How modifiable is childhood cognitive performance?


A new investigation looks at the modifiable factors that can impact childhood cognitive performance.

Childhood cognitive performance is very likely not set in stone and could in fact be modifiable in a number of ways. One of the key inequalities could be linked with racial disparities. An investigation in JAMA Pediatrics looks at what modifiable factors could help improve cognitive test scores.1

Researchers ran a longitudinal pregnancy cohort study that looked at mother-child pairs who were enrolled in the University of Tennessee Health Science Center–Conditions Affecting Neurodevelopment and Learning in Early Life study, which ran from December 2006 to July 2011. The children were examined every year until they were aged 4 to 6 years. Environment-wide associations were examined through 155 prenatal, perinatal, and postnatal exposures. The cohorts sample of mothers included pregnant women who were recruited when they were at 16 to 28 weeks of gestation and were receiving care at 4 hospitals in Shelby County, Tennessee. High-risk pregnancies were excluded from the study.

There were 1055 children included in the study. Twenty-four factors were examined. The researchers noted links between child cognitive performance and parental education as well as breastfeeding. With each increase of 1.0 standard deviation in exposure, positive links were seen with fostering cognitive growth from maternal reading ability (β = 1.42; 95% CI, 0.16-2.68) as well as observed parent-child interactions (β = 1.12; 95% CI, 0.24-2.00). A negative association was found with parenting stress (β = −1.04; 95% CI, −1.86 to −0.21). The researchers found that a moderate increase in the beneficial exposures were linked with a noted improvement in estimated cognitive testing scores when using marginal means (0.5% of a standard deviation). Overall black children had fewer beneficial cognitive performance exposures.

The investigators concluded that there were a number of beneficial cognitive performance exposures that were modifiable and also linked with mean differences in cognitive performance by race. They believe that the study could guide other studies that are focused on decreasing racial disparities found in childhood cognitive performance.


1. LeWinn K, Bush N, Batra A, Tylavsky F, Rehkop D. Identification of modifiable social and behavioral factors associated with childhood cognitive performance. JAMA Pediatr. September 21, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.2904

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