State of the Art Review: Poverty and the Developing Brain

Abstract

In the United States, >40% of children are either poor or near-poor. As a group, children in poverty are more likely to experience worse health and more developmental delay, lower achievement, and more behavioral and emotional problems than their more advantaged peers; however, there is broad variability in outcomes among children exposed to similar conditions. Building on a robust literature from animal models showing that environmental deprivation or enrichment shapes the brain, there has been increasing interest in understanding how the experience of poverty may shape the brain in humans. In this review, we summarize research on the relationship between socioeconomic status and brain development, focusing on studies published in the last 5 years. Drawing on a conceptual framework informed by animal models, we highlight neural plasticity, epigenetics, material deprivation (eg, cognitive stimulation, nutrient deficiencies), stress (eg, negative parenting behaviors), and environmental toxins as factors that may shape the developing brain. We then summarize the existing evidence for the relationship between child poverty and brain structure and function, focusing on brain areas that support memory, emotion regulation, and higher-order cognitive functioning (ie, hippocampus, amygdala, prefrontal cortex) and regions that support language and literacy (ie, cortical areas of the left hemisphere). We then consider some limitations of the current literature and discuss the implications of neuroscience concepts and methods for interventions in the pediatric medical home.

Childhood poverty and adult psychological well-being

“…This is an important result because the ability to retain information in short-term memory is fundamental to a host of basic cognitive skills, including language and achievement. Furthermore, there is some evidence that spatial short-term memory functioning resides in the hippocampus, a subcortical region known to be highly sensitive to chronic stress exposure (26,29,30) and recently found to be associated with childhood poverty (32)(33)(34). One hypothesis worthy of further exploration is whether alterations in hippocampal structure or function associated with early experience of disadvantage might underlie deficits in spatial short-term memory associated with childhood poverty.…”

Drivers of human development: How relationships and context shape learning and development1

“…Poverty can limit support for dealing with these stressors, including access to high-quality health care, and this, in turn, can diminish developmental opportunities (e.g., Blair & Raver, 2016). Caregiver experience of chronic stress can lower their ability to buffer their children's stress through attunement, warmth, and sensitivity, and can contribute to heightening the stress response in children (Duncan, Magnuson, & Murnane, 2016;S. B. Johnson, Riis, & Noble, 2016).…”

Developmental delay in early childhood is associated with visual-constructive skills at school age in a Brazilian cohort

“…Previous publications with this longitudinal data reported that socioeconomic conditions and maternal mental health were associated with language (Piccolo et al, 2012), memory and executive function performance, and stress (Piccolo et al 2016). Studies have reported that environmental-such as socioeconomic status, home language environment, parental style, parental mental health-and biological factors-cortisol and neurotransmitter levels, for example-may influence the typical sequence of child development, affecting cognitive abilities (Brito & Noble, 2014;Johnson et al 2016;Noble et al, 2015). The stimulation of sensorimotor abilities in the first years of life seems to be crucial for the development of subsequent cognitive skills (Hernandez & Caçola, 2015;Tierney & Nelson, 2009).…”

“…Children living in deprived environments are more susceptible to adverse environmental conditions such as toxins, chronic malnutrition, nutrient deficiency, and lack of stimulation, leading to a higher risk of neurological and behavioral disorders, such as learning disabilities and intellectual deficit later in life (Handal et al, 2007;Johnson et al, 2016). Given that the groups assessed in this study were composed of children from low SES families, the socioeconomic factors may have limited sensorimotor experiences in early childhood.…”