Adversity, Timing of Intervention and Long-Term Effects on Brain, Behavior and Physical Health in Children

• In Event: 2-068 - Social Origins of Developmental Risk for Mental and Physical Illnesses

Integrative Statement

Decades of basic, developmental, clinical and epidemiological research demonstrate that adverse childhood experiences contribute to increased risk of poor outcomes in cognitive, social and emotional functioning, as well as poor physical health in childhood, adolescence and adulthood (Felitti et al., 1998; Edwards et al., 2003; Anda et al., 2006; Nelson et al., 2014). Yet, data from both cross-sectional and longitudinal studies of human participants is for the most part descriptive and correlational, often including retrospective reporting of adverse life events (Nelson et al., 2016; McEwen and McEwen, 2017). Evidence from studies of human children now suggests that different types of adversity may have different effects on brain and behavior (Sheridan and McLaughlin, 2014). The timing of adverse events also appears to have an impact on the nature of perturbed brain development and behavior. The Bucharest Early Intervention Project (BEIP) represents the first and only randomized controlled trial of a foster care intervention for infants and young children who were exposed to early psychosocial adversity (Zeanah et al., 2003). The study included an assessment of young children living in conditions of neglect followed by randomization to placement in families (the Foster Care Group) or to remain in the institutions (Care as Usual). Both groups were followed prospectively across childhood and adolescence.Initial results revealed significant impacts on all domains of functioning in young children who were living in Bucharest institutions. They were significantly delayed in their intellectual functioning (IQ) (Smyke et al., 2007), had abnormal attachment-like behaviors towards caregivers (Zeanah et al., 2005), displayed significantly low EEG alpha power (Marshall et al., 2004). Post-randomization children randomized to Foster Care displayed higher IQ scores compared to those remaining in Care as Usual at each of the assessment points. At the early assessments (30, 42 and 54 months), there appeared to be a critical period for the impact of the intervention. This pattern of intervention and timing effects held true not only for IQ but for attachment behavior (Smyke et al., 2010), and for EEG alpha activity (Vanderwert et al., 2010) as well. For psychiatric status and socio-emotional responding, there were effects of the intervention across assessment points but no evidence of timing effects (Humphreys et al., 2015). For measures of gray matter volume (Sheridan et al., 2012), executive function (Bos et al., 2009) or ADHD symptoms (Humphreys et al., 2015) there was no evidence of an intervention effect. The work to be presented illustrates the need to understand the effects of early adversity on developmental outcomes, the importance of intervention early in life and the long-term perturbations by adversity on brain and behavioral development. As well, catch-up growth among post-institutionalized children, may pose a health concern.

Author

• Nathan Fox, University of Maryland
  Presenting Author