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Virginia Delaney-Black, MD, MPH; Chandice Covington, PhD, RN, CPNP; Steven J. Ondersma, PhD; Beth Nordstrom-Klee, PhD; Thomas Templin, PhD; Joel Ager, PhD; James Janisse, PhD; Robert J. Sokol, MD

Arch Pediatr Adolesc Med. 2002;156:280-285.

Background  Exposure to violence in childhood has been associated with lower school grades. However, the association between violence exposure and performance on standardized tests (such as IQ or academic achievement) in children is unknown. It is also not known whether violence exposure itself or subsequent symptoms of trauma are primarily responsible for negative outcomes.

Objective  To examine the relationship between violence exposure and trauma-related distress and standardized test performance among early school-aged urban children, controlling for important potential confounders.

Design  A total of 299 urban first-grade children and their caregivers were evaluated using self-report, interview, and standardized tests.

Main Outcome Measures  The child's IQ (Wechsler Preschool and Primary Scale of Intelligence–Revised) and reading ability (Test of Early Reading Ability, second edition) were the outcomes of interest.

Results  After controlling for confounders (child's gender, caregiver's IQ, home environment, socioeconomic status, and prenatal exposure to substance abuse) violence exposure was related to the child's IQ (P = .01) and reading ability (P = .045). Trauma-related distress accounted for additional variance in reading ability (P = .01). Using the derived regression equation to estimate effect sizes, a child experiencing both violence exposure and trauma-related distress at or above the 90th percentile would be expected to have a 7.5-point (SD, 0.5) decrement in IQ and a 9.8-point (SD, 0.66) decrement in reading achievement.

Conclusion  In this study, exposure to violence and trauma-related distress in young children were associated with substantial decrements in IQ and reading achievement.

From the Division of Neonatal/Perinatal Medicine, Department of Pediatrics, Children's Hospital of Michigan (Drs Delaney-Black and Nordstrom-Klee), the Merrill-Palmer Institute (Dr Ondersma), the Center for Healthcare Effectiveness Research (Drs Ager and Janisse), the College of Nursing (Dr Templin), and the C. S. Mott Center for Human Growth and Development and Department of Obstetrics and Gynecology (Dr Sokol), Wayne State University, Detroit, Mich; and the School of Nursing, University of California, Los Angeles (Dr Covington).

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