Establishing clinically and theoretically grounded cross-domain cumulative risk and protection scores in sibling groups exposed prenatally to substances. (October 2020)

• Record Type: Journal Article
• Authors: Bondi, Bianca C.; Pepler, Debra J.; Motz, Mary; Andrews, Naomi C.Z.
• Is Part Of: Child abuse & neglect. Volume 108(2020)
• Publication Date: 2020-10
• Subjects: Cumulative risk -- Cumulative protection -- Cross-domain -- Neurodevelopment -- Child maltreatment -- Prenatal substance exposure; Child abuse -- Periodicals; 362.76
• DOI: 10.1016/j.chiabu.2020.104631
• Languages: English
• ISSNs: 0145-2134

Abstract

Highlights: Clinically and theoretically grounded cross-domain cumulative risk and protection. Cross-domain and total percentages reported in substance-exposed sibling groups. Consideration of number of significant domains of risk relative to protection. Intra- and inter-domain risk and protection within and between sibling groups. 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.