Extensive literature suggests that adverse experiences in early childhood may deleteriously impact later health. These effects are thought to be related to the impact of persistent or chronic stress on various biological processes, mediated by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and ultimately irregularities in cortisol levels. Ameliorating persistent stress in young children requires accurately measuring the chronicity of physiologic stress, which is difficult in young children because of unreliable self-report and the burden and inaccuracy associated with using invasive acute-stress biomeasures. A better way to approximate persistent stress in young children is measuring hair cortisol concentration (HCC), as it only requires one noninvasive collection to measure months of HPA-axis activity or experienced stress. However, few studies measure HCC in young children despite wide use in adult stress research. This article reviews and synthesizes research that uses HCC to approximate persistent stress in healthy children, 12-60 months of age. Reviewed studies indicate that HCC is elevated in young children who are experiencing forms of persistent stress such as low socioeconomic status and maternal distress. Hair cortisol is thus a promising measure of early childhood persistent stress, but due to the limited use of HCC in this population, much research is still needed. Specifically, nurse researchers may need to measure several factors associated with early childhood persistent stress and HCC to identify which children are at risk for stress-related disease.

Objectives: The study examined the relations between parent-child interaction in the first year of life to toddlers' language skills at age 2 years for a sample of children reared in poverty; of specific interest was testing the Family Stress Model, which proposes that the conditions of poverty influence children's language skills through caregiver well-being (e.g., distress, depression) and interaction dysregulation. Methods: Participants were from the Kids in Columbus Study, a birth-cohort study of children born to urban families experiencing material hardship. Caregiver questionnaires were collected when the child was 4-7 months to document poverty conditions (maternal hardship, institutional resources), caregiver well-being (depression, distress), and dysregulation in parent-child interactions. The Bayley-III assessed receptive and expressive language skills when the children were 2 years. Results: On average, receptive language skills were nearly 1 SD below the normative mean. Path models showed a significant effect of caregiver-child dysregulated interactions on toddlers' language skills, and an indirect effect of maternal distress on parent-child interactions and, in turn, toddlers' language skills. Conclusion: This study confirmed the theoretical Family Stress Model as a viable representation of the effects of poverty on the language skills of toddlers reared in homes experiencing socioeconomic disadvantage.

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Objectives-Young children living in low-income households experience disparities in language development compared to their advantaged peers, with large differences in language skill by kindergarten entry. In this study, we sought to determine whether there were disparities in early language trajectories within a low-income sample of children from 9 -36 months as a function of maternal education. We hypothesized that children with more highly educated mothers would show accelerated language trajectories compared to children with less educated mothers.Methods-Using observational data collected from a longitudinal birth-cohort sample of 192 low-income mother-infant dyads in Ohio from 2014 to 2018, children's language skills were assessed at three time-points (ages 9-13 months, 20-24 months, and 32-36 months). Multi-level growth curve models were used to examine early language trajectories through three years of age as a function of maternal education.Results-Multilevel growth curve models showed distinct language trajectories: young lowincome children have significantly better language skills at 15 months if their mother had a college education compared to not, and this gap remained significant to almost three years of age.Conclusion-Among young low-income children, disparities emerge in early language trajectories that differentiate children with less-versus more-educated mothers. Given that these disparities are apparent near the child's first birthday, it is necessary that pediatric care providers monitor children's early language trajectories and guide families to resources when lags are apparent. Keywords language; early childhood; developmental disparities; poverty; maternal education Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1