NICHD research seeks to assure that all children have the opportunity to fulfill their potential for a healthy and productive life, unhampered by disease or disability. During the previous year, research funded by the NICHD found new ways to safeguard the nation's children from abuse, disease, and injury.

School-based Early Education Reduces Child Abuse and Neglect. Each year, approximately three million cases of suspected child abuse and neglect are reported to U.S. child welfare agencies. Estimated federal and state expenditures on child welfare services exceed $11 billion. Approximately 30 percent of confirmed cases of child abuse result in placement of children outside the home, at a yearly cost of $22,000 or more.[1] Researchers recently reported, however, that significant human and financial cost savings could be realized by reducing risks of child maltreatment with a school-based program combining enriched early education for children with extensive support services for their parents. Children in Chicago's poorest neighborhoods who attended such a program had a 52 percent lower rate of being abused and neglected, compared with similar children not in the program. The greatest reduction in risk of child maltreatment occurred among the poorest children in the program and among those that stayed in the program from beginning to end (age three to second or third grade). The risk reduction was also long-lasting and actually strengthened in children age 10 to 17 years, well after they and their parents finished the program. These findings, from a longitudinal study of the Child-Parent Centers (CPCs) of the Chicago School District, contrast with the mixed record of child abuse prevention programs that offer similar services, but typically for shorter periods of time and in non-school settings. Researchers attribute the positive effects of the Chicago schools' program to 1) improving the child's academic and behavioral performance, thereby increasing parents' satisfaction with their child and lessening negative family interactions; and 2) addressing parents' poor parenting practices, low educational levels, social isolation, and other stressors that contribute to the risk of child maltreatment. Cost savings attributable to the CPC program appear to be substantial. The researchers reported that the per-child cost of the enriched early education program is about half of the weighted average annual per-child cost of $9,492 (1998 dollars) of child welfare services generally.

Children Not Harmed by Mothers Leaving Welfare and Going to Work. Major federal welfare reform legislation of 1996 created work requirements for parents on welfare and raised concerns about the effects on children of welfare mothers entering the workplace. With NICHD support, and co-funding from the National Institute of Mental Health (NIMH), five other Department of Health and Human Services (DHHS) agencies, and 14 private organizations, researchers are following a large sample of children in three cities (Boston, Chicago, and San Antonio) whose mothers are moving from welfare to work. The researchers are assessing cognitive achievement, problem behaviors, and psychological well-being in preschool-age children and young adolescents. Findings from the first period of the study (1999-2001) do not show either significantly negative or positive effects in the preschoolers that could be attributed to a parent leaving welfare and entering the workforce.[2] The researchers reported similar results in the older children. In fact, they reported some gains in the adolescents' well-being, which were associated with their mothers' entry into the workforce. These first findings should help to allay concerns about immediate adverse impacts on children of the welfare reform work requirements. Researchers will continue to follow the children to assess longer-term effects.

New Clues to Autism Spectrum Disorders Emerge. Autism spectrum disorders (ASDs) are complex biological disorders of development that impair an individual's capacity to interact and communicate with other people and that may limit the individual's activities and interests. ASDs vary in severity and, depending on diagnosis, affect 10 to 20 of every 10,000 people.[3] New data from clinical centers in the Collaborative Programs of Excellence in Autism add to the growing body of evidence that may ultimately explain the atypical brain development that occurs at the cellular level in ASD. In one study of three- and four-year-old children with ASD, researchers found that concentrations of five neurochemicals implicated in healthy brain functioning differed significantly in ASD children, compared with concentrations in typically-developing (TDs) three- and four-year-olds. The atypical neurochemical levels occurred throughout various regions of the brain in children with ASD. Because earlier studies indicated that structural anomalies associated with ASD are similarly dispersed, the findings on neurochemical levels add new evidence that atypical development in ASD is not limited to a single region of the brain.

Findings from other studies also add to the growing body of evidence on atypical head and brain sizes in individuals with ASD. In one study of three- and four-year-old children with ASD, researchers found that children's brain volumes were significantly larger (9.8 percent) than those of TD children. A second study indicated that the accelerated brain development observed in younger children with ASD stopped by age 12. Researchers concluded that larger head circumferences in adolescents and adults with ASD resulted from early excess brain growth, but their larger, overall head sizes do not accurately reflect brain volumes.[4] Together, these studies can help scientists to better understand the developmental and physiological mechanisms contributing to ASD to identify accurate markers of this complex disorder and, ultimately, to develop new and improved interventions.

Reducing Teens' Motor-Vehicle Accidents by Promoting Parental Limits on Teen Driving. Among adolescents ages 16 through 20, injuries from motor vehicle crashes are the major cause of death.[5] In 2000, nearly 5,000 teenagers died of injuries from motor vehicle crashes, which accounted for 14 percent of all motor vehicle-related deaths, yet teens represented only 10 percent of the U.S. population.[6] NICHD researchers addressing this important issue recently reported that a program ("Checkpoints Program") could persuade parents that they could lessen their teenage children's risk of traffic accidents by setting clear, safety-related limits on the teens' driving privileges. The program also teaches parents how to set such limits. In addition to educational materials for parents and teens, the program includes model "driving agreements," to help families negotiate safety limits on teens' driving. Different versions of the program were tested in two states and both versions showed that participation in the program was associated with greater levels of parental controls on teen driving. These studies built on earlier research showing that closer parental involvement with their teenage children could reduce some of their other risk-taking behaviors, and that parents may underestimate their own ability to influence their children's behaviors. Because the explicit parental limits recommended by the program would reduce practices known to contribute to teen traffic accidents, such as driving at night or with multiple teenage passengers, the program could ultimately reduce rates of adolescents' motor vehicle crashes.