Influences of environmental stressors on autonomic function in 12-month-old infants: understanding early common pathways to atypical emotion regulation and cognitive performance

Each unhappy family is unhappy in its own way† - a call for clearer conceptualization of adverse family factors in biosocial research on child and adolescent mental health problems

Child and adolescent mental health problems stem from an interaction between biological and environmental factors. In the past decades, conceptualizations of genetic and neurobiological factors have become increasingly detailed. Development of our conceptualizations of environmental factors, in contrast, is lacking behind. Environmental adversity is usually conceptualized as one rather global factor, including, for example, both structural factors (e.g. poverty and racism) and psychosocial factors (e.g. parental violence or neglect). Or, as Chow et al. (2025) in this issue put it 'There is not yet a consensus on the best way to conceptualise adverse childhood experience'. In this Editorial, we call for clearer, more specific conceptualizations of family adversity in biosocial research. This development is essential for unravelling the mechanisms that shape child and adolescent mental health problems.

Effects of acoustic stimulation on painful procedures in preterm and full-term infants: A systematic review and network meta-analysis

AIM

This study aims to compare and rank the effects of acoustic stimulation on painful procedures in both preterm and full-term infants.

METHODS

Six databases including Medline, Web of Science, the Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, and SinoMed, were searched from inception to July, 2023. A Bayesian network meta-analysis with random effects models was performed using R software and Stata 15.0. The quality of included studies was assessed using the Cochrane Collaboration's tool. The study protocol was registered at PROSPERO (Registration number: CRD42023451102).

RESULTS

A total of 28 studies involving 2624 preterm and full-term infants were included and 8 acoustic stimulation interventions were identified. Regarding pain levels during procedures, maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, vocal music therapy, white noise, and white noise plus were significantly more effective than control group [standardized mean differences (SMD) ranged from -2.6 to -0.87]. White noise plus was the most effective intervention for reducing pain levels during procedures (90.6 %). Regarding pain levels after procedures (no specific time mentioned), maternal voice, maternal voice plus, music therapy and maternal voice plus, music therapy plus, other pharmaceutical interventions, other non-pharmaceutical interventions, routine care, vocal music therapy, and white noise plus were significantly more effective than control group (SMD ranged from -4.7 to -1.6). Music therapy and maternal voice plus was the most effective intervention for reducing pain levels after procedures, without specific time mentioned (95.29 %). Regarding pain levels 1 min after procedures, only music therapy plus and other pharmaceutical interventions were effective (SMD ranged from -4.5 to -4.9) and music therapy plus was the most effective intervention (93.41 %). No interventions had significant effects on pain levels 3, 5, and 10 min after procedures. Regarding heart rate, only white noise plus could provide a lower increase during procedures. For oxygen saturation, only vocal music therapy could provide a lower decrease after painful procedures (no specific time mentioned). No interventions had significant effects on stabilizing respiratory rate.

CONCLUSION

This review suggests that multiple acoustic stimulation interventions are effective for pain relief in both preterm and full-term infants undergoing painful procedures. More high quality studies with larger sample size are required to generate evidence regarding the short- and long-term effectiveness and safety of acoustic stimulation interventions on painful procedures.

Longitudinal high-density cortical auditory event-related potentials and speech-sound discrimination in the first two years of life in extremely and very preterm infants without developmental disorders

Maturation of the auditory system in early childhood significantly influences the development of language-related perceptual and cognitive abilities. This study aims to provide insights into the neurophysiological changes underlying auditory processing and speech-sound discrimination in the first two years of life. We conducted a study using high-density electroencephalography (EEG) to longitudinally record cortical auditory event-related potentials (CAEP) in response to synthesized syllable sounds with pitch/duration change in a cohort of 79 extremely and very preterm-born infants without developmental disorders. EEG were recorded at 6 timepoints from term to 24 months corrected age, using a pseudorandom oddball paradigm. We found that the infant-P1 component of CAEP showed decreasing latency with age and more focalized cortical source stabilizing in the left primary auditory cortex by 6 months. By 6 months, a negative infant-N1 component emerged, its amplitude increasing with age and source localization showing increasing distribution over the left temporal, parietal and frontal lobes. Mismatch responses demonstrated significant differences in auditory discrimination capabilities starting from 6 months, indicating the infants' ability to detect phonetic differences. There was no correlation between infant-P1 latency, infant-P1 amplitude or mismatch response at term age and gestational age. This study suggests that cortical sound detection occurs very early and is not significantly influenced by the extent of prematurity but rather by corrected age. Early sound detection is followed by cortical sound content processing from about 6 months, with gradual organization along the cortical auditory dorsal stream and mirror neuron system in the first two years of life. Auditory discrimination of speech sounds also significantly changes from around 6 months of age.

Finding order in chaos: influences of environmental complexity and predictability on development

Environments are dynamic and complex. Some children experience more predictable early life environments than others. Here, we consider how moment-by-moment complexity and predictability in our early environments influence development. New studies using wearable sensors are quantifying this environmental variability at a fine temporal resolution across hierarchically structured physical and social features. We identify three types of predictability: periodicities ('at X time intervals, Y happens'), stability ('given statex, statex+1 is known'), and contingency ('when I do X, Y happens'). We discuss how the temporal dynamics of environments may differ between individuals and the diverse developmental neural pathways through which this may influence outcomes, such as central nervous system (CNS) arousal and executive control. Finally, we discuss practical consequences and directions for future research.

Current perspectives on perinatal mental health and neurobehavioral development: focus on regulation, coregulation and self-regulation

PURPOSE OF REVIEW

Perinatal mental health research provides an important perspective on neurobehavioral development. Here, we aim to review the association of maternal perinatal health with offspring neurodevelopment, providing an update on (self-)regulation problems, hypothesized mechanistic pathways, progress and challenges, and implications for mental health.

RECENT FINDINGS

(1) Meta-analyses confirm that maternal perinatal mental distress is associated with (self-)regulation problems which constitute cognitive, behavioral, and affective social-emotional problems, while exposure to positive parental mental health has a positive impact. However, effect sizes are small. (2) Hypothesized mechanistic pathways underlying this association are complex. Interactive and compensatory mechanisms across developmental time are neglected topics. (3) Progress has been made in multiexposure studies. However, challenges remain and these are shared by clinical, translational and public health sciences. (4) From a mental healthcare perspective, a multidisciplinary and system level approach employing developmentally-sensitive measures and timely treatment of (self-)regulation and coregulation problems in a dyadic caregiver-child and family level approach seems needed. The existing evidence-base is sparse.

SUMMARY

During the perinatal period, addressing vulnerable contexts and building resilient systems may promote neurobehavioral development. A pluralistic approach to research, taking a multidisciplinary approach to theoretical models and empirical investigation needs to be fostered.

Auditory chaos classification in real-world environments

Background & motivation

Household chaos is an established risk factor for child development. However, current methods for measuring household chaos rely on parent surveys, meaning existing research efforts cannot disentangle potentially dynamic bidirectional relations between high chaos environments and child behavior problems.

Proposed approach

We train and make publicly available a classifier to provide objective, high-resolution predictions of household chaos from real-world child-worn audio recordings. To do so, we collect and annotate a novel dataset of ground-truth auditory chaos labels compiled from over 411 h of daylong recordings collected via audio recorders worn by N = 22 infants in their homes. We leverage an existing sound event classifier to identify candidate high chaos segments, increasing annotation efficiency 8.32× relative to random sampling.

Result

Our best-performing model successfully classifies four levels of real-world household auditory chaos with a macro F1 score of 0.701 (Precision: 0.705, Recall: 0.702) and a weighted F1 score of 0.679 (Precision: 0.685, Recall: 0.680).

Significance

In future work, high-resolution objective chaos predictions from our model can be leveraged for basic science and intervention, including testing theorized mechanisms by which chaos affects children's cognition and behavior. Additionally, to facilitate further model development we make publicly available the first and largest balanced annotated audio dataset of real-world household chaos.

Preventing Excessive Noise Exposure in Infants, Children, and Adolescents

Noise exposure is a major cause of hearing loss in adults. Yet, noise affects people of all ages, and noise-induced hearing loss is also a problem for young people. Sensorineural hearing loss caused by noise and other toxic exposures is usually irreversible. Environmental noise, such as traffic noise, can affect learning, physiologic parameters, and quality of life. Children and adolescents have unique vulnerabilities to noise. Children may be exposed beginning in NICUs and well-baby nurseries, at home, at school, in their neighborhoods, and in recreational settings. Personal listening devices are increasingly used, even by small children. Infants and young children cannot remove themselves from noisy situations and must rely on adults to do so, children may not recognize hazardous noise exposures, and teenagers generally do not understand the consequences of high exposure to music from personal listening devices or attending concerts and dances. Environmental noise exposure has disproportionate effects on underserved communities. In this report and the accompanying policy statement, common sources of noise and effects on hearing at different life stages are reviewed. Noise-abatement interventions in various settings are discussed. Because noise exposure often starts in infancy and its effects result mainly from cumulative exposure to loud noise over long periods of time, more attention is needed to its presence in everyday activities starting early in life. Listening to music and attending dances, concerts, and celebratory and other events are sources of joy, pleasure, and relaxation for many people. These situations, however, often result in potentially harmful noise exposures. Pediatricians can potentially lessen exposures, including promotion of safer listening, by raising awareness in parents, children, and teenagers. Noise exposure is underrecognized as a serious public health issue in the United States, with exposure limits enforceable only in workplaces and not for the general public, including children and adolescents. Greater awareness of noise hazards is needed at a societal level.

The Contribution of Environmental Science to Mental Health Research: A Scoping Review

Mental health is influenced by multiple complex and interacting genetic, psychological, social, and environmental factors. As such, developing state-of-the-art mental health knowledge requires collaboration across academic disciplines, including environmental science. To assess the current contribution of environmental science to this field, a scoping review of the literature on environmental influences on mental health (including conditions of cognitive development and decline) was conducted. The review protocol was developed in consultation with experts working across mental health and environmental science. The scoping review included 202 English-language papers, published between 2010 and 2020 (prior to the COVID-19 pandemic), on environmental themes that had not already been the subject of recent systematic reviews; 26 reviews on climate change, flooding, air pollution, and urban green space were additionally considered. Studies largely focused on populations in the USA, China, or Europe and involved limited environmental science input. Environmental science research methods are primarily focused on quantitative approaches utilising secondary datasets or field data. Mental health measurement was dominated by the use of self-report psychometric scales. Measures of environmental states or exposures were often lacking in specificity (e.g., limited to the presence or absence of an environmental state). Based on the scoping review findings and our synthesis of the recent reviews, a research agenda for environmental science's future contribution to mental health scholarship is set out. This includes recommendations to expand the geographical scope and broaden the representation of different environmental science areas, improve measurement of environmental exposure, prioritise experimental and longitudinal research designs, and giving greater consideration to variation between and within communities and the mediating pathways by which environment influences mental health. There is also considerable opportunity to increase interdisciplinarity within the field via the integration of conceptual models, the inclusion of mixed methods and qualitative approaches, as well as further consideration of the socio-political context and the environmental states that can help support good mental health. The findings were used to propose a conceptual model to parse contributions and connections between environmental science and mental health to inform future studies.

Allostasis and metastasis: The yin and yang of childhood self-regulation

Most research has studied self-regulation by presenting experimenter-controlled test stimuli and measuring change between baseline and stimulus. In the real world, however, stressors do not flash on and off in a predetermined sequence, and there is no experimenter controlling things. Rather, the real world is continuous and stressful events can occur through self-sustaining interactive chain reactions. Self-regulation is an active process through which we adaptively select which aspects of the social environment we attend to from one moment to the next. Here, we describe this dynamic interactive process by contrasting two mechanisms that underpin it: the "yin" and "yang" of self-regulation. The first mechanism is allostasis, the dynamical principle underlying self-regulation, through which we compensate for change to maintain homeostasis. This involves upregulating in some situations and downregulating in others. The second mechanism is metastasis, the dynamical principle underling dysregulation. Through metastasis, small initial perturbations can become progressively amplified over time. We contrast these processes at the individual level (i.e., examining moment-to-moment change in one child, considered independently) and also at the inter-personal level (i.e., examining change across a dyad, such as a parent-child dyad). Finally, we discuss practical implications of this approach in improving the self-regulation of emotion and cognition, in typical development and psychopathology.

Signal in the noise: Dimensions of predictability in the home auditory environment are associated with neurobehavioral measures of early infant sustained attention

The home auditory environment influences the development of early language abilities, and excessive noise exposure is increasingly linked with deficits in language and reading scores in children. However, fewer studies have considered the role of noise exposure in shaping the development of attentional processing in early infancy, a foundational neurocognitive skill relevant for learning. Here, we used passive at-home auditory recording to investigate how multiple dimensions of infants' home auditory environments, including both the quantity and the predictability of auditory input, impacts neural and behavioral measures of sustained attention in a sociodemographically diverse sample of 3-month-old infants (N = 98 infants, 62 males; age M = 3.48 months, SD = 0.39; 52% Hispanic/Latino). Results indicated that infants who were exposed to more predictable patterns of auditory input in the home demonstrated longer overall time in sustained attention during laboratory assessments. In addition, infants' who experienced more predictable auditory input also demonstrated greater relative increases in electroencephalography frontal theta power during periods of sustained attention, a neural marker relevant to information processing and attentional control. These findings provide novel evidence into the importance of the predictability of early environmental inputs in shaping developing cortical circuitry and attentional systems from the first months of postnatal life.

Anxious parents show higher physiological synchrony with their infants

BACKGROUND

Interpersonal processes influence our physiological states and associated affect. Physiological arousal dysregulation, a core feature of anxiety disorders, has been identified in children of parents with elevated anxiety. However, little is understood about how parent-infant interpersonal regulatory processes differ when the dyad includes a more anxious parent.

METHODS

We investigated moment-to-moment fluctuations in arousal within parent-infant dyads using miniaturised microphones and autonomic monitors. We continually recorded arousal and vocalisations in infants and parents in naturalistic home settings across day-long data segments.

RESULTS

Our results indicated that physiological synchrony across the day was stronger in dyads including more rather than less anxious mothers. Across the whole recording epoch, less anxious mothers showed responsivity that was limited to 'peak' moments in their child's arousal. In contrast, more anxious mothers showed greater reactivity to small-scale fluctuations. Less anxious mothers also showed behaviours akin to 'stress buffering' - downregulating their arousal when the overall arousal level of the dyad was high. These behaviours were absent in more anxious mothers.

CONCLUSION

Our findings have implications for understanding the differential processes of physiological co-regulation in partnerships where a partner is anxious, and for the use of this understanding in informing intervention strategies for dyads needing support for elevated levels of anxiety.

Environmental noise, brain structure, and language development in children

While excessive noise exposure in childhood has been associated with reduced language ability, few studies have examined potential underlying neurobiological mechanisms that may account for noise-related differences in language skills. In this study, we tested the hypotheses that higher everyday noise exposure would be associated with 1) poorer language skills and 2) differences in language-related cortical structure. A socioeconomically diverse sample of children aged 5-9 (N = 94) completed standardized language assessments. High-resolution T1-weighted magnetic resonance imaging (MRI) scans were acquired, and surface area and cortical thickness of the left inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) were extracted. Language Environmental Analysis (LENA) was used to measure levels of exposure to excessive environmental noise over the course of a typical day (n = 43 with complete LENA, MRI, and behavioral data). Results indicated that children exposed to excessive levels of noise exhibited reduced cortical thickness in the left IFG. These findings add to a growing literature that explores the extent to which home environmental factors, such as environmental noise, are associated with neurobiological development related to language development in children.

Oscillatory entrainment to our early social or physical environment and the emergence of volitional control

An individual's early interactions with their environment are thought to be largely passive; through the early years, the capacity for volitional control develops. Here, we consider: how is the emergence of volitional control characterised by changes in the entrainment observed between internal activity (behaviour, physiology and brain activity) and the sights and sounds in our everyday environment (physical and social)? We differentiate between contingent responsiveness (entrainment driven by evoked responses to external events) and oscillatory entrainment (driven by internal oscillators becoming temporally aligned with external oscillators). We conclude that ample evidence suggests that children show behavioural, physiological and neural entrainment to their physical and social environment, irrespective of volitional attention control; however, evidence for oscillatory entrainment beyond contingent responsiveness is currently lacking. Evidence for how oscillatory entrainment changes over developmental time is also lacking. Finally, we suggest a mechanism through which periodic environmental rhythms might facilitate both sensory processing and the development of volitional control even in the absence of oscillatory entrainment.

Noise pollution and human cognition: An updated systematic review and meta-analysis of recent evidence

BACKGROUND

This systematic review provides a comprehensive synthesis of recent epidemiological evidence that environmental noise negatively impacts human cognition.

METHODS

We update a prior review with recent publications (PROSPERO CRD42019151923). The strength of evidence for associations was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. We also conducted random-effects meta-analyses where suitable.

RESULTS

16 studies were identified and reviewed in tandem with 32 studies previously reviewed by Clark & Paunovic (2018). A meta-analysis from 3 studies found that reading comprehension scores in quiet classrooms were 0.80 (95% confidence interval: 0.40; 1.20) points higher than children in noisier classrooms. Meta-analysis of the impact of 1 dB (dB) increase in environmental noise on reading and language abilities gave a pooled beta coefficient of -0.11(95% confidence interval: -0.32; 0.10). A meta-analysis of Odds Ratios (OR) from 3 studies found higher odds of cognitive impairment in people aged 45 + with higher residential noise exposure (OR 1.40, 95% CI: 1.18;1.61). After qualitative synthesis of remaining studies, there was high quality evidence for an association between environmental noise and cognitive impairment in middle-to-older adults, moderate quality evidence for an association between aircraft noise and reading and language in children, and moderate quality evidence against an association between aircraft noise and executive functioning in children. Generally the literature was supportive for other cognitive outcomes, but with low or very low-quality evidence.

DISCUSSION

The evidence so far suggests that noise exposure is associated with cognition, but more good quality research using standardised methodology is required to corroborate these results and to allow for precise risk estimation by larger meta-analyses. There is also a need for more research with older teenagers and young-to-middle aged adults, on the synergistic effects of noise and air pollution, and in Africa, Central and South America, South Asia and Australasia.

Stress and Learning in Pupils: Neuroscience Evidence and its Relevance for Teachers

Our understanding of how stress affects primary school children's attention and learning has developed rapidly. We know that children experience differing levels of stressors (factors that cause stress) in their environments, and that this can influence how they respond to new stressors when they occur in educational contexts. Here, we review evidence showing that stress can increase children's attention and learning capacities in some circumstances but hinder them in others. We show how children differ in their attention and learning styles, dependent on stress levels: for example, more highly stressed children may be more distracted by superficial features and may find it harder to engage in planning and voluntary control. We review intervention research on stress management techniques in children, concentrating on psychological techniques (such as mindfulness and stress reappraisal), physiological techniques (such as breathing exercises) and environmental factors (such as reducing noise). At the current time, raising teachers' awareness of pupils' differing stress responses will be an important step in accommodating the differing needs of children in their classrooms.

The Strengths of People in Poverty

On average, psychological variables are often statistically different in people living in poverty compared with people living in affluence. The default academic response to this pattern is often the deficit model: Poverty damages or impairs brain function, which leads to poor performance that only exacerbates the poverty. Deficits and damage are real phenomena. However, there are also other processes: People living in poverty may have made reasonable psychological responses to their circumstances or may have developed strengths that enhance their ability to cope with challenges in their lives. We illustrate these points by discussing the linked examples of time preference, early reproduction, and hidden talents. We argue for a balanced approach to the psychology of poverty that integrates deficit and strengths-based models. Future research could focus on the ways in which impairment and adaptation interact.