Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

Infancy to Middle Childhood in Rural Appalachia

Funded Projects Search

Advanced Search >>

Project Number: R40 MC 00316-03
Grantee: Marshall University Research Corporation
Department/Center: Family & Community Health
Project Date: 01/01/2003

Final Report

Infancy to Middle Childhood in Rural Appalachia Final Report (PDF) Exit Disclaimer

Principal Investigator

Margaret Fish, Ph.D.
Clinical Professor
401 11th Street, Suite 1400
Huntington, WV  25701
Phone: (304) 691-1185


  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)


Large numbers of rural children experience chronic poverty, and the majority of poor rural children are White, but comparatively little is known about development in this group. Poverty and low family socioeconomic status (low SES) increase the risk that children will have behavior problems, will have low academic achievement, and will use tobacco. Many rural Appalachian children are growing up in low-SES families, and thereby, are at risk for these problems. We propose to study normative development and the risk and protective factors which predict individual differences in social and academic competence and tobacco attitudes/use of 10-year-old, low-SES, rural Appalachian children. The research design incorporates multiple sources of data (child self-report, observation of the child, mother-report, teacher-report, and school achievement tests) and multiple methods of data collection (standardized measures, interviews, and semi-structured interactions). This longitudinal study follows one cohort of children from birth through middle childhood. Prior study, based on an ecological model of child development, assessed child temperament, mother-child interaction and relationships, and care giving environment variables as predictors of infant and preschool attachment and language skills, preschool behavior problems, and adjustment in kindergarten. Building on our previous study, we will investigate stability and change over time in social adjustment and academic competence, identify risk and protective factors, and examine developmental processes related to individual differences in middle childhood social adjustment, academic competence, and tobacco attitudes/use.


Listed is descending order by year published.

Reynolds ME, Fish M. Language skills in low-SES rural Appalachian children: kindergarten to middle childhood. J Applied Dev Psychol. 2010 May-Jun;31(3):238-48.

Fish M, Amerikaner MJ, Lucas CJ. Parenting preschoolers in rural Appalachia: measuring attitudes and behaviors and their relations to child development. Parenting Sci Practice. 2007 Jul;7(3):205-33.

Fish M, Amerikaner MJ, Lucas CJ. Dispelling the stereotypes: Rural Appalachian mothers talk about physical punishment. J Appalachian Stud. 2006 Spring;12(1):26-39.

Fish M. Attachment in infancy and preschool in low socioeconomic status rural Appalachian children: stability and change and relations to preschool and kindergarten competence. Dev Psychopathol. 2004 Spring;16(2):293-312.


Rural, School Outcomes & Services, Smoking, Social & Emotional Development, Cognitive & Linguistic Development

Title V in Your State