Predictive Value of Developmental Assessment in a Neonatal Intensive Care Unit (NICU) Follow-Up Clinic.

OBJECTIVE: Neonatal Intensive Care Unit (NICU) Follow-Up programs vary in the duration for which they monitor child development and neurocognitive outcomes. This study explores the early predictive value of a widely used developmental measure for intellectual functioning during early childhood to better inform whether there is value added in continued monitoring. METHODS: Participants were 209 children who had at least two assessments between the ages of 1 and 6 years old as part of NICU Follow-Up clinic. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) was administered when children were 1 and 2 years old and the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) was administered when children were 3 years and older. RESULTS: The Bayley-III at 1 year of age was a significant predictor of Bayley-III performance at age 2. Similarly, Bayley-III at ages 1 year and 2 years were significant predictors of WPPSI-IV performance. Strength of prediction was moderate with the majority of variance unexplained. Exploratory analyses examining whether early developmental abilities as assessed on the Bayley-III could identify patients at risk for poorer WPPSI-IV performance indicated appropriate specificity but inadequate sensitivity. CONCLUSIONS: This study supports ongoing assessment of children who were born with perinatal complications into at least early childhood. Assessing development only during the infant and toddler years did not sufficiently identify children who went on to have lower cognitive functioning in preschool and the early school years.

Lifetime stressors, hair cortisol, and executive function: Age-related associations in childhood.

Extant research is mixed regarding the relations among lifetime exposure to stressors, adrenocortical activity, and executive function (EF), particularly in children. Aggregate measures of adrenocortical activity like hair cortisol concentration (HCC), timing of stress exposure, and age at assessment may clarify these associations. This cross-sectional study examined the association among parent-reported exposure to stressors, hair cortisol concentration (HCC), and children's EF via a tablet task in a community sample (n = 318, 52.5% female) of children across a wide age range (4-13 years, M = 9.4, SD = 2.3). Path analyses revealed that parent-reported child lifetime exposure to stressors, but not past-year stressful life events, negatively predicted HCC. There was also a marginally significant moderation by age such that HCC was associated negatively with EF for younger children (age < 9.7 years) but not older children. HCC did not significantly mediate the association between lifetime exposure to stressors and EF. Findings are consistent with the proposition that chronically high cortisol production has a neurotoxic effect on brain regions supporting EF. However, lifetime exposure to stressors predicted relatively lower cumulative cortisol production, consistent with a stress inoculation effect in this normative-risk sample.

A short executive functioning questionnaire in the context of early childhood screening: psychometric properties.

Early childhood executive functioning (EF) predicts later adjustment and academic achievement. However, measuring EF consistently and efficiently across settings in early childhood can be challenging. Most researchers use task-based measures of EF, but these methods present practical challenges that impede implementation in some settings. The current study of 380 3-5-year-old children in the United States evaluated the psychometric properties of a new 14-item parent-reported measure of EF in a diverse urban school district. This questionnaire aimed to capture a normative range of EF skills in ecologically valid contexts. There was evidence for two specific subscales - one that measures children's EF challenges and another that measures children's EF skills. Results suggested that several items demonstrated differential item functioning by age and race. After adjusting for measurement differences across demographic groups and controlling for age at screening, the EF challenges subscale was more strongly related to task-based measures of EF than was the EF skills subscale. EF challenges predicted third-grade math achievement, controlling for demographic variables and a performance-based measure of children's early cognitive and academic skills. Results suggest that this parent report of EF could be a useful and effective early childhood screening tool.

Predictive Validity of the NIH Toolbox Executive Function Measures with Developmental Extensions from Early Childhood to Third Grade Achievement.

The National Institutes of Health Toolbox includes two executive function measures: the Dimensional Change Card Sort (DCCS) and the Flanker Inhibitory Control and Attention Test. Developmental extension (Dext) versions were created with easier levels for younger and more disadvantaged children. Although research on early (E-Prime) and later (iPad) versions of the Dext measures demonstrated their short-term validity, this study investigated their longer-term predictive validity. Participants included 402 children (Mage = 55.02 months) who completed the DCCS-Dext and Flanker-Dext (E-Prime) during early childhood screening and achievement tests in the third grade. Both measures significantly predicted math and reading scores among diverse groups of children.

Intergenerational continuity of adverse childhood experiences in homeless families: Unpacking exposure to maltreatment versus family dysfunction.

Despite the expanding research on adverse childhood experiences (ACEs) and corpus of studies on intergenerational maltreatment in high-risk families, studies have not examined intergenerational ACEs more broadly, much less in severely disadvantaged families. This study investigated the intergenerational continuity of ACEs in mothers and young children aged 4 to 6 years living in emergency homeless shelters. It also examined whether unpacking ACEs into categories of exposure to maltreatment versus family dysfunction affected intergenerational continuity patterns or child socioemotional problems in school. Negative parenting, in the form of observed inept coercive discipline with children, and cumulative sociodemographic risk were examined as additional predictors of child ACEs and socioemotional problems. Mothers (N = 95; aged 20-45; 64.2% African American, 3.2% African Native, 11.6% Caucasian, 7.4% biracial/multiracial, and 13.6% other) completed questionnaires on parent and child ACEs and cumulative risk factors. They participated in videotaped parent-child interactions rated for observed coercive discipline, and teachers provided reports of children's socioemotional problems. Results indicated that higher parental ACEs predicted higher child ACEs, with higher numbers of parental ACEs in either category (maltreatment or family dysfunction) predicting higher levels of child ACEs in both categories. However, child exposure to maltreatment, but not family dysfunction, significantly predicted elevations in children's socioemotional problems. Findings underscore the role of intergenerational childhood adversity in homeless families and also emphasize that unpacking ACEs in children may illuminate key areas of vulnerability for school adjustment. (PsycINFO Database Record

Executive function and parenting in the context of homelessness.

There is mounting evidence that maternal executive function (EF) plays a critical role in parenting behavior. However, the majority of the research on this topic has been conducted in low-risk samples. The purpose of the present study was to investigate whether individual differences in maternal EF are associated with parenting behavior in the high-risk, high adversity context of family homelessness. The study included 94 mothers and their children, ages 4 to 6 years, living in emergency homeless shelters. Mothers completed a battery of "hot" and "cool" EF tasks as well as a self-report questionnaire of perceived stress. Parenting measures were based on observed parent-child interactions that were later coded for harsh and positive parenting practices. Results indicated that hot EF in mothers was related to positive parenting. The relation between maternal planning ability, assessed by a cool EF task, and harsh parenting was also significant, but only for mothers reporting higher levels of stress. These findings add to a growing body of research suggesting that the influence of EF and other forms of cognitive control on parenting need to be interpreted within the context of environmental stress and adversity. (PsycINFO Database Record