Intergenerational risk transmission and toxic stress: Impact on child development in a Community Social Pediatrics Context
CPS ePoster Library. Melançon A. 06/01/17; 176645; 84
Andréane Melançon
Andréane Melançon
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Background: Child well-being and development is closely dependent on his proximal environment. Early life chronic adversity exposure engenders toxic stress that will jeopardize cognitive, emotional, and health development. Poverty is a well-documented risk factor. However, less is known about the intergenerational transmission effects of cumulative risk factors such as maternal history of early adversity (MHEA) and low socioeconomic status (SES). Because childhood SES influences developmental outcomes with effects sustained in adulthood, it is essential to address the influence of MHEA on child well-being in the context of low SES.

Objectives: Community Social Pediatrics is an integrated social medicine model that brings together expertise from the medical, legal and social science in an eco-biological way in order to detect, reduce or eliminate sources of toxic stress in vulnerable children. Services and multidisciplinary interventions are provided in a single location, the community social pediatric center (CSPC). The goal of this study is to examine the influence of maternal history of early adversity (MHEA) and toxic stressors on child well-being in the context of CSPC.

Methods: Two groups were compared: CSPC users (mothers-children dyads, age 18 to 48 months, n = 34) and a low SES sub-sample (mothers-children dyads, age 48 months, n = 64). The latter is taken from a longitudinal study on maternal adversity. MHEA was assessed using the Childhood Trauma Questionnaire (CTQ) and child behavior was measured using the Child Behavior Checklist (CBCL).

Results: Results show that MHEA is significantly higher among CSP users than in normative samples (p < .05). Pearson correlations revealed more associations between CTQ and CBCL scores in the CSPC group as compared to the low SES sub-sample. Moreover, MHEA was more correlated with externalizing problems, aggressive behavior, and emotionally reactive behavior in CSPC children. Follow-up analyses will be performed to evaluate CSP interventions on reduction of toxic stress.

Conclusion: These results suggest that not all low SES families are equally vulnerable. One may hypothesize, that children exposed to toxic stress are at increased risk of developing behavioural problems. It emphasizes the need to implement early, tailored and complex interventions to break the intergenerational risk transmission pathway.To our knowledge, this study is the first to evaluate both the effects of maternal history of early adversity on families in a CPSC context and the benefits of interventions on toxic stress levels and on child development. This is of critical importance, as the CSPC model can be easily implemented in different communities.

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