title: Adversity, Maltreatment, and Resilience in Young Children.
abstract: BACKGROUND
  Much of the research on children in high risk environments, particularly those who have been maltreated, has focused on negative outcomes. Yet, much can be learned from some of these children who fare relatively well. The objective was to examine resilience in high-risk preschoolers, and to probe contributors to their adaptive functioning.
  
  
  METHODS
  The sample of 943 families was from the Longitudinal Studies of Child Abuse and Neglect, a consortium of 5 sites, prospectively examining the antecedents and outcomes of maltreatment. Most of the families were at high risk for maltreatment, and many had been reported to Child Protective Services (CPS) by the time the children were aged 4 years. Standardized measures were used at ages 4 and 6 to assess the children's functioning in behavioral, social and developmental domains, and parental depressive symptoms and demographic characteristics. Maltreatment was determined on the basis of CPS reports. Logistic regressions were conducted to predict resilience, defined as competencies in all 3 domains, over time.
  
  
  RESULTS
  Forty-eight percent of the sample appeared resilient. This was associated with no history of maltreatment (odds ratio = 1.50; 95% confidence interval [CI], 1.02-2.20; P = .04), a primary caregiver reporting few depressive symptoms (odds ratio = 2.19; 95% CI, 1.63-2.94; P < .001), (P = .014), and fewer children in the home (P = .03).
  
  
  CONCLUSIONS
  Almost half of the sample appeared resilient during this important developmental period of transition to school. This enables clinicians to be cautiously optimistic in their work with high-risk children and their families. However, more than half the sample was not faring well. Child maltreatment and caregiver depressive symptoms were strongly associated with poor outcomes. These children and families deserve careful attention by pediatric practitioners and referral for prevention and early intervention services.
authors: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md. Electronic address: hdubowitz@peds.umaryland.edu.
authors: Howard
authors: H
authors: Dubowitz
authors: Richard H. Calica Center for Innovation in Children and Family Services, Juvenile Protective Association, Chicago, Ill.
authors: Richard
authors: R
authors: Thompson
authors: Judge Baker Children's Center, Harvard Medical School, Boston, Mass.
authors: Laura
authors: L
authors: Proctor
authors: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md.
authors: Richard
authors: R
authors: Metzger
authors: Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Md.
authors: Maureen M
authors: MM
authors: Black
authors: School of Social Work, University of Washington, Seattle, Wash.
authors: Diana
authors: D
authors: English
authors: Human Services Psychology, University of Maryland Baltimore County, Baltimore, Md.
authors: Gina
authors: G
authors: Poole
authors: Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Md.
authors: Lawrence
authors: L
authors: Magder
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002652:Child Behavior; D002657:Child Development; D000068216:Child Protective Services / Q000706:statistics & numerical data; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D010290:Parents / Q000523:psychology*; D055500:Resilience, Psychological; D012919:Social Behavior; D055815:Young Adult
keywords: adversity; child maltreatment; competencies; resilience