Collaborative ECHO research led by Julie Hofheimer, PhD of the University of North Carolina at Chapel Hill and Monica McGrath, ScD and Rashelle Musci, PhD, both of Johns Hopkins Bloomberg School of Public Health, investigates the link between family hardships, newborn health outcomes, and the behavior of young children. The researchers collected information on the behavior of 3,934 children between the ages of 18 and 72 months and used that data to identify early factors that increase a child’s risk for experiencing behavioral and emotional difficulties. The study found that children born preterm and those whose families had been exposed to more social, economic, or environmental hardships were more likely to experience continuous behavioral difficulties. This research, titled “Psychosocial and Neonatal Risk Factors Associated with Behavioral Dysregulation Trajectories Among Young Children from 18 through 72 Months of Age,” is published in JAMA Network Open.
Adverse conditions and family hardships have steadily increased over the past two decades, challenging the emotional and behavioral well-being of children and their families. To understand how health and environmental hardships affect a child’s risk for developing continuous behavioral problems, ECHO researchers collected early childhood behavior data from 20 ECHO cohorts from across the United States. About 20% of these children were born preterm (before 37 weeks of gestation).
The researchers collected caregiver self-reports, demographics, and medical and environmental data about the children and their mothers before and during pregnancy and from infancy through age six. Caregivers completed the Child Behavior Checklist at several study visits, and the researchers compared the children’s combined difficulty with anxiety, depression, attention, and aggression to their behavioral well-being across the first six years of life.
Some children who experienced less family adversity showed improved behavior over time. Importantly, some children were able to overcome hardships and improve their behavior. Through this study, the researchers were able identify early factors that increase a child’s risk for experiencing behavioral and emotional difficulties.
“Conditions during pregnancy and early infancy can identify toddlers who may benefit from early enriched services,” said Dr. Hofheimer. “Family support services tailored to the individual needs of children may prevent later behavioral problems and improve future outcomes for vulnerable children and their families.”
Future ECHO research may examine how childhood behavior continues to develop from six years onward, examining the link between early risk factors and behavioral patterns in middle school and adolescence.