Behavior rating and intelligence testing in primary school children exposed to multiple adverse experiences

Background Early childhood frequent exposure to toxic stress such as abuse or neglect, parental substance abuse or parental mental illness, and violence can have a cumulative impact on the child’s mental health. Therefore, the study aimed to assess the association between frequent exposures to family-related adverse experiences and the development of behavioral and cognitive impairment in a random sample of Egyptian primary school children. Results Witnessing household member treated violently was the most prevalent adversity in 90.4% of the studied students, followed by emotional neglect in 88.6%. The highly exposed children were more likely to have below-average performance IQ, 2.5 times more than the exposed group ( P = 0.03) [IQ score is considered average if it ranged 90–110 and below average if it ranged 70–89]. They were nearly 3 times at risk to develop behavioral problems ( P = 0.003), 2.5 times more likely to develop attention deficit ( P = 0.02), and nearly 5 times more likely to develop externalizing behavior ( P < 0.001) than their peers. Conclusion Early exposure to adverse experiences increases the child’s vulnerability to attention deficit and externalizing behavior with negative impact on IQ scores especially performance IQ.