212 - Main and Interactive Effects of Gestational Age Categories and Early Childhood ACEs on Academic Achievement and Effortful Control at Kindergarten : Test of the Cumulative Risk Hypothesis

Publication Number: 3204.212

Prachi E. Shah, University of Michigan, Ann Arbor, MI, United States; Julie Poehlmann, University of Wisconsin-Madison, Madison, WI, United States; Maria Spinelli, University G. d'Annunzio Chieti-Pescara, Chieti, Abruzzi, Italy; Niko Kaciroti, University of Michigan Medical School, Ann Arbor, MI, United States

Background: Cumulative risks have a more deleterious impact on child outcomes. The degree of prematurity and elevated Adverse Child Experiences (ACEs) are both independent risk factors for learning and attention problems in young children, however the combined effect (cumulative risk) of higher ACEs and greater prematurity on learning and self-regulation has not been examined in a nationally representative sample. It is not known whether the effect of higher adverse child experiences (ACEs) on kindergarten learning and emotion regulation outcomes is magnified in infants born at earlier gestational ages, compared to infants born less preterm.

Objective: To examine the main and interactive associations between the degree of prematurity, and level of early childhood ACEs on reading and math academic achievement, and effortful control at kindergarten in a nationally representative sample.

Design/Methods: Sample included 5800 infants (GA 24-41 weeks) from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). Kindergarten outcomes included reading and math academic achievement, and a measure of effortful control derived from a parent-report behavioral questionnaire. Gestational age was categorized: (Very preterm (VPT < 32 weeks); moderate/late preterm (MLPT: 32-36 weeks); full term (FT: 37-41 weeks)), and 7 ACEs were ascertained from parent report questionnaires (Range: 0-5 ACEs) . Multivariate linear regression examined the main and interactive associations between gestational age categories, ACEs, and academic achievement in reading and math, and effortful control at kindergarten.

Results: In adjusted models, both lower gestational age (VPT) and higher ACES were independently associated with lower reading and math academic achievement, and lower effortful control at kindergarten. We also found evidence of interactive effects between lower gestational age and higher ACES on effortful control (p=.049), with a greater magnitude of association seen in children born VPT who experienced higher early childhood ACEs (B=- 0.15, p=0.04). (Figure 1).

Conclusion(s): Consistent with previous research, lower gestational age, and higher ACEs were associated with greater deficits in academic achievement and emotion regulation. We also found support for the cumulative risk hypothesis, where greater ACEs in early childhood, in combination with lower gestational age (VPT birth), was associated with greater deficits in effortful control at kindergarten. Recognition of the "dual risk" of ACEs and VPT birth can identify preterm infants who may benefit from trauma-focused resources to support the development of effortful control.

Interactive Effects of Gestational Age Categories and Early Child ACEs on Effortful Control Scores at Kindergarten.
Analyses controlled for the following covariates: Maternal race, education, infant sex, growth restriction, poverty, preschool attendance and history of growth restriction
SOURCE: U.S. Department of Education, National Center for Education Statistics, Early Childhood Longitudinal Study, Birth Cohort. Selected years 2001-2007