Early environmental factors that affect children’s cognitive test performance appear modifiable

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08 October 2020

2 minutes to read

Disclosures: LeWinn reports receiving grants from the Urban Child Institute. Please see the study for relevant financial information from all other authors.


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According to the results of a study published in JAMA Pediatrics.

“While we often have a very complex and layered view of the factors that shape child development, we tend to look at each of these factors independently.” Kaja The Winn, ScD, MS, from the Department of Psychiatry and Behavioral Sciences at the University of California at San Francisco, told Healio Psychiatry. “This hypothesis-driven approach is at the heart of scientific discovery, but it doesn’t always help us get the big picture of what matters. Prediction methods can help us see the bigger picture, and the approach we took in this study allowed us to look at many factors within a single study and identify which are the most strongly associated with cognitive test scores in early childhood.

“We have included several areas and types of exposures (eg, family and neighborhood resources, maternal well-being, early childhood exposures such as breastfeeding, parenthood, etc.) prevention efforts.” LeWinn added.

Kaja The Winn

LeWinn and his colleagues used the full data set from the Conditions Affecting Neurodevelopment and Learning in Early Life (CANDLE) longitudinal cohort study, in which researchers collected data from 2006 to 2011, for prospective analysis and have used 155 independent fitted multivariate regression models. The CANDLE Study collected longitudinal data from mothers twice during pregnancy and each year during infancy, and then measured children’s cognitive abilities with Stanford-Binet Intelligence Scales during follow-up visits to the hospital. age from 4 to 6 years old. The final analysis of 1,055 mothers, most of whom were black, assessed 155 pre- and postnatal target exposures.

The results showed that of the seven exposures correlated with cognitive test scores in the final analysis, all except birth order “could be considered modifiable.” Factors associated with higher children’s cognitive test scores included parents completing higher education, mother’s literacy level, behaviors that promote cognitive growth, and breastfeeding. Factors associated with lower children’s cognitive test scores included parental stress. According to the researchers, black children were less likely to experience 22 of 24 exposures that benefit cognitive performance.

LeWinn noted that the researchers created a model that improved each of the exposures by a modest amount. They observed a 7 point increase in cognitive test scores.

“It is important to note that racial inequalities in the identified exposures, although measured at the individual level, are closely related to upstream structural inequalities,” LeWinn told Healio Psychiatry. “For example, the quality of and access to education varies considerably across the United States. Black children are more likely to attend low-resource schools that offer inadequate preparation for high school education.

“In the South, where this study took place, some have called this legacy of disparate educational opportunities the ‘education debt’,” LeWinn added. “In our study, black children were much more likely to live in neighborhoods with poor educational opportunities than white children. These inequalities in early learning environments need to be addressed in order to minimize the impact on the next generation. “

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