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Comparing Variable- and Person-Centered Approaches When Studying Perinatal Risk Factors and Neurodevelopmental Outcomes

Fri, March 24, 9:30 to 10:15am, Salt Palace Convention Center, Floor: 2, Meeting Room 250 D

Abstract

Background: Numerous pregnancy-related factors have been identified as potential risk factors for impaired neurodevelopment, coined Neurodevelopmental Perinatal Risk (NPR) factors. Given that many neurodevelopmental impairments are present at birth, identifying risk factors before the child is born is critical for providing early, targeted screening and intervention services. Previous studies have primarily relied on the variable-centered, single factor approach to study perinatal risk factors and neurodevelopment, while more recent research has begun incorporating overall burden measures (e.g., sum score). The current study directly compared the benefits and drawbacks of traditional, variable-centered approaches and a novel, person-centered approach to examine the role of NPR factors in the early detection of neurodevelopmental impairments. We utilized data from the Early Autism Risk Longitudinal Investigation (EARLI) to identify the clinical, research, and public health utility of each of these methodological approaches.
Methods: We examined the association between NPR factors (e.g., reproductive history, perinatal complications, mental health symptoms) and risk for impaired neurodevelopment among mother-child dyads participating in EARLI, a cohort with increased familial likelihood for ASD. Mothers were followed throughout pregnancy, and the child’s neurodevelopment was assessed at 36 months (e.g., social skills (Social Responsiveness Scale), cognition (Mullen Scales of Early Learning), adaptive functioning (Vineland Adaptive Behavior Scales), autism spectrum disorder (ASD)). First, we used three variable-centered approaches (i.e., single factor, sum score, optimality score) to examine the association between NPR factors and neurodevelopment. Second, we employed a person-centered, latent variable approach to identify the association between clusters of NPR factors and neurodevelopmental outcomes.
Results: The final sample included 240 mother-child dyads participating in EARLI. The single factor approach was beneficial in identifying NPR factors that specifically increased risk for ASD but not other impairments (e.g., infection and risk for ASD only), as well as NPR factors that were associated with multiple, transdiagnostic impairments (e.g., high blood pressure and risk for ASD, cognitive impairments, adaptive functioning). The sum and optimality score approaches identified a clear association between an increasing number of NPR factors in the mother and an increased risk for ASD and impaired social functioning in the child, yet there was no association with cognition or adaptive functioning. The person-centered approach was beneficial in identifying how NPR factors cluster in mothers and how those clusters map onto specific neurodevelopmental outcomes. For example, we identified that children of mothers who reported a specific constellation of NPR factors (i.e., perinatal complications, weight concerns, and mental health symptoms) were at increased risk for impaired social and adaptive functioning coupled with elevated attention deficits.
Conclusions: Given the complexity of neurodevelopment, numerous methodological approaches should be employed in order to improve our ability to identify children in need of specific intervention services. The findings from each of these approaches can aid researchers and clinicians in tailoring screening services for children, identifying potential targets for public health interventions, and detecting NPR factors in need of further research. This research may also help identify mothers in need of increased access to affordable, inclusive prenatal care services.

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