Early Prevention of Aberrant Behavior in Neurodevelopmental Disorders in Peru

秘鲁神经发育障碍异常行为的早期预防

基本信息

批准号：
7845973
负责人：
STEPHEN ROBERT SCHROEDER
金额：
$ 13.76万
依托单位：
UNIVERSITY OF KANSAS LAWRENCE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-06-01 至 2012-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7845973
关键词：
Address Adult Age Aggressive behavior Agreement Algorithms American Area Argentina Arts Behavior Behavioral Bolivia Brain Diseases Brazil Caring Certification Cessation of life Chicago Child Child health care Childhood Chronic Client Clinical Cognitive Collaborations Colombia Communities Community Integration Complex Computers Consult Consultations Contracts Country Data Data Storage and Retrieval Databases Dental Dentistry Developing Countries Development Developmental Disabilities Diagnostic Discipline Distance Learning Early identification Early treatment Ecuador Educational process of instructing Educational workshop Environment Environmental Pollution Europe Evaluation Evidence based program Evidence based treatment Experimental Designs Failure Family Feedback Fellowship Fostering Functional disorder Funding Future Genes Genetic Goals Grant Guatemala Hand Health Hour Illinois Indigenous Infant Institutes International Intervention Kansas Latin America Lead Learning Length Letters Life Link Longevity Measures Medical Psychology Medicine Mission Modeling Monitor Neurobiology Neurodevelopmental Disorder Neurologic Neurosciences Nicaragua Occupational Therapy Occupations Pediatrics Peru Philosophy Physical therapy Pilot Projects Play Policies Population Population Study Poverty Prevalence Prevalence Study Prevention Prevention program Preventive Intervention Procedures Province Psychiatry Psychology Psychopharmacology Reading Recording of previous events Recruitment Activity Reporting Research Research Ethics Research Ethics Committees Research Infrastructure Research Personnel Research Project Grants Research Training Resources Rest Risk Risk Factors Role Rotation Sampling Schools Security Self-Injurious Behavior Services Siblings Social Work Socialization Source Spain Special Education Stereotyped Behavior Students Talents Testing Time Toddler Training Training Programs Translating Translations Universities Validation Validity and Reliability Visit Work Writing age group base blind brain behavior cost design evidence base experience high risk human subject improved instrument interest intervention program lectures nutrition policy implication prevent professor programs psychoeducational psychopharmacologic public health relevance research study response socioeconomics stereotypy symposium treatment program

项目摘要

DESCRIPTION (provided by applicant): Aberrant behaviors, i.e. self-injury, aggression, and stereotyped behavior, are some of the most devastating neurodevelopmental disorders (ND). They lead to deteriorating health and, sometimes, early death; they prevent community integration; they impair learning and socialization opportunities; and they are the most salient reason for job failure in the community. They are often linked to several gene-brain-behavior dysfunctions. Prevalence estimates of ND in the U.S., UK, and Europe average c.10% in total population studies. Among all people with ND, prevalence studies in these countries estimate approximately 10-25 % have severe aberrant behaviors, but prevalence is unknown in Latin American countries. Extensive research on behavioral and psychopharmacological treatment and prevention exists, but not in Latin America, where this population is severely underserved. This project aims to study the development and prevention of aberrant behaviors of people with ND in Peru (population 22 million), where only 2% of the population of an estimated 3 million people who have ND are being served. The Centro Ann Sullivan Center del Peru (CASP) is a state-of-the-art school for neurodevelopmental disorders based in Lima, with a network of satellite programs in Peru, Argentina, Brazil, Bolivia, Colombia, Guatemala, Nicaragua, Ecuador, and Spain. CASP has a 27-year history of collaborative sponsorship with the Life Span Institute at the University of Kansas In response to Fogarty PAR-08-113, we propose an R21 to screen 1000 infants and toddlers expecting to find 250 who are at risk for ND, 6-36 mos., 50% of whom are also likely to be at risk for aberrant behaviors (AB) and to follow 100 or more of them plus 100 or more matched controls with ND, but not at risk for AB, at 6- month intervals for 12 months with in-depth interdisciplinary evaluations involving pediatric, psychoeducational, behavioral, neurological, and genetic assessments, to see if they develop aberrant behaviors, as was shown in the U.S. by Berkson, et al.( 2002). The results of this early identification program will be followed by a 5-year R01 on early preventive intervention of aberrant behavior in infants and young children with ND in Lima, Peru. The R21 will also concentrate on building on the existing excellent psycho-educational program and distance learning network at CASP by adding research infrastructure, increasing the research capacity of staff, translation and validation of assessment instruments, and collaborations with appropriate investigators in universities in the U.S., Peru, and other Latin American countries, who will then participate in the subsequent R01. There may be differences in the development of aberrant behavior due to sociocultural practices and health issues, such as uncontrolled environmental pollution, in Latin America. PUBLIC HEALTH RELEVANCE: This project concerns the gene-brain-behavior relationships involved in the development of aberrant behaviors among infants and young children with neurodevelopmental disorders (ND) who live in high-risk environments in Lima, Peru. We plan to develop a risk algorithm that will permit a cost-effective effort at early preventive intervention that can be replicated throughout Latin America, across the CASP distance learning network and beyond, for young children with these extremely debilitating problems.

描述（由申请人提供）：异常行为，即自残、攻击性和刻板行为，是最具破坏性的神经发育障碍 (ND) 之一。它们会导致健康状况恶化，有时甚至导致早逝；它们阻碍社区融合；它们损害了学习和社交机会；他们是社区工作失败的最显着原因。它们通常与多种基因-大脑行为功能障碍有关。在美国、英国和欧洲总人口研究中，ND 患病率估计平均约为 10%。在所有 ND 患者中，这些国家的患病率研究估计大约 10-25% 的人有严重异常行为，但拉丁美洲国家的患病率未知。存在关于行为和精神药理学治疗和预防的广泛研究，但在拉丁美洲却没有，因为那里的人群服务严重不足。该项目旨在研究秘鲁（人口 2200 万）ND 患者异常行为的发展和预防，在秘鲁估计有 300 万 ND 患者中，只有 2% 得到了服务。秘鲁安沙利文中心 (CASP) 是一所最先进的神经发育障碍学校，总部位于利马，在秘鲁、阿根廷、巴西、玻利维亚、哥伦比亚、危地马拉、尼加拉瓜、厄瓜多尔、和西班牙。 CASP 与堪萨斯大学寿命研究所有 27 年的合作赞助历史。为了回应 Fogarty PAR-08-113，我们建议采用 R21 筛查 1000 名婴幼儿，预计发现 250 名有 ND 风险的儿童，6-36 个月，其中 50% 的人也可能面临异常行为 (AB) 的风险，并遵循 100 或其中更多的人加上 100 名或更多匹配的 ND 对照，但没有 AB 风险，每隔 6 个月进行一次，持续 12 个月，进行深入的跨学科评估，涉及儿科、心理教育、行为、神经学和遗传评估，看看它们是否发展出异常行为，正如美国的 Berkson 等人（2002 年）所表明的那样。在这一早期识别计划的结果之后，将开展为期 5 年的 R01，对秘鲁利马的 ND 婴幼儿异常行为进行早期预防干预。 R21 还将致力于通过增加研究基础设施、提高工作人员的研究能力、评估工具的翻译和验证以及与美国大学的适当研究人员合作，在 CASP 现有的优秀心理教育项目和远程学习网络的基础上进行建设。、秘鲁等拉丁美洲国家，他们将参加后续的R01。在拉丁美洲，由于社会文化习俗和健康问题（例如不受控制的环境污染），异常行为的发展可能存在差异。公共健康相关性：该项目涉及生活在秘鲁利马高危环境中的患有神经发育障碍 (ND) 的婴幼儿异常行为发展所涉及的基因-大脑-行为关系。我们计划开发一种风险算法，该算法将允许在整个拉丁美洲、整个 CASP 远程学习网络及其他地区为患有这些极其衰弱问题的幼儿提供具有成本效益的早期预防干预措施。