Maternal-Child Contributions to

Cognitive Development in 12, 24, and 36 Month

Olds

J.C. Graff, L.E. Murphy, F.B. Palmer, C.M. Warner-Metzer, C. Butzon-Reed, B. Keisling, C.

Klubnik, L. Benner, S. Bliss, F.A. TylavskyUniversity of Tennessee Health Science Center,

The Urban Child Institute

PurposeExamine maternal and child predictors of cognitive development in 12, 24, and 36 month old children enrolled in the CANDLE Study being conducted by a cross-disciplinary, cross-institutional team of researchers.

CANDLE Study

The CANDLE Study (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) is designed to:

Evaluate 1,500 pregnant women and their children living in Memphis/Shelby County, TN from the second trimester into childhood.

Investigate the wide range of genetic, epigenetic, demographic, environmental and social factors influencing child development across urban and suburban neighborhoods.

Maternal Criteria for Enrollment

Pregnant women between 16 and 28 weeks gestationShelby County resident Low risk pregnancy Between the ages of 16 and 40 Speak and understand English Single pregnancy Must be willing to give consent

MeasuresBayley Scales of Infant and Toddler Development, 3rd edition (BSID-III; Bayley, 2006)

Cognitive, Receptive communication, Expressive communication

Parent-Child Interaction Teaching Scale (PCI, Sumner & Spietz, 1994)

Caregiver and child subscales and total scoresWechsler Abbreviated Scale of Intelligence (WASI, Wechsler, 1999)

Total IQDemographic characteristics of participants

Maternal age, education, race, marital status, insurance Child gestational age

Characteristics of participants

12 mo.(N=835)

24 mo.(N=509)

36 mo(N=202)

Maternal

Age, M(SD) 26.46 (5.45) 26.25 (5.52) 24.78 (5.46)

Education, n(%)<high schoolhigh school>high school

79 (9.5)381 (45.6)374 (44.9)

56 (11.0)243 (47.7)209 (41.0)

42 (20.8)104 (51.5)

55 (27.2)

Race, n(%)African AmericanWhiteOther

540 (64.7)274 (32.8)

21 (2.5)

345 (67.8)154 (30.3)

10 (2.0)

152 (75.2)46 (22.8)

4 (2.0)

Marital status, n(%)Married/living with partnerNot married

498 (59.6)336 (40.3)

279 (54.8)229 (45.0)

91 (45.0)110 (54.5)

Insurance, n(%)MedicaidOtherNone

462 (55.3)362 (43.4)

11 (1.3)

307 (60.3)201 (39.5)

1 (.2)

153 (75.7)48 (23.8)

1 (.5)

Cognitive growth fostering, M(SD)

11.40 (2.92) 12.21 (2.76) 12.00 (2.82)

WASI total score, M(SD) 189.44 (39.45)

186.25 (40.64)

172.37 (39.95)

Child gestational age, M(SD) 38.78 (1.72) 38.80 (1.80) 38.86 (1.77)

BSID-III variables 12 mo.(N=835)

1

24 mo.(N=509)

36 mo(N=202)

Cognitive risk, n(%)CompetentEmerging or at risk

706 (84.6)125 (15.0)

- -

Receptive communication risk, n(%)

Competent Emerging or at risk

627 (75.1)204 (24.4)

- -

Expressive communication risk, n(%)

CompetentEmerging or at risk

704 (84.3)127 (15.2)

- -

Cognitive scaled score, M(SD) - 9.50 (2.67) 8.56 (1.73)

Receptive communication scaled, M(SD)

- 9.13 (2.76) 9.66 (2.12)

Expressive communication scaled, M(SD)

- 9.67 (2.58) 9.52 (2.03)

1BSID-III Screener administered.

Cognitive outcomes

Logistic regression predicting development at 12 months

Variable β SE OR 95% CI Wald statisti

c

p

Cognitive Risk

Maternal age 0.04

0.02 1.04

[0.99, 1.08]

3.49 .062

WASI Total T score

-0.0

1

0.00 0.99

[0.98, 0.99]

7.44 .006

Gestational age -0.1

3

0.05 0.88

[0.79, 0.96]

6.91 .009

Receptive Communication Risk

WASI Total T score -0.0

1

0.00 0.99

[0.98, 0.99]

9.85 .002

Cognitive growth fostering behavior

-0.0

7

0.03 0.93

[0.88, 0.99]

5.33 .021

Expressive Communication Risk

Cognitive growth fostering behavior

-0.1

3

0.03 0.87

[0.82, 0.93]

17.08 .000

Regression analysis predicting cognitive development at 24

months

Maternal variables

B SE B β t p

Education 0.35 0.11 0.16 3.26 .001

Race 0.97 0.24 0.19 3.98 .000

WASI total T score 0.01 0.00 0.19 3.34 .001

Cognitive growth fostering behavior

0.16 0.04 0.17 3.95 .000

Note. R2 = .32 (N=500, p <.001).

Regression analysis predicting cognitive development at 36 months

Maternal variables

B SE B β t p

Race 1.46 0.24 0.41 6.20 .000

Cognitive growth fostering behavior

0.134

0.04 0.22 3.28 .001

Note. R2 = .29 (N=202, p <.001).

ConclusionObserved cognitive growth fostering behavior measured by the Teaching Scale contributed to cognitive development in 12, 24, and 36 month olds. The variables making the greatest contribution to the young child’s development varied across these three time points. Additionally, maternal characteristics, i.e., education, socioeconomic status, and race, varied at each time point.

RecommendationFactors contributing to maternal behaviors that foster child development should be examined carefully.As the CANDLE Study data collection continues, statistical analyses can be conducted to identify groups within this population that can benefit from interventions that are tailored to maternal and child characteristics and available resources to the children, their mothers, and their families.

Special thanks to CANDLE study mothers,

children and their families!

Contact Information:J. Carolyn Graff, PhD, RN

cgraff@uthsc.eduFran A. Tylavsky, DPHftylavsky@uthsc.edu

Amy Mary Scheck, MAascheck@uthsc.edu

CANDLE Investigators, Examiners, Staff, and

CollaboratorsUniversity of Tennessee Health Science Center

College of Medicine Preventive Medicine Pediatrics Boling Center for

Developmental Disabilities

College of NursingThe Urban Child InstituteUniversity of Memphis

Regional Medical CenterVanderbilt UniversityUniversity of Alabama, BirminghamTulane UniversityTexas Tech UniversityUniversity of North Carolina, CharlotteUniversity of Montreal