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

项目总结 通过及早识别和治疗，可以减轻社交和语言障碍 婴儿期的干预。然而，对这些损伤的可靠检测仍然局限于蹒跚学步的几年，而且很少 已知它们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 从出生起。社交和语言障碍以及自闭症谱系的流行 早产儿(HR-PT)和ASD儿童的婴儿兄弟姐妹(HR-SIB)的障碍(ASD)大大超过 这是普通民众的问题。然而，潜在的社会沟通和社会缺陷的关键机制路径 语言在很大程度上仍不为人所知。语言出现在丰富的社会互动的背景下，这种互动始于 新生儿期，并通过一组必要的等级条件(统称为 新生儿神经行为)。这种层级结构始于新生儿最基本的任务--自主和 生理稳定性，以及控制运动的进步，自适应自我舒缓策略，持续 保持冷静、警觉，并注意人和物体的时期。一旦完成了最后一步，新生儿就 准备好并准备好接受社会关注和互动。我们假设在地球上的任何一个点上 神经行为层级将阻止婴儿建立社交互动的准备，导致 改变了早期的社会体验，降低了偶发社会互动的频率和质量，并降低了 社交和语言学习机会。目前的研究将直接检验破坏了这一假设的假设 神经行为发育(例如，自主神经失调、运动组织不良、自我抚慰能力下降、 和异常注意力)在出生到4个月之间的关键神经发育期 在下游，对社会交流和语言的发展产生了负面影响。目标1将 描述低风险、HR-PT和 HR-SIB婴儿。目标2将确定社交沟通技能出现的神经行为决定因素 和语言的习得。新生儿的神经行为将在1-4个月内进行纵向测量， 交流将在9个月到2年的5个时间点进行衡量，语言结果将是 测量时间为24个月。关键的是，这项研究将把早期检测研究延伸到生命的第一个月， 当神经学组织正在经历重大变革时。临床措施的创新使用 在对两组高危婴儿进行密集的纵向抽样的情况下，将确定具体的， 早期神经行为发育与社会沟通和社会发展之间的机制联系 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.