Mutual Regulation in Very Low Birthweight Preschoolers

描述（申请人提供）：我们补助金的第二次修订的目标是通过检查在母亲和他们的VLBW（<1600 g）或健康之间的联合游戏期间观察到的五种不同的相互调节（MR）过程，足月（FT）儿童在1 1/2和2 1/2岁后中介儿童的生物或社会风险状态和他们的发展和行为结果在2 1/2年之间的关系。其他目标是评价VLBW状态、共病医疗风险、社会风险、儿童性别及其相互作用与每个年龄和纵向的这些MR过程相关的程度，并评价该时间段内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），我们将编码母亲和儿童的影响和行为，从录像带的联合发挥会议在每个年龄。 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（二元情感共享、修复、同步性、双向性和母体调节反应）。已经收集了联合游戏会议的录像带，作为一项更大规模的、已完成的研究的一部分，该研究是关于新生儿白色物质障碍（NWMD）对婴儿从出生到足月后1岁半的神经运动发育的影响（RO 1 NS 33002 - 01 A2，E. Tronick，PI）。使用我们自己的资金，我们跟踪了83（95%）对夫妇到2 1/2年后的任期。拟定的分析将基于参与第2年或第21/2年访视的88对夫妇（62%为男孩，53%为VLBW）。在每次访问中，儿童的发展和行为功能（BSID-II MDI和PDI，BRS，语言技能）进行了评估，母亲提供有关人口统计学，他们的孩子的功能，以及他们自己的适应信息。研究结果将提供新的信息，在VLBW人口的母子关系的个体差异，并进一步阐明如何母子互动过程可能介导VLBW/医疗风险和儿童的发展和行为结果之间的关系。这些信息将提高我们为极低出生体重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.