Susan A. Zeisel

Relating quality of center-based child care to early cognitive and language development longitudinally.

How quality of center-based child care relates to early cognitive and language development was examined longitudinally from 6 to 36 months of age in a sample of 89 African American children. Both structural and process measures of quality of child care were collected through observation of the infant classroom. Results indicated that higher quality child care was related to higher measures of cognitive development (Bayley Scales of Infant Development), language development (Sequenced Inventory of Communication Development), and communication skills (Communication and Symbolic Behavior Scales) across time, even after adjusting for selected child and family characteristics. In addition, classrooms that met professional recommendations regarding child:adult ratios tended to have children with better language skills. Classrooms that met recommendations regarding teacher education tended to have girls with better cognitive and receptive language skills. These findings, in conjunction with the growing child-care literature, provide further evidence that researchers and policymakers should strive to improve the quality of child care to enhance early development of such vulnerable children.

Cumulative risk and early cognitive development: a comparison of statistical risk models.

Although it is generally accepted that social risk factors predict delays in early cognitive and language development, there is less agreement about how to represent such associations statistically. Using data collected prospectively on 87 African American children during their first 4 years, this study examined 3 analytic methods for describing a childs level of social risk: (a) individual risk variables, (b) factor scores derived from those risk variables, and (c) a risk index computed by tallying the number of risk conditions present. Comparisons indicated that the individual-risk-variables approach provides better overall prediction of developmental outcomes at a particular age but is less useful in predicting developmental patterns. The risk-factor approach provides good prediction of developmental trajectories when sample sizes are moderate to large. Finally, the risk-index approach is useful for relating social risk to developmental patterns when a large number of risk variables are assessed with a small sample or when other constructs are of primary interest.

Social Risk and Protective Factors for African American Children's Academic Achievement and Adjustment during the Transition to Middle School.

The transition to middle school is often marked by decreased academic achievement and increased emotional stress, and African American children exposed to social risk may be especially vulnerable during this transition. To identify mediators and protective factors, the authors related severity and timing of risk exposure to academic achievement and adjustment between 4th and 6th grade in 74 African American children. Longitudinal analyses indicated that severity more than timing of risk exposure was negatively related to all outcomes and that language skills mediated the pathway from risk for most outcomes. Transition to middle school was related to lower math scores and to more externalizing problems when children experienced higher levels of social risk. Language skills and parenting served as protective factors, whereas expectations of racial discrimination was a vulnerability factor. Results imply that promoting parenting and, especially, language skills, and decreasing expectations of racial discrimination provide pathways to academic success for African American children during the transition from elementary to middle school, especially those exposed to adversity.

Social Risk and Protective Child, Parenting, and Child Care Factors in Early Elementary School Years

Objective. African American children exposed to multiple social risk factors during early childhood often experience academic difficulties, so identification of protective factors is important. Design. Academic and school behavior trajectories from kindergarten through third grade were studied among 75 African American children who have been followed prospectively since infancy to test hypothesized protective factors: quality of home and child care environments during early childhood, child language and social skills at entry to kindergarten, and school characteristics. Results. Children exposed to multiple risks in early childhood showed lower levels of academic and social-emotional skills from kindergarten through third grade. Parenting mediated the association with risk. Childrens language skills, parenting, and child care quality serve as protective factors in acquisition of mathematics skills and reduction in problem behaviors during the first 4 years of primary school for African American children facing multiple risks. Attending a school with a higher proportion of children from low-income families might predict increasing numbers of problem behaviors over time. Conclusions. Exposure to social risk in early childhood negatively predicted academic achievement and adjustment during early elementary school for African American children, in part through associations between exposure to social risk and less responsive and stimulating parenting. Furthermore, the negative associations between risk and academic outcomes were substantially weaker when children had more responsive and sensitive parents or child care providers or entered school with stronger language skills.

Otitis media, hearing sensitivity, and maternal responsiveness in relation to language during infancy

The relation of otitis media with effusion (OME) and associated hearing loss to language and cognitive skills at 1 year of age was studied to determine whether OME-related hearing loss had a direct association with language and cognitive outcomes at 1 year of age or an indirect association with these outcomes, as mediated by the child-rearing environment. Subjects were 61 black infants attending community-based child care programs. The presence of OME was assessed biweekly from 6 to 12 months of age by otoscopy and tympanometry. Hearing was assessed with visual reinforcement audiometry when children were well and when ill with OME. Language and cognitive skills and the child-rearing environment at home and in child care were examined. The results indicated a modest correlation between hearing loss associated with OME and receptive language. However, the direct association between OME-related hearing loss and all the language and cognitive measures was negligible. Hearing loss had an indirect association with receptive and expressive language, cognitive development, and overall communication as mediated by child-rearing factors. That is, children with more frequent hearing loss tended to have less responsive mothers and home environments, and this association was linked to lower performance on the infant assessments.

Otitis Media, the Caregiving Environment, and Language and Cognitive Outcomes at 2 Years

Objective. To examine the relationship between otitis media with effusion (OME) and associated hearing loss between 6 and 24 months of age and childrens language and cognitive development at 2 years of age. Study Design. A prospective cohort design in which 86 African-American infants who attended group child-care centers were recruited between 6 and 12 months of age. Between 6 and 24 months, assessments included serial ear examinations using otoscopy and tympanometry, serial hearing tests, two ratings of the childrearing environment at home and in child care, and language and cognitive outcomes at 2 years. Results. Children experienced either unilateral or bilateral OME an average of 63% and reduced hearing sensitivity an average of 44% of the time between 6 and 24 months of age. Although proportion of time with OME or with hearing loss was modestly correlated with measures of language and cognitive skills, these relationships were no longer significant when the ratings of the home and child-care environments were also considered. Children with more OME or hearing loss tended to live in less responsive caregiving environments, and these environments were linked to lower performance in expressive language and vocabulary acquisition at 2 years. Conclusions. Both OME and hearing loss were more strongly related to the quality of home and child-care environments than to childrens language and cognitive development. Study results might be explained either by suggesting that children in less responsive caregiving environments experience conditions that make them more likely to experience OME and/or by suggesting that it may be more difficult for caregivers to be responsive and stimulating with children with more OME.

Social and family risk factors for infant development at one year: An application of the cumulative risk model

This study examined the utility of using a cumulative risk model for predicting cognitive and language outcomes in an infant sample. The sample was comprised of 83 biologically normal 12 month-old African-American infants who attended local child care centers. The sample was 53% female and approximately two-thirds fell within the lower socioeconomic strata. Ten social and family risk factors based on Sameroffs risk model were used to construct a Cumulative Risk Index: poverty status, maternal education less than high school, household size, unmarried mother, stressful life events, depressed maternal affect, mother-infant interactions, maternal IQ, the quality of the home environment, and quality of the day care environment. Outcome measures included the Mental Development Index from the Bayley Scales of Infant Development (MDI), the Total Score from the Communication and Symbolic Behavior Scale (CSBS), and the Receptive Communication Age score from the Sequenced Inventory for Communication Development-Revised (SICD-RCA). Results indicated that the Cumulative Risk Index was significantly correlated with the CSBS and SICD-RCA, but not with the MDI, with modest amounts of variance being accounted-for. Further, the predictive utility of the Cumulative Risk Index was slightly better than an overall regression model of prediction for the CSBS, but was outperformed by the regression model on the other two outcome measures.

Early Otitis Media with Effusion, Hearing Loss, and Auditory Processes at School Age

Objectives: To examine the effect of conductive hearing loss (HL) secondary to otitis media with effusion (OME) in the first 3 years of life on physiologic, peripheral, and higher-order behavioral auditory measures examined at school age. Methods: Peripheral hearing sensitivity for conventional and extended high-frequency audiometric ranges, physiologic (distortion product otoacoustic emissions, contralateral and ipsilateral acoustic middle ear muscle reflexes), auditory brain stem response (ABR), and higher-order auditory processing measures (masking level difference; Virtual Auditory Localization, Speech Intelligibility Gain; adaptive Pediatric Speech Intelligibility task) were examined at the end of the second grade of elementary school in two cohorts (North Carolina, N = 73, and New York, N = 59). All participants (mean age, 8 years) were followed prospectively in infancy and early childhood (7 to 39 months) for middle ear status and hearing loss (using pneumatic otoscopy/tympanometry and repeated conditioned behavioral audiometric response procedures). Multivariate analyses were conducted to address whether early OME and early conductive HL were related to physiologic, peripheral, and higher-order auditory processes. Results: Early hearing loss and OME were significantly associated with peripheral hearing at school age; extended high-frequency thresholds accounted for the result. Similarly, hearing loss in early life and OME were significantly associated with the acoustic middle ear muscle reflex: The contralateral stimulation condition accounted for the association. Significant associations with both early OME and early HL were also found for the auditory brain stem response measure and were explained by the correlations between early hearing loss and the ABR Wave V latency but not other ABR indices. There were no reliable associations between either early OME or early HL on any other auditory processes evaluated at the end of second grade. Conclusions: Extended high-frequency hearing and brain stem auditory pathway measures in childhood were significantly associated with children’s experiences with OME and hearing loss from 7 to 39 months of age. However, no significant associations were found for psychoacoustic measures of binaural processing or a behavioral adaptive speech-in-noise test at school age.

Longitudinal predictors of reading and math trajectories through middle school for African American versus Caucasian students across two samples.

This studys primary purpose was to examine the relative contribution of social-behavioral predictors to reading and math skills. The study expands on Duncan et al.s (2007) work by using longitudinal methodology from the National Institute of Child Health and Human Developments Study of Child Care and Youth Development (SECCYD) and the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K) databases, and by focusing on potential differences in patterns of early predictors of later reading and math trajectories for African American versus Caucasian students. Predictor measures were selected at kindergarten, and the outcomes included standardized reading and math scores obtained from Grades 1, 3, 5, and 9 for the SECCYD sample, and Grades 3, 5, and 8 for the ECLS-K sample. Consistent with Duncan et al.s findings, results reflect the relative contributions of early reading and math skills to later functioning in these respective academic domains for both samples, and there are indications for the importance of early expressive language skills to both reading and math in the SECCYD sample. Findings related to the power of social-behavioral predictors, however, are not consistent across samples. Although the SECCYD sample evidenced no such predictors, several interactions in the ECLS-K sample suggested the moderating effects of early ratings of aggressive behaviors and internalizing behaviors on later reading and math for African American students. The moderating effects of early teacher ratings of attention and internalizing behaviors for African American students as compared with Caucasian students in later math growth also were noted. The importance of early social-behavioral functions as related to later academic skills remains an important area of inquiry.

Otitis media in early childhood in relation to preschool language and school readiness skills among black children

Objective. To examine whether otitis media with effusion (OME) and associated hearing loss (HL) during the first 5 years of life were related to childrens language skills during the preschool years and to school readiness skills at entry to kindergarten. Methods. In a prospective study, the ears of 85 black children primarily from low-income families and recruited from community-based childcare programs were repeatedly examined from 6 months to 5 years of age for the presence of OME and from 6 months to 4 years of age for HL when well and ill with OME. Assessments were made annually of the childrens child-rearing environments at home and in childcare, and childrens language skills between 3 and 5 years of age and readiness skills in literacy and math were evaluated at entry into kindergarten. Results. Children had either bilateral or unilateral OME ∼30.4% and HL 19.6% of the observation time. OME and associated HL were significantly positively correlated with some measures of expressive language at 3 and 4 years of age; however, these direct relationships were no longer significant when the childs gender, socioeconomic status, maternal educational level, and the responsiveness and support of the home and childcare environments were also considered. Further, both OME and HL were moderately correlated with school readiness skills at entry to school, with children having more OME scoring lower in verbal math problems and with children with more HL scoring lower in math and recognizing incomplete words. These associations continued to remain significant even after partialing out the child and family background factors. Conclusions. There was not a significant relationship between childrens early OME history or HL and language skills during the preschool years. However, children with more frequent OME had lower scores on school readiness measures. These associations were moderate in degree, however, and the home environment was more strongly related to academic outcomes than was OME or HL. These results should be interpreted cautiously when generalizing to other populations.