Longitudinal Effects of Spina Bifida on Learning

脊柱裂对学习的纵向影响

• 批准号: 7008866
• 负责人: SUSAN LANDRY
• 金额: $ 34.96万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-02-01 至 2009-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7008866
• 关键词: attention; behavioral /social science research tag; brain morphology; child (0-11); child psychology; clinical research; early experience; human subject; language development; learning; longitudinal human study; magnetic resonance imaging; problem solving; psychomotor function; spina bifida; visual perception

DESCRIPTION (provided by applicant): Spina bifida myelomeningocele (SB), a neural tube defect associated with deformities of the spine and brain, is associated with motor, non-verbal cognitive, attention, language, and adaptive behavior problems. While these deficiencies are well documented in school-age children, their developmental origins are not well understood since few studies have examined cognitive development for children with SB in early childhood. Research with school- age children has demonstrated that older children with SB have core deficits involving timing, attention orientation, and motor control/learning, and functional deficits in visual perception, attention regulation, and skills involving the integration of information/contingency learning (II/CL): rule-based problem solving, contextual language, and behavioral regulation. These deficits cut across outcome domains. In the current longitudinal study of infants with SB, the development over 6 to 36 months of core deficits and functional deficits from 6-36 months of age, including II/CL skills, have been examined in order to determine their origins and possible links to the later problems identified for SB. Findings from the current longitudinal study show that infants with SB do exhibit core deficits in timing, motor quality and organization, and attention orientation. These core deficits are apparent as early as 7 months of age, persist across early childhood, and appear to be related to growth in emerging functional deficits at 3 years, which demonstrates their importance as a foundation for later SB problems. To link core and functional deficits with school age assessments of similar skills, and to traditional assessments of outcomes, the proposed research will examine longitudinally core and functional deficits for the same 85 children with SB and 73 children normally developing controls that have participated in our current study. In the proposed extension, we will see these children at 7.5, 8.5, and 9.5 years of age to examine growth of core and functional deficits, assess traditional outcomes involving intelligence, language, academics, adaptive behavior, and social functions. We expect that the children's early performance on core and functional tasks will predict their development of similar skills during the early school-age period, and explain variations in traditional outcomes. However, we predict that relations among skills over time will be moderated by the nature and severity of CNS (spine and brain) anomalies and by important environmental variables, including concurrent and previous maternal interactive style. In particular, the caregivers' abilities to maintain the children's attention focus, respond contingently and warmly to children's signals, and provide cognitively enriching verbal input are likely to moderate the degree to which early core deficits lead to functional deficits and predict later ability in these skills. Relations between specific CNS abnormalities documented at 9.5 years for children with SB and the developmental trajectories and concurrent relations with this group of skills, should reveal important information about brain- behavior relations for younger SB children. This study is 1 of few studies of children with SB in the preschool years, and would be the only systematic, comprehensive follow- up into the school- age years. Completion of the study would allow a link with a significant body of research on school- age children with SB.

描述（由申请人提供）：脊柱裂（SB）脊髓脑膜静脉曲张（SB）是与脊柱和大脑畸形相关的神经管缺陷，与运动，非语言认知，注意力，语言和适应性行为问题有关。尽管这些缺陷在学龄儿童中有充分的文献记载，但由于很少有研究检查了童年时期SB儿童的认知发展，因此他们的发育起源尚未得到很好的了解。与学龄儿童进行的研究表明，患有SB的大儿童具有涉及时间安排，注意力方向，运动/学习/学习的核心缺陷，以及视觉感知，注意力调节和涉及信息/意外学习（II/CL）的技能的功能缺陷：基于规则的问题，基于规则的问题解决问题，上下文解决，上下文解决，行为语言和行为调节。这些赤字跨越了结果域。在当前对SB婴儿的纵向研究中，已经检查了6至36个月的核心缺陷和功能性缺陷，包括6-36个月大，包括II/CL技能，以确定其起源，并可能与SB确定的后期问题的链接。当前纵向研究的发现表明，患有SB的婴儿确实在时间，运动质量和组织以及注意力方向方面表现出核心缺陷。这些核心缺陷早在7个月大时就显而易见，在幼儿期间一直存在，并且似乎与3年的新兴功能缺陷的增长有关，这表明它们是后来SB问题的基础的重要性。为了将核心和功能缺陷与对类似技能的学龄面化评估以及对结果的传统评估联系起来，拟议的研究将检查纵向核心和功能缺陷，以及同一85名具有SB的儿童，有73名儿童和73名正常参与我们当前研究的控制措施。在拟议的扩展中，我们将看到这些儿童在7.5、8.5和9.5岁之间，以检查核心和功能缺陷的增长，评估涉及智力，语言，学术界，适应性行为和社会功能的传统成果。我们预计，孩子们在核心和功能任务上的早期表现将预测他们在早期学龄时期的相似技能的发展，并解释传统成果的差异。但是，我们预测，随着时间的推移，技能之间的关系将由中枢神经系统（脊柱和大脑）异常的性质和严重性以及重要的环境变量（包括并发和以前的孕产妇互动风格）进行调节。特别是，护理人员能够保持儿童注意力的注意力，对儿童信号的反应和热情反应，并提供认知能力丰富的口头输入，这可能会使早期核心缺陷导致功能不足并预测这些技能的后期能力的程度。 SB儿童与9.5岁的特定中枢神经系统异常之间的关系以及与这组技能的发展轨迹和并发关系应揭示有关年轻SB儿童的脑行为关系的重要信息。这项研究是学龄前几年对SB儿童的少数研究，这将是唯一的系统性，全面的后续跟进。这项研究的完成将允许与SB学龄儿童进行大量研究联系。