142nd APHA Annual Meeting and Exposition

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Living in a disadvantaged neighborhood is associated with behavior problems among young children with cognitive delay

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Erika R. Cheng, PhD, MPA , Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, Boston, MA
Hyojun Park, MA , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI
Stephanie Robert, PhD, MSW , School of Social Work, University of Wisconsin, Madison, WI
Mari Palta, PhD , Departments of Population Health Sciences and Department of Biostatistics & Medical Informatics, University of Wisconsin, Madison, WI
Whitney P. Witt, PhD, MPH , Truven Health Analytics, Bethesda, MD
Background: Neighborhood factors are associated with children's behavioral outcomes in the general population, but this relationship has not been examined among children with cognitive delay (CD). We investigated the relationships among CD, neighborhood factors, and behavior problems over a two-year period in early childhood using a national sample of US families.

Methods: Data were from three waves of the Early Childhood Longitudinal Study, Birth Cohort (n=7,700). CD was defined as falling in the lowest 10% of mental scores from the Bayley Short Form-Research Edition at 9 and 24 months. Children were classified as typically developing or as having resolved, newly developed, or persistent CD. Child behavior was measured at age 4 using the Preschool and Kindergarten Behavior Scales (range 0-36). A neighborhood disadvantage index (NDI) was derived by principal components analysis of 5 census-tract variables. Hierarchical linear modeling regressed child behavior at age 4 on CD and neighborhood disadvantage at 24 months, adjusted for confounders.

Results: Behavior scores at age 4 were higher among children with newly developed (β for difference in means=2.03, SE=0.33) and persistent (β=2.44, SE=0.51) CD at 24 months than for typically developing children. The interaction between NDI and CD status was statistically significant, suggesting that neighborhood disadvantage was particularly detrimental for children with persistent CD.

Conclusions: Living in a disadvantaged neighborhood is associated with behavior problems among young children with CD. The neighborhood context may provide an opportunity for the design and implementation of public health interventions to improve the behavioral health of children with CD.

Learning Areas:

Epidemiology
Social and behavioral sciences

Learning Objectives:
Describe how neighborhood disadvantage influences children’s behavioral outcomes. Identify how neighborhood disadvantage impacts the development of behavior problems among children with cognitive delay. Discuss programmatic and policy implications of our findings.

Keyword(s): Behavioral Research, Children With Special Needs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a post-doctoral research fellow at Harvard Medical School and the Division of General Academic Pediatrics at Massachusetts General Hospital for Children. My work focuses on intergenerational risk transmission between women and their children and in identifying determinants of childhood psychosocial and behavior problems in a framework of lifecourse epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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