Child Abuse and Neglect and Cognitive Function at 14 Years of Age: Findings From a Birth Cohort

OBJECTIVE: To examine the association between child maltreatment (abuse and neglect) and long-term cognitive outcomes within a prospective birth cohort. METHODS: A birth cohort of 7223 children was recruited. Independent reports of suspected child maltreatment were confidentially linked to the longitudinal study database. The principal predictor variable was notification to the state child-protection authority for suspected maltreatment (abuse, neglect, or both). The outcome variables were scores on the Wide Range Achievement Test (WRAT) reading test and Raven's Standard Progressive Matrices (RSPM), completed at 14 years of age. Multivariate regression analysis was used to adjust for potential confounders. RESULTS: A total of 3796 subjects completed either the WRAT or RSPM. There was a higher loss to follow-up among children who had been reported to the state as suspected victims of maltreatment. After controlling for a range of possible confounders and modifiers, notification to the state for child maltreatment (abuse, neglect, or both) was associated with a lower score on both the WRAT (mean difference: -4.4 when the SD is 15 [95% confidence interval: -6.3 to -2.5]) and RSPM (mean difference: -4.8 when the SD is 15 [95% confidence interval: -6.7 to -2.9]). Both reported abuse and neglect were independently associated with lower reading ability and perceptual reasoning. CONCLUSIONS: Both child abuse and child neglect are independently associated with impaired cognition and academic functioning in adolescence. These findings suggest that both abuse and neglect have independent and important adverse effects on a child's cognitive development. Pediatrics 2011;127:4-10