Exposure to Environmental Toxicants and Early Language Development for Children Reared in Low-Income Households

Precision Medicine as a New Frontier in Speech-Language Pathology: How Applying Insights From Behavior Genomics Can Improve Outcomes in Communication Disorders

PURPOSE

Precision medicine is an emerging intervention paradigm that leverages knowledge of risk factors such as genotypes, lifestyle, and environment toward proactive and personalized interventions. Regarding genetic risk factors, examples of interventions informed by the field of medical genomics are pharmacological interventions tailored to an individual's genotype and anticipatory guidance for children whose hearing impairment is predicted to be progressive. Here, we show how principles of precision medicine and insights from behavior genomics have relevance for novel management strategies of behaviorally expressed disorders, especially disorders of spoken language.

METHOD

This tutorial presents an overview of precision medicine, medical genomics, and behavior genomics; case examples of improved outcomes; and strategic goals toward enhancing clinical practice.

RESULTS

Speech-language pathologists (SLPs) see individuals with various communication disorders due to genetic variants. Ways of using insights from behavior genomics and implementing principles of precision medicine include recognizing early signs of undiagnosed genetic disorders in an individual's communication patterns, making appropriate referrals to genetics professionals, and incorporating genetic findings into management plans. Patients benefit from a genetics diagnosis by gaining a deeper and more prognostic understanding of their condition, obtaining more precisely targeted interventions, and learning about their recurrence risks.

CONCLUSIONS

SLPs can achieve improved outcomes by expanding their purview to include genetics. To drive this new interdisciplinary framework forward, goals should include systematic training in clinical genetics for SLPs, enhanced understanding of genotype-phenotype associations, leveraging insights from animal models, optimizing interprofessional team efforts, and developing novel proactive and personalized interventions.

Adverse Childhood Experiences (ACEs) and Environmental Exposures on Neurocognitive Outcomes in Children: Empirical Evidence, Potential Mechanisms, and Implications

The purpose of this article is to examine the current literature regarding the relationship between adverse childhood experiences (ACEs) and environmental exposures. Specifically, the paper will focus on how this relationship between ACEs and physical environmental factors impacts the neurocognitive development of children. With a comprehensive literary search focusing on ACEs, inclusive of socioeconomic status (SES), and environmental toxins common in urban environments, the paper explores how these factors contribute to cognitive outcomes that are associated with the environment and childhood nurturing. The relationship between ACEs and environmental exposures reveals adverse outcomes in children's neurocognitive development. These cognitive outcomes include learning disabilities, lowered IQ, memory and attention problems, and overall poor educational outcomes. Additionally, potential mechanisms of environmental exposures and children's neurocognitive outcomes are explored, referencing data from animal studies and evidence from brain imaging studies. This study further analyzes the current gaps in the literature, such as the lack of data focusing on exposure to environmental toxicants resulting from experiencing ACEs and discusses the research and social policy implications of ACEs and environmental exposure in the neurocognitive development of children.

Understanding "Atmosome", the Personal Atmospheric Exposome: Comprehensive Approach

BACKGROUND

Modern environmental health research extensively focuses on outdoor air pollutants and their effects on public health. However, research on monitoring and enhancing individual indoor air quality is lacking. The field of exposomics encompasses the totality of human environmental exposures and its effects on health. A subset of this exposome deals with atmospheric exposure, termed the "atmosome." The atmosome plays a pivotal role in health and has significant effects on DNA, metabolism, skin integrity, and lung health.

OBJECTIVE

The aim of this work is to develop a low-cost, comprehensive measurement system for collecting and analyzing atmosomic factors. The research explores the significance of the atmosome in personalized and preventive care for public health.

METHODS

An internet of things microcontroller-based system is introduced and demonstrated. The system collects real-time indoor air quality data and posts it to the cloud for immediate access.

RESULTS

The experimental results yield air quality measurements with an accuracy of 90% when compared with precalibrated commercial devices and demonstrate a direct correlation between lifestyle and air quality.

CONCLUSIONS

Quantifying the individual atmosome is a monumental step in advancing personalized health, medical research, and epidemiological research. The 2 main goals in this work are to present the atmosome as a measurable concept and to demonstrate how to implement it using low-cost electronics. By enabling atmosome measurements at a communal scale, this work also opens up potential new directions for public health research. Researchers will now have the data to model the impact of indoor air pollutants on the health of individuals, communities, and specific demographics, leading to novel approaches for predicting and preventing diseases.

Temperament and sleep behaviors in infants and toddlers living in low-income homes

Temperament is a dynamic trait that can be shaped by maturity and environmental experiences. In this study, we sought to determine whether and the extent to which temperament was predicted by sleeping behaviors in an understudied sample of primarily Black and White infants and toddlers living in low-income homes (N = 150). Sleeping behaviors were assessed at 15-19 months of age with caregiver report of the Tayside Children's Sleep Questionnaire. Temperament was examined as effortful control, negativity, and surgency with the Infant Behavior Questionnaire Very Short Form at 9-12 months of age and with the Early Childhood Behavior Questionnaire Short Form at 20-24 months of age. Covariates were maternal education, household income, and child sex and race. Continuous variables were standardized, then missing data from independent variables were multiply imputed in 20 datasets. Regression analyses showed that about 1 SD improvement in toddler sleep behaviors significantly predicted about 1/5 SD better toddler effortful control. However, sleep behaviors did not significantly predict toddler surgency or negative affect. This study shows that for a sample of infants and toddlers in low-income homes, how a child learns to regulate sleeping behaviors may influence the development of overall effortful control about six months later.

Media exposure and language for toddlers from low-income homes

In the current study, we examined whether the quantity of toddlers' exposure to media was related to language skills and whether meeting the American Association of Pediatrics (AAP) recommendations of limiting media exposure to one hour or less per day was related to language skills. We examined these associations in a sample of toddlers (N = 157) living in low-income homes. Toddlers were about two years of age (M = 28.44 months, SD = 1.48 months) during the first visit when parents reported on toddlers' exposure to media in the home. Toddlers were about three years of age (M = 33.61 months, SD = 1.06 months) during the second visit when direct measures of toddlers' expressive and receptive language and receptive vocabulary skills were completed. Controls were child gender, race, mothers' education, marital status, work status, and center-based child care. Results indicated that more frequent exposure to media was related to lower expressive language, but not receptive language or receptive vocabulary. The predictor of AAP recommendation was not significantly related to any child language outcomes. These results suggest that media exposure may be related to the displacement of language-enhancing activities during a critical time for toddlers' language development. However, the AAP media recommendation of one hour may not be related to language development.

Sleep and stress in mother-toddler dyads living in low-income homes

Optimal sleeping behaviors are critical for overall development, yet some evidence suggests stress and living in a low-income environment are associated with disruptions of sleeping behaviors early in life. In this study, we investigated the association of toddler sleeping behaviors, particularly difficulties initiating and/or maintaining sleep (DIMS), and maternal and toddler prolonged stress using hair cortisol from dyads living in low-income homes. Hair cortisol was mainly sampled at the posterior vertex of mothers and toddlers (age 20-24 months) and analyzed with immunoassay (n = 94). Toddler DIMS were assessed at 15-19 and 27-31 months of age through mother-rated reports using the Tayside Children's Sleep Questionnaire. We found no associations between toddler DIMS and maternal stress. Additionally, early DIMS did not predict toddler stress. However, while controlling for early DIMS and sociodemographic factors, we found that higher toddler stress predicted greater DIMS in later toddlerhood (b = -2.28, SE = 0.98, p = .02, d_s  = 0.64). These study findings highlight the importance of understanding the role of early life stress on later sleep patterns.