Predicting ASD and Other Developmental Outcomes in the First Year of Life Using EEG in a Diverse Community-based Sample (Administrative Supplement)

摘要 尽管大多数婴儿似乎不费什么力气就学会了语言，但有一小部分人被称为迟言者(LT)， 在生命的第二年或第三年表现出语言里程碑的早期延迟，并有可能在以后得到诊断 患有发育性语言障碍。到目前为止，对LT的研究已经确定了几个潜在的因素 与这个年龄段较差的语言有关，包括人口统计、家族史和儿童神经认知 变量，但很少有研究集中在生命的第一年，在发病之前的LT的预测因素 主要的语言里程碑。研究早期预测因素对于确定哪些婴儿发育最快至关重要 需要以促进言语和语言发展为重点的先发制人的干预措施。我们建议 在我们正在进行的RO1 NS12908项目中登记的婴儿中解决这个问题，该项目是一项纵向研究 从一家大型城市儿科医院招募的一大批社会经济、种族和民族多样化的婴儿 波士顿儿童医院的初级保健设施。这一父项目提供了一个独特的机会 调查在出生第一年收集的一组丰富的LT预测因素。为了实现我们的目标，我们计划 从12个月时实施的CSBS中识别LT(定义为低于20%)，或使用 18个月或24个月的MCDI。我们将增加18个月的探视时间，以管理MCDI并收集亲子 基于游戏的互动。我们亦计划扩大在24个月内收集的语文措施，以包括 MCDI和亲子互动，并增加了为期30个月的结果访问，在那里同样丰富了一套 将收集语言测量数据。这些额外的时间点将使我们能够调查事态发展 被确认为LT的婴儿在三岁时语言的变化。该副刊将针对 遵循特定的目标。目标1：将前瞻性研究设计用于种族、人种和 对于不同社会经济背景的初级保健人群，我们将确定在 4个月、9个月和12个月的第一年，与12、18或12个月识别的说话迟缓者(LT)有关 24个月；目标2：在相同的婴儿样本中，我们将确定人口统计和环境 与12个月、18个月或24个月后确定的迟言者(LT)相关的因素和目标3：我们将 开发LT的探索性预测模型，包括暂时性LT(30个月可解决)和持久性LT LT(在30个月时保持在最低20%)，使用脑电和行为/人口统计学/ 在生命的第一年收集的环境因素。在家长资助的同时，我们的目标是 结合人口统计、家庭和健康病史创建可扩展的实用神经生物学工具 信息将提高我们在生命的第一年跨资源设置识别LT的能力，减少 消除识别方面的差异，从而大大改善早期语言和交流的机会 干预措施。

ABSTRACT Although most infants acquire language with seemingly little effort, a subset, referred to as late talkers (LT), show early delays in language milestones in the second or third year of life, and are at risk for a later diagnosis of developmental language disorder. To date, research on LT has identified several potential factors that are associated with poorer language at this age including demographic, family history and child neurocognitive variables but there is little research focusing on predictors of LT in the first year of life, before the onset of major language milestones. Studying early predictors is critical for identifying those infants who are in greatest need for pre-emptive interventions that focus on promoting speech and language development. We propose to address this issue in the infants enrolled in our ongoing RO1 NS12908 project, which is a longitudinal study of a large cohort of socioeconomic, racially and ethnically diverse infants recruited from a large urban pediatric primary care facility at Boston Children's Hospital. This parent project provides a unique opportunity to investigate a rich set of predictors of LT collected in the first year of life. In order to address our goals, we plan to identify LT (defined as below the 20th percentile) from the CSBS administered at 12 months, or using the MCDI at 18 or 24 months.. We will add an 18 month visit to administer the MCDI and collect a parent-child play-based interaction. We also plan to expand the language measures collected at 24 months to include the MCDI and parent-child interaction, and add a 30- month outcome visit, at which the same set of enriched language measures will be collected. These additional time points will allow us to investigate development change in language in infants identified as LT into the third year of life. The supplement will address the following specific aims. Aim 1: Using a prospective study design in a racially, ethnically and socioeconomically diverse primary care population, we will identify the EEG features measured during the first year of life at 4, 9 and 12 months that are associated with late talkers (LT) identified at 12, 18 or 24 months; Aim 2: In this same sample of infants, we will identify demographic and environmental factors that are associated with late talkers (LT) identified at 12, 18 or 24 months And Aim 3: We will develop exploratory predictive models of LT, both transient LT (resolved by 30 months) and persistent LT (remaining at lowest 20% at 30 months), using both EEG and behavioral/demographic/ environmental factors collected in the first year of life. In parallel with the parent grant, our goal is to create scalable, practical neurobiologically-based tools combined with demographic, family and health history information that will advance our ability to identify LT in the first year of life across resources settings, reduce disparities in identification, and thereby greatly improve access to early language and communication interventions.