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Early cognitive development is sensitive to multiple biological, social, familial, and psychological factors. However, discerning the underlying mechanistic pathways has proved to be challenging. Using data from 506 mother-child dyads from the prospective longitudinal birth-cohort of the INMA—INfancia y Medio Ambiente—(Environment and Childhood) Project, this study aimed to test how maternal SES influences early cognitive development, examining potential mediating factors, including maternal mental health, family context, and first nursery school attendance. Results indicate that the association of maternal mental health and SES on early cognitive development is fully mediated by the quality of the family context. Nursery attendance early in life also had a full mediation effect on maternal SES. These findings suggest that epidemiological studies should consider more than SES variables when studying environmental influences on early cognitive development. Policy implications are discussed in the current context of a global likelihood of economic crises and mental health challenges.

As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (>60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.

Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.

Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.

BACKGROUND: Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. OBJECTIVES: We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. METHODS: Ours was a collaborative study of four European population-based birth/child cohorts--CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides ([NO.sub.2], [NO.sub.x]) and particulate matter (PM) with diameters of < 2.5 [micro]m ([PM.sub.2.5]), [less than or equal to] 10 [micro]m ([PM.sub.10]), and between 2.5 and 10 [micro]m (PMcoarse), and [PM.sub.2.5] absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. RESULTS: A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-[micro]g/[m.sup.3] increase in [NO.sub.2] pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. CONCLUSIONS: Prenatal exposure to [NO.sub.2] and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies. http://dx.doi.org/10.1289/ehp.1408483, Introduction Autism spectrum disorders (ASD) are lifelong developmental disabilities characterized by social interaction impairment, communication deficits, and repetitive behaviors (van Engeland and Buitelaar 2008). The prevalence of ASD has increased [...]

Background Prenatal exposure to air pollutants has recently been identified as a potential risk factor for neuropsychological impairment. Objectives To assess whether prenatal exposure to fine particulate matter (PM 2.5 ), nitrogen dioxide (NO 2 ) and benzene were associated with impaired development in infants during their second year of life. Methods Regression analyses, based on 438 mother–child pairs, were performed to estimate the association between mother exposure to air pollutants during pregnancy and neurodevelopment of the child. The average exposure to PM 2.5 , NO 2 and benzene over the whole pregnancy was calculated for each woman. During the second year of life, infant neuropsychological development was assessed using the Bayley Scales of Infant Development. Regression analyses were performed to estimate the association between exposure and outcomes, accounting for potential confounders. Results We estimated that a 1 μg/m 3 increase during pregnancy in the average levels of PM 2.5 was associated with a − 1.14 point decrease in motor score (90% CI: − 1.75; − 0.53) and that a 1 μg/m 3 increase of NO 2 exposure was associated with a − 0.29 point decrease in mental score (90% CI: − 0.47; − 0.11). Benzene did not show any significant association with development. Considering women living closer (≤ 100 m) to metal processing activities, we found that motor scores decreased by − 3.20 (90% CI: − 5.18; − 1.21) for PM 2.5 and − 0.51 (− 0.89; − 0.13) for NO 2 , while mental score decreased by − 2.71 (90% CI: − 4.69; − 0.74) for PM 2.5 , and − 0.41 (9% CI: − 0.76; − 0.06) for NO 2 . Conclusions Our findings suggest that prenatal residential exposure to PM 2.5 and NO 2 adversely affects infant motor and cognitive developments. This negative effect could be higher in the proximity of metal processing plants. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic stressors affected youth's mental health. This longitudinal study aims to explore these effects while considering predictive factors such as age and sex., Methods: An initial sample of 1502 caregivers answered a longitudinal survey evaluating their youths' (4-17 years of age) emotional/behavioral symptoms using the Pediatric Symptom Checklist (PSC) screening tool. First assessment in May-July 2020 included the prior year's retrospective (T R ) and since-lockdown-start (T 0 ) PSC, followed by monthly evaluations until February 2021., Results: A positive screening PSC (PSC+) was reported in 13.09% of cases at T R and 35.01% at T 0, but the likelihood of PSC+ quickly decreased over time. At T 0 , a more pronounced impact was found on children (39.7%) compared to adolescents (25.4%); male children exhibited higher risk for a PSC+ at T 0 and longitudinally than females. Adolescents presented a weaker effect of time-improvement. PSC+ at T R , experienced stressors, and caregiver's stress/depressive symptoms positively predicted PSC+ at T 0 and longitudinally; adolescents' unproductive coping style predicted PSC+ at T 0. CONCLUSION: The study shows a caregiver-reported increase in emotional/behavioral symptoms in youths during the COVID-19 pandemic, affecting predominantly younger children in the early stages and showing gradual improvement over time, albeit possibly slower in adolescents., Impact: The results show the anticipated surge in emotional and behavioral symptoms during the COVID-19 lockdown in youth reported by caregivers, followed by subsequent amelioration. Of greater significance, the study reveals a heightened impact on young children initially, yet it suggests a slower improvement trajectory in adolescents. The study also identifies risk factors linked to emotional and behavioral symptoms within each age group. Alongside the longitudinal approach, the authors underscore the remarkable inclusion of a significant representation of young children, an unusual feature in such surveys., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)