Abstract
OBJECTIVES: 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.