Poverty, Low Birth Weight and Early Cognitive Delay: A Population-Based Approach

描述(由申请人提供)：认知迟缓的儿童很可能会经历一系列负面的教育和社会后果。因此，准确识别那些增加儿童认知延迟风险的因素是很重要的。然而，认知延迟的病因既复杂又鲜为人知。很少有研究使用对广泛的假设风险因素(例如贫穷、低出生体重、儿童健康状况不佳)和允许无偏见人口分组(例如非洲裔美国人、拉丁美洲人、亚洲人)估计的样本的衡量。到目前为止，还没有一项研究通过反复评估儿童头五年的认知能力来调查认知延迟。该项目使用一个新的、具有全国代表性的数据集--早期儿童纵向研究-出生队列(ECLS-B)来探索这种疾病的病因。该项目有两个具体目标：1)使用一个非常大的、具有全国代表性的低出生体重和非低出生体重儿童样本，在很小的年龄就有多个数据收集点，研究9、24、48和60个月大时认知延迟的发展模式，以及这些模式与贫困、低出生体重及其相互关系，包括单亲和种族/少数民族地位；2)测试三种类型的出生后风险因素，作为对(A)贫穷、低出生体重及其相关因素和(B)9、24、48和60个月时认知障碍之间关系的潜在解释。这些额外的风险因素是儿童健康状况不佳、父母教养不足和低质量的托儿服务。该项目将通过对9个月、24个月、48个月和60个月大的儿童的ECLS-B数据进行广义线性混合模型来实现这些目标。在这些模型中，孩子的身体健康、父母养育质量和照看能力将作为时变协变量出现。通过对提高儿童认知延迟风险的因素提供准确的估计，该项目将有助于确定早期干预的有希望的途径。公共卫生相关性：认知迟缓的幼儿面临一系列负面的长期健康和社会后果的高风险。该项目将利用一个新的、具有全国代表性的数据集来阐明导致幼儿认知延迟的多种途径，并确定有希望的早期干预途径。

DESCRIPTION (provided by applicant): Children who are cognitively delayed are very likely to experience a range of negative educational and societal outcomes. Thus, it is important to accurately identify those factors that elevate a child's risk for cognitive delay. Yet cognitive delay's etiology is both complex and poorly understood. Few studies have used measures of the wide range of hypothesized risk factors (e.g., poverty, low birthweight, poor child health) and samples that allow for unbiased population sub-group (e.g., African Americans, Latinos, Asians) estimates. No study to date has investigated cognitive delay by repeatedly assessing the cognitive abilities of children over their first five years. This project explores the disorder's etiology using a new, nationally representative dataset, the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B). The project has two specific aims: 1) To use an unusually large, nationally representative sample of low birthweight and non-low-birthweight children, with multiple data collection points at very young ages, to examine developmental patterns of cognitive delay at 9, 24, 48, and 60 months of age, and how these are related to poverty, low birthweight, and their correlates, including single parenthood and racial/ethnic minority status; and 2) To test three types of post-birth risk factors as potential explanations for the relationships between (a) poverty, low birthweight, and their correlates, and (b) cognitive disability at 9, 24, 48, and 60 months. These additional risk factors are poor child health, inadequate parenting, and low quality childcare. The project will address these aims by fitting generalized linear mixed models to ECLS-B data for children at 9, 24, 48, and 60 months of age. In these models, child physical health, parenting quality, and caregiving will appear as time-varying covariates. By providing accurate estimates of the factors that elevate a child's risk for cognitive delay, the project will help identify promising avenues for early intervention. PUBLIC HEALTH RELEVANCE: Young children with cognitive delays are at high risk for a range of negative long-term health and social outcomes. This project will capitalize on the availability of a new, nationally representative dataset to illuminate the multiple pathways that lead to cognitive delay during young childhood, and identify promising avenues for early intervention.