742 - Exploring the Relationship between Child Opportunity Index and Bayley-III Scores in Young Children

Publication Number: 742.4875

Manuela Iglesias, Children's National Health System, Arlington, VA, United States; Daniella S. McCausland, Children's National Health System, Alexandria, VA, United States; Malavika Mahendran, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Heather Gordish-Dressman, Children's National Health System, Washington, DC, United States; Robin Baker, Inova Children's Hospital, Washington, DC, United States; Gianluca Ursini, Lieber Institute for Brain Development, Johns Hopkins University, Baltimore, MD, United States; Sarah B. Mulkey, Children's National Health System, Washington, DC, United States

Background: A child's environment can impact their neurodevelopment. Research indicates that socioeconomic factors tied to geographic location play a crucial role. The Child Opportunity Index (COI) quantifies zip code/neighborhood influences at the metro, state, and nation level. The Bayley Scales of Infant and Toddler Development (Bayley-III) is a standard tool for assessing cognitive, motor, and language skills in early childhood. To our knowledge, this is the first study to examine the relationships between COI and Bayley-III developmental outcomes.

Objective: To explore the relationship between COI and Bayley-III scores to understand how a child’s zip code relates to developmental outcomes.

Design/Methods: Demographic data were obtained from 163 children enrolled in a developmental outcomes study in the context of the COVID-19 pandemic from the Washington, DC metro area. Each child completed the Bayley-III at either age 2 and/or 3 years. Zip code data for each participant was used to determine overall COI score and sub-scores across the Education, Health/Environment, and Social/Economic subdomains at metro, state, and national levels. The COI scores are categorized into groups 5 ranging from “very high” to “very low.” To assess the relationship between Bayley-III scores and the overall COI scores and the relationship between Bayley-III scores and COI sub-scores at the metro level, linear regression and multiple linear regression were performed, respectively.

Results: Bayley-III and COI scores were obtained in 163 children. Of these, 27% were White, 6% Black, 4% Asian, 55% other racial categories, and 8% unknown. Additionally, 64% of children were Hispanic or Latino. Lower COI scores correlate with reduced cognitive and language outcomes at the metro, state, and national level (p < 0.05, Figure 1). The association between motor scores and COI levels was weaker, reaching significance only at national level (p=0.018). Local COI level sub-scores further reinforced these findings, with significant associations for cognition and language but not for motor scores in Education, Health/Environment, and Social/Economic (p < 0.05, Table 1).

Conclusion(s): COI scores are significantly associated with Bayley-III scores in young children. Higher COI scores reflect areas with greater resources, which are linked to better outcomes for children. However, additional factors such as maternal education levels and further categorization of the Education, Health/Environment, and Social/Economic subdomains may contribute to the understanding of the complex relationship between a child’s zip code and performance in the Bayley-III.

Relationship between Overall COI Scores and Bayley-III Outcomes
Figure 1 shows the relationship between overall COI scores at three different geographical levels and Bayley-III language, cognitive, and motor scores.
(*) Indicates significant associations between overall COI scores and Bayley-III scores (p < 0.05).

Relationship between COI Sub-scores and Bayley-III Outcomes
Table 1 shows the significant relationship between local COI sub-domain scores and the Bayley-III cognitive, language, and motor scores. Bayley-III Mean Percentile Scores are reported for each group of children, categorized as with “very high”, “high”, “moderate”, “low”, “very low”, COI scores.