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(ELBW/EPTB，1000克或28周孕周)儿童的存活率大幅增加，但这部分儿童患学习和行为问题的风险最高。这些障碍在入学时尤其令人担忧，因为它们预示着长期的教育失败。本研究的主要目的是：(1)调查学龄儿童早期学习和行为问题的表现和发展，(2)确定其认知基础，特别是执行功能缺陷(EF)，以及(3)考察家庭和学校环境作为这些结果的预测因素和ELBW/EPTB影响的调节因素。为了实现这些目标，我们将评估在幼儿园出生的患有ELBW/EPTB的儿童(n=150)的出生队列，并在接下来的两年里跟踪他们。ELBW/EPTB的后果将通过将队列与匹配的足月儿对照组(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，更高的精神障碍发生率，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，积极的学习和行为进步会更少。我们进一步假设，EF的特定缺陷将预测早期学习失败，与更好的学习和行为结果相关的环境将缓冲ELBW/EPTB的影响。创新功能包括对学生和教师行为的课堂观察，使用为年幼儿童设计的EF测量方法，以及对家庭和学校环境的全面评估。该项目采用了一种综合的方法，包括健康和发展、神经科学和教育角度。这一发现将为识别和治疗入学高危儿童学习障碍的努力提供依据。

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.