Social Ecology of Children’s Vulnerability to Environmental Pollutants

BACKGROUND: The outcomes of exposure to neurotoxic chemicals early in life depend on the properties of both the chemical and the host’s environment. When our questions focus on the toxicant, the environmental properties tend to be regarded as marginal and designated as covariates or confounders. Such approaches blur the reality of how the early environment establishes enduring biologic substrates. OBJECTIVES: In this commentary, we describe another perspective, based on decades of biopsychological research on animals, that shows how the early, even prenatal, environment creates permanent changes in brain structure and chemistry and behavior. Aspects of the early environment—encompassing enrichment, deprivation, and maternal and neonatal stress—all help determine the functional responses later in life that derive from the biologic substrate imparted by that environment. Their effects then become biologically embedded. Human data, particularly those connected to economically disadvantaged populations, yield equivalent conclusions. DISCUSSION: In this commentary, we argue that treating such environmental conditions as confounders is equivalent to defining genetic differences as confounders, a tactic that laboratory research, such as that based on transgenic manipulations, clearly rejects. The implications extend from laboratory experiments that, implicitly, assume that the early environment can be standardized to risk assessments based on epidemiologic investigations. CONCLUSIONS: The biologic properties implanted by the early social environment should be regarded as crucial elements of the translation from laboratory research to human health and, in fact, should be incorporated into human health research. The methods for doing so are not clearly defined and present many challenges to investigators

Moving Through Adolescence: Developmental Trajectories of African American and European American Youth. VII: Problem Behaviors

In this monograph, we investigate the developmental trajectories of a predominantly middle‐class, community‐based sample of European American and African American adolescents growing up in urban, suburban, and rural areas in Maryland, United States. Within risk‐protection and positive youth development frameworks, we selected developmental measures based on the normative tasks of adolescence and the most widely studied indicators in the three major contexts of development: families, peer groups, and schools. Using hierarchical linear growth models, we estimated adolescents’ growth trajectories from ages 12 to 20 with variation accounted for by socioeconomic status (SES), gender, race/ethnicity, and the gender by race/ethnicity interaction. In general, the results indicate that: (a) periods of greatest risk and positive development depended on the time frame and outcome being examined and (b) on average, these adolescents demonstrated much stronger evidence of positive than problematic development, even at their most vulnerable times. Absolute levels of their engagement in healthy behaviors, supportive relationships with parents and friends, and positive self‐perceptions and psychological well‐being were much higher than their reported angry and depressive feelings, engagement in risky behaviors, and negative relationships with parents and peers. We did not find evidence to support the idea that adolescence is a time of heightened risk. Rather, on average, these adolescents experienced relatively stable and developmentally healthy trajectories for a wide range of characteristics, behaviors, and relationships, with slight increases or decreases at different points in development that varied according to domain. Developmental trajectories differed minimally by SES but in some expected ways by gender and race/ethnicity, although these latter differences were not very marked. Overall, most of the young people navigated through their adolescence and arrived at young adulthood with good mental and physical health, positive relationships with their parents and peers, and high aspirations and expectations for what their future lives might hold

Effectiveness of early intervention programs for parents of preterm infants: a meta-review of systematic reviews

Background: Various intervention programs exist for parents of preterm babies and some systematic reviews (SRs) have synthesised the evidence of their effectiveness. These reviews are, however, limited to specific interventions, components, or outcomes, and a comprehensive evidence base is lacking. The aim of this meta-review was to appraise and meta-synthesise the evidence from existing SRs to provide a comprehensive evidence base on the effectiveness of interventions for parents of preterm infants on parental and infant outcomes. Methods: We conducted a comprehensive search of the following databases to identify relevant SRs: Cochrane library, Web of science, EMBASE, CINAHL, British Nursing Index, PsycINFO, Medline, ScienceDirect, Scopus, IBSS, DOAJ, ERIC, EPPI-Centre, PROSPERO, WHO Library. Additional searches were conducted using authors’ institutional libraries, Google Scholar, and the reference lists of identified reviews. Identified articles were screened in two stages against an inclusion criteria with titles and abstracts screened first followed by full-text screening. Selected SRs were appraised using the AMSTAR tool. Extracted data using a predesigned tool were synthesised narratively examining the direction of impact on outcomes. Results: We found 11 SRs eligible for inclusion that synthesised a total of 343 quantitative primary studies. The average quality of the SRs was ‘medium’. Thirty four interventions were reported across the SRs with considerable heterogeneity in the structural framework and the targeted outcomes that included maternal-infant dyadic, maternal/parental, and infant outcomes. Among all interventions, Kangaroo Care (KC) showed the most frequent positive impact across outcomes (n = 19) followed by Mother Infant Transaction Program (MITP) (n = 14). Other interventions with most consistent positive impact on infant outcomes were Modified-Mother Infant Transaction Program (M-MITP) (n = 6), Infant Health and Development Program (IHDP) (n = 5) and Creating Opportunities for Parent Empowerment (COPE) (n = 5). Overall, interventions with both home and facility based components showed the most frequent positive impact across outcomes. Conclusions: Neonatal care policy and planning for preterm babies should consider the implementation of interventions with most positive impact on outcomes. The heterogeneity in interventions and outcomes calls for the development and implementation of an integrated program for parents of preterm infants with a clearly defined global set of parental and infant outcomes

Developmental and evolutionary assumptions in a study about the impact of premature birth and low income on mother–infant interaction

In order to study the impact of premature birth and low income on mother–infant interaction, four Portuguese samples were gathered: full-term, middle-class (n=99); premature, middle-class (n=63); full-term, low income (n=22); and premature, low income (n=21). Infants were filmed in a free play situation with their mothers, and the results were scored using the CARE Index. By means of multinomial regression analysis, social economic status (SES) was found to be the best predictor of maternal sensitivity and infant cooperative behavior within a set of medical and social factors. Contrary to the expectations of the cumulative risk perspective, two factors of risk (premature birth together with low SES) were as negative for mother–infant interaction as low SES solely. In this study, as previous studies have shown, maternal sensitivity and infant cooperative behavior were highly correlated, as was maternal control with infant compliance. Our results further indicate that, when maternal lack of responsiveness is high, the infant displays passive behavior, whereas when the maternal lack of responsiveness is medium, the infant displays difficult behavior. Indeed, our findings suggest that, in these cases, the link between types of maternal and infant interactive behavior is more dependent on the degree of maternal lack of responsiveness than it is on birth status or SES. The results will be discussed under a developmental and evolutionary reasonin