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

描述（由申请人提供）：认知延迟的儿童很可能会经历一系列负面的教育和社会后果。因此，重要的是要准确地识别那些因素，提高儿童的认知延迟的风险。然而，认知延迟的病因既复杂又知之甚少。很少有研究使用广泛的假设风险因素（例如，贫困、出生体重低、儿童健康状况差）和允许无偏见的人口亚组（例如，非裔美国人、拉丁美洲人、亚洲人）估计。到目前为止，还没有研究通过反复评估儿童前五年的认知能力来研究认知延迟。该项目使用一个新的、具有全国代表性的数据集，即早期儿童纵向研究-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）使用一个异常大的，具有全国代表性的低出生体重和非低出生体重儿童样本，在非常小的年龄有多个数据收集点，以检查9，24，48和60个月大时认知延迟的发展模式，以及这些与贫困，低出生体重及其相关因素的关系，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）贫困、低出生体重及其相关因素与（B）9、24、48和60个月认知障碍之间关系的潜在解释。这些额外的风险因素包括儿童健康状况差、父母养育不足和儿童保育质量低。该项目将通过将广义线性混合模型与ECLS-B数据拟合来实现这些目标，这些数据针对9个月、24个月、48个月和60个月的儿童。在这些模型中，儿童的身体健康，父母的质量，和养育将出现随时间变化的协变量。通过提供对提高儿童认知延迟风险的因素的准确估计，该项目将有助于确定有希望的早期干预途径。公共卫生相关性：认知延迟的幼儿面临着一系列负面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，阐明导致幼儿期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.