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）：早产影响了美国约 13% 的新生儿，其公共卫生后果远远超出了新生儿时期。大约一半的早产儿会出现认知、语言和学习问题，这会对他们的长期结果产生不利影响。一旦这些孩子达到学龄，教育计划将根据他们在学术领域的功能水平来决定，而不考虑任何学习困难的潜在发病机制。为了改善结果，我们必须确定早产儿 (PT) 的学习问题是否与足月儿 (FT) 的学习问题具有相似的认知特征、神经基础和/或发育过程。我们还必须调查 PT 儿童是否对已知可有效教育患有学习障碍的 FT 儿童的相同干预措施做出积极反应。由于阅读在教育和长期成果中发挥着关键作用，我们组建了一支经验丰富的跨学科团队，专注于 PT 儿童的阅读技能。本研究的具体目的是（1）使用行为测量和扩散张量成像（DTI）（一种评估大脑白质微观结构的磁共振成像技术）来比较 PT 和 FT 儿童的认知概况和阅读技能的神经基础，（ 2）确定哪些行为或神经特征可以预测两组的持续良好或较差的阅读技能，以及（3）试点测试一项干预措施，以提高 PT 较差读者的阅读技能。我们将招收 6 岁幼儿园学生（PT n=50 和 FT n=50），对他们进行一系列阅读和认知测量，获得 DTI，并跟踪他们直到 8 岁时我们重复扩展电池和 DTI 。我们假设 PT 组的表现会比 FT 组更差。我们将评估 PT 组与 FT 儿童相比是否具有独特的测试表现或白质微结构模式（等同于单字阅读水平）。两年后，我们将确定哪些行为和/或神经特征与持续性阅读困难相关。在 4 年级和 5 年级，我们将招募另一批阅读成绩低于年龄 25% 的 PT 儿童样本。我们将使用两种循证课程试行为期 6 周的暑期辅导计划，一种课程狭隘地侧重于音素意识，另一种则更广泛地侧重于其他方面，包括阅读理解。我们将确定家庭干预的可行性和可接受性，并评估早产儿是否有注意力能力和耐力，能够以 3 人为一组，每周 5 天，每次 90 分钟，持续 6 周。这项创新研究将对以下方面产生持续影响：(1) PT 儿童的阅读结果，(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，即白质的能力随着时间和教育干预的进行而发生变化。这将使我们能够在后续阶段对早产儿进行阅读干预的随机临床试验。