Neurobehavioral Determinants of Social Communication and Language Impairments in at - Risk Infants

项目摘要 社交和语言障碍的减轻是可能的，非常早期的识别和 干预婴儿期。然而，对这些损伤的可靠检测仍然局限于蹒跚学步的年龄， 已知其在新生儿期的发病机制。识别最早的神经和行为 社会交流和语言的决定因素取决于对高危婴儿的前瞻性纵向研究 从出生开始社交和语言障碍以及自闭症谱系的患病率 对于早产儿（HR-PT）和ASD儿童的婴儿兄弟姐妹（HR-SIB）， 普通人的生活。然而，在社会沟通和 语言仍然基本上不为人所知。语言是在丰富的社会交往中产生的，这种交往开始于 新生儿期，并通过一组必要的分层条件（统称为 新生儿神经行为）。这种层次结构从最基本的任务开始，即自动化和 生理稳定性，并在控制运动，自适应自我安慰策略，持续 平静的警觉期，注意人和物体。一旦完成了这最后一步，新生儿 为社会关注和互动做好准备。我们假设，在任何时候的中断， 神经行为层次将阻止婴儿建立社会互动的准备，导致 改变了早期的社会经验，减少了偶然社会互动的频率和质量， 社会和语言学习机会。目前的研究将直接测试这一假设， 神经行为发育（例如，自主神经失调，运动组织不良，自我安慰减少， 在出生到4个月之间的关键神经发育期， 下游，对社会沟通和语言的发展产生负面影响。目标1将 在低风险、HR-PT中描述神经行为和社会沟通发展的轨迹， HR-SIB婴儿。目标2将确定社会沟通技能出现的神经行为决定因素 和语言的习得。新生儿神经行为将从1 - 4个月纵向测量，社会 沟通将在9个月至2年的5个时间点进行测量，语言结果将 在24个月时测量。至关重要的是，这项研究将把早期检测研究扩展到生命的第一个月， 神经组织正在经历重大的转变。临床措施的创新应用 在密集的情况下，对两组高危婴儿进行纵向抽样将确定具体的， 早期神经行为发展与社会交往的出现之间的机械联系， 语言障碍

PROJECT SUMMARY Attenuation of social-communication and language impairments is possible with very early identification and intervention in infancy. Yet reliable detection of these impairments remains limited to the toddler years, and little is known about their pathogenesis in the neonatal period. Identification of the earliest neural and behavioral determinants of social communication and language hinges on prospective, longitudinal study of at-risk infants from birth. The prevalence of social-communication and language impairments, as well as autism spectrum disorder (ASD), for preterm infants (HR-PT) and infant siblings of children with ASD (HR-SIB) greatly exceeds that of the general population. Yet the key mechanistic pathways underlying deficits in social communication and language remain largely unknown. Language emerges in the context of rich social interactions, which begin in the neonatal period, and are made possible by a set of necessary hierarchical conditions (collectively called neonatal neurobehavior). This hierarchy begins with the most basic task of the newborn–autonomic and physiologic stability, and advances to controlled motor movements, adaptive self-soothing strategies, sustained periods of calm alertness, and attention to people and objects. Once this last step is achieved, neonates are primed and ready for social attention and interaction. We hypothesize that disruption at any point in the neurobehavioral hierarchy will prevent the infant from establishing readiness for social interaction, resulting in altered early social experiences, diminished frequency and quality of contingent social interactions, and reduced social and language learning opportunities. The current study will directly test the hypothesis that disrupted neurobehavioral development (e.g., autonomic dysregulation, poor motor organization, decreased self-soothing, and abnormal attention) during the critical neurodevelopmental period between birth and 4 months will have downstream, negative consequences on the development of social communication and language. Aim 1 will characterize trajectories of neurobehavioral and social-communication development across low-risk, HR-PT, and HR-SIB infants. Aim 2 will identify neurobehavioral determinants of the emergence of social-communication skills and the acquisition of language. Neonatal neurobehavior will be measured longitudinally from 1-4 months, social communication will be measured at 5 time points from 9 months to 2 years, and language outcome will be measured at 24 months. Critically, this study will extend early detection research down to the first month of life, when neurological organization is undergoing significant transformation. The innovative use of clinical measures in the context of dense, longitudinal sampling across two groups of at-risk infants will identify specific, mechanistic links between early neurobehavioral development and the emergence of social-communication and language impairments.