Poor Reading in Preterms: Neural Basis, Prediction, & Response to Intervention

早产儿的阅读能力差：神经基础、预测、

• 批准号: 8510701
• 负责人: Heidi M. Feldman
• 金额: $ 32.26万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-25 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510701
• 关键词: 6 year old; 8 year old; Access to Information; Address; Affect; Age; Anisotropy; Area; Attention; Awareness; Behavior assessment; Behavioral; Biological; Birth; Caring; Cerebrum; Characteristics; Child; Clinical; Clinical Treatment; Cognitive; Comprehension; Corpus Callosum; Development; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Early Diagnosis; Education; Educational Curriculum; Educational Intervention; Enrollment; Family; Future; Goals; Gold; Imaging Techniques; Intelligence; Intervention; Language; Language Development; Learning; Learning Disorders; Left; Lesion; Linguistics; Magnetic Resonance Imaging; Measures; Medical; Memory; Names; Neurocognitive; Neuronal Plasticity; Newborn Infant; Oral; Outcome; Parietal; Pathogenesis; Pattern; Performance; Perinatal; Phase; Pilot Projects; Play; Population; Positioning Attribute; Premature Birth; Preparation; Primary Prevention; Problem-Based Learning; Property; Public Health; Randomized Clinical Trials; Reader; Reading; Reading Disabilities; Recruitment Activity; Research; Role; Sampling; School-Age Population; Students; Testing; Time; Work; base; behavior measurement; behavior test; design; elementary school; evidence base; executive function; experience; forging; group intervention; high risk; improved; injured; innovation; kindergarten; peer; performance tests; phonology; premature; processing speed; programs; public health relevance; relating to nervous system; repaired; response; skills; white matter; white matter injury

DESCRIPTION (provided by applicant): Prematurity affects about 13% of the US births and its public health consequences extend far beyond the newborn period. About half of children born preterm develop cognitive, language and learning problems that adversely impact their long-term outcomes. Once these children reach school age, educational programs are dictated by their level of function in academic domains, irrespective of the underlying pathogenesis of any learning difficulties. To improve outcomes, we must ascertain whether the learning problems of children born preterm (PT) have a similar cognitive profile, neural basis, and/or developmental course as learning problems in children born full term (FT). We must also investigate if PT children respond favorably to the same interventions known to be effective in educating FT children with learning disorders. We have forged an accomplished interdisciplinary team to focus on reading skills in PT children because of the pivotal role reading plays in education and long term outcomes. The specific aims of this study are to (1) compare the cognitive profiles and neural basis of reading skills in PT and FT children using behavioral measures and diffusion tensor imaging (DTI), an magnetic resonance imaging technique that evaluates cerebral white matter microstructure, (2) determine which behavioral or neural features predict persistent good or poor reading skills in both groups and (3) pilot test an intervention to improve reading skills n PT poor readers. We will enroll 6-year old kindergarten students (PT n=50 and FT n=50), test them on a battery of reading and cognitive measures, obtain DTIs, and follow them until age 8 years when we repeat an expanded battery and DTI. We hypothesize that the PT group will perform more poorly than the FT group. We will assess if the PT group has distinctive profiles of test performance or patterns of white matter microstructure compared to FT children equated for single word reading level. We will determine which behavioral and/or neural features are associated with persistent reading difficulties two years later. In Years 4 and 5 we will recruit another sample of PT children with reading scores below the 25th percentile for age. We will pilot test a 6-week summer tutoring program using two evidence-based curricula, one focused narrowly on phonemic awareness and one focused more broadly on other aspects, including reading comprehension. We will establish the feasibility and acceptability of the intervention for families and assess if the preterm children have the attentional capacity and endurance to work in small groups of 3 for 90 minutes 5 days/week for 6 weeks. This innovative study will make a sustained impact on understanding (1) reading outcomes in PT children, (2) the neural basis of normal and abnormal reading in both PT and FT children, and (3) neural plasticity, the ability of white matter to change over time and with educational interventions. It will position us to conduct a randomized clinical trial on reading intervention in children born preterm in the subsequent phase.

描述（由申请人提供）：早产影响约13％的美国出生及其公共卫生后果远远超出了新生儿时期。大约一半出生的儿童早产会发展认知，语言和学习问题，从而对他们的长期结果产生不利影响。一旦这些孩子达到学龄，教育计划就由他们在学术领域的功能水平决定，而与任何学习困难的潜在发病机理无关。为了改善结果，我们必须确定出生的早产儿（PT）的学习问题是否具有类似的认知概况，神经基础和/或发展过程，与出生完整期儿童的学习问题（FT）。我们还必须调查PT儿童是否对已知有效教育学习障碍儿童有效的相同干预措施做出了有益的反应。由于在教育和长期成果中扮演着重要角色的角色，我们已经建立了一个成就卓著的跨学科团队，专注于PT儿童的阅读技能。 The specific aims of this study are to (1) compare the cognitive profiles and neural basis of reading skills in PT and FT children using behavioral measures and diffusion tensor imaging (DTI), an magnetic resonance imaging technique that evaluates cerebral white matter microstructure, (2) determine which behavioral or neural features predict persistent good or poor reading skills in both groups and (3) pilot test an intervention to improve reading skills n PT可怜的读者。我们将注册6岁的幼儿园学生（Pt n = 50和ft n = 50），以一系列阅读和认知措施进行测试，获得DTI，并跟随他们直到我们重复扩展的电池和DTI，直到8岁。我们假设PT组的表现比FT组更差。我们将评估PT组是否具有与单词阅读水平等同的FT儿童相比，PT组是否具有独特的测试性能或白质微观结构模式。我们将确定两年后的行为和/或神经特征与持续阅读困难有关。在4年和第5年中，我们将招募另一个PT儿童样本，其阅读分数低于25％的年龄。我们将使用两个基于证据的课程进行一个为期6周的夏季辅导计划，该课程狭窄地专注于音素知名度，一个集中于其他方面，包括阅读理解。我们将确定家庭干预的可行性和可接受性，并评估早产儿童是否具有注意力和耐力，可以在3天/周/周中以3天为单位的小组在3周中工作6周。这项创新的研究将对理解（1）PT儿童的阅读结果产生持续的影响，（2）PT和FT儿童正常和异常阅读的神经基础，以及（3）神经可塑性，白质的能力随时间和教育干预措施随时间而变化。它将定位我们在随后的阶段对早产儿童进行阅读干预的随机临床试验。