In response to the RFA # OD-99-006, titled Research on Child Neglect, we propose a 5-year cross sectional investigation to non-invasively examine the psychobiological consequences of neglect in children. Child neglect is associated with delays in and deficits of multi-system developmental achievements in behavioral, cognitive and emotional regulation. These findings may be caused by adverse brain development. To this effect, we propose to examine the effects of neglect on the development of biological stress systems, brain maturation and neuropsychological (cognitive) function of prepubertal children. Seventy neglected subjects, age 3 to 10 years, will be enrolled after a recent referral to child protective services (CPS) and who meet pre-determined study criteria for neglect. They will be compared to seventy non- maltreated sociodemographically similar control children. We are specifically studying this age group because brain maturation measures increase robustly and linearly during this developmental period. Thus, if child neglect is associated with adverse brain development, intervention during this time period could help attenuate these hypothesized brain changes because it is a time of active brain development. 24-hour urinary catecholamine and urinary free cortisol (UFC) concentrations will assess biological stress systems. Brain maturation will be assessed with measures of MRI-based brain morphometry of cerebral volume and cortical myelination (i.e. cortical white matter volume and corpus callosum area). Neuropsychological functioning will assess brain function.
Specific aims are to compare measures of biological stress systems, brain maturation, and neuropsychological function in neglected non-physically and non-sexually abused children to non-maltreated sociodemographically similar controls. We hypothesize that compared to controls, neglected non-abused children will show evidence of alterations in biological stress systems and brain maturation and poorer neuropsychological functioning. Secondary aims are to explore clinical summary variable measures of: 1) the subject's neglect, 2) environmental and emotional stimulation, 3) physical growth, and 4) measures of traumatic experiences and symptoms of PTSD, to try and identify the best clinical predictors of outcome measures of biological stress systems, brain maturation and neuropsychological function. Within the neglect group, we expect to identify a subsample with without psychopathology. We will explore these same clinical summary variable measures as well as measures of biological stress systems and brain maturation for protective factors against child psychopathology and delayed neuropsychological function in this resilient subgroup of neglected children.
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