Prenatal Stress and Maternal Adverse Childhood Experiences Linked to Higher Risk of Child Mental Health Problems

Posted on March 11, 2026April 6, 2026 by Jodi Snare

Stress during pregnancy and a mom’s own adverse childhood experiences (ACEs) may be associated with higher risk of mental health problems for their children, according to a recent ECHO Cohort study led by Shaikh Ahmad, PhD, Alexandra Sullivan, PhD, and Nicole Bush, PhD of University of California, San Francisco, and Marie Churchill, MS and Rosa Crum, MD, MHS of Johns Hopkins Bloomberg School of Public Health.

The global rise in pediatric mental health problems has highlighted the importance of identifying factors that may affect children’s mental health. Previous research has suggested that maternal stress—both adverse experiences during the mother’s own childhood and stress during pregnancy—may affect child mental health. To better understand how these exposures affect child mental health, researchers collected information from over 6,000 mothers and their children enrolled in 34 ECHO Cohort Study Sites across the United States.

Key Takeaways include:

Mothers’ own ACEs and experiences of stress during pregnancy were each independently associated with a higher risk of mental health problems in their children, suggesting that maternal stressors during each period may have contributed to the child’s risk in a potentially accumulative manner.
These effects on children included both internalizing (e.g., anxiety, depression) and externalizing (e.g., ADHD, behavior problems) mental health issues.
The effects of maternal ACEs and pregnancy stress on child mental health problems were similar for boys and girls and were seen throughout childhood and adolescence.

“Using a large and diverse sample, this study highlights the potential two-generational benefits of early screening and intervention related to maternal stress and adversity—not only in improving maternal health, but also in reducing mental health problems in offspring,” said Dr. Ahmad.

Additional research could help researchers identify other factors that may influence the risk of child mental health problems (e.g., paternal ACEs) and factors that could improve support for pregnant women.

This collaborative research, titled “Maternal Adverse Childhood Experiences and Prenatal Stress: Intergenerational Transmission and Offspring Mental Health in the ECHO Cohort,” is published in Psychological Medicine.

Read the research summary.

Limited Access to Medical Services Linked to Differences in Children’s Sleep Patterns, New ECHO Cohort Study Finds

Posted on February 12, 2026February 12, 2026 by Jodi Snare

Children living in communities with too few healthcare providers may experience different sleep patterns than those in better-resourced areas, according to a new ECHO Cohort study led by Brittany Lancaster, PhD, of Mississippi State University, Christy W. Hockett, PhD, of the Avera Research Institute, and Anna Wallisch, PhD, of the University of Kansas Medical Center.

Most prior research on child sleep has focused on individual and family-level behaviors—such as routines or screen use—without fully considering how living in rural or medically underserved communities shapes access to health-promoting resources. Families in these areas often face barriers such as long travel distances, limited medical services, and fewer health supports. These challenges can indirectly influence key behaviors, such as sleep.

This study included 22,234 youth ages 1–17 years, categorized into four groups based on whether they lived in rural areas, medically underserved areas, both, or neither. Using parent or self-reported questionnaires, researchers examined sleep duration, bedtimes, wake times, time to fall asleep, and bedtime habits, then compared patterns across these community types. A medically underserved area is defined as having too few primary care providers, high infant mortality, or high poverty and/or high elderly population.

Key Takeaways Include:

Children in medically underserved areas tended to go to bed later, wake up later, and were less likely to get the recommended amount of sleep, especially among children aged 12 and under.
Rural versus non‑rural differences were small; rural children generally went to bed and woke up earlier, while preschoolers in non‑rural areas slept longer due to more frequent naps.
Bedtime habits differed slightly: toddlers and teens in well‑resourced areas were more likely to have consistent bedtime routines, while preschoolers in underserved communities were more likely to use electronics before bed.
Results suggest that limited access to medical services—not rurality alone—may contribute more meaningfully to disparities in children’s sleep health.

“Our findings highlight an increased need to support families in medically underserved areas with practical strategies for bedtime routines and reducing screen time before bed, as these approaches may meaningfully improve sleep duration and quality among young children,” Dr. Lancaster said.

Targeted community programs through daycares, schools, and community centers may help support healthier sleep practices, particularly in medically underserved areas. Future research will continue to examine how environment, resources, and community characteristics influence children’s sleep.

This collaborative research, titled “Exploring Sleep Outcomes in Youth Across Settings: Are There Differences based on Rurality or Medically Underserved Status in the ECHO Cohort?”, is published in Sleep Medicine.

Family Lifestyle and Behavior Changes During COVID-19 Pandemic Associated with Youth Mental Health

Posted on February 11, 2026February 11, 2026 by Jodi Snare

Children and teens who experienced significant changes in their lifestyle and health behaviors during the COVID-19 pandemic may be more likely to experience symptoms of pandemic-related post-traumatic stress (PTS), according to a recent ECHO Cohort study led by Amy Margolis, PhD of The Ohio State University.

The United States is facing a growing youth mental health crisis with a significant increase in mental or behavioral health conditions, partly linked to changes during the COVID-19 pandemic. To understand how changes in family hardships, behaviors, and coping strategies during the COVID-19 pandemic influenced youth PTS symptoms, researchers collected information from 7,786 children and 1,353 teens and young adults and their parents or caregivers across the United States between April 2020 and August 2021.

Key Takeaways include:

Two groups of families were identified based on their experiences of hardships, changes in daily behaviors, and coping strategies during COVID-19. The first group had minimal changes in their lifestyle and behaviors, while the second group had significant changes. The low change group included a higher proportion of Black families, single-parent households, and lower income and education levels.
Children and teens in the group with significant changes had higher Pandemic-related Traumatic Stress Scale (PTSS) scores compared to the group with minimal changes.
Some aspects of parent or caregiver experiences, including their ability to isolate during the pandemic, were associated with lower PTSS scores in children. Youth whose parents or caregivers reported no change in their own behaviors were more likely to report lower PTSS scores.
Changes in youth health behaviors (like eating, physical activity, and media use) and access to healthcare were important factors associated with PTSS scores. Stability in these areas was linked to lower PTSS scores.
The use of coping strategies by children and teens did not significantly reduce PTSS scores. Some coping strategies, like increased media use and substance use, were linked to higher PTSS scores.

This study provides valuable insight that could help improve youth mental health now and in the wake of future public health emergencies. It demonstrates the importance of stability in health behaviors, access to healthcare, and the ability for parents to isolate safely as key factors in reducing youth PTS symptoms.

This collaborative research, titled “Changes to Family Life, Youth COVID-19 Pandemic-Related Traumatic Stress, and the Youth Mental Health Crisis,” is published in the Journal of Clinical Child & Adolescent Psychology.

Read the research summary.

Courtney K Blackwell, PhD, MEd: The kids are(n’t) alright: The role of social media in youth mental health

The kids are(n’t) alright: The role of social media in youth mental health

Key Takeaways: The parallel rise of youth mental health problems and social media use has led to speculations that the latter is a key contributor to the former. The US Surgeon General’s Advisory bolstered such speculations with a recent report detailing the potential harmful effects of social media use on youth mental health. However, others suggest engaging in social media can have positive psychological influences by increasing social connectedness and providing opportunities for creative self-expression and identity exploration. Dr. Blackwell will explore this duality by reviewing what we know about youth social media use and mental health outcomes, highlighting recent and on-going ECHO studies on this topic. She will also provide insight into the ECHO media use data more broadly to inspire future work leveraging the ECHO Cohort.

Courtney K Blackwell, PhD, MEd
she/her/hers
Associate Professor
Department of Medical Social Sciences (Outcome and Measurement Science)
Feinberg School of Medicine, Northwestern University
MPI, ECHO Measurement Core

Biography:

Courtney Blackwell, PhD, MEd, is an Associate Professor in the Department of Medical Social Sciences at Northwestern University Feinberg School of Medicine. She is the MPI of the ECHO Measurement Core and has expertise in the development, validation, and implementation of patient-reported outcome measures and population health surveys for use across the lifespan, general and clinical populations, and health domains. Her research on pediatric mental health and well-being emphasizes promotive and protective factors of children’s positive psychological health. With a background in communication studies and the effects of digital media on child development, Dr. Blackwell has spent the past 10 years collaborating with such organizations as Common Sense Media, Sesame Workshop, PBS, Google, and Code.org on national surveys of children’s media use, the development and evaluation of educational media products, and investigations of the effects of digital media on children’s learning and development. She is also a Faculty Affiliate with the Northwestern University Institute for Innovations in Developmental Sciences (“DevSci”) and the Northwestern Institute for Adolescent Mental Health and Well-Being.

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NIH Study Finds No Significant Link Between Time Spent in Childcare and Young Children’s Mental Health, Even Amid Early Adversity

Posted on December 17, 2024August 27, 2025 by Jodi Snare

Sending children to childcare outside the home may not significantly affect children’s mental health, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health. This finding holds true even for children who face challenges, such as a parent’s mental illness or financial struggles at home.

Many children in the U.S. under the age of 5 years spend some time in childcare outside the home. Researchers wanted to learn whether attending childcare influenced the mental health of children, particularly those who had experienced early adversity.

“Despite the extensive use of childcare in the U.S. and documented benefits, there are still some concerns that childcare attendance (vs. staying at home with a parent) increases the risk for poor child outcomes,” said Michelle Bosquet Enlow, PhD, of Boston Children’s Hospital and Harvard Medical School. “This can lead to considerable feelings of guilt and worry for parents who use childcare.”

The study looked at various forms of childcare, including center-based care, home-based non-relative care, and care by a relative. However, previous findings on the role of childcare in child mental health have produced mixed results. While many studies highlight positive associations with attending childcare, some raise concerns that childcare may increase the risk for poor child developmental outcomes. “Understanding how childcare can influence children's development, especially for those facing extra challenges, can help shape public policies that promote healthy outcomes for kids,” said Dr. Bosquet Enlow.

Key Findings

Children facing early life adversity were more likely to have higher levels of anxiety, depression, aggression, or hyperactivity symptoms.
Childcare attendance did not seem to be associated with increased or decreased levels of mental health symptoms, including among children facing adversity.
The study did not find any evidence that the number of hours in childcare corresponded to worse mental health outcomes for children, even those at elevated psychosocial and socioeconomic risk.

The findings suggest that while children facing higher levels of stress, mental illness in the family, and economic hardship were more likely to have higher levels of internalizing symptoms (such as anxiety and depression) and externalizing symptoms (such as aggression and hyperactivity), number of hours in childcare did not appear to play a significant role in altering these outcomes.

About the study

The study followed 2,024 parent-child pairs from three diverse U.S. research groups within the ECHO Cohort. Participants were recruited from hospitals in North Carolina, Pennsylvania, and Tennessee, as well as from adoption agencies across the United States.

Researchers measured children’s childcare experiences from birth to age 3 years and examined parental factors like childhood adversity, depression, and education level. Between ages 3 and 5.5 years, the children’s mental health was assessed for symptoms like anxiety, depression, and aggression.

This collaborative research was published in Development and Psychopathology.

Bosquet Enlow, M., et al. (2024) The Influence of Early Childhood Education and Care on the Relation between Early Life Social Adversity and Children’s Mental Health in the Environmental influences for Child Health Outcomes Program. Development and Psychopathology. DOI: 10.1017/S0954579424001822

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About ECHO: Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth for the latest ECHO Program updates on X.

ECHO Cohort Researchers Investigate How Fish Consumption During Pregnancy Affects Child Health

Posted on July 31, 2024March 31, 2025 by Jodi Snare

Fish is an important part of a healthy diet, especially during pregnancy. For example, the evidence-based Dietary Guidelines for Americans recommend that pregnant and breastfeeding women consume 8 to 12 ounces of fish per week.

However, relatively little information is available about how much fish people actually consume in pregnancy, and more research is needed on health outcomes related to consumption of fish, or the omega-3 fatty acids for which fish is a rich source, during pregnancy.

ECHO Cohort researchers addressed these gaps at a recent ECHO Discovery webinar on the science of fish consumption.

Kristen Lyall, ScD of the A.J. Drexel Autism Institute; Emily Oken, MD, MPH of Harvard Medical School and the Harvard Pilgrim Health Care Institute; and Margaret Karagas, PhD of the Geisel School of Medicine and Dartmouth College presented the latest science and discussed what ECHO researchers are hoping to contribute.

These ECHO Cohort researchers described what is currently known about fish consumption during pregnancy and childhood and why the ECHO Program is uniquely positioned to further explore how fish can enhance the health of pregnant women and children.

Fish is rich in omega-3 fatty acids, essential nutrients for healthy fetal brain and eye development, Oken explained. Omega-3 fatty acid consumption during pregnancy also reduces the risk of preterm and early preterm birth, as summarized in a 2023 publication in the American Journal of Obstetrics & Gynecology.

The ECHO Program’s large, diverse participant population allows researchers to better understand the impact of fish consumption and omega-3 supplement intake among pregnant women in the U.S.

Because of the representative sample size, ECHO Cohort researchers are examining consumption of fish intake and docosahexaenoic acid (DHA) supplements, an omega-3 fatty acid naturally found in seafood, during pregnancy.

Analysis of ECHO Cohort data found that around a quarter of the pregnant participants reported no fish intake during pregnancy. Even fewer participants reported taking omega-3 supplements. (Read the full analysis in the Journal of Public Health Nutrition.)

The data also show that people who did not consume enough fish also did not take DHA supplements. The people who ate enough fish took more supplements, Oken explained. She highlighted that in addition to a positive impact on brain and eye development, taking DHA supplements during pregnancy is associated with decreased preterm birth.

Prenatal fish consumption and autism spectrum disorder

In other recent work, ECHO investigators have examined how eating fish or taking DHA supplements affects childhood autism spectrum disorder (ASD) diagnoses and autism-related traits. (Read the full analysis in the American Journal of Clinical Nutrition.)

ECHO Cohort researchers are in a unique position to examine the relationship between fish intake and supplement use during pregnancy and childhood autism spectrum disorder (ASD) diagnosis and autism-related traits because of the large and representative study population.

A research article published July 1, 2024 in the American Journal of Clinical Nutrition provides an analysis of ECHO Cohort data to address this relationship. This analysis suggests that eating more fish, rather than taking supplements, may be associated with a lower likelihood of ASD diagnosis and, to a lesser extent, a lower likelihood of autism-related traits.

Fish consumption and child growth and development

Many questions remain regarding fish consumption in pregnancy.

The National Academies of Sciences, Engineering, and Medicine (NASEM) recently released a report on the role of maternal and child seafood consumption in child growth and development. Drs. Oken and Karagas served on the report committee, as did ECHO Cohort investigator Julie Herbstman, PhD, of Columbia Mailman School of Public Health; Dr. Herbstman also participated in the ECHO Discovery presentation.

Using data from the National Health and Nutrition Examination Survey (NHANES), the NASEM report found that children ages 1 to 2 years ate fewer than two seafood meals per month on average; only 6 percent of children ages 2 to 19 years reported eating two or more seafood meals per week.

In future work, ECHO Cohort researchers will continue to study how fish consumption impacts child growth and development. ECHO’s ongoing follow-up, broad focus on health outcomes, and diverse participants allow the initiative to address the many research gaps surrounding the role of fish consumption on child health outcomes.

Reminder: Through the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Data and Specimen Hub (DASH), the ECHO Program provides de-identified data about ECHO participants so that the larger scientific community can discover new insights about pediatric health.

Living Near Green Space Associated With Fewer Emotional Problems in Preschool-Age Kids, NIH Study Finds

Posted on April 10, 2024August 27, 2025 by Jodi Snare

FOR IMMEDIATE RELEASE

Children who live in areas with natural spaces (e.g., forests, parks, backyards) from birth may experience fewer emotional issues between the ages of 2 and 5, according to a study funded by the NIH Environmental Influences on Child Health Outcomes (ECHO) program.

While research has suggested that time in nature is important for mental health, studies examining the effects on young children are limited. ECHO investigators addressed this research gap by analyzing information from parents about the behavior of their children from ages 2 to 11. They combined this data with the family’s residential address when the child was born and satellite data on live vegetation density around their homes.

What researchers found in their analysis, published in JAMA Network Open, was that higher levels of green spaces up to three-fourths of a mile from a child’s home were linked with lower anxiety and depression symptoms from ages 2 to 5 years. The association persisted even after researchers factored in the child’s sex, parent education, age at birth, and neighborhood socioeconomic vulnerability. Researchers did not find a significant association between green space around the home and mental health symptoms in later childhood years from ages 6 to 11, when children spend more time at school.

“Our research supports existing evidence that being in nature is good for kids,” said Nissa Towe-Goodman, PhD, an ECHO researcher from the Frank Porter Graham Child Development Institute at the University of North Carolina, Chapel Hill. “It also suggests that the early childhood years are a crucial time for exposure to green spaces.”

Most research so far has been limited to studying one or a few cities at a time, and focused on adult health. Because the ECHO Program collects data nationwide, researchers were able to examine data from children in 199 counties across 41 U.S. states, exploring the connection between exposure to green spaces from birth and anxiety, depression, aggression, and other symptoms during early or middle childhood.

The study included children born between 2007 and 2013 and whose parents completed the Child Behavior Checklist, a common survey to rate a child’s emotional and behavioral symptoms. The 2,103 children included in the study ranged in age from 2 to 11, spanning early and middle childhood.

Green space exposure was measured using the Normalized Difference Vegetation Index (NDVI), a widely used metric for quantifying vegetation density using sensor data. NDVI values range from -1 to 1. High NDVI values (approximately 0.6 to 0.9) represent dense vegetation, such as forests; values close to zero represent areas without live vegetation.

“In the future, researchers could look into what kinds of experiences in nature are connected to kids' early mental health,” said Dr. Towe-Goodman. “Also, we should study how creating or preserving natural areas around homes and schools might make a difference in a child’s mental health.”

Dr. Towe-Goodman lead this collaborative research in JAMA Network Open.

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About ECHO:

Launched in 2016, the Environmental influences on Child Health Outcomes (ECHO) Program is a research program in the Office of the Director at the NIH with the mission to enhance the health of children for generations to come. ECHO investigators study the effects of a broad range of early environmental influences on child health and development. For more information, visit echochildren.org.

About the NIH: NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information, visit www.nih.gov.

Media Contacts

For information or to request an interview, contact Rebekah Yeager, rebekah.yeager@nih.gov.

If you are not a member of the media, but have a general inquiry, please contact NIHKidsandEnvironment@od.nih.gov.

Connect With Us

Check out the recent issues of our bi-monthly newsletter, the ECHO Connector, for program news and the latest research findings.

To receive the ECHO Connector through email, subscribe here.

Follow @ECHOChildHealth on X for the latest ECHO Program updates.

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

Posted on February 2, 2024May 20, 2024 by Jodi Snare

Collaborative ECHO research led by Elena Jansen, PhD of Johns Hopkins School of Medicine, and Kristine Marceau, PhD of the College of Health and Human Sciences at Purdue University reviewed existing literature on what is known about a father’s role in child development, highlighting how a father’s history and personal characteristics can influence their child’s health and well-being. This research, titled “The Role of Fathers in Child Development from Preconception to Postnatal Influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program,” is published in Developmental Psychobiology.

While few studies on parental health and child development include fathers in any substantial way, a growing body of literature emphasizes their vital role—even before birth. This literature review studied existing research on the role of fathers in child development. It evaluated the quality of this research, focusing on three outcome areas of the ECHO Program: obesity, neurodevelopment, and positive health. The review also discussed how the ECHO Program can address gaps in the literature by designing studies that address unanswered questions.

The review first described data collected by the ECHO Cohort and identified critical gaps in the research related to the role of fathers in ECHO’s five key health outcome areas. After understanding the program’s data collection methods, the research team analyzed multiple research papers categorized into three broad stages of child development—preconception, prenatal, and postnatal.

This review focused on which previously studied characteristics or behaviors of fathers have been connected to children’s development. It demonstrated how studying the effect of fathers on child development has revealed additional insights into children’s health outcomes, including reasons for declines in physical or mental health. Compared to the pregnancy and pre-pregnancy stages, this study allowed researchers to better understand a father’s role once a baby is born.

“One unique aspect of this work is describing how fathers can impact the child by first influencing the mother, for example, by helping her follow healthy behaviors, such as cooking or helping to cook healthy meals and eating healthy food himself,” Dr. Jansen said.

This literature review also revealed gaps in the research community’s understanding of the father’s role in child development, highlighting the need to incorporate maternal and paternal reported data on fathers’ characteristics. While many studies offer insights into the role of fathers, often fathers do not provide this information themselves, or existing data do not allow researchers to compare the roles of fathers and mothers.

Additionally, the study team proposed a new conceptual model to guide future inquiry considering paternal influences, and suggest methods researchers can use to help fill in some knowledge gaps.

“Our model can help guide other researchers to focus on the pieces of the puzzle that we currently know very little about,” Dr. Jansen said. “It may help explain how each parent interacts with their child and which influence has a stronger impact or is more prevalent for which parent.”

With more data becoming available from the ECHO Program, information on fathers’ characteristics can be connected to the rich data on family characteristics, mothers’ influences, and child development. Additional data will be gathered to provide further insights and answer remaining questions.

Read the research summary.

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

<< Back to Research Summaries

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

Authors: Elena Jansen, Kristine Marceau, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.

Why was this study needed?

While few studies on parental health and child development include fathers in any substantial way, a growing body of literature emphasizes their vital role—even in the period before birth. This study reviewed existing literature on what is known about the father’s role in child development. It highlights how a father’s history and personal characteristics before the baby is born, during pregnancy, and after birth can influence their child directly via their parenting behaviors and indirectly by influencing the child’s mother. The study also discusses how the ECHO Program can address key gaps in the literature by designing studies that address unanswered questions.

What were the study results?

The researchers reviewed the existing literature to find out which characteristics or behaviors of fathers have been connected to children’s development, especially their physical and mental health. While many studies give some information about the role of fathers, often fathers do not provide this information themselves, or existing data do not allow researchers to compare the role of fathers to that of mothers. Compared to the pregnancy and pre-pregnancy stages, this study allows researchers to better understand a father’s role once a baby is born. The study team created a model to guide future inquiry and suggest methods researchers can use to help fill in some knowledge gaps in the future. One unique aspect of this work is describing how fathers can impact the child by first influencing the mother, for example, by helping her follow healthy behaviors, such as cooking or helping to cook healthy meals and eating healthy food himself.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should always consult with a qualified healthcare provider for diagnosis and for answers to your personal questions.

What was this study's impact?

This review of other publications reveals gaps in the research community’s understanding of the father’s role in child development. First, very little is known about the father’s role in child development before birth. The study authors noted that more studies are needed to research mothers and fathers before they have children, focusing on including fathers in a substantial way. Some of the father data collected in the existing literature was reported by the mother. This highlights a gap in the literature and the need to incorporate maternal and paternal reported data on father characteristics. Second, this review demonstrates how studying the effect of fathers on child development has revealed additional insights into children’s health outcomes, including reasons for declines in physical or mental health.

This study also introduces a model designed to guide other researchers in focusing on pieces of the puzzle that are currently less understood. The model may help explain how each parent interacts with their child and which influence has a stronger impact or is more prevalent for which parent.

Who was involved?

This literature review involved an in-depth look into existing research on the role of fathers in child development and evaluated its quality. The study focuses on three specific child outcome areas of the ECHO program: obesity, neurodevelopment, and positive health.

What happened during the study?

This literature review begins by describing data collected by the ECHO Cohort and identifying critical gaps in the research related to the role of fathers in ECHO’s five key health outcome areas. After understanding the program’s data collection methods, the research team analyzed multiple research papers categorized into three broad stages of child development—preconception, prenatal, and postnatal. The review concludes with the presentation of a new proposed conceptual model to guide future studies considering paternal influences in ECHO and beyond.

What happens next?

With more data becoming available from the ECHO Program, information on fathers' characteristics can be connected to the rich data on family characteristics, mothers' influences, and child development. Additional data will be gathered to provide further insights and answer remaining questions.

Where can I learn more?

Access the full journal article, titled “The Role of Fathers in Child Development from Preconception to Postnatal Influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) Program” in Developmental Psychobiology.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published December 27, 2023

Read the associated article.

Download this summary

New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

ECHO Cohort Study Identifies Best Tests of Biological Age to Use for Different Types of Pediatric Tissue Samples

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ECHO Cohort Study Identifies Best Tests of Biological Age to Use for Different Types of Pediatric Tissue Samples

Authors: Fang Fang, et al.

Who sponsored this study?

The Environmental influences on Child Health Outcomes (ECHO) Program, Office of The Director, National Institutes of Health supported this research.

Why was the study needed?

A molecular process called DNA methylation, or DNAm, that adds a tag to the DNA that can control gene expression. Certain well-studied DNAm have been associated with many age-related chronic diseases, including aging itself.

Researchers have developed biochemical models called epigenetic clocks that use DNAm to estimate an individual’s biological age. Scientists have studied these clocks in adult populations in whom accelerated biological age (DNAm-predicted age older than actual chronological age) seems strongly connected to age-related health complications. However, only epigenetic clocks for pediatric populations have only recently been built. Epigenetic clocks also allow scientists to evaluate the impact of various environmental exposures on early-life development and children’s health outcomes.

This study conducted a comprehensive evaluation on seven of these epigenetic clocks—Horvath, Knight, Bohlin, Lee, Mayne, PedBE, and NeoAge—all of which researchers developed for different purposes and tissue types. It is important for scientists to understand how these clocks perform in different tissue types and developmental stages throughout early life to ensure researchers are designing studies appropriately and then correctly interpreting the results of these studies.

What were the study results?

The results of this study suggest that the best epigenetic clock to use depends on the type of sample being studied. For example, the Bohlin and Knight clocks were very similar when predicting gestational age from blood cell samples; the Lee clock outperformed the Mayne clock in predicting gestational age from placental samples; and the PedBE clock was more accurate than the Horvath clock at predicting chronological age from buccal cells. However, the Horvath clock was better at predicting chronological age when using blood cells samples. The study results suggest the importance of researchers choosing the appropriate clock depending on the focus of their study.

Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.

What was the study's impact?

This study provides practical recommendations for selecting the most appropriate epigenetic clock in different research contexts, therefore leading to more accurate estimates of biological age. The findings of this study may help scientists make better research tools, improving child health research.

Who was involved?

Researchers used data from 3,789 children, who contributed a total of 4,555 samples, from 20 ECHO research sites. The sample set consisted of 2,273 male and 2,282 female samples.

What happened during the study?

The researchers evaluated seven different epigenetic clocks based on the DNAm data generated from the selected sample set. The study evaluated each clock in corresponding tissues based on previous study results, and then compared clocks across different tissue samples. After comparing the suitability of various epigenetic clocks for each tissue type, researchers evaluated their performance across diverse populations. This evaluation included comparing epigenetic clocks between preterm and term infants within the same tissue type, across different self-reported racial groups, between males and females, and across different tissue types within the same set of participants.

What happens next?

Future studies may use the various epigenetic clocks as recommended to check the health of babies and children. However, researchers should interpret this data with caution as it pertains to conclusions about the performance of specific epigenetic clocks in pediatric populations with varied health backgrounds. Future studies may examine the effects of genetics on the performance of different epigenetic clocks.

Where can I learn more?

Access the full journal article, titled “Evaluation of Pediatric Epigenetic Clocks Across Multiple Tissues,” in Clinical Epigenetics.

The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Published October 9, 2023

Access the associated article.

Download this summary

ECHO Cohort Study Identifies Best Tests of Biological Age to Use for Different Types of Pediatric Tissue Samples

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New ECHO Research Highlights Gaps in Literature Studying Role of Fathers in Child Development

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ECHO Cohort Study Identifies Best Tests of Biological Age to Use for Different Types of Pediatric Tissue Samples

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