Poverty: Effects on Neural and Cognitive Development from Birth - 12 Months

描述(由申请者提供)：在贫困中长大的儿童认知结果差的风险增加，这可以说是我们国家今天面临的最关键的问题之一。虽然许多研究表明，贫困的影响在两岁时就很明显，但对两岁以下儿童的影响知之甚少。贫穷的影响什么时候开始发挥作用？哪些认知系统会受到影响？在发育中的大脑中可以检测到变化吗？哪些环境因素影响最大？本研究将：1)提供关于贫困的神经影响的新数据；2)确定贫困影响的时间和特定的认知系统；3)探索神经结构和功能与认知结果的关系；4)评估母亲、儿童和环境因素对贫困影响的中介作用。我们的长期目标是通过以下方式改善弱势儿童的结局：1)确定可以实施干预的最早时间段和具体系统；2)根据发育中大脑的变化和与认知结果最相关的环境风险设计干预措施。在一项前瞻性研究中，我们建议通过招募60名出生在低收入家庭(n=30)或高收入家庭(n=30)的健康的非裔美国女性足月妊娠婴儿来实现这些目标。从出生到12个月的儿童评估如下：神经成像：1个月和12个月的MRI(主要白束、皮质区域和海马体)；婴儿发育：6个月和12个月的一般认知发育、语言和执行功能。被认为是贫困对儿童结局影响的中介因素的产妇、儿童和环境因素将从产前开始进行评估，一直持续到婴儿12个月。母性因素包括营养、压力、抑郁和智商。儿童因素包括性情、成长和健康。环境因素包括父母的教育和职业、家庭环境和育儿。对于神经和认知结果的评估，将以收入组为主要自变量进行横断面和纵向分析，然后进行中介分析。据我们所知，这是第一项利用神经成像技术研究在贫困中长大的婴儿的神经和认知结果的前瞻性研究。神经成像的纳入不仅为贫困对婴儿大脑发育的影响提供了第一次评估，也提供了一个前所未有的机会，将大脑结构和行为联系起来，进而探索影响幼儿发育的中介机制。成功实现所提出的目标不仅将提高科学知识，而且还将产生关于贫困的因果关系、可逆性和预防有害影响的假设。 与公共卫生相关：美国有1400多万儿童生活在贫困线以下；所有儿童都面临着在学校表现不佳的风险。提高我们对贫困首先如何以及何时影响儿童大脑和行为的了解，对于设计适当的干预计划至关重要。我们在1个月至1岁婴儿中进行的具体目标的实现，将为更多地关注贫困对婴儿发展的影响、使用脑部扫描评估贫困对婴儿大脑的影响以及为这一年幼的儿童设计适当的干预战略奠定基础。

DESCRIPTION (provided by applicant): Children growing up in poverty are at increased risk for poor cognitive outcomes, arguably one of the most critical issues facing our nation today. While many studies have shown that effects of poverty are apparent by age two years, far less is known regarding effects in children younger than two years. When do the effects of poverty first exert their effects? What cognitive systems are affected? Are changes detectable in the developing brain? What environmental factors are most influential? This research will: 1) provide novel data regarding neural effects of poverty; 2) identify timing of effects and specific cognitive systems affected by poverty; 3) explore relation of neural structure and function with cognitive outcomes; and 4) assess mediation of poverty's effects by maternal, child, and environmental factors. Our long-term goals are to improve outcome of disadvantaged children through: 1) identifying the earliest time period at which, and specific systems for which, interventions can be implemented; and 2) designing interventions based on changes in the developing brain and on environmental risks most strongly associated with cognitive outcomes. We propose to accomplish these aims through enrollment of 60 healthy, African American female term gestation infants born into families with low (n=30) or high (n=30) income in a prospective study. Child assessments will be conducted from birth through age 12 months as follows: Neuroimaging: MRI (major white tracts, cortical regions and hippocampus) at 1 and 12 months; and Infant Development: general cognitive development, language, and executive function at 6 and 12 months. Maternal, child, and environmental factors considered mediators of the effects of poverty on child outcome will be assessed starting in the prenatal period and continuing through infant age 12 months. Maternal factors include nutrition, stress, depression, and IQ. Child factors include temperament, growth, and health. Environmental factors include parental education and occupation, home environment, and childcare. For evaluation of neural and cognitive outcomes, cross- sectional and longitudinal analyses will be conducted with income group as the primary independent variable, followed by mediational analysis. To our knowledge this is the first prospective study that leverages the use of neuroimaging in the study of neural and cognitive outcomes of infants growing up in poverty. The inclusion of neuroimaging provides not only the first assessment of poverty's effect on the developing brain of infants, but also an unprecedented opportunity to link brain structure and behavior, and in turn explore mediational mechanisms affecting development of very young children. Successful achievement of proposed aims not only will advance scientific knowledge but also be hypothesis generating regarding causality, reversibility, and prevention of injurious effects of poverty. PUBLIC HEALTH RELEVANCE: There are more than 14 million children in America living below the poverty line; all are at risk for poor performance in school. Improving our knowledge of how and when poverty first affects children's brains and behavior is critical to designing appropriate intervention programs. Achievement of our specific aims, conducted in infants from 1 month to 1 year of age, will provide a foundation for greater focus on effects of poverty on infant development, use of brain scans to assess effects of poverty on the infant brain, and design of appropriate intervention strategies for children at this very young age.