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

项目概要/摘要-与最初提交的资料相比没有变化 博士约瑟夫的长期目标是成为一名独立的医生调查员，专门从事识别 新生儿和婴儿发展为注意力缺陷/多动障碍（ADHD）的前兆， 早期干预，旨在预防ADHD风险儿童的症状表现。她擅长于 从童年到成年的ADHD评估和治疗。K23职业发展奖 这使她成为少数几个准备评估新生儿和婴儿的医生调查员之一， 发育障碍的风险。在最近的工作中，约瑟夫博士评估了学龄前儿童的行为， 父亲患有和没有儿童多动症的孩子。她发现有ADHD家族风险的儿童 早在3岁时就观察到行为失调，这是一个潜在的指标， ADHD的发展。为了研究ADHD的早期前兆，约瑟夫博士的目标是接受以下方面的培训：（1） 儿童ADHD的纵向病程，包括ADHD症状随时间的变化和 功能结果（2）从出生到童年的注意力认知发展，以了解如何 婴儿期注意力不集中可能是非典型发育的早期指标;（3）高级统计学 纵向数据分析方法。这些目标将通过以下结合来实现： 课程作业、指导性阅读和辅导。约瑟夫博士的导师团队由布鲁克博士 莫利纳（初级导师），在ADHD领域的领导者，专门为个人的课程和成果， Jana Iverson（共同导师），一位非典型发育和识别高危婴儿专家 和埃里克·蒂森（Erik Thiessen）（二级导师），一位认知障碍专家， 沿着知识渊博、技能互补的顾问。大学 匹兹堡提供了一个强大的研究环境，在其中培训与支持专业发展 和基础设施，以帮助参与者招募。后代（N=100），其中一半父母患有ADHD，将被 连续评估新生儿（新生儿-1个月）和婴儿（8-10个月）与父母报告的行为 在幼儿期（18个月）收集，以比较ADHD高风险与低风险后代的注意力指数 (Aim 1）评估新生儿和婴儿注意力指数作为幼儿注意力的预测因子（目的2）。父母的 与他们婴儿的共同注意力将被检查与父母ADHD状态和后代注意力的关系， 幼儿期（目标3）。来自该项目的数据可能为新的早期标记物的实用性提供初步证据。 儿童注意力不集中在生命的第一年就可以检测到，这是早期识别的关键一步， 对儿童ADHD的干预拟议的研究符合NIMH战略目标2， 疾病轨迹，包括行为发展维度的表征，以确定最佳的 干预的时机。

Project Summary/Abstract - no change from original submission 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.