Early School Progress in <1000g Birthweight Children

描述（由申请人提供）：尽管新生儿重症监护的最新进展导致极低出生体重或极早产儿童（ELBW/EPTB, <1000 g或<28孕周）的存活率急剧增加，但这类儿童在学习和行为问题方面的风险最高。这些障碍在入学时尤其值得关注，因为它们预示着长期的教育失败。本研究的主要目的是：(1)调查学龄期早期学习和行为问题的表现和发展；(2)确定其认知基础，特别关注执行功能缺陷（EF）；(3)研究家庭和学校环境作为这些结果的预测因子和ELBW/EPTB影响的调节因子。为了实现这些目标，我们将对一组在幼儿园患有ELBW/EPTB的儿童（n = 150）进行评估，并在接下来的两年里对他们进行跟踪。ELBW/EPTB的后果将通过将该队列与匹配的足月新生儿对照组（n = 150）进行比较来确定。我们假设，与对照组相比，ELBW/EPTB组将表现出更多的学业缺陷，更高的精神障碍率，更少的学习投入和更多的不适当的课堂行为，随着时间的推移，更少的积极学习和行为进步。我们进一步假设，EF的特定缺陷将预测早期学习失败，而与更好的学习和行为结果相关的环境将缓冲ELBW/EPTB的影响。创新的特点包括对学生和教师行为的课堂观察，为年幼儿童设计的EF测量方法的使用，以及对家庭和学校环境的综合评估。该项目采用综合方法，包括健康和发展、神经科学和教育观点。研究结果将为识别和治疗高危儿童入学时的学习障碍提供信息。

DESCRIPTION (provided by applicant): Although recent advances in neonatal intensive care have led to dramatic increases in the survival of children with extremely low birth weight or extremely preterm birth (ELBW/EPTB, <1000 g or <28 weeks gestational age), this subset of the children is at the highest risk for risk for learning and behavioral problems. These disorders are of particular concern at school entry, as they forecast long-term educational failure. The primary aims of this study are to: (1) investigate the manifestations and development of learning and behavioral problems during the early school-age years, (2) determine their cognitive basis, with specific focus on deficits in executive functions (EF), and (3) examine the home and school environments as predictors of these outcomes and as moderators of the effects of ELBW/EPTB. To accomplish these aims, we will assess an established birth cohort of children with ELBW/EPTB (n = 150) in kindergarten and follow them across the next two years in school. Consequences of ELBW/EPTB will be determined by comparing the cohort with a matched control group of term-born children (n = 150). We hypothesize that the ELBW/EPTB group, relative to controls, will display more academic deficiencies, higher rates of psychiatric disorders, less engagement in learning and more inappropriate classroom behavior, and less positive learning and behavioral progress over time. We further hypothesize that specific deficits in EF will predict early learning failure, and that environments associated with better learning and behavioral outcomes will buffer the effects of ELBW/EPTB. Innovative features include classroom observations of student and teacher behavior, use of measures of EF designed for younger children, and comprehensive assessments of the home and school environments. The project employs an integrative approach encompassing health and developmental, neuroscience, and educational perspectives. The findings will inform efforts to identify and treat learning disorders in high-risk children at school entry.