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已导致极低出生体重或极早产（ELBW/EPTB，<1000 g或<28周胎龄）儿童的存活率显著增加，但这部分儿童的学习和行为问题风险最高。这些障碍在入学时特别令人关切，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（EF）缺陷，（3）检查家庭和学校环境作为这些结果的预测因子和ELBW/EPTB效应的调节因子。为了实现这些目标，我们将评估幼儿园ELBW/EPTB儿童（n = 150）的既定出生队列，并在未来两年的学校中跟踪他们。ELBW/EPTB的后果将通过比较队列与足月出生儿童的匹配对照组（n = 150）来确定。我们假设ELBW/EPTB组，相对于对照组，将显示更多的学术缺陷，精神疾病的发生率较高，较少参与学习和更多不适当的课堂行为，随着时间的推移，积极的学习和行为进步较少。我们进一步假设EF的特定缺陷将预测早期学习失败，并且与更好的学习和行为结果相关的环境将缓冲ELBW/EPTB的影响。创新的功能包括学生和教师行为的课堂观察，使用为年幼儿童设计的EF措施，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，神经科学和教育的观点。这些发现将为在入学时识别和治疗高危儿童学习障碍的努力提供信息。

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.