Longitudinal Academic Performance in Children with a History of Neonatal Abstinence Syndrome

点击翻译按钮获取中文摘要

Project Summary/Abstract The objectives of this project are to more thoroughly understand the relationship between neonatal abstinence syndrome (NAS) and longitudinal academic performance. NAS is a withdrawal condition due to in utero drug exposure, most commonly opioids. The syndrome affects more than 32,000 newborns annually in the U.S., and its incidence continues to rise. Researchers report poorer development in toddler and preschool years, higher rates of inattention and behavioral problems, and worse and deteriorating school performance in children with a history of NAS, indicating the effects of NAS may last well beyond the newborn period. However, these existing studies do not sufficiently account for the complex interaction of biologic, health, and socioenvironmental influences on childhood development. Thus, the relationship between NAS and long-term neurodevelopment and academic achievement remains largely unknown. As school achievement is directly associated with adult productivity and negatively correlated with participation in crime, a better understanding of NAS and academic performance is urgently needed to optimize outcomes across a lifetime. This proposal aims to assess the independent relationship between NAS, NAS severity, NAS treatment, in utero drug exposure and longitudinal academic performance after controlling for relevant biologic, health, and socioenvironmental variables; to explore the moderator effects of early community and school resource support on NAS; and to learn how families’ school experiences may explain childhood academic performance. The former aims will be accomplished using an inclusive, uniquely-integrated South Carolinian data warehouse. With this data system, a child with a diagnosis of NAS can be linked with his/her mother, and the dyad can be followed so that a broad range of childhood outcomes can be examined in the context of relevant, influential factors. In addition, through qualitative interviews with parents and guardians of children with a history of NAS followed at a Pennsylvania academic medical center, the project will 1) explore if and how caregivers’ experiences regarding early community and school resource support are related to childhood academic performance and 2) analyze themes that emerge around barriers and facilitators of academic achievement in children with NAS. Under this career development award, the applicant receives training in methodology of data-driven, public health studies and patient-oriented, clinical research design; epidemiology, mixed methodologies, community health, and applying public health principles to clinical practice; and moving research to policy. Successful completion of the project will not only provide data to serve as the foundation for future studies evaluating NAS outcomes and treatment, but, in addition to her training and mentorship plan, will prepare the applicant to become an independent physician-scientist able to conduct clinical trials aimed at improving outcomes of children affected by NAS.