Amsterdam 2015
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| Abstract #2316 - Cognitive development in children and adolescents | ||||
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Session: 16.3: Cognitive development in children and adolescents (Parallel) on Wednesday @ 14.30-16.00 in C001 Chaired by Xiaoming Li, Igor Grant Authors: Presenting Author: Dr Tamsen Rochat - University of KwaZulu-Natal, South Africa |
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| Additional Authors: | ||||
| Aim: In the United States and Europe children whose parents abuse alcohol during their primary-schooling years are reported to have lower academic achievement and more behavioural problems, although some of this may be accounted for by genetic influences, or co-morbid psychiatric disorders. However little is known about alcohol use amongst parents in HIV-endemic African contexts. We investigate alcohol usage and dangerous drinking (DD) amongst parents, exploring prevalence, factors associated with risk including parental HIV, and the effects of DD on child behaviour and cognitive performance. | ||||
| Method / Issue: We re-enrolled a large longitudinal population-based cohort (Africa Centre/VTS) of 1524 HIV-uninfected children, aged 7-12 years, including children whose biological mothers were HIV-infected during pregnancy HIV-infected since the pregnancy and HIV-uninfected. Psychometric measures included: Patient Health Questionnaire Depression Scale (PHQ-9) Patient Health Questionnaire General Anxiety Scale (GAD-7) Alcohol Use Disorders Identification Test (AUDIT-6) using the WHO cut off of >8 for DD Parenting Stress Index (PSI-36) Child Behaviour Checklist (CBCL-parent reported) Kauffman Developmental Assessment Battery (KABC-II) for child cognition. | ||||
| Results / Comments: Amongst 1524 mothers/caregivers of children aged 7-12 years, 12% reported consuming alcohol with 3% classed as dangerous drinkers (DD). Higher maternal age, education and length of partnership with child’s biological father were significantly protective. Food insecurity and having a child with behavioural problems were significantly associated with alcohol consumption. Being HIV-infected during, or since, pregnancy significantly increased the odds of DD in univariable, but not multivariable, analyses. Maternal psychiatric morbidity was not significantly related to alcohol consumption in the multivariable model. Detailed examination of the 46 caregiver-child pairs reporting DD found most were biological mothers and not alternate caregivers (42 vs 4). Although many had some mental health symptomology, only a few had co-morbid mental illness meeting clinical thresholds: depression (3/46) anxiety (3/46) while a further 3/46 met criteria for both depression and anxiety. Higher numbers (12/46) had significant parenting stress particularly associated with the difficult child subscale: Difficult child: (DD M26.9, SD10.2 [23.9-30.0] No DD M23.1, SD7.9 [22.7-23.5] p=0.013). Children of DD mothers/caregivers were significantly more likely to have lower scores on the KABC Learning Scale (DD M12.80 SD3.9 [11.6-13.9] No DD M14.24 SD4.0 [14.0-14.4] p=0.018). Children in the DD group also had significant psychopathology 13/46 (30.4%), with conduct disorder (10/46) being the most common, although this was highly co-morbid with depression, anxiety and somatic disorders, and to lesser extent attention problems. | ||||
| Discussion: Although the prevalence of DD was low, there was a substantial association with children’s emotional and cognitive development. Children of DD parents scored significantly lower on the Learning cognitive scale, which measures ability to learn/store educational material efficiently and is important for educational success. Evidence suggests that integrated approaches engaging parents together with their families in treatment are more effective for improving parent-child outcomes than individual psychiatric care. Families with DD parents require specialist care, even in poorly resourced settings, to reduce morbidity. Better identification and care strategies are needed for these low prevalence, but high burden psychiatric health care problems. | ||||
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