Predicting language processing efficiency in preterm children: Social-environmental and neuro-biological factors

预测早产儿的语言处理效率：社会环境和神经生物学因素

• 批准号: 10447724
• 负责人: Heidi M. Feldman
• 金额: $ 62.85万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10447724
• 关键词: Advanced Development; Age; Age-Months; Axon; Brain; Caregivers; Child; Child Language; Clinical; Development; Early Intervention; Early identification; Enrollment; Environment; Environmental Risk Factor; Eye; Family; Funding; Grant; Hearing; Human; Impairment; Infant; Intervention; Laboratories; Language; Language Development; Language Tests; Lead; Learning; Link; Longitudinal Studies; MRI Scans; Measures; Mediating; Methods; Modeling; Myelin; Names; Neonatal; Neurobiology; Outcome; Outcome Measure; Parents; Pathogenesis; Pathway interactions; Pediatric Hospitals; Performance; Population Heterogeneity; Populations at Risk; Pregnancy; Premature Birth; Property; Reaction Time; Reporting; Risk; Sampling; Scanning; Speech; Standardization; Survivors; Testing; Time; Toddler; Variant; Vocabulary; adverse outcome; base; brain magnetic resonance imaging; clinical practice; educational atmosphere; experience; gaze; high risk; improved; infancy; language outcome; language processing; low socioeconomic status; mortality; neonatal period; neonate; neuroimaging; outcome prediction; premature; preterm newborn; primary outcome; processing speed; programs; prospective; secondary outcome; skills; social; visual tracking; white matter; white matter change

Each year in the U.S., more than one in 10 children are born preterm (PT). Approximately half of very preterm survivors, born at < 32 weeks’ gestation, develop language-based learning impairments that may be discovered late and put children at substantial risk for poor outcomes throughout their lives. Our previous grant (HD069150) convincingly demonstrated that language processing efficiency, assessed at 18 months in an eye- tracking paradigm, called looking-while-listening (LWL), was more predictive of long-term outcomes than standardized tests and parent reports. PT children who were faster at language processing at 18 months showed advantages in both verbal and non-verbal skills at 54 months. Our next step is to understand early predictors of language processing efficiency in PT children. In this renewal, we enroll PT neonates (n = 140) from two language groups, primarily English- and primarily Spanish families, to increase the diversity of our sample and to improve generalizability. We assess social-environmental predictors at 12 months (infant environment) and 18 months (toddler environment) using day-long audio recordings of the child’s language environment and naturalistic laboratory observations of caregiver-child interactions. We assess neurobiological predictors, focusing on white matter microstructure, in the neonatal period (neonatal scans) and at 12 months (infant scans). We use two complementary types of MRI scans to assess white matter axonal properties and myelin content. At 18 months, the primary outcome measure is language processing speed in the LWL task, the time it takes the child to shift eye gaze to the picture of an object that was just named. Parent reports of vocabulary and scores on a standardized test of language development are secondary measures. Our aims are to: (1) determine if properties of the infant and/or toddler environments predict language processing speed and secondary outcomes in PT children from the two language-groups; (2) determine if properties of white matter pathways, assessed from neonatal and/or infant MRI scans, predict language processing speed and secondary outcomes, after consideration of language group, clinical variables, and other covariates; and (3) investigate the contributions of social-environmental factors and white matter development on language processing speed in this diverse sample of children born PT. Our main hypothesis is that relations between language learning environments and language processing speed are mediated by changes in white matter development, suggesting that supportive learning environments impact language outcomes because learning environments advance the development of white matter microstructure. The demonstration that white matter change mediates the association of social-environmental factors on language outcomes provides a clear example of experience-dependent plasticity in the human brain. This finding would represent a theoretical contribution to models of learning and development in PT children across language groups and would inform clinical practice and early intervention for PT children who are at high risk for poor language outcomes.

在美国，每年有超过十分之一的儿童早产 (PT)。大约有一半非常 妊娠 < 32 周出生的早产幸存者会出现基于语言的学习障碍，这可能是 发现较晚，会使儿童一生面临不良后果的巨大风险。我们之前的资助 （HD069150）令人信服地证明，在 18 个月时用眼睛评估的语言处理效率 跟踪范式，称为“边听边看”（LWL），比“边听边看”更能预测长期结果 标准化测试和家长报告。 18 个月大时语言处理速度更快的 PT 儿童 54 个月时，她在语言和非语言技能方面都表现出了优势。我们的下一步是尽早了解 PT 儿童语言处理效率的预测因子。在本次更新中，我们招募了 PT 新生儿 (n = 140) 来自两个语言组，主要是英语和西班牙语家庭，以增加我们的多样性 样本并提高普遍性。我们评估 12 个月大时的社会环境预测因素（婴儿 环境）和 18 个月（幼儿环境），使用儿童语言的全天录音 对照顾者与儿童互动的环境和自然实验室观察。我们评估神经生物学 预测因子，重点关注新生儿期（新生儿扫描）和 12 个月时的白质微观结构 （婴儿扫描）。我们使用两种互补类型的 MRI 扫描来评估白质轴突特性并 髓磷脂含量。 18 个月时，主要结果指标是 LWL 任务中的语言处理速度， 孩子将目光转移到刚刚被命名的物体的图片上所需的时间。家长报告 词汇量和语言发展标准化测试的分数是次要的衡量标准。我们的目标 目的是：（1）确定婴儿和/或幼儿环境的特性是否可以预测语言处理速度 以及来自两个语言组的 PT 儿童的次要结果； (2) 判断白色的性质 通过新生儿和/或婴儿 MRI 扫描评估的物质通路可预测语言处理速度和 考虑语言组、临床变量和其他协变量后的次要结果；和（3） 研究社会环境因素和白质发育对语言的贡献 PT 出生的不同儿童样本的处理速度。我们的主要假设是，之间的关系 语言学习环境和语言处理速度是由白质的变化调节的 发展，表明支持性学习环境会影响语言结果，因为学习 环境促进白质微观结构的发展。白质的证明 变化介导社会环境因素对语言结果的关联提供了明确的 人脑中依赖于经验的可塑性的例子。这一发现代表了理论上的 对跨语言群体的 PT 儿童的学习和发展模式做出贡献，并将提供信息 针对语言结果不良高风险的 PT 儿童的临床实践和早期干预。