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. Tylavsky University of Tennessee.

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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. Tylavsky University of Tennessee Health Science Center, The Urban Child Institute

Examine 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.

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.

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

Bayley Scales of Infant and Toddler Development, 3 rd 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 scores Wechsler Abbreviated Scale of Intelligence (WASI, Wechsler, 1999)  Total IQ Demographic characteristics of participants  Maternal age, education, race, marital status, insurance  Child gestational age

Characteristics of participants12 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 school high 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 American White Other 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 partner Not married 498 (59.6) 336 (40.3) 279 (54.8) 229 (45.0) 91 (45.0) 110 (54.5) Insurance, n(%) Medicaid Other None 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) (39.45) (40.64) (39.95) Child gestational age, M(SD)38.78 (1.72)38.80 (1.80)38.86 (1.77)

BSID-III variables12 mo. (N=835) 1 24 mo. (N=509) 36 mo (N=202) Cognitive risk, n(%) Competent Emerging 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(%) Competent Emerging 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) 1 BSID-III Screener administered.

VariableβSEOR95% CIWald statistic p Cognitive Risk Maternal age [0.99, 1.08] WASI Total T score [0.98, 0.99] Gestational age [0.79, 0.96] Receptive Communication Risk WASI Total T score [0.98, 0.99] Cognitive growth fostering behavior [0.88, 0.99] Expressive Communication Risk Cognitive growth fostering behavior [0.82, 0.93]

Maternal variablesBSE Bβtp Education Race WASI total T score Cognitive growth fostering behavior Note. R 2 =.32 (N=500, p <.001).

Maternal variablesBSE Bβtp Race Cognitive growth fostering behavior Note. R 2 =.29 (N=202, p <.001).

Observed 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.

Factors 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 Fran A. Tylavsky, DPH Amy Mary Scheck, MA

University of Tennessee Health Science Center  College of Medicine  Preventive Medicine  Pediatrics  Boling Center for Developmental Disabilities  College of Nursing The Urban Child Institute University of Memphis Regional Medical Center Vanderbilt University University of Alabama, Birmingham Tulane University Texas Tech University University of North Carolina, Charlotte University of Montreal