Table.

Summary of Causes and Examples of Pediatric Neurologic Disorders and Their Associations With Socioeconomic Status (SES)

Categories of Causes	Examples	Potential or Known SES Associations With the Occurrence or Developmental Outcomes of the Condition
Genetic anomalies  Chromosomal  Single gene	Down syndrome Fragile X syndrome	Notable associations with SES. Access to prenatal screening and pregnancy termination is differential by SES in some populations, leading to SES disparities in occurrence. Access to early interventions and treatments may be differential by SES, leading to SES disparities in developmental and functional outcomes.
Nutritional deficiencies  Prenatal  Childhood	Iodine deficiency disorder Iron deficiency	Globally, most prevalent in low-income populations without access to fortified foods or supplements. Children of lower SES have a higher prevalence of iron deficiency in infancy, which has been shown to have long-term effects on intellectual functioning. Access to early child development services, special education and healthcare may be limited in populations at greatest risk for nutritional deficiencies, leading to increased SES disparities in developmental outcomes.
Infections  Prenatal/perinatal  Postnatal/childhood	Congenital viral infections (eg, rubella and Zika) Haemophilus influenza type b (Hib) meningitis	Potentially most frequent in low-income populations due to lack of access to vaccines and other protective measures. Access to early child development services and healthcare may be limited in populations at greatest risk for congenital infections affecting the nervous system, leading to increased SES disparities in adverse developmental outcomes.
Toxic exposures  Prenatal  Childhood	Fetal alcohol spectrum disorder (FASD) Lead poisoning	Low-income communities are at increased risk of lead exposure in water, air, dust and products. The SES of mothers of children with FASD is consistently lower than controls. The concept of “weathering” (cumulative effects of poor living conditions, poor nutrition, discrimination and high levels of stress) is believed to contribute to higher rates of FASD among women of lower SES. Access to early child development services and healthcare may be limited in populations at greatest risk for neurotoxic exposures, leading to increased SES disparities in adverse developmental outcomes.
Perinatal complications  White matter damage associated with very preterm birth	Cerebral palsy (CP), epilepsy, and intellectual disability (ID)	The risks of preterm birth and low birth weight are strongly associated with poverty and socioeconomic disadvantage. At the same time, survival of infants with brain injuries associated with very preterm birth may be associated with economic advantage.
Injury  Traumatic brain injury Near drowning	Postnatal onset CP, ID	Increased risk among infants and children in poverty due to increased exposure to hazardous environments and childcare practices, and lack of access to or use of protective equipment. Access to early child development services and healthcare may be limited in populations at greatest risk for neurotrauma, leading to increased SES disparities in adverse developmental outcomes.
Unknown and multifactoral	Most cases of ID, CP, epilepsy, and autism	Strong and consistent association between low SES and mild ID. Severe ID, CP, and epilepsy are generally but not consistently found to be moderately associated with low SES. No consistent association between autism and SES. In countries with universal access to autism diagnostic and treatment services, the association between SES and autism prevalence has been found to be weakly negative or nil. In countries lacking universal access to autism services, autism prevalence has been found to increase with increasing SES.