A University of Oregon longitudinal study that accounts for the many factors— environmental, social, familial—that affect the mental health and wellbeing of children from the prenatal period to age 20 years has received a $1.9 million National Institutes of Health (NIH) grant for the first two-year study phase, with plans for distribution of another $7.9 million for a subsequent five-year study phase. Leslie Leve, the Lorry Lokey professor of Education in the Department of Counseling Psychology and Human Services in the College of Education and research scientist in the Prevention Science Institute is the UO lead on the project.

The national crisis of the downward trend of children’s mental health points to the urgent needs to understand the underlying factors. Itself part of a larger national effort involving more than 50,000 children, the UO’s study delves into answering the question of how the timing of exposure to specific environmental influences—for example a traumatic experience or exposure to pollutants—matter for specific health outcomes. Leve and her colleagues hope to determine whether there are developmental periods during which recovery from earlier environmental exposures is most possible, as well as whether positive aspects of a child’s environment can provide a buffer against exposure to a negative environmental event or context earlier in their development.

The Environmental influences on Child Health Outcomes (ECHO) Program, funded by NIH, focuses on five pediatric health outcome areas: pre-, peri- and postnatal; upper and lower airways; obesity; neurodevelopment; and positive health, such as happiness and a sense of well-being.

“In this incredible national study, we will be assessing children each year, for the next seven years,” Leve said. “The data we collect will be shared with the ECHO Program to create a very large national sample of children from diverse backgrounds and geographical regions, which will be available to researchers across the globe to learn more about environmental influences on children’s health outcomes.”

Leve’s study focuses on neurodevelopmental and positive health aspects—as related to children’s “psychosocial” environment, which includes parent and peer relationships, discrimination, and neighborhood characteristics. There is great societal benefit to helping children avoid or learn to healthily navigate exposures or experiences that damage their mental health or negatively affect their neurodevelopment: It is estimated that the public cost per child with conduct disorder to be $70,000 over seven years.

A unique facet of the study is that about half of the participants are children who were adopted; often, people who were adopted don’t know much about their birth family’s health or demographic history and how it may impact their lives. One outcome of the initial grant funding is the “nature via nurture” finding that the genetic makeup of adopted children impacts how they are parented.

The current project phase builds on a $12.5 million award in 2018, during which Leve and collaborators Jenae Neiderhiser, professor of psychology at The Pennsylvania State University, and Jody Ganiban, professor of clinical and developmental psychology at George Washington University, collected data from 1,000 children and their parents, which will be further analyzed in the years to come. UO’s portion of the ECHO Program began in 2016 and will now continue until 2030.

The power of longitudinal studies like ECHO is that they can help researchers determine change over time. The effects of generation-defining events, such as COVID-19, the September 11 terrorist attacks, or regional wildfire tragedies, become possible to measure across a cohort of people.

“The ECHO study will enable us to look over time at what makes some children more resilient in the face of adversity, whereas others suffer, with the goal of improving prevention programs and services for those who are most vulnerable to negative outcomes,” Leve said.

— By Kelley Christensen, Office of the Vice President for Research and Innovation