Amanda R. Tarullo

Child maltreatment and the developing HPA axis

The developing HPA axis is under strong social regulation in infancy and early childhood and is vulnerable to perturbation in the absence of sensitive, responsive caregiving. Child maltreatment has complex, long-term influences both on basal cortisol levels and on HPA responsivity to pharmacological and psychological stressors, depending on current psychiatric status, current life adversity, age, and most likely, genetic factors. Among the more consistent findings, maltreated children with internalizing problems have elevated basal cortisol most often detected in early AM concentrations, whereas adults maltreated as children often exhibit low basal cortisol levels and elevated ACTH response to psychological stressors. To disentangle these complicated interactions, future research must take the above qualifiers into account, study the transition to puberty, explore the moderating role of candidate genes, and utilize animal models and pharmacological challenges, when ethical, to localize changes in the HPA axis. Post-institutionalized children may provide a model to separate early adverse care histories from current adversity.

Disinhibited Social Behavior Among Internationally Adopted Children

Postinstitutionalized children frequently demonstrate persistent socioemotional difficulties. For example, some postinstitutionalized children display an unusual lack of social reserve with unfamiliar adults. This behavior, which has been referred to as indiscriminate friendliness, disinhibited attachment behavior, and disinhibited social behavior, was examined by comparing children internationally adopted from institutional care to children internationally adopted from foster care and children raised by their biological families. Etiological factors and behavioral correlates were also investigated. Both groups of adopted children displayed more disinhibited social behavior than the nonadopted children. Of the etiological factors examined, only the length of time in institutional care was related to disinhibited social behavior. Disinhibited social behavior was not significantly correlated with general cognitive ability, attachment-related behaviors, or basic emotion abilities. However, this behavior was negatively associated with inhibitory control abilities even after controlling for the length of time in institutional care. These results suggest that disinhibited social behavior might reflect underlying deficits in inhibitory control.

Newborn infants learn during sleep

Newborn infants must rapidly adjust their physiology and behavior to the specific demands of the novel postnatal environment. This adaptation depends, at least in part, on the infants ability to learn from experiences. We report here that infants exhibit learning even while asleep. Bioelectrical activity from face and scalp electrodes was recorded from neonates during an eye movement conditioning procedure in which a tone was followed by a puff of air to the eye. Sleeping newborns rapidly learned the predictive relationship between the tone and the puff. Additionally, in the latter part of training, these infants exhibited a frontally maximum positive EEG slow wave possibly reflecting memory updating. As newborns spend most of their time sleeping, the ability to learn about external stimuli in the postnatal environment during nonawake states may be crucial for rapid adaptation and infant survival. Furthermore, because eyelid conditioning reflects functional cerebellar circuitry, this method potentially offers a unique approach for early identification of infants at risk for a range of developmental disorders including autism and dyslexia.

Postadoption parenting and socioemotional development in postinstitutionalized children

Children adopted from institutions (e.g., orphanages) overseas are at increased risk of disturbances in social relationships and social understanding. Not all postinstitutionalized children exhibit these problems, although factors like the severity of deprivation and duration of deprivation increase their risk. To date, few studies have examined whether postadoption parenting might moderate the impact of early adverse care. Three groups were studied: postinstitutionalized and foster care children both adopted internationally and nonadopted children reared in their families of origin. The Emotional Availability (EA) Scales were assessed at 18 months in parent-child dyads. Parent emotional availability was found to predict two aspects of social functioning shown in previous studies to be impaired in postinstitutionalized children. Specifically, EA positively correlated with emotion understanding at 36 months; in interaction with initiation of joint attention at 18 months and group, it predicted indiscriminate friendliness as scored from a parent attachment interview at 30 months. Among the postinstitutionalized children but not among the children in other groups, higher EA scores reduced the negative association between initiation of joint attention and indiscriminate friendliness, thus suggesting that parenting quality may moderate the effects of early institutional deprivation.

Atypical EEG power correlates with indiscriminately friendly behavior in internationally adopted children.

While effects of institutional care on behavioral development have been studied extensively, effects on neural systems underlying these socioemotional and attention deficits are only beginning to be examined. The current study assessed electroencephalogram (EEG) power in 18-month-old internationally adopted, postinstitutionalized children (n = 37) and comparison groups of nonadopted children (n = 47) and children internationally adopted from foster care (n = 39). For their age, postinstitutionalized children had an atypical EEG power distribution, with relative power concentrated in lower frequency bands compared with nonadopted children. Both internationally adopted groups had lower absolute alpha power than nonadopted children. EEG power was not related to growth at adoption or to global cognitive ability. Atypical EEG power distribution at 18 months predicted indiscriminate friendliness and poorer inhibitory control at 36 months. Both postinstitutionalized and foster care children were more likely than nonadopted children to exhibit indiscriminate friendliness. Results are consistent with a cortical hypoactivation model of the effects of early deprivation on neural development and provide initial evidence associating this atypical EEG pattern with indiscriminate friendliness. Outcomes observed in the foster care children raise questions about the specificity of institutional rearing as a risk factor and emphasize the need for broader consideration of the effects of early deprivation and disruptions in care.

Inhibition and Exuberance in Preschool Classrooms: Associations with Peer Social Experiences and Changes in Cortisol across the Preschool Year

Associations between behavioral inhibition and activity of the hypothalamic-pituitary-adrenocortical (HPA) system, a stress-sensitive neuroendocrine system indexed by salivary cortisol, have varied widely across studies. In the current study, we examined the role of peer social experiences in moderating patterns of association between inhibition/risk-aversion and cortisol reactivity. As expected based on previous research, preschool children (N = 165, 78 boys, 87 girls, 3.0-5.0 years) had significantly different social experiences in their preschool classrooms depending on temperament. Highly inhibited/risk-averse children were less socially integrated, less dominant, and less involved in aggressive encounters than both average and highly exuberant/risk-seeking children, but they were no more likely to be peer rejected. Highly exuberant children were more dominant, exhibited anger more often, and had friendships characterized by higher conflict. Cortisol levels fell from fall to spring for average and highly exuberant children but not for highly inhibited children. Unexpectedly, for highly inhibited children, having friends and being more dominant and popular than other highly inhibited children was associated with increasing cortisol levels over the school year. In contrast, highly exuberant children who were less socially integrated than other highly exuberant children maintained higher cortisol levels. Results indicate that the types of social experiences that affect stress-responsive biological systems may differ markedly for highly inhibited and highly exuberant children.

Fetal cerebrovascular resistance and neonatal EEG predict 18-month neurodevelopmental outcome in infants with congenital heart disease

The purpose of this study was to investigate early markers of risk for neurobehavioral compromise in survivors with congenital heart disease (CHD).

Toward an electrocortical biomarker of cognition for newborn infants

The event-related potential (ERP) effect of mismatch negativity (MMN) was the first electrophysiological probe to evaluate cognitive processing (change detection) in newborn infants. Initial studies of MMN predicted clinical utility for this measure in identification of infants at risk for developmental cognitive deficits. These predictions have not been realized. We hypothesized that in sleeping newborn infants, measures derived from wavelet assessment of power in the MMN paradigm would be more robust markers of the brains response to stimulus change than the ERP-derived MMN. Consistent with this premise, we found increased power in response to unpredictable and infrequent tones compared to frequent tones. These increases were present at multiple locations on the scalp over a range of latencies and frequencies and occurred even in the absence of an ERP-derived MMN. There were two predominant effects. First, theta band power was elevated at middle and late latencies (200 to 600 ms), suggesting that neocortical theta rhythms that subserve working memory in adults are present at birth. Second, late latency (500 ms) increased power to the unpredictable and infrequent tones was observed in the beta and gamma bands, suggesting that oscillations involved in adult cognition are also present in the neonate. These findings support the expectation that frequency dependent measures, such as wavelet power, will improve the prospects for a clinically useful test of cortical function early in the postnatal period.

Infant hair cortisol: associations with salivary cortisol and environmental context.

Early chronic stress has enduring implications for physical and mental health outcomes. Hair cortisol concentration (HCC) has emerged as a marker of cumulative cortisol exposure, yet HCC in infants is not well understood. We examined how infant HCC relates to widely used basal salivary cortisol measures, maternal HCC, and environmental context in 111 infants assessed at 6 and 12 months of age. Maternal HCC at 6 and 12 months was correlated with infant HCC at 12 months. At 12 months, infant HCC was positively associated with waking salivary cortisol concentration (SCC), evening SCC, and area under the curve (AUC), but was independent of diurnal slope. Breastfeeding was associated with lower HCC, whereas increased sleep disruption was related to flatter slope. Reduced nighttime sleep duration was related both to higher HCC and to flatter slope. A person-focused analysis indicated that the combination of high HCC and flattened slope was associated with more environmental risks, highlighting the importance of investigating the interplay between HCC and diurnal cortisol slope. Results support the validity of HCC as a marker of cumulative cortisol exposure in infancy, while emphasizing the value of including multiple cortisol measures assessing distinct aspects of hypothalamic-pituitary-adrenal (HPA) function.

Gamma power in rural Pakistani children: Links to executive function and verbal ability

Children in low- and middle-income countries are at high risk of cognitive deficits due to environmental deprivation that compromises brain development. Despite the high prevalence of unrealized cognitive potential, very little is known about neural correlates of cognition in this population. We assessed resting EEG power and cognitive ability in 105 highly disadvantaged 48-month-old children in rural Pakistan. An increase in EEG power in gamma frequency bands (21–30 Hz and 31–45 Hz) was associated with better executive function. For girls, EEG gamma power also related to higher verbal IQ. This study identifies EEG gamma power as a neural marker of cognitive function in disadvantaged children in low- and middle-income countries. Elevated gamma power may be a particularly important protective factor for girls, who may experience greater deprivation due to gender inequality.