Mutual Regulation in Very Low Birthweight Preschoolers

描述(由申请人提供)：本资助第二次修订的目的是通过研究母亲与其极低出生体重(VLBW)(1600g)或健康足月(FT)儿童在1 1/2年和2 1/2岁后的联合游戏会议中观察到的五种不同的相互调节(MR)过程是否调解儿童的生物或社会风险状况与他们在2 1/2岁时的发育和行为结果之间的关系，从而增加我们对极低出生体重(VLBW)儿童发育的了解。其他目标是评估极低出生体重、共病医疗风险、社会风险、儿童性别及其相互作用在各个年龄段和纵向上与这些MR过程相关的程度，并评估这一时期MR过程的稳定性。使用微分析、计算机化的评分系统(儿童和照顾者相互调节系统，CCMR)，我们将从每个年龄段的联合游戏环节的录像带中编码母婴情感和行为。 将使用时间序列分析和顺序数据分析技术生成五个MR变量(二元情感分享、修复、同步、双向和母体调节反应)。联合游戏会议的录像带已经被收集，作为一个更大的和完成的关于新生儿白质障碍(NWMD)对婴儿从出生到一年半后神经运动发育的影响的更大和完整的研究的一部分(RO1 NS33002-01A2，E.Tronick，PI)的一部分。使用我们自己的资金，我们跟踪83例(95%)二联体至两年半后。拟议的分析将基于88名双亲(62%的男孩，53%的VLBW)，他们参加了1年或21年半的访问。在每次访问中，对儿童的发展和行为功能(BSID-II MDI和PDI，BRS，语言技能)进行评估，母亲提供关于人口统计数据、孩子的功能和他们自己的适应能力的信息。研究结果将提供有关极低出生体重儿人群母子关系个体差异的新信息，并进一步阐明母子互动过程如何在极低出生体重儿/医疗风险与儿童的发育和行为结果之间起中介作用。这些信息将增强我们为VLBW儿童及其家庭设计和实施有效预防和干预服务的能力。

DESCRIPTION (provided by applicant): The goal in this second revision of our grant is to increase our understanding of the development of very low birth weight (VLBW) children by examining whether five different mutual regulatory (MR) processes observed during a joint play session between mothers and their VLBW (< 1600g) or healthy, term (FT) children at 1 1/2 and 2 1/2 years post term mediate the relation between children's biologic or social risk status and their developmental and behavioral outcomes at 2 1/2 years. Other goals are to evaluate the extent to which VLBW status, co-morbid medical risk, social risk, child gender, and their interactions are related to these MR processes at each age and longitudinally, and to evaluate the stability of MR processes during this time period. Using a microanalytic, computerized scoring system (Child and Caregiver Mutual Regulation System, CCMR), we will code maternal and child affect and behavior from videotapes of the joint play session at each age. Five MR variables (dyadic affect sharing, reparation, synchrony, bi-directionality, and maternal regulatory responsiveness) will be generated using time series analysis and sequential data analytic techniques. The videotapes of the joint play sessions have already been collected as part of a self-funded extension of a larger and completed study of the effect of Neonatal White Matter Disorder (NWMD) on infant neuromotor development from birth to 1 1/2 years post term (RO1 NS33002-01A2, E. Tronick, PI). Using our own funds, we followed 83 (95%) dyads to 2 1/2 years post term. The proposed analyses will be based on the 88 dyads (62% boys, 53% VLBW) that participated in either the lY2 or the 21/2-year visit. At each visit, children's developmental and behavioral functioning (BSID-II MDI & PDI, BRS, language skills) was evaluated, and mothers provided information about demographics, their child's functioning, and their own adaptation. Findings will provide novel information about individual differences in the mother-child relationship in the VLBW population and shed further light on how mother-child interactive processes may mediate the relation between VLBW/medical risk and children's developmental and behavioral outcomes. This information will enhance our ability to design and implement effective prevention and intervention services for VLBW children and their families.