence their children under any circumstance. Results are discussed in the context of child effects on parent behavior and changes in parenting across middle childhood.

Linking Quality and Quantity of Parental Linguistic Input to Child Language Skills: A Meta-Analysis.

This meta-analysis examined associations between the quantity and quality of parental linguistic input and children's language. Pooled effect size for quality (i.e., vocabulary diversity and syntactic complexity; k = 35; N = 1,958; r = .33) was more robust than for quantity (i.e., number of words/tokens/utterances; k = 33; N = 1,411; r = .20) of linguistic input. For quality and quantity of parental linguistic input, effect sizes were stronger when input was observed in naturalistic contexts compared to free play tasks. For quality of parental linguistic input, effect sizes also increased as child age and observation length increased. Effect sizes were not moderated by socioeconomic status or child gender. Findings highlight parental linguistic input as a key environmental factor in children's language skills.

The Development of Empathic Concern in Siblings: A Reciprocal Influence Model.

This study utilized actor-partner interdependence modeling to examine the bidirectional effects of younger (Mage  = 18 months) and older siblings (Mage  = 48 months) on later empathy development in a large (n = 452 families), diverse (42% immigrant) Canadian sample. Controlling for parenting, demographic characteristics, sibling relationship quality, and within-child stability in empathic concern, both younger and older siblings' observed empathic concern uniquely predicted relative increases in the other's empathy over a period of 18 months. The strength of the partner effects did not differ by birth order. Sex composition moderated the younger sibling partner effect, whereas age gap moderated the older sibling partner effect. This study highlights the important role that siblings play in enhancing the development of care and concern for others.

The Ontario Birth Study: A prospective pregnancy cohort study integrating perinatal research into clinical care.

BACKGROUND: Pregnancy and early childhood represent critical periods that impact health throughout the life-course. The Ontario Birth Study (OBS) is a pregnancy cohort study designed as a platform for research on pregnancy complications, maternal and infant health, and the developmental origins of health and disease. METHODS: Pregnant women <17 weeks gestational age were recruited between 2013 and 2015 from antenatal clinics at Mount Sinai Hospital, Toronto, Canada. Life style and diet questionnaires, biospecimens, and clinical data were collected throughout the pregnancy and postpartum period at the time of clinical care. The OBS was integrated into clinical care to reduce participant burden, improve efficiency, and increase research potential. RESULTS: There were 3181 eligible women approached for recruitment and 1374 (43%) participated in the study. Among the 1374 participants, 1272 (93%) delivered a liveborn infant and were followed to 6-10 weeks postpartum. Of the 1272 women who completed the study, 98% had at least one pregnancy blood sample collected, 97% had vaginal swabs collected, 90% completed the prenatal life style questionnaires, and 78% completed the Diet History Questionnaire. Most women (88%) were ≥30 years of age, 55% had no previous children, 24% were overweight or obese pre-pregnancy and 78% of parents had postsecondary education. Most pregnancies were singleton (3% twins), 34% delivered by caesarean section, and 6% preterm (<37 weeks gestation). CONCLUSIONS: The OBS is a contemporary cohort with detailed data including banked biospecimens for studies of pregnancy health and the gene-environment interactions that establish developmental trajectories to health, learning, and social functioning.

An Examination of the Sibling Training Hypothesis for Disruptive Behavior in Early Childhood.

Sibling training for disruptive behavior (one sibling teaching another disruptive behavior) is examined during early childhood. We used a conservative, recently developed, statistical model to identify sibling training. Sibling training was operationalized as the cross-lagged association between earlier child behavior and later sibling behavior, and differentiated from other reasons that contribute to sibling similarity. A three-wave longitudinal study tracked 916 children (Mage  = 3.46, SD = 2.23) in 397 families using multi-informant data. Evidence for sibling training was found. Earlier younger siblings' disruptive behavior predicted later lower levels of older siblings' disruptive behavior. Thus, the sibling training found in early childhood was producing greater dissimilarity, rather than similarity, on disruptive behavior.

Birth weight interacts with a functional variant of the oxytocin receptor gene (OXTR) to predict executive functioning in children.

Genetic variation in the oxytocin receptor gene (OXTR) is associated with several psychiatric conditions characterized by deficits in executive functioning (EF). A specific OXTR variant, rs2254298, has previously been associated with brain functioning in regions implicated in EF. Moreover, birth weight variation across the entire range is associated with individual differences in cortical structure and function that underlie EF. This is the first study to examine the main and interactive effect between rs2254298 and birth weight on EF in children. The sample consisted of 310 children from an ongoing longitudinal study. EF was measured at age 4.5 using observational tasks indexing working memory, cognitive flexibility, and inhibitory control. A family-based design that controlled for population admixture, stratification, and nongenomic confounds was employed. A significant genetic association between rs2254298 and EF was observed, with more copies of the major allele (G) associated with higher EF. There was also a significant interaction between rs2254298 and birth weight, such that more copies of the major allele in combination with higher birth weight predicted better EF. Findings suggest that OXTR may be associated with discrete neurocognitive abilities in childhood, and these effects may be modulated by intrauterine conditions related to fetal growth and development.

Maternal Adverse Childhood Experience and Infant Health: Biomedical and Psychosocial Risks as Intermediary Mechanisms.

OBJECTIVE: To assess the mechanisms accounting for the transfer of risk from one generation to the next, especially as they relate to maternal adverse childhood experiences and infant physical and emotional health outcomes. STUDY DESIGN: Participants were 501 community mother-infant dyads recruited shortly after the birth and followed up at 18 months. Mothers retrospectively reported on their adverse childhood experiences. The main outcome measures were parent-reported infant physical health and emotional problems. Potential mechanisms of intergenerational transmission included cumulative biomedical risk (eg, prenatal and perinatal complications) and postnatal psychosocial risk (eg, maternal depression, single parenthood, marital conflict). RESULTS: Four or more adverse childhood experiences were related to a 2- and 5-fold increased risk of experiencing any biomedical or psychosocial risk, respectively. There was a linear association between number of adverse childhood experiences and extent of biomedical and psychosocial risk. Path analysis revealed that the association between maternal adverse childhood experiences and infant physical health operated specifically through cumulative biomedical risk, while the relationship between adverse childhood experiences and infant emotional health operated specifically through cumulative psychosocial risk. This pattern was not explained by maternal childhood disadvantage or current neighborhood poverty. CONCLUSIONS: Maternal adverse childhood experiences confer vulnerability to prenatal, perinatal, and postnatal psychosocial health. The association between adverse childhood experiences and offspring physical and emotional health operates through discrete intermediary mechanisms.

Parent-offspring transaction: Mechanisms and the value of within family designs.

This article is part of a Special Issue "Parental Care". Parenting is best understood as a transactional process between parents and their offspring. Each responds to cues in the other, adapting their own behavior to that of their partner. One of the goals of parenting research in the past twenty years has been to untangle reciprocal processes between parents and children in order to specify what comes from the child (child effects) and what comes from the parent (parent effects). Child effects have been found to relate to genetic, pre and perinatal, family-wide, and child-specific environmental influences. Parent effects relate to stresses in the current context (e.g. financial strain, marital conflict), personality and ethnicity but also to adverse childhood experiences (e.g. parental mental health and substance abuse, poverty, divorce). Rodent models have allowed for the specification of biological mechanisms in parent and child effects, including neurobiological and genomic mechanisms, and of the causal role of environmental experience on outcomes for offspring through random assignment of offspring-mother groupings. One of the methods that have been developed in the human and animal models to differentiate between parent and child effects has been to study multiple offspring in the family. By holding the parent steady, and studying different offspring, we can examine the similarities and differences in how parents parent multiple offspring. Studies have distinguished between family average parenting, child-specific parenting and family-wide dispersion (the within family standard deviation). These different aspects of parenting have been differentially linked to offspring behavioral phenotypes.

Oxytocin and vasopressin hormone genes in children's externalizing problems: A cognitive endophenotype approach.

Externalizing problems are among the most common mental health problems of children. Research suggests that these problems are heritable, yet little is known about the specific genes involved in their pathophysiology. The current study examined a genotype-endophenotype-phenotype model of externalizing problems in 320 preschool-aged children. Markers of the oxytocin (OXT) and arginine vasopressin (AVP) hormone genes were selected as candidates owing to their known association with psychopathology in other domains. We tested whether OXT and AVP variants were related to children's externalizing problems, as well as two cognitive endophenotypes presumed to underlie these problems: theory of mind (ToM) and executive functioning (EF). Externalizing problems were assessed at age 4.5 using a previously-validated rating scale. ToM and EF were measured with age-appropriate tasks. Using a family-based association design and controlling for non-genomic confounds, support was found for an association between a two-marker OXT haplotype (rs2740210-rs2770378) and a two-marker AVP haplotype (rs1887854-rs3761249) and externalizing problems. Specific associations of these haplotypes with ToM and EF were also observed. Further, ToM and EF were shown to independently and jointly predict externalizing problems, and to partially mediate the effects of OXT and AVP on externalizing problems. This study provides the first evidence that genetic variation in OXT and AVP may contribute to individual differences in childhood externalizing problems, and that these effects may operate through emerging neurocognitive abilities in the preschool period.

Cumulative risk disparities in children's neurocognitive functioning: a developmental cascade model.

The current longitudinal study examined the role of cumulative social risk on children's theory of mind (ToM) and executive functioning (EF) across early development. Further, we also tested a cascade model of development in which children's social cognition at 18 months was hypothesized to predict ToM and EF at age 4.5 through intermediary language skills at age 3. We then examined whether this developmental mechanism varied as a function of social risk status. Participants were 501 children recruited when they were newborns, at which point eight psychosocial risk factors were assessed and combined into a metric of cumulative social disadvantage. Families were followed up at 18 months, at which point four social-cognitive skills were assessed using developmentally sensitive tasks: joint attention, empathy, cooperation, and self-recognition. Language was measured at age 3 using a standardized measure of receptive vocabulary. At age 3 and 4.5, EF and ToM were measured using previously validated tasks. Results showed that there were notable cumulative risk disparities in overall neurocognitive skill development, and these effects became more differentiated over time. Support was also found for a developmental mechanism wherein the effect of social cognition at 18 months on ToM and EF in the preschool period operated specifically through children's receptive language ability at age 3. This pathway functioned similarly for children with both low- and high-risk backgrounds. These results extend previous findings by documenting the role of cumulative social disadvantage on children's neurocognition and the pathways that link key neurocognitive abilities across early development.

Neighborhood Collective Efficacy Moderates the Association between Maternal Adverse Childhood Experiences and Marital Conflict.

In a socio-demographically diverse sample of 501 caregivers participating in a longitudinal birth cohort study during the childbearing years, we examined whether neighborhood collective efficacy moderated the association between maternal adverse childhood experience (ACEs) and marital conflict. Maternal ACEs were assessed via retrospective reports. Neighborhood collective efficacy was measured via maternal and paternal reports at 2 months, and maternal reports of marital conflict were collected at infant age 2 and 18 months. Multiple linear regression analyses revealed that maternal ACEs were associated with increased marital conflict. Neighborhood collective efficacy moderated the association between early maternal ACEs and marital conflict, such that mothers experiencing ACEs had lower levels of marital conflict when exposed to high levels of neighborhood collective efficacy. Results suggest that extra-familial sources of social support and control, such as feelings of security, trust, order, and connectedness with others, may buffer the effects of early adversity on marital discord.

The development of a measure of maternal cognitive sensitivity appropriate for use in primary care health settings.

BACKGROUND: Parental responsivity is important to children's cognitive and socioemotional development, yet is under-represented in primary healthcare, because the measurement is specialized and time-consuming. METHODS: The current study developed a measure of maternal cognitive sensitivity (CS), which uses impressionistic ratings based on brief observations of parent-child interaction when children are 3 years old. RESULTS: Using data from a longitudinal cohort (Time 1, N = 501), the CS measure had good psychometric properties, was significantly related to a gold-standard maternal responsivity measure, and was predicted by the same socio-demographic factors predictive of other measures of parental responsivity. Finally, a well-established pathway from socioeconomic risk (child age 2 months) to compromised parenting (child age 3 years) to negative child outcome (child age 4.5 years) was demonstrated with CS as the mediator. CONCLUSION: The maternal CS measure is brief, can be easily trained, and takes 8 min to administer and code, making it potentially useful in primary healthcare settings.

Birth Weight Variability and Language Development: Risk, Resilience, and Responsive Parenting.

OBJECTIVE: This study examined whether birth weight variation within the normal range was associated with language ability at 36 months, and whether responsive parenting-the putative protective factor-buffered children from the risk of relatively low birth weight. METHODS: In all, 467 community mother-child dyads were followed longitudinally from birth. Receptive language was measured at 36 months. Responsive parenting was assessed through observed interactions at 18 months and examined as the hypothesized moderator. RESULTS: Controlling for confounds, both birth weight and responsive parenting positively predicted children's language skills. There was also a significant interaction between birth weight and responsive parenting-higher responsivity was associated with better language ability, and this link was especially pronounced for children at risk owing to relatively low birth weight. CONCLUSION: Normative differences in birth weight are a source of variability in children's language, but postnatal socialization factors such as parenting may buffer this risk.

Cumulative contextual risk, maternal responsivity, and social cognition at 18 months.

By 18 months children demonstrate a range of social-cognitive skills that can be considered important precursors to more advanced forms of social understanding such as theory of mind. Although individual differences in social cognition have been linked to neurocognitive maturation, sociocultural models of development suggest that environmental influences operate in the development of children's social-cognitive outcomes. In the current study of 501 children and their mothers, we tested and found support for a model in which distal environmental risk, assessed when children were newborns, was indirectly associated with children's social-cognitive competency at 18 months through mothers' responsivity at 18 months. Part of this effect also operated through children's concomitant language skills, suggesting both a language-mediated and a language-independent mechanism of social-cognitive development. These findings are discussed with respect to the Vygotskian themes of internalization and semiotic mediation.

Association between the arginine vasopressin receptor 1A (AVPR1A) gene and preschoolers' executive functioning.

Recent evidence implicates the arginine vasopressin (AVP) system in complex neuropsychological disorders which are characterized by deficits in executive functioning (EF). Despite the genetic contribution to EF, little is currently known about its molecular genetic basis. Drawing on research from social neuroscience and the role of related physiological systems in psychopathology, the current study hypothesized that variability in the AVP receptor 1a gene (AVPR1A) would be associated with EF in an epidemiological sample of 323 normally developing preschool-aged children. Using a family-based association design, the current study found that variability in the rs7298346 marker, located in the 5'-flanking region, was significantly related to a composite measure of EF in 4-year-old children after controlling for a variety of covariates and children's theory of mind. The converse association between AVPR1A and theory of mind (after controlling for EF) was not significant, suggesting a level of specificity in this relationship. The results are discussed in terms of the difficulties faced by genetic association studies in teasing apart the behavioral phenotypes that characterize complex psychological diseases and the involvement of multiple physiological systems in human behavior.

Differentiating children with and without a history of repeated problematic sexual behavior.

Many adolescents who sexually offend commenced problematic sexual behaviors as children. There is little evidence to indicate which children may be at risk to continue problematic sexual behaviors and which children will desist once identified. The goal of this study was to determine variables that differentiate children who repeated problematic sexual behaviors following adult reprimand from those who did not. Predictive accuracy of 33 risk variables was investigated using 62 children assessed for problematic sexual behaviors. Eight individual variables were related to group membership, and a total score based on the combination of these variables was predictive of group membership. The results indicate variables that may assist in identifying children requiring intervention versus those likely to discontinue problematic sexual behaviors once they are identified and reprimanded.

Multilevel mediation: cumulative contextual risk, maternal differential treatment, and children's behavior within families.

This study tests the hypothesis that links between contextual risk and children's outcomes are partially explained by differential parenting. Using multi-informant measurement and including up to four children per family (Mage  = 3.51, SD = 2.38) in a sample of 397 families, indirect effects (through maternal differential parenting: self-reported and observed) of cumulative contextual risk on four child outcomes were investigated. Cumulative risk was associated with higher levels of differential parenting and, in turn, with higher levels of behavioral problems. Indirect effects were strongest for attentional and social problems but also evident for aggression. The link between differential parenting and outcome was moderated by favoritism, but this was only evident for maternal report and strongest for aggression.

Association between maternal sensitivity and child receptive language development: Quasi-causal evidence using a sibling comparison design.

Observational studies have shown that caregiver sensitivity predicts child language skills. These studies, however, have entirely relied on between-family designs (single parent-child dyad per family), which cannot rule out the contribution of shared family confounds (e.g., genetics, books in home). The current study investigates whether observed caregiver sensitivity predicts changes in child receptive language using a sibling comparison design. Participants were 890 Canadian children (51.7% male; 52.4% White) nested within 447 families from diverse socioeconomic backgrounds with children between the ages of 2 and 3.5 years (Wave 1) and 3.5 and 5 years (Wave 2). Independent observers provided ratings of maternal sensitivity with each sibling using several coding protocols (i.e., Coding of Attachment-Related Parenting and the Parent-Child Interaction System). Child receptive language was assessed using the Peabody Picture Vocabulary Test. Maternal sensitivity predicted within-person change in receptive language. That is, the sibling that receives comparatively more sensitivity from the caregiver showed more development in language over time when compared to their sibling. The obverse association, child language to later maternal sensitivity, was not observed, pointing to a unidirectional association of maternal sensitivity on child receptive language. Our sibling comparison design rules out the role of shared family confounders, which provides a strong test of causal processes within an observational design. (PsycInfo Database Record (c) 2023 APA, all rights reserved).