Using Infant Non-Nutritive Suck as a Diagnostic Measure of Future Speech Function

项目摘要 儿科喂养障碍正在上升，并且存在于20-50%的典型发育儿童（1-8岁）中， 33-80%的发育迟缓儿童（9，10）。此外，早产儿 特别是在风险的吸吮和喂养困难（11，12）。早期非营养性吸吮（NNS）-或吸吮 没有营养物质被输送-和喂养技能已被证明是可靠的指标， 神经系统（CNS）完整性（18）。事实上，据报道， 大约35-48%的婴儿患有不同类型的新生儿脑损伤（18）。吮吸，进食，说话， 和语言都在生命的第一年平行发展，并严重依赖于感觉运动整合。 然而，吸吮和喂养技能、中枢神经系统功能和发育之间的联系超出了大脑的功能。 新生儿期新兴的回顾性研究将新生儿吸吮和喂养模式与随后的 言语（13岁）和语言（14-17岁）发展。虽然这些行为出现在一个 相似的时间轴和共享神经资源和肌肉组织，他们很少一起研究， 他们之间的关系仍然未知。我们提出了一个纵向研究，样本NNS数据在3，6，9，和12 在足月（n=85）和中度至重度（n = 10）的年龄和12、24和36个月时的言语结局中， 晚期早产儿（胎龄32-37周; n=85）。拟议研究的具体目标如下： 如下：（目标1）建立一岁内足月和早产婴儿的NNS典型模式 生活和利用功能数据分析来检查婴儿的NNS爆发波形，并（目的3）确定 NNS预测早产儿和足月儿随后言语发育的能力， 三.我们假设，婴儿出生后的第一年，婴儿吸吮会发生显著变化， 早产儿在这些指标上的表现比足月儿差。此外，我们假设， 新生儿吸吮可预测早产儿和足月儿的言语发育。这项研究提供了一个 在识别新生儿吸吮和随后的语言之间的联系方面， 出现有几个原因：我们将使用我们的（1）创新，定制和定量NNS设备来采样 吸吮（2）两组婴儿，并将（3）利用功能数据分析更好地了解NNS 发展及其对以后生活中言语发展的影响。(4)我们将使用标准化和非- 标准化的方法来纵向研究语音发展，这将允许一个更强大的， 对NNS和语言在婴儿和儿童中如何联系的微妙理解。总的来说，这个项目 捕捉三年的深入口腔运动协调使用国家的最先进的方法和合作者， 回答重要的理论问题。通过临床相关和理论驱动产生的结果 这项研究将在临床医生如何处理幼儿喂养和语言治疗方面产生范式转变。

PROJECT SUMMARY Pediatric feeding disorders are on the rise and are present in 20-50% of typically developing children (1-8) and in 33-80% of children with developmental delay (9, 10). Furthermore, infants who are born preterm are particularly at-risk for sucking and feeding difficulties (11, 12). Early non-nutritive suck (NNS) – or sucking without nutrients being delivered – and feeding skills have been shown to be reliable indicators of central nervous system (CNS) integrity (18). In fact, delays in sucking and feeding have been reported in approximately 35-48% of infants with different types of neonatal brain injury (18). Sucking, feeding, speech, and language all develop in parallel in the first year of life and rely heavily on sensorimotor integration. However, the link between sucking and feeding skills, CNS function, and development extends beyond the neonatal period. Emerging retrospective research links neonatal sucking and feeding patterns to subsequent speech (13) and language (14-17) development in early childhood. Although these behaviors emerge on a similar timeline and share neural resources and musculature, they are rarely studied together and the links between them remain unknown. We propose a longitudinal study to sample NNS data at 3, 6, 9, and 12 months of age and speech outcomes at 12, 24, and 36 months of age across full-term (n=85) and moderate to late preterm (32-37 weeks’ gestational age; n=85) infants. The specific goals of the proposed research are as follows: (Aim 1) to establish typical patterns of NNS across infants born full-term and preterm in the first year of life and utilize a functional data analysis to examine infants’ NNS burst waveforms, and (Aim 3) to determine the ability of NNS to predict subsequent speech development across preterm and full-term infants until age three. We hypothesize that infant suck will change significantly across the first year of life with infants born premature performing worse on these measures compared to full-term infants. In addition, we hypothesize that neonatal suck will predict speech development across preterm and full-term infants. This study provides an unprecedented level of power in identifying the connection between neonatal sucking and subsequent speech emergence for several reasons: we will use our (1) innovative, custom and quantitative NNS device to sample suck across (2) two groups of infants and will (3) utilize functional data analyses to better understand NNS development and its implications for speech development later in life. (4) We will use standardized and non- standardized approaches to longitudinally study speech development, which will allow for a more robust and nuanced understanding of how NNS and speech are connected in infants and children. Overall, this project captures three years of in-depth oral motor coordination using state-of-the-art methods and collaborators to answer important theoretical questions. Results generated by this clinically relevant and theoretically driven study will create a paradigm shift in how clinicians approach feeding and speech therapies in early childhood.