Executive Function Development in Preschool Children

描述（由申请人提供）：“个性化医疗”的一个中心原则是能够预测谁有可能患上包括精神疾病在内的后期疾病（NIH，2007）。为了改变我们对导致后期功能障碍的起源、机制和过程的认识，国家心理健康咨询理事会（2007年）呼吁增加纵向的、“以自我为基础”的研究，包括“神经发育的敏感、可塑期”，以满足新的NIMH战略计划的目标1和2。随着最近方法学的进步，揭示了儿童精神病理学的发展途径，PA 07 -158中反映了迫切需要确定特定的前体，以改善早期识别和干预。执行控制（EC）是儿童外化障碍（包括ADHD）的一个强有力的候选前体，尽管有两个挑战阻碍了进展：1）缺乏EC的精确定义和2）对EC如何有助于以后的功能结果的理解不足。在过去的资助期间，我们已经取得了实质性的进展，通过使用先进的统计方法，以经验确定最合适的，理论推导的模型在学龄前儿童EC的定义。因此，本更新申请的目的是阐明前体EC如何与后来的功能结果相关，这是临床应用的下一个转化步骤。参与者将是大型的，仔细的，纵向（每9个月，3-0至5-3年）抽样的学龄前队列（一半是在社会人口风险）谁将进入2009-2011年秋季1或2年级。将对春季1-4年级的功能结果进行多方法评估，重点关注外部化问题（冲动/多动，注意力不集中，蔑视和攻击），社交技能（敏感性，责任感和同伴关系），学术技能（数学和阅读成绩）和掌握问题（动机差，持久性，策略使用）。这一群体正处于关键的5->7转变的尖端，这一发展转型的特征是成年人对目标导向思维、持续独立工作、适应性关系和社会功能的期望大幅增加。在这个5->7的转变中，小学是这些增加的期望挑战或“迫使”孩子部署执行控制以成功管理这个转变的中心背景，这是后来功能成功的关键因素。结构方程模型将被用来测试学前执行控制，行为在5->7转移，和功能性结果之间的先验直接和冥想关系。为了确定谁更有可能出现不良结局，将进行尖端的、以人为中心的生长混合模型，以确定EC发育不良的学龄前儿童的潜在亚组，然后比较以后的功能结局，并检查响应性养育的贡献。在学龄前阶段的执行控制的性质，以及它如何涉及到后来的功能结果的轨迹的特点将阐明的基本机制，在儿童心理病理学和识别的前兆，用于在未来的工作，量身定制的预防性干预措施，那些谁站在受益最大。

DESCRIPTION (provided by applicant): One central tenet of "personalized medicine" is to be able to predict who is at risk for later medical conditions, including mental illness (NIH, 2007). To transform our knowledge of the origins, mechanisms, and processes that contribute to later dysfunction, the National Advisory Mental Health Council (2007) has called for increased longitudinal, "trajectory-based" studies that include "sensitive, malleable periods of neurodevelopment" to meet Objectives 1 and 2 of the new NIMH Strategic Plan. With recent methodological advances that have shed light on developmental pathways toward childhood psychopathology, there is a pressing need reflected in PA07-158 to identify specific precursors to improve early identification and intervention. Executive control (EC) is a strong candidate precursor for childhood externalizing disorders (including ADHD), although two challenges have hampered progress: 1) lack of a precise definition of EC and 2) inadequate understanding of how EC contributes to later functional outcomes. In this past funding period, we have made substantial progress in defining EC in preschool children by using sophisticated statistical methods to empirically determine the best fitting, theoretically derived model. The objective of this renewal application, then, is to elucidate how precursor EC relates to later functional outcome, the next translational step towards clinical application. Participants will be the large, carefully, longitudinally (every 9 months, 3-0 to 5-3 years) sampled preschool cohort (half are at sociodemographic risk) who will enter grades 1 or 2 in fall 2009-2011. Multi-method assessments of functional outcome in spring grades 1-4 will be conducted, focusing on externalizing problems (impulsivity/hyperactivity, inattention, defiance, and aggression), social skills (sensitivity, responsibility, and peer relationships), academic skills (mathematics and reading achievement), and mastery problems (poor motivation, persistence, strategy use). The cohort is on the cusp of a key 5->7 shift, the developmental transition characterized by a substantial increase in adult expectations for goal-directed thought, sustained independent work, adaptive relationships and social functioning. In this 5->7 shift, elementary school is the central context where these increased expectations challenge or "press" the child to deploy executive control to successfully manage this transition, a key factor in later functional success. Structural equation modeling will be used to test the a priori direct and meditation relations among preschool executive control, behavior in the 5->7 shift, and functional outcome. To pinpoint who is at greater risk for poor outcome, cutting-edge, person-centered growth mixture modeling will be conducted to identify latent subgroups of preschool children with poor EC development and then to compare later functional outcome and examine the contribution of responsive parenting. Characterizing the nature of executive control in the preschool period and how it relates to trajectories of later functional outcome will elucidate the fundamental mechanisms that go awry in childhood psychopathology and identify precursors for use in future work to tailor preventive interventions to those who stand to benefit most.