Publications (2)2.27 Total impact
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Article: Socioeconomic differences and the impact of being small for gestational age on neurodevelopment among preschool-aged children.
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ABSTRACT: Studies of small for gestational age (SGA) birth and subsequent childhood cognitive outcomes are inconsistent. Few studies have assessed whether effects varied by socioeconomic status (SES). To assess child cognitive and behavioral outcomes according to SGA and severe SGA (<10th and <5th percentiles) and SES. We followed 474 infants initially selected for a case-control study assessing SGA vs. appropriate-for-gestational age (AGA). The infants were born at two hospitals: a public hospital serving a low-income, African-American population and a private hospital serving a predominantly white, middle-class population. At age 54 months, a psychologist administered the Differential Abilities Scales (DAS), and Vineland Adaptive Behavior Scales (VABS). The mother completed the Child Behavior Checklist (CBCL). Associations were analyzed using multiple linear regression. Among AGA children, the mean DAS score was >1 standard deviation lower for children born at the public vs. the private hospital (75.2 vs. 95.7 among boys; 76.3 vs. 101.8 among girls). Being SGA had a weaker effect on DAS scores, overall. Severe SGA had a significant effect on DAS scores of children born at the private hospital (average reduction 8.0 +/- 2.5 points), but not on children born at the public hospital (average reduction 1.1 +/- 2.2 points). In the latter group, severe SGA was associated with a lower VABS score (average reduction 9.2 +/- 2.5 points). Poor fetal growth influences neurodevelopment, but this influence is modified by postnatal environment. Adverse effects associated with low SES might mask or attenuate associations between prenatal exposures and developmental outcomes in some populations.Reviews on environmental health 01/2011; 26(3):221-9. -
Article: Math performance and behavior problems in children affected by prenatal alcohol exposure: intervention and follow-up.
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ABSTRACT: Fetal alcohol spectrum disorders (FASD), resulting from maternal alcohol use during pregnancy, are associated with significant academic and behavior problems. Although affected children are common in clinical practice, information to guide recommendations about interventions with this high risk group is very limited. This study evaluated the persistence of effects of an intervention on the math performance and behavior of 54 children, 3- to 10-years, diagnosed with fetal alcohol syndrome or FASD. Children were randomly assigned to a 6-week Math intervention (n = 28) tailored to this clinical group or to a standard psychoeducational contrast group (n = 26). All caregivers received identical educational interventions to promote learning readiness and improve behavioral outcomes. In a previous study, participants were assessed before interventions and immediately following completion. In this follow-up study, participants were recontacted and reassessed at 6 months post completion to determine if positive results on math functioning and child behavior would persist after treatment discontinuation. Focus was on 2 outcomes: (1) Math performance, assessed using standardized measures of math achievement and (2) Behavior problems as reported by caregivers on the Child Behavior Checklist (CBCL) and teachers on the Teacher Report Form (TRF). Experimental-group participants demonstrated significantly greater scores on math outcome measures than Contrast group members and CBCL and TRF behavior was improved over pretest scores in both groups. This 6-month follow-up confirms that both math skills and behavior of alcohol-affected children are improved significantly by interventions designed to meet their specific learning and behavior needs.Journal of developmental and behavioral pediatrics: JDBP 03/2008; 30(1):7-15. · 2.27 Impact Factor
