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Early Child Social-Emotional Problems and Child Obesity: Exploring the Protective Role of a Primary Care-Based
Rachel S Gross1, Rahil D Briggs, Rebecca S Hershberg
1*Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY; †Division of General Pediatrics, Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY.
Insights
Early social-emotional problems in children are linked to obesity and unhealthy feeding styles if not addressed by interventions. Intervention participation appeared protective against obesity in this study.
Area of Science:
- Child development
- Behavioral health
- Pediatric obesity
Background:
- Early social-emotional problems can impact child development and health outcomes.
- Parenting interventions in primary care aim to support developmental monitoring and intervention.
- Understanding the link between social-emotional health and child feeding is crucial for preventing obesity.
Purpose of the Study:
- To investigate the association between early social-emotional problems and child feeding practices.
- To examine the relationship between social-emotional problems, maternal feeding styles, and child obesity at age 5.
- To assess the role of a primary care-based parenting intervention in mitigating these associations.
Main Methods:
- Retrospective cohort study of 5-year-old children screened for social-emotional risk using the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) in early childhood.
- ASQ:SE scores were categorized as 'at risk' or 'not at risk'; 'at risk' children were further divided by intervention participation.
- Regression analyses controlled for confounders to evaluate relationships between social-emotional status, feeding, and weight at age 5.
Main Results:
- Children identified as 'at risk' and not participating in the intervention were significantly more likely to be obese at age 5 (aOR=3.12).
- Mothers of 'at risk-no participation' children showed less restrictive/limiting feeding and more pressure-to-eat behaviors.
- Children 'at risk' who participated in the intervention did not differ in weight status compared to 'not at risk' children.
Conclusions:
- Unmitigated early social-emotional problems are associated with specific feeding styles and increased risk of childhood obesity.
- Primary care-based general parenting interventions may offer a protective effect against obesity development in at-risk children.
- Further research is needed to elucidate the mechanisms by which these interventions confer protection.
Objective:
To determine whether early social-emotional problems are associated with child feeding practices, maternal-child feeding styles, and child obesity at age 5 years, in the context of a primary care-based brief general parenting intervention led by an integrated behavioral health specialist to offer developmental monitoring, on-site intervention, and/or referrals.
Methods:
A retrospective cohort study was conducted of mothers with 5-year-old children previously screened using the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) during the first 3 years of life. ASQ:SE scores were dichotomized "not at risk" versus "at risk." "At risk" subjects were further classified as participating or not participating in the intervention. Regression analyses were performed to determine relationships between social-emotional problems and feeding practices, feeding styles, and weight status at age 5 years based on participation, controlling for potential confounders and using "not at risk" as a reference group.
Results:
Compared with children "not at risk," children "at risk-no participation" were more likely to be obese at age 5 years (adjusted odds ratio, 3.12; 95% confidence interval, 1.03 to 9.45). Their mothers were less likely to exhibit restriction and limit setting and more likely to pressure to eat than mothers in the "not at risk" group. Children "at risk-participation" did not demonstrate differences in weight status compared with children "not at risk."
Conclusion:
Early social-emotional problems, unmitigated by intervention, were related to several feeding styles and to obesity at age 5 years. Further study is needed to understand how a general parenting intervention may be protective against obesity.
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