Violence Exposure and Cognitive Outcomes Among Children in Low- and Middle-Income Countries (LMICs): A Systematic Review.

Abstract

This article examines how exposure to violence in childhood is linked to impaired cognitive functioning and academic performance. Children who reside in low- and middle-income countries (LMICs) are more likely to be exposed to violence yet their representation in published studies is often limited. Here, we conducted a systematic review to examine the evidence regarding the association between childhood violence exposure and cognitive outcomes assessed up to age 11 in children from LMICs. EMBASE, Medline, and PsychInfo were systematically searched to identify cross-sectional, case-control, or cohort studies published from inception to May 2023. All studies were assessed for risk of bias. We identified 17 studies that met our inclusion criteria, encompassing 27,643 children from 20 LMICs. Children were exposed to maltreatment, intimate partner violence, and war. Cognitive outcomes assessed included cognitive development (n = 9), executive functioning (n = 6), general intelligence (n = 2), language (n = 2), and memory (n = 1). A majority (71%) of the studies found a relationship between violence exposure and poor cognitive outcomes in childhood. Our findings suggest associations between different forms of violence and poor cognitive outcomes in children in LMICs. An increased investment in prevention is needed to tackle this human rights violation, and early interventions are important to ensure that LMIC children achieve their full potential. This is crucial in LMICs in which the burden of violence is high.