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Journal Article

Citation

Dubowitz H, Thompson R, Proctor L, Metzger R, Black MM, English D, Poole G, Magder L. Acad. Pediatr. 2016; 16(3): 233-239.

Affiliation

Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.

Copyright

(Copyright © 2016, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2015.12.005

PMID

26868289

Abstract

BACKGROUND AND OBJECTIVES: Much of the research on children in high risk environments, particularly those who have been maltreated, has focused on negative outcomes. Yet, much can be learned from some of these children who fare relatively well. The objective was to examine resilience in high risk preschoolers, and to probe contributors to their adaptive functioning.

METHODS: The sample of 943 families was from the Longitudinal Studies on Child Abuse and Neglect (LONGSCAN), a consortium of 5 sites, prospectively examining the antecedents and outcomes of maltreatment. Most of the families were at high risk for maltreatment, and many had been reported to Child Protective Services by age 4. Standardized measures were used at ages 4 and 6 to assess the children's functioning in Behavioral, Social and Developmental domains, and parental depressive symptoms and demographic characteristics. Maltreatment was based on CPS reports. Logistic regressions were conducted to predict resilience, defined as competencies in all three domains, over time.

RESULTS: Forty-eight percent of the sample appeared resilient. This was associated with no history of maltreatment (OR=1.50, 95%CI=1.02-2.20, P=.04)), a primary caregiver reporting few depressive symptoms (OR=2.19, 95%CI=1.63-2.94, P<.001), was employed (P =.014), and fewer children in the home (P=-.03).

CONCLUSIONS: Almost half the sample appeared resilient during this important developmental period of transition to school. This enables clinicians to be cautiously optimistic in their work with high risk children and their families. However, over half the sample was not faring well. Child maltreatment and caregiver depressive symptoms were strongly associated with poor outcomes. These children and families deserve careful attention by pediatric practitioners and referral for prevention and early intervention services.


Language: en

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