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Non-maternal care associated with reduced physical aggression
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CHICAGO—Among children of mothers with low education levels, those who receive regular care from other adults during preschool years may be less likely to have problems with physical aggression, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

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Hitting, kicking, biting and other forms of physical aggression are central features of a severe conduct disorder, according to background information in the article. These behaviors may be associated with social, physical and mental health problems. "The origin of physical aggression problems can be traced back to early childhood, and studies have specifically shown that maternal characteristics, especially low levels of education, are among the best predictors of high physical aggression from early childhood to adolescence," the authors write.

Sylvana M. Côté, Ph.D., of the University of Montreal, and colleagues studied 1,759 infants representative of all children born in Quebec in 1997 or 1998. Mothers were interviewed yearly from the time the children were age 5 months to 60 months, answering questions about family, parent and child characteristics and behaviors. This included details about non-maternal care services, provided to care for a child, usually while the mother is working. This may have involved center-based day care, family arrangements or other non-maternal care provided regularly during preschool years. Physical aggression levels were evaluated at 17, 30, 42, 54, and 60 months.

Of the 1,691 children who were followed for the whole study, 111 (6.6 percent) received no non-maternal care before preschool, 234 (13.8 percent) received some type of non-maternal care beginning before age 9 months and 1,346 (79.6 percent) received non-maternal care beginning at age 9 months or after. Children whose mothers had a low education level (i.e., did not have a high school diploma) were less likely to receive day care. However, children who did receive non-maternal care had lower levels of physical aggression, and the association was statistically significant among children who started day care before age 9 months.

Children of mothers who graduated from high school were at lower risk of developing physical aggression problems, and non-maternal care had no additional effect on their behavior.

"In summary, we provide robust evidence that the provision of non-maternal care services to children of mothers with low levels of education could substantially reduce their risk of chronic physical aggression, and that the protective impact is more important if children begin to receive these services before age 9 months," the authors conclude. "Because the children most likely to benefit from non-maternal care services are those less likely to receive them, universal programs involving the provision of non-maternal care should include special measures encouraging the use of non-maternal care services among high-risk families."
(Arch Gen Psychiatry. 2007;64(11):1305-1312.

Editor's Note: This research was supported by the Quebec Government Ministry of Health and Fond, Quebecois de la Recherche sur la Societe et la Culture, Canada’s Social Science and Humanities Research Council, Canadian Institutes for Health Research, St-Justine Hospital’s Research Center and the University of Montreal. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org .

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