• Alice M Saperstein, Seonjoo Lee, Elizabeth J Ronan, Rachael S Seeman, and Alice Medalia.
• Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York; andDivision of Mental Health Service and Policy Research, New York State Psychiatric Institute, New York, New York saperst@nyspi.columbia.edu.
• Pediatrics. 2014 Jul 1;134(1):e138-45.

Background And ObjectivesThere is increasing recognition of the cognitive consequences of socioeconomic adversity during childhood, which can impair learning and negatively affect social and emotional development. However, there is a paucity of research on cognitive functioning and mental health among transition-age homeless youth. This study aimed to address this knowledge gap by examining the prevalence and functional significance of cognitive impairment and mental health disorders in a sample of 18- to 22-year-old homeless youth.MethodsParticipants (N = 73) were recruited from a vocational support program at Covenant House New York, a care agency for homeless youth. Assessments included diagnostic assessment for mental health disorders and evaluation of neurocognition and vocational outcomes.ResultsYouth demonstrated histories of academic instability, academic achievement below expectation, and high rates of untreated psychiatric disorders, the most prominent of which were anxiety, substance use, and mood disorders. Of those who had a mental health diagnosis, more than half demonstrated cognitive deficits. Performance on measures of working memory and verbal memory was <70% of that of the age-matched normative population. Cognitive impairment was associated with a significant risk for making a wage insufficient for independent living.ConclusionsThese data confirm the need to focus on cognitive as well as emotional and physical health in transition-age youth. Comprehensive intervention at this later developmental stage has the potential to facilitate the acquisition of skills needed for academic, vocational, and independent living success in adulthood.Copyright © 2014 by the American Academy of Pediatrics.

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