Child opportunity and cognitive development in a clinically referred sample

This study examined associations between neighborhood context (quality of resources/conditions important for healthy child development) and IQ in youth presenting for neuropsychological evaluations. Participants included 4,633 DC Metro Area youth (ages 2-22) who underwent neuropsychological evaluation. Neighborhood opportunity was assessed with the Child Opportunity Index (COI) 2.0 (Metro norms). Multiple regression analyses examined associations between COI and IQ and explored moderation of age, sex, and medical condition. Controlling for age, sex, and medical condition, neighborhood opportunity was positively associated with IQ, with the model accounting for approximately 10-14% of the variance in cognitive outcomes (full scale IQ: β = 0.198; verbal IQ: β = 0.202; non-verbal IQ: β = 0.148, p's < 0.001). Age moderated the association between COI and cognitive outcomes (full scale IQ: β = 0.005, p = 0.018; verbal IQ: β = 0.005, p = 0.043; non-verbal IQ: β = 0.005, p < 0.001) with stronger association at older ages. Cognitive outcomes were associated with educational (p < 0.01) and social/economic (p < 0.001) but not health/environmental opportunity (p = 0.553). Children living in higher opportunity neighborhoods showed higher performance on measures of IQ. A child's neighborhood resources (especially educational and social/economic) are an important consideration when interpreting cognitive performance of children. These findings support the need for advocacy to improve community resources as a path toward addressing inequities that may impact cognitive development.