Introduction
More than 200 million children fail to reach their full developmental potential in
low- and middle-income countries. Adverse childhood experiences, maternal mental health,
and intimate partner violence are negatively associated with child development outcomes.
The relationship of these risk factors with child communication, gross motor, fine
motor, problem-solving, and personal–social development scores in Brazil are assessed.
Methods
A population-based, cross-sectional study of preschool children living in the state
of Ceará, Brazil, in 2017 was conducted. Child development was assessed with the Ages
and Stages Questionnaire. Adverse childhood experiences for children were self-reported
by the participants’ mothers using the Centers for Disease Control and Prevention
Adverse Childhood Experiences Study‒adapted metric. Maternal mental health and intimate
partner violence were evaluated using validated questionnaires. Sample-adjusted multivariable
generalized linear models with interaction terms were used to determine the association
of intimate partner violence, maternal mental health, and adverse childhood experiences
with developmental outcomes and identify possible moderators. Data were analyzed between
2019 and 2020.
Results
Children exposed to ≥3 adverse childhood experiences had −0.12 (95% CI= −0.24, 0)
lower communication, −0.25 (95% CI= −0.46, −0.03) lower gross motor, −0.27 (95% CI=
−0.47, −0.07) lower fine motor, and −0.17 (95% CI= −0.3, −0.03) lower personal–social
domain scores than children with no adverse childhood experiences. Furthermore, the
greater number of adverse childhood experiences was linearly associated with lower
developmental scores. Maternal mental health and intimate partner violence were also
associated with lower development scores.
Conclusions
Adverse childhood experiences were independently associated with developmental outcomes
in Brazilian children. Community-based interventions to reduce the impact of adverse
childhood experiences, intimate partner violence, and maternal mental health may benefits
child development outcomes.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level.Lancet Glob Health. 2016; 4: e916-e922
- Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention.JAMA. 2009; 301: 2252-2259
- Inequality in early childhood: risk and protective factors for early child development.Lancet. 2011; 378: 1325-1338
- The impact of childhood health on adult labor market outcomes.Rev Econ Stat. 2009; 91: 478-489
- Schooling and wage income losses due to early-childhood growth faltering in developing countries: national, regional, and global estimates.Am J Clin Nutr. 2016; 104: 104-112
- Developmental potential in the first 5 years for children in developing countries.Lancet. 2007; 369: 60-70
- Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential.WHO, GenevaPublished 2018https://apps.who.int/iris/bitstream/handle/10665/272603/9789241514064-eng.pdf?ua=1Date accessed: August 20, 2020
- Impact of adversity on early childhood growth & development in rural India: findings from the early life stress sub-study of the SPRING cluster randomised controlled trial (SPRING-ELS).PLoS One. 2019; 14e0209122
- Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.Lancet Psychiatry. 2016; 3: 973-982
- Effects of poverty and maternal depression on early child development.Child Dev. 2001; 72: 1794-1813
- Intimate partner violence, depression, and child growth and development.Pediatrics. 2018; 142e20173457
- Maternal depression and child development.J Child Psychol Psychiatry. 1994; 35: 73-112
- Paternal depression in the postnatal period and child development: a prospective population study.Lancet. 2005; 365: 2201-2205
- Maternal depression and early childhood growth in developing countries: systematic review and meta-analysis.Bull World Health Organ. 2011; 89: 608-615
- Leveraging the biology of adversity to address the roots of disparities in health and development.Proc Natl Acad Sci U S A. 2012; 109: 17302-17307
- The lifelong effects of early childhood adversity and toxic stress.Pediatrics. 2012; 129: e232-e246
- Psychological stress in childhood and susceptibility to the chronic diseases of aging: moving toward a model of behavioral and biological mechanisms.Psychol Bull. 2011; 137: 959-997
- Lifecourse health development: past, present and future.Matern Child Health J. 2014; 18: 344-365
- The magnitude of intimate partner violence in Brazil: portraits from 15 capital cities and the Federal District.Cad Saude Publica. 2006; 22: 425-437
- Violence and injuries in Brazil: the effect, progress made, and challenges ahead.Lancet. 2011; 377: 1962-1975
- Adverse childhood experiences: prevalence and related factors in adolescents of a Brazilian birth cohort.Child Abuse Negl. 2016; 51: 21-30
- Methodology of maternal and child health populational surveys: a statewide cross-sectional time series carried out in Ceará, Brazil, from 1987 to 2017, with pooled data analysis for child stunting.Ann Glob Health. 2019; 85: 24
- Ages & Stages Questionnaires.Paul H. Brookes Publishing, Baltimore, MD2009
- Adaptação Transcultural e Avaliação Psicométrica Do Ages and Stages Questionnaires (ASQ) Em Creches Públicas Da Cidade Do Rio de Janeiro.Pontifícia Universidade Católica do Rio de Janeiro, Rio de Janeiro, Brazil2011
- Validação Concorrente Do Ages & Stages Questionnaires Com o Screening Test Da Bayley Scales of Infant and Toddler Development, III No Programa De Saúde Da Família.Universidade Federal de Pernambuco, Recife, Brazil2013
- Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.Psychol Med. 1980; 10: 231-241
- Avaliação de desempenho do Self-Reporting Questionnaire como instrumento de rastreamento psiquiátrico: um estudo comparativo com o Structured Clinical Interview for DSM-IV-TR.Cad Saude Publica. 2008; 24: 380-390
- Screening for domestic violence in a predominantly Hispanic clinical setting.Fam Pract. 2005; 22: 617-623
- Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the Adverse Childhood Experiences (ACE) Study.Am J Prev Med. 1998; 14: 245-258
- Adverse family experiences and flourishing amongst children ages 6-17 years: 2011/12 National Survey of Children's Health.Child Abuse Negl. 2017; 70: 240-246
- Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers.Early Hum Dev. 2013; 89: 561-576
- Parent-completed developmental screening in a Norwegian population sample: a comparison with U.S. normative data.Acta Paediatr. 2004; 93: 1525-1529
- Child development: risk factors for adverse outcomes in developing countries.Lancet. 2007; 369: 145-157
- Stressing out the poor: chronic physiological stress and the income-achievement gap.Pathways. 2011; (Accessed August 2020)
- Intimate partner violence trends in Brazil: data from two waves of the Brazilian National Alcohol and Drugs Survey.Braz J Psychiatry. 2016; 38: 98-105
- Prenatal cortisol exposure predicts infant cortisol response to acute stress.Dev Psychobiol. 2013; 55: 145-155
- Preschool outcomes of children of depressed mothers: role of maternal behavior, contextual risk, and children's brain activity.Child Dev. 2003; 74: 1158-1175
- The role of parents in children's psychological development.Pediatrics. 1999; 104 (Accessed July 1, 2020): 164-167
- Childhood poverty and young adults’ allostatic load: the mediating role of childhood cumulative risk exposure.Psychol Sci. 2012; 23: 979-983
- Childhood poverty, chronic stress, and adult working memory.Proc Natl Acad Sci U S A. 2009; 106: 6545-6549
- Parental verbal affection and verbal aggression in childhood differentially influence psychiatric symptoms and wellbeing in young adulthood.Child Abuse Negl. 2014; 38: 91-102
- Exposure to parental verbal abuse is associated with increased gray matter volume in superior temporal gyrus.Neuroimage. 2011; 54: S280-S286
- A conceptual framework for action on the social determinants of health. Discussion paper for the Commission on Social Determinants of Health. Published April 2007; http://www.who.int/social_determinants/resources/csdh_framework_action_05_07.pdfDate accessed: August 20, 2020
Article Info
Publication History
Published online: November 04, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.