Mutual Regulation in Very Low Birthweight Preschoolers

描述（由申请人提供）：本基金第二次修订的目的是通过研究在母亲和她们的极低出生体重（< 1600g）或健康足月（FT）儿童在产后1 1/2和2 1/2岁的联合游戏期间观察到的五种不同的相互调节（MR）过程是否介导了儿童的生物或社会风险状况与其2 1/2岁时的发育和行为结果之间的关系，来增加我们对极低出生体重（VLBW）儿童发展的理解。其他目标是评估VLBW状态、共病医疗风险、社会风险、儿童性别及其相互作用在每个年龄和纵向上与这些MR过程的关系程度，并评估这一时期MR过程的稳定性。使用微观分析，计算机评分系统（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会议的录像带中编码母亲和儿童的影响和行为。

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.