Predicting ASD and Other Developmental Outcomes in the First Year of Life Using EEG in a Diverse Community-based Sample (Administrative Supplement)

摘要 尽管大多数婴儿似乎不费吹灰之力就能学会语言，但有一小部分婴儿，被称为晚说话者（LT）， 在生命的第二年或第三年出现语言里程碑的早期延迟，并且有后期诊断的风险 发育性语言障碍到目前为止，对LT的研究已经确定了几个潜在的因素， 与此年龄段语言能力较差相关，包括人口统计学、家族史和儿童神经认知 变量，但很少有研究集中在预测LT在第一年的生活，发病前， 主要的语言里程碑研究早期预测因素对于确定那些处于最严重疾病状态的婴儿至关重要。 需要采取先发制人的干预措施，重点是促进言语和语言的发展。我们建议 在我们正在进行的RO 1 NS 12908项目中，我们将在入选的婴儿中解决这个问题，该项目是一项纵向研究， 从一个大型城市儿科医院招募了一大批社会经济、种族和民族多样化的婴儿， 波士顿儿童医院的初级保健设施。这个父项目提供了一个独特的机会， 调查在出生后第一年收集的一组丰富的LT预测因子。为了实现我们的目标，我们计划 从12个月时给予的CSBS中识别LT（定义为低于第20百分位数），或使用 18或24个月时的MCDI。我们将增加一次18个月访视，以管理MCDI并收集一份亲子样本 基于游戏的互动。我们还计划扩大24个月时收集的语言措施，以包括 MCDI和亲子互动，并增加30个月的结果访问，在同一套丰富的 将收集语言数据。这些额外的时间点将使我们能够调查发展 语言的变化在婴儿确定为LT到生命的第三年。该补编将讨论 具体目标。目的1：在一个种族、人种和 社会经济多样化的初级保健人群，我们将确定在 第一年的4个月、9个月和12个月，与12个月、18个月或18个月时确定的晚说话者（LT）相关。 24个月;目标2：在同一样本婴儿中，我们将确定人口统计学和环境 与12个月、18个月或24个月时发现的晚说话者（LT）相关的因素，目标3：我们将 开发LT的探索性预测模型，包括一过性LT（30个月内消退）和持续性LT LT（30个月时保持在最低20%），使用EEG和行为/人口统计学/ 在生命的第一年收集的环境因素。与家长补助金同时，我们的目标是 创建可扩展的，实用的基于神经生物学的工具，结合人口统计学，家庭和健康史 这些信息将提高我们在生命的第一年跨资源环境识别LT的能力， 在识别方面的差异，从而大大改善早期语言和沟通的机会 干预措施。

ABSTRACT Although most infants acquire language with seemingly little effort, a subset, referred to as late talkers (LT), show early delays in language milestones in the second or third year of life, and are at risk for a later diagnosis of developmental language disorder. To date, research on LT has identified several potential factors that are associated with poorer language at this age including demographic, family history and child neurocognitive variables but there is little research focusing on predictors of LT in the first year of life, before the onset of major language milestones. Studying early predictors is critical for identifying those infants who are in greatest need for pre-emptive interventions that focus on promoting speech and language development. We propose to address this issue in the infants enrolled in our ongoing RO1 NS12908 project, which is a longitudinal study of a large cohort of socioeconomic, racially and ethnically diverse infants recruited from a large urban pediatric primary care facility at Boston Children's Hospital. This parent project provides a unique opportunity to investigate a rich set of predictors of LT collected in the first year of life. In order to address our goals, we plan to identify LT (defined as below the 20th percentile) from the CSBS administered at 12 months, or using the MCDI at 18 or 24 months.. We will add an 18 month visit to administer the MCDI and collect a parent-child play-based interaction. We also plan to expand the language measures collected at 24 months to include the MCDI and parent-child interaction, and add a 30- month outcome visit, at which the same set of enriched language measures will be collected. These additional time points will allow us to investigate development change in language in infants identified as LT into the third year of life. The supplement will address the following specific aims. Aim 1: Using a prospective study design in a racially, ethnically and socioeconomically diverse primary care population, we will identify the EEG features measured during the first year of life at 4, 9 and 12 months that are associated with late talkers (LT) identified at 12, 18 or 24 months; Aim 2: In this same sample of infants, we will identify demographic and environmental factors that are associated with late talkers (LT) identified at 12, 18 or 24 months And Aim 3: We will develop exploratory predictive models of LT, both transient LT (resolved by 30 months) and persistent LT (remaining at lowest 20% at 30 months), using both EEG and behavioral/demographic/ environmental factors collected in the first year of life. In parallel with the parent grant, our goal is to create scalable, practical neurobiologically-based tools combined with demographic, family and health history information that will advance our ability to identify LT in the first year of life across resources settings, reduce disparities in identification, and thereby greatly improve access to early language and communication interventions.