Establishing clinically and theoretically grounded cross-domain cumulative risk and protection scores in sibling groups exposed prenatally to substances

Bianca C Bondi; Debra J Pepler; Mary Motz; Naomi C Z Andrews

doi:10.1016/j.chiabu.2020.104631

Establishing clinically and theoretically grounded cross-domain cumulative risk and protection scores in sibling groups exposed prenatally to substances

Child Abuse Negl. 2020 Oct:108:104631. doi: 10.1016/j.chiabu.2020.104631. Epub 2020 Jul 31.

Authors

Bianca C Bondi¹, Debra J Pepler², Mary Motz³, Naomi C Z Andrews⁴

Affiliations

¹ York University, Department of Psychology, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. Electronic address: bbondi@yorku.ca.
² York University, Department of Psychology, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. Electronic address: pepler@yorku.ca.
³ Mothercraft, Early Intervention Department, 860 Richmond Street West, Toronto, ON, M6J 1C9, Canada. Electronic address: mmotz@mothercraft.org.
⁴ Brock University, Department of Child and Youth Studies, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada. Electronic address: nandrews@brocku.ca.

PMID: 32745799
DOI: 10.1016/j.chiabu.2020.104631

Abstract

Background: Prenatal substance exposure is associated with neurodevelopmental deficits. Deficits are exacerbated by cumulative risks yet attenuated by cumulative protective factors. Cross-domain relative to intra-domain risk exposure presents more neurodevelopmental challenges. Cumulative risk and protection scores must be clinically and theoretically grounded, with cross-domain considerations.

Objectives: 1) Create clinically and theoretically grounded, cross-domain cumulative risk and protection scores; 2) Describe the benefits of our methodological approach.

Participants & setting: This study included three sibling groups (N = 8) at Mothercraft's Breaking the Cycle, a child maltreatment prevention and early intervention program for substance using mothers and their children.

Method: We outlined the process of establishing clinically and theoretically grounded, cross-domain cumulative risk and protection scores. Total and cross-domain cumulative risk and protection percentages, and the balance between domains of risk and protection, were explored.

Results: Clinically and theoretically grounded, cross-domain cumulative risk and protection scores were established. Total percentages were reported. Cross-domain profiles of cumulative risk and protection, and the number of significant domains of risk relative to protection, were reported. The cross-domain profiles facilitated consideration of intra- and inter-domain risk and protection within and between sibling groups.

Conclusions: Emerging patterns indicate the importance of establishing cumulative risk and protection scores that are: 1) clinically and theoretically grounded, 2) cross-domain, and 3) encompass cumulative protection and risk. In understanding profiles of risk and protection, we can inform evidence-based early interventions that address: 1) high-risk children, 2) the full range of risks, 3) vulnerable domains, and 4) protective factors.

Keywords: Child maltreatment; Cross-domain; Cumulative protection; Cumulative risk; Neurodevelopment; Prenatal substance exposure.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Male
Mothers
Parent-Child Relations
Pregnancy
Prenatal Exposure Delayed Effects / etiology*
Retrospective Studies
Risk Factors
Siblings*

Grants and funding

77757/CIHR/Canada