227 - Disability Perspectives on Research Priorities for Environmental Influences on Child Health Outcomes: Results of a Large National Survey

Publication Number: 3219.227

Melissa M. Murphy, University of Colorado School of Medicine, Aurora, CO, United States; Judy L. Aschner, Hackensack Meridian Health, Nutley, NJ, United States; Jennifer Lyman, Cerebral Palsy Foundation, Ponte Vedra Beach, FL, United States; Ashley Harris Whaley, Cerebral Palsy Foundation, New York, NY, United States; Rachel Byrne, Cerebral Palsy Foundation, New York, NY, United States; Nathalie L. Maitre, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, United States

Background: The goal of the Environmental Influences on Child Health Outcomes (ECHO) Program is to understand effects of a broad range of early environmental exposures on child health and development. To date, disability-related research in ECHO has been limited to neurodevelopmental outcomes with no ECHO science focusing on children with motor or sensory disabilities. It is currently unclear what caregivers of children with disabilities and people now living with disability may view as priorities for future ECHO research in environmental exposures and health outcomes.

Objective: We conducted a national survey with questions co-designed with a diverse stakeholder advisory board of people with disabilities and caregivers of children with disabilities to understand disability perspectives on research priorities.

Design/Methods: The survey was distributed 4/1-6/30 2025 via Survey Monkey through a broad reaching email and social media campaign across multiple organizations engaging people with disabilities. Eligible participants were 18 years or older with a disability, or a parent or caregiver of a child under 18 years with a disability. On a scale of 1-most to 5-least important, respondents ranked various environmental exposures (chemical/physical, community, psychosocial, behaviors, and biological) with the greatest impact on their daily life and health, as well as the importance of research on major health outcomes, including pregnancy and birth, breathing, body weight, brain development, and positive health. Demographics (e.g., education, employment, insurance status, race/ethnicity, gender) were collected.

Results: In the entire sample (n=1209), chemical/physical factors were ranked as mattering most (Rank=1) followed by psychosocial and community (Both Rank=2), behaviors (Rank=4), and biological factors (Rank=5). Health outcomes ranked most-least important were pregnancy/birth and brain development (both Rank=1), body weight (Rank=3), breathing (Rank=3), and positive health (Rank=5). Analysis indicated significant differences in relative importance of select exposures and outcomes between adult (n=824) and caregiver (n=385) groups (Figures 1-2). Open-ended and multiple-choice questions detected priorities beyond those prioritized by ECHO (Table 1).

Conclusion(s): These results can inform researchers how to prioritize the study of environmental factors impacting child development to maximize the relevance of their research for the disability community. Differences in adult and caregiver rankings reflect evolving perspectives with implications for all researchers striving to impact the study of disability.

Group differences in environmental factor ratings
Differences in adults and caregivers ratings of the importance (1-most to 5-least) of environmental factors affecting child health outcomes.

Group differences in health outcome rankings
Differences in adults and caregivers ratings of the importance (1-most to 5-least) of child health outcomes.

Endorsement of importance of "other" environment and health outcomes not previously listed: Number (%)
PAS Abstract_Table 1.pdf