771 - Unique contribution of early relational health to child developmental outcomes

Publication Number: 771.6685

Andreane Lavallee, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Jennifer M. Warmingham, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Elena Arduin, Columbia University, New York, NY, United States; Nicole Shearman, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Ginger Atwood, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Marissa R. Lanoff, Columbia University Vagelos College of Physicians and Surgeons, New York City, NY, United States; Vitoria Chaves, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Imaal Ahmed, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Margaret Kyle, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Morgan R. Firestein, Columbia University Medical Center, New York, NY, United States; Dani Dumitriu, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States

Background: In 2023, the American Academy of Pediatrics (AAP) published a cornerstone statement making universal promotion of caregiver-child early relational health (ERH) an essential pediatric practice. ERH is a blanket term for constructs describing the tie between caregivers and children (e.g., bonding, sensitivity). Though decades of data support the correlation between ERH and child development, it remains unclear how distinct ERH constructs uniquely contribute to the promotion or buffering of various child neurodevelopmental and socioemotional developmental domains.

Objective: Leveraging available data from the ongoing COMBO Initiative, we explored the association between ERH constructs at 4mo and prospective child development at 24-36mo.

Design/Methods: ERH includes mother-reported bonding (Postpartum Bonding Questionnaire), and video-coded maternal sensitivity (adaptation of Ainsworth Maternal Sensitivity Scale) and emotional connection (Welch Emotional Connection Screen). Child neurodevelopment includes cognitive, expressive/receptive language, and gross/fine motor skills assessed through the observer-based Developmental Assessment of Young Children-2nd edition (DAYC-2), and internalizing and externalizing symptoms mother-reported on the Child Behavior Checklist (CBCL). We tested: 1-the individual association between each ERH construct and development using linear regression, and 2-the unique contribution using 2-wave Structural Equation Modeling (SEM) combining all 3 ERH constructs in one model. Analyses were controlled for maternal race, ethnicity and insurance, and child sex and age at neurodevelopmental assessment.

Results: When considered individually, lower 4mo bonding predicts 24-36mo externalizing symptoms (n=484, B=-0.17, p=0.001), and stronger 4mo emotional connection predicts better gross motor (n=173, B=0.16, p=0.04), expressive (n=173, =0.21, p=0.006) and receptive language (n=173, B=0.16, p=0.02) at 24mo. When modeled together (n=98), 4mo maternal sensitivity uniquely predicts more advanced cognitive development (B=0.247, p=0.005) and less externalizing symptoms (B=-0.221, p=0.026) at 24-36mo, emotional connection uniquely predicts 24mo expressive language (B=0.249, p=0.008), but bonding does not predict any developmental outcome.

Conclusion(s): Preliminary results support the hypothesis that ERH constructs uniquely predict specific fundamental aspects of child development. Results further support the importance of considering multiple ERH constructs within caregiver-child cohorts to tease apart their unique contribution and explain variations across developmental outcomes throughout childhood.