title: Impact of county disadvantage on behavior problems among US children with cognitive delay.
abstract: OBJECTIVE
  We investigated relationships among cognitive delay, community factors, and behavior problems over 2 years in early childhood with a national sample of US families.
  
  
  METHODS
  Data were from 3 waves of the Early Childhood Longitudinal Study, Birth Cohort (2001-2005; n = 7650). We defined cognitive delay as the lowest 10% of mental scores from the Bayley Short Form-Research Edition, administered at 9 and 24 months. At 24 months, we classified children as typically developing or as having resolved, newly developed, or persistent cognitive delays. Behavior was measured at age 4 years with the Preschool and Kindergarten Behavior Scales (range = 0-36). Community factors included perceived neighborhood safety and an index of county disadvantage.
  
  
  RESULTS
  Behavior scores at age 4 years (mean = 12.4; SD = 4.9) were higher among children with resolved (Β = 0.70; SE = 0.20), newly developed (Β = 1.92; SE = 0.25), and persistent (Β = 2.96; SE = 0.41) cognitive delays than for typically developing children. The interaction between county disadvantage and cognitive delay status was statistically significant (P < .01), suggesting that county disadvantage was particularly detrimental for children with persistent delays.
  
  
  CONCLUSIONS
  The community context may provide an opportunity for public health interventions to improve the behavioral health of children with cognitive delays.
authors.affiliation: Erika R. Cheng is with Harvard Medical School and Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Center for Child and Adolescent Health Research and Policy, Boston, MA. Hyojun Park, Stephanie A. Robert, and Mari Palta are with Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison. Whitney P. Witt is with Behavioral Health and Quality Research, Truven Health Analytics, Bethesda, MD.
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.forename: Hyojun
authors.initials: H
authors.lastname: Park
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Robert
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
mesh_terms: D059269:Chilaiditi Syndrome; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000209:etiology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011204:Poverty Areas; D011581:Psychological Tests; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology