Prevalence of maternal trauma exposure and association with teacher rating of child social skills in preschool
Kistin, Caroline J.
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OBJECTIVE: To examine the association between maternal trauma exposure and children's social skills in preschool. METHODS: We nested a prospective cohort study within an ongoing randomized controlled trial of a maternal depression prevention intervention. Each participating mother had a three to five year-old child in Head Start. Maternal trauma history was assessed at baseline. Six months later, Head Start teachers (masked to both study arm and mothers' depression status) completed the Social Skills Rating system (SSRS) to assess children's social skills and problem behaviors. SSRS scores of children of mothers with and without a trauma history were compared using t-tests for bivariate comparisons. To evaluate for potential effect measure modification and confounding, we conducted a stratified analysis by the variables of interest. We evaluated for effect measure modification by comparing stratum-specific estimates to each other. we then evaluated for confounding by comparing the standardized to the crude estimates. Finally, we conducted a multivariate analysis, adjusting for potential confounders. RESULTS: Eighty-two mother-child pairs completed the baseline and follow-up evaluations. Sixty mothers (73%) reported a history of trauma. The most common traumatic exposures included emotional abuse (58%), the violent death of a close contact (53%), and physical assault (43%). In the bivariate analysis, children of mothers with a history of trauma had lower overall social skills scores when compared to children of mothers without trauma [101.48 (54th percentile) vs. 109.18 (66th percentile), p. 0.04]. When adjusted for multiple potential confounders, mean social skills scores were 10.01 points lower (95% CI -18.88, -1.14) for children of mothers with a history of trauma. There was no evidence of effect measure modification by study group assignment, ethnicity single parenthood, or depression score. CONCLUSIONS: Among urban Head Start mothers, trauma exposure is common and is associated with lower child social skills. Because social skills are a critical aspect of kindergarten readiness, specifically addressing maternal trauma in preschool programs that serve high-risk populations may be important.
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