Dubowitz
H
,
Thompson
R
,
Proctor
L
, et al
.
Adversity, maltreatment, and resilience in young children
.
Acad Pediatr
.
2016
;
16
(
3
):
233
239
; doi:
https://doi.org/10.1016/j.acap.2015.12.005

Researchers from multiple institutions aimed to characterize competencies and resilience in high-risk children and to identify factors associated with resilience. They used data from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN), which are prospective studies characterizing consequences of child maltreatment and other adverse experiences. LONGSCAN data were collected between 1990 and 1995 from 5 geographically diverse sites in the United States. Families included in LONGSCAN were at high risk for maltreatment based on characteristics such as poverty and foster care placement, but specific inclusion criteria varied by region. Inclusion in the present study required that the child and caregiver participated in LONGSCAN data collection when the child was 4 and 6 years of age. The current study looked retrospectively at data initially collected in a prospective manner.

Data collection included demographics, history of report to Children’s Protective Services (CPS), caregiver financial information, and caregiver depression, as measured by the Center for Epidemiological Studies-Depression Scale. In addition, study children were assessed for competency in 3 domains, including behavioral, social, and developmental, with standardized tests at 4 and 6 years of age. “Resilience” was defined as being competent in 5 of the 6 measures of the 3 domains, each assessed twice (age 4 and 6). Logistic regression was used to identify associations between family characteristics and resilience in study children.

The study population consisted of 943 families. There was a history of a CPS report for nearly two thirds of study children. Nearly half of caregivers had high depressive symptoms and 71% had an annual income of <$20,000. At age 4, only 29% of participants were competent in all 3 domains. This increased to 52% by age 6. Overall, 48% of study children were categorized as “resilient” based on competencies in the 3 domains. In the regression analysis, resilience was statistically associated with caregiver depression, child maltreatment, and number of children in the home. Specifically, children with a caregiver who had few depressive symptoms were approximately twice as likely to be resilient; those without a CPS report prior to age 4 were 1.5 times as likely to be resilient, and children living in households with <6 children were significantly more likely to be resilient than those from larger families. No difference in resilience was seen based on gender, household annual income, or number of adults in the household.

The authors conclude that many children from high-risk situations may be resilient, but children who have a history of a report to CPS, or have caregivers who are depressed, are less likely to be resilient.

Dr Anderst has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

The impact of early childhood adversity, “toxic stress”, and their consequences has been previously...

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