Last week, the first grant awards were made for the HEALthy Brain and Child Development (HBCD) study, which will recruit a large cohort of pregnant women at 25 centers around the country and follow them and their children from the prenatal period through early childhood. Similar in conception to the Adolescent Brain Cognitive Development (ABCD) study already underway, HBCD will utilize regular neuroimaging in the infants and children as well as collecting a wide array of biospecimen and behavioral data to chart the development and health of the participants through the first decade of life. The cohort will include a population of mothers who used drugs during their pregnancy as well as mothers from similar backgrounds who did not use drugs, in order to answer longstanding questions about the long-term impact of environmental adversity during pregnancy, including prenatal substance exposures, neglect, trauma, and social and economic challenges.
In a world radically changed by the pandemic, longitudinal studies of child development have never been more crucial, and these grant awards couldn’t come at a more opportune time. For the past year and a half, parents and caregivers have been burdened by troubling questions about their children’s development and mental health. Those who have had to improvise non-optimal childcare solutions for young children wonder about the effects of reduced physical activity and socialization and increased screen time. Parents of school-aged children want to know whether a year of at-home learning may have set their kids behind academically. And researchers want to know how traumatic events associated with the pandemic, like loss of a parent or home eviction, influence their developmental trajectories. These are exactly the kinds of questions ABCD and, soon, HBCD will be poised to answer.
Despite challenges caused by the pandemic, the ABCD study, currently in its fifth year, continues to collect vast quantities of data on a wide range of topics including early adolescent substance use and obesity, brain development as related to socioeconomic status, and the impact of discrimination on suicidality. Researchers are already publishing data on changes in adolescents’ alcohol and nicotine use after the start of the pandemic. That study cohort is large and diverse enough to be able to compare brain development and other health and behavioral outcomes in adolescents who participated in at-home learning through the entire 2020-21 school year with those whose schools remained open for some of that time. Now the HBCD study will enable scientists to examine how early childhood development and health are impacted by some of the stressors affecting young families that have arisen during the pandemic, including the impact of maternal COVID-19 infection on their offspring.
We still have major gaps in our understanding of how infants’ and children’s brains develop and how that development is affected by exposure to adversity. Because the brain undergoes major and rapid development throughout infancy, childhood, and adolescence, many of our traits and aptitudes, as well as our resilience or vulnerability to challenges that may lead to substance use and mental illnesses, are being powerfully shaped by our experiences throughout the first two decades of life. Social disruption and dislocation produced by wars, natural disasters, economic crises, social unrest, and pandemics may have lasting impact, sometimes in ways that are not immediately apparent and that manifest in problems years down the road.
Yet while the extreme plasticity of the developing brain makes children vulnerable, it can also be a strength. Children can be enormously resilient, and studies are showing that with the right supports and targeted prevention programs, the neurocognitive impacts of adverse environments like poverty can be compensated for or overcome. Information provided by HBCD and ABCD will help us understand the relative magnitude of different risks such as lack of social interaction or physical activity or financial instability, as well as how different risks interact, who is most affected, and whether some environmental adversity can be countered or compensated for. With insights gleaned from these studies, it may be possible to predict which children are most at risk from the multiple and varied stresses of the pandemic and to design interventions to prevent adverse consequences or intervene early with those children.
The pandemic has posed an unprecedented challenge to life, health, and well-being for everyone on the globe. Science rose to the challenge of developing vaccines in record time. Now, with two major longitudinal studies of development covering the prenatal period through young adulthood, NIH-funded science is poised to address some of the urgent questions facing America’s parents: How are kids affected by the stresses and transformations that are reshaping our society before our very eyes? What challenges can they expect? Which children are the most vulnerable? And how can we help them meet those challenges and thrive?