Effects of a school readiness intervention on hypothalamus-pituitary-adrenal axis functioning and school adjustment for children in foster care

Alice M. Graham, Katherine C. Pears, Hyoun K. Kim, Jacqueline Bruce, Philip A. Fisher

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7 Citations (Scopus)


Maltreated children in foster care are at high risk for dysregulated hypothalamus-pituitary-adrenal (HPA) axis functioning and educational difficulties. The present study examined the effects of a short-term school readiness intervention on HPA axis functioning in response to the start of kindergarten, a critical transition marking entry to formal schooling, and whether altered HPA axis functioning influenced children's school adjustment. Compared to a foster care comparison group, children in the intervention group showed a steeper diurnal cortisol slope on the first day of school, a pattern previously observed among nonmaltreated children. A steeper first day of school diurnal cortisol slope predicted teacher ratings of better school adjustment (i.e., academic performance, appropriate classroom behaviors, and engagement in learning) in the fall of kindergarten. Furthermore, the children's HPA axis response to the start of school mediated the effect of the intervention on school adjustment. These findings support the potential for ameliorative effects of interventions targeting critical transitional periods, such as the transition of formal schooling. This school readiness intervention appears to influence stress neurobiology, which in turn facilitates positive engagement with the school environment and better school adjustment in children who have experienced significant early adversity.

Original languageEnglish
Pages (from-to)651-664
Number of pages14
JournalDevelopment and Psychopathology
Issue number2
Publication statusPublished - 2018 May 1

Bibliographical note

Funding Information:
Graham Alice M. a Pears Katherine C. b Kim Hyoun K. b c Bruce Jacqueline b Fisher Philip A. b d a Oregon Health and Science University b Oregon Social Learning Center c Yonsei University d University of Oregon Support for this article was provided by Grants R01 DA021424 and P30 DA023920 from the Division of Epidemiology, Services and Prevention Research, Prevention Research Branch, National Institute of Drug Abuse, US Public Health Service. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding organization. The authors thank Deena Scheidt for project management, Sally Schwader for editorial assistance, and the staff and families of the Kids In Transition to School Program for their ongoing dedication and participation. Drs. Katherine Pears and Philip Fisher are codevelopers of the Kids in Transition to School Program. Address correspondence and reprint requests to: Katherine C. Pears, Oregon Social Learning Center , 10 Shelton McMurphey Boulevard , Eugene , OR 97401 ; E-mail: katherinep@oslc.org . 18 09 2017 05 2018 30 2 651 664 Copyright © Cambridge University Press 2017  2017 Cambridge University Press

Publisher Copyright:
© 2017 Cambridge University Press.

All Science Journal Classification (ASJC) codes

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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