Establishing Clinically And Theoretically Grounded Cross-Domain Cumulative Risk And Protection Scores In Sibling Groups Exposed Prenatally to Substances.
Bondi, Bianca C. Pepler, Debra J. Motz, Mary. Andrews, Naomi C. Z.
Published: October 2020
Child Abuse and Neglect
Vol. 108 , p. 1-13
Customer Service Department 6277 Sea Harbor Drive
Orlando, FL 32887-4800
Tel: +1 (877) 839-7126
Fax: +1 (407) 363-1354
Background: Prenatal substance exposure is associated with neurodevelopmental deficits. Deficits are exacerbated by cumulative risks yet attenuated by cumulative protective factors. Cross-domain relative to intra-domain risk exposure presents more neurodevelopmental challenges. Cumulative risk and protection scores must be clinically and theoretically grounded, with crossdomain considerations. Objectives: 1) Create clinically and theoretically grounded, cross-domain cumulative risk and protection scores; 2) Describe the benefits of our methodological approach. Participants & Setting: This study included three sibling groups (N = 8) at Mothercraft’s Breaking the Cycle, a child maltreatment prevention and early intervention program for substance using mothers and their children.Method: We outlined the process of establishing clinically and theoretically grounded, crossdomain cumulative risk and protection scores. Total and cross-domain cumulative risk and protection percentages, and the balance between domains of risk and protection, were explored. Results: Clinically and theoretically grounded, cross-domain cumulative risk and protection scores were established. Total percentages were reported. Cross-domain profiles of cumulative risk and protection, and the number of significant domains of risk relative to protection, were reported. The cross-domain profiles facilitated consideration of intra- and inter-domain risk and protection within and between sibling groups. Conclusions: Emerging patterns indicate the importance of establishing cumulative risk and protection scores that are: 1) clinically and theoretically grounded, 2) cross-domain, and 3) encompass cumulative protection and risk. In understanding profiles of risk and protection, we can inform evidence-based early interventions that address: 1) high-risk children, 2) the full range of risks, 3) vulnerable domains, and 4) protective factors. (Author abstract)
child abuse; risk factors; siblings; prenatal drug exposure; substance abusing parents; risk factors; measures