Early Signals of Inattention in Neonates and Infants at Familial Risk for ADHD

项目摘要/摘要 约瑟夫博士的长期目标是成为一名独立的内科医生兼调查员，专门研究 新生儿和婴儿注意力缺陷/多动障碍(ADHD)及其早期发展的先兆 旨在预防ADHD高危儿童症状表现的干预措施。她在以下方面有专长 儿童至成人多动症的评估和治疗。这个K23职业发展奖将 让她成为为数不多的准备评估有风险的新生儿和婴儿的内科调查人员之一 治疗发育障碍。在最近的工作中，约瑟夫博士评估了学龄前儿童的行为 患有和不患有儿童ADHD的父亲所生的孩子。她发现，有ADHD家族风险的儿童 早在3岁时就被观察到有失调的行为，这可能是最终 注意缺陷多动障碍的发展。为了研究ADHD的早期先兆，约瑟夫博士的目标是接受(1) 儿童ADHD的纵向过程，包括ADHD症状随时间和范围的变化 功能结果(2)注意力从出生到童年的认知发展 婴儿期注意力不集中可作为非典型发育的早期指标；以及(3)高级统计学 方法对纵向数据进行分析。这些目标将通过以下方式结合起来实现 课程作业、定向阅读和教程。约瑟夫博士的导师团队由布鲁克·莫利纳博士组成 (初级导师)，ADHD领域的领导者，专门为患有 Jana Iverson(共同导师)，非典型发育和识别高危婴儿的专家 神经发育障碍和Erik Thiessen(二级导师)，认知障碍专家 在婴儿期发展，以及具有互补技能的知识丰富的顾问。伊利诺伊大学 匹兹堡提供了一个强大的研究环境，在其中进行培训并支持专业发展 和基础设施，以帮助招募参与者。子女(N=100)，其中一半父母患有ADHD，将是 连续评估为具有父母报告的行为的新生儿(出生-1个月)和婴儿(8-10个月) 在蹒跚学步(18个月)时收集数据，比较ADHD高风险和低风险子女的注意力指数 (目标1)评估新生儿和婴儿的注意力指数作为幼儿注意力的预测因子(目标2)。父母的 与婴儿的共同关注将与父母的ADHD状态和子女的关注相关联 蹒跚学步(目标3)来自该项目的数据可能为新型早期标记的应用提供初步证据 童年注意力不集中在生命的第一年被察觉，这是迈向早期识别和 对儿童ADHD的干预。拟议的研究与NIMH的战略目标2保持一致，以绘制心理图 疾病轨迹包括行为中发育维度的特征，以确定最佳 干预的时机。

Project Summary/Abstract Dr. Joseph’s long-term goal is to become an independent physician-investigator specializing in identification of neonatal and infant precursors to the development of Attention-Deficit/Hyperactivity Disorder (ADHD) and early interventions aimed at preventing symptom expression in children at risk for ADHD. She has expertise in assessment and treatment of ADHD from childhood to adulthood. This K23 career development award will allow her to emerge as one of the few physician-investigators prepared to evaluate neonates and infants at risk for developmental disorders. In recent work Dr. Joseph evaluated child behaviors among preschool-aged children born to fathers with and without childhood ADHD. She found that children at familial risk for ADHD were observed to have dysregulated behavior as early as 3 years of age, a potential indicator of the eventual development of ADHD. To study earlier precursors of ADHD, Dr. Joseph aims to receive training in (1) the longitudinal course of childhood ADHD including the variability in ADHD symptoms over time and range of functional outcomes (2) the cognitive development of attention from birth through childhood to understand how inattention in infancy may serve as an early indicator of atypical development; and (3) advanced statistical methods in the analysis of longitudinal data. These aims will be accomplished through a combination of coursework, directed readings, and tutorials. Dr. Joseph’s mentorship team is comprised of Drs. Brooke Molina (primary mentor), a leader in the field of ADHD specializing in course and outcomes for individuals with the disorder, Jana Iverson (co-mentor), an expert in atypical development and identification of infants at-risk for neurodevelopmental disorders, and Erik Thiessen (secondary mentor), a specialist in the cognitive development in infancy, along with knowledgeable consultants with complementary skill sets. The University of Pittsburgh offers a strong research environment in which to train with supports for professional development and infrastructure to aid in participant recruitment. Offspring (N=100), half with a parent with ADHD, will be assessed serially as neonates (brith-1 month) and infants (8-10 months) with parent reported behavior collected in toddlerhood (18 months) to compare indices of attention in offspring at high vs. low risk for ADHD (Aim 1) and evaluate neonate and infant indices of attention as predictors of toddler attention (Aim 2). Parent’s joint attention with their infant will be examined in relation to parent ADHD status and offspring attention in toddlerhood (Aim 3). Data from this project may provide initial evidence for the utility of novel early markers of childhood inattention detectable in the first year of life, a critical step towards early identification and intervention for childhood ADHD. The proposed study aligns with NIMH strategic objective 2 to chart mental illness trajectories including characterization of developmental dimensions in behavior to determine optimal timing of intervention.