Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, 401 Parnassus Ave, San Francisco, CA, 94143, USA.
Division of Public Health, Pediatric Public Health Initiative, Michigan State University, Flint, MI, 48502, USA.
J Neurodev Disord. 2021 Aug 19;13(1):29. doi: 10.1186/s11689-021-09377-y.
Children in Flint, Michigan, have experienced myriad sociodemographic adversities exacerbated by the Flint water crisis. To help inform child-focused prevention and intervention efforts, we aimed to describe patterns of neurodevelopmental outcomes among preschoolers who experienced the Flint water crisis before age 2 years.
Participants were 170 preschoolers who completed a comprehensive neurodevelopmental assessment battery, including directly administered measures of cognitive and executive functioning and maternal-report of adaptive skills and behavioral problems. We used latent profile analysis to derive subgroups. Multivariate multinomial logistic regression was conducted to examine the predictors of profile memberships, including child sex and maternal/family-level factors selected from an array of measured exposures using least absolute shrinkage and selection operator regression.
Three latent profiles were identified: Profile 1-relative weakness in all domains (50%); Profile 2-normative functioning in all domains (34.1%); and Profile 3-relative strengths in executive function and behavior (15.9%). Profile 1 showed lower scores across cognitive and behavioral domains. Profile 2 demonstrated abilities within the normal range across domains. Profile 3 showed relative strength in executive functioning with few behavior problems, despite lower cognitive performance. Children across all profiles showed adaptive behavior in the adequate range. Child sex and maternal IQ were significant predictors of profile membership.
Children in Flint demonstrated diverse patterns of development in the face of sociodemographic and environmental adversities. Comprehensive screening and neurodevelopmental profiling of children in this at-risk population are needed to identify areas of needs and inform appropriate service delivery.
密歇根州弗林特市的儿童经历了无数社会人口逆境，这些逆境因弗林特水危机而加剧。为了帮助制定以儿童为重点的预防和干预措施，我们旨在描述在 2 岁之前经历过弗林特水危机的学龄前儿童的神经发育结果模式。
参与者为 170 名学龄前儿童，他们完成了全面的神经发育评估工具包，包括直接进行的认知和执行功能测量以及母亲报告的适应技能和行为问题。我们使用潜在剖面分析来得出亚组。使用多元多项逻辑回归检查预测因素，包括儿童性别和从一系列测量暴露中选择的母婴/家庭水平因素，使用最小绝对收缩和选择算子回归。
确定了三个潜在剖面：第 1 组-所有领域的相对弱点（50%）；第 2 组-所有领域的正常功能（34.1%）；第 3 组-执行功能和行为的相对优势（15.9%）。第 1 组在认知和行为领域的得分均较低。第 2 组在所有领域都表现出正常范围内的能力。第 3 组在执行功能方面表现出相对优势，行为问题较少，尽管认知表现较低。所有组的儿童在适应行为方面均处于足够水平。儿童性别和母亲智商是剖面成员的重要预测因素。
面对社会人口和环境逆境，弗林特的儿童表现出多样化的发展模式。需要对这个高风险人群中的儿童进行全面的筛查和神经发育分析，以确定需求领域，并为提供适当的服务提供信息。
