Abstract Infant and child development is a complex interaction between environmental, biological,...
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Abstract Infant and child development is a complex interaction between environmental, biological, social, cultural, and familial factors influenced by neighborhood and community context and operating from preconception, through gestation, infancy, and childhood. The CANDLE Study (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) is a longitudinal cohort study designed to follow 1,500 pregnant women and their children living in Memphis/Shelby County, TN from the second trimester into childhood. The study is constructed to investigate the wide range of genetic, epigenetic, demographic, and social factors influencing child development across urban and suburban neighborhoods of Memphis/Shelby County, Tennessee. CANDLE data include biological samples; demographic, health and nutritional measures of mother and infant; infant cognitive, language, socioemotional, and adaptive outcomes at 12, 24 and 36 months; screening for specific disabilities (e.g., autism); maternal mental health and cognition; and maternal-infant interactions. CANDLE grew from a broad partnership of university and community resources committed to improving the health, development and well-being of Memphis/Shelby County children. It is grounded in Life Course Model principles that: today’s experiences and exposures shape tomorrow’s health/development; health/development trajectories are strongly influenced during early sensitive periods; and the biologic, physical, and social environment greatly affects the capacity to be healthy and develop optimally. This poster outlines the CANDLE study design and structure. It highlights the multidisciplinary collaboration and the critical sponsorship role of The Urban Child Institute, a Memphis non-profit organization committed to improving the lives of children and families by focusing on brain development from conception to 3-years of age. The poster reviews the key roles of the UCEDD/LEND in developing and implementing outcome evaluations, including the significant roles of UCEDD/LEND trainees. Selected early basic and clinical research findings are presented to illustrate the broad potential of CANDLE. Opportunities for researchers from other programs to collaborate with CANDLE are available. Selected Measures Selected Maternal Measures: •Brief Symptom Inventory (BSI) [maternal psychological problems] •Edinburgh Postnatal Depression Scale (EPDS) •Parenting Stress Index (PSI) •Temperament Evaluation of Memphis, Pisa, Paris, San Diego (TEMPS) Selected Infant Measures: •Bayley Scales of Infant &Toddler Development- Screener (Bayley) •Brief Infant-Toddler Social and Emotional Assessment (BITSEA) •Scales of Independent Behavior-Revised (SIB-R) •Children with Special Healthcare Needs (CSHCN) Conclusions • CANDLE will ultimately follow 1500 Memphis/Shelby County children, their mothers, and families into early childhood. • CANDLE is research based on Life Course Theory. It has the capacity to examine key biological, physical and social determinants of health and development in children and families. • As the cohort is evaluated through infancy and early childhood, CANDLE provides the opportunity to track individual, family, and community trajectories over time. • CANDLE offers opportunities for other researchers to collaborate in areas of their interest. Acknowledgements • CANDLE Participants: Parents and their children • CANDLE Staff: Patti Simpson MS, Maureen Miller MPH • LEND/UCEDD Cognitive Examiners: Colby Butzon PhD, Christina Warner- Metzger PhD, Bruce Keisling PhD, Cynthia Klubnick PhD, Danijela Zlatevski MS, Kristin Hoffman PhD, Jessica Myszak PhD, Pamela Najera PsyD, Caroline Gardner MA, Rachel Minelli BA, Lauren Benner MS, Jennifer Maynard BA, Tera Traylor BA. The CANDLE Study: A Multidisciplinary, Multi-University Research Partnership Frederick B. Palmer MD, J. Carolyn Graff PhD, Laura E. Murphy EdD, Frances A. Tylavsky PhD The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study Boling Center for Developmental Disabilities and Department of Preventive Medicine, University of Tennessee Health Science Center The Urban Child Institute, Memphis, TN Design and Sample Selected Results 0 0.1 0.2 0.3 0.4 0.5 2 3 4 5 6 7 African American Other Estimated probably of SE problem associated with EPDS score CV1 and race EPDS score at CV (12 months) Estimated Probability Model Predicting Socioemotional (SE) Problems at 12 Months (N=228) Variable Chi- square statisti c P EPDS score CV1 14.97 <.001 TEMPS cyclothymic score M1 8.28 .004 Birth head circumference M3 5.25 .022 Race 1.13 .288 Race*EPDS score CV1 4.10 .043 Selected Maternal and Infant Measures by Visit (see Handout for more) Measure M1 >15 wk M2 27-42 wk M3 Birth HV 4 wk CV 12 mo CV 24mo CV 36mo Demographic s X X X X Bayley X X X BSI X X X X BITSEA X X PCI X X EPDS X X PSI-SF X X X SIB-R X X X TEMPS X X CSHCN Screener X X X Maternal blood X X X Maternal urine X X X The Urban Child Institute The Urban Child Institute is a non-profit organization dedicated to the well-being and health of children from conception to three years old in Memphis and Shelby County. Organizationally, it is a data-driven, results- oriented coalition of community researchers, strategists, and practitioners who share a common vision of turning research into actionable knowledge. The Institute is working to become a recognized leader in child advocacy research, a trustworthy community partner, and a place of choice for expertise, advice, and collaboration for those who want to improve the lives of New born DNA M ethylation LevelsDecrease as M aternal Age Increases • Addingm ethyl groupsto DNA isone principal m echanism forcontrolling gene expression. • An individual’slevelsofDNA m ethylation decrease w ith increasingage. • In cord blood of168 CANDLE new bornsw e m easured the level ofm ethylation at27,578 sitesfrom 14,495 genesusing a m icroarray from Illumina(Humanmethylation27). • Atm ostsitesthere w asno relationship betw een the age ofthe m otherand m ethylation. • How ever, at a subset of sites a significantnegative correlation (<1.8x10 -6 )w asfound betw een DNA m ethylation and m aternal age: asm aternal age increased the level of methylationdecreased. • Thisisthe firstindication thatthere isalso a relationship betw een m aternal age and levels ofDNA m ethylation in the next generation. • Although speculative, itispossible thatthis trend playsa role in the increased risk of negative outcom esthatchildren ofolder m othersexperience, such asautism , obsessive-com pulsivedisorder, cancers, diabetesand schizophrenia. Maternal depression at 12 months was the best predictor of SE problems in 12 month old infants. However, an interaction between race and maternal depression is noted: as depression scores for African American mothers increased, the probability of these mothers reporting infant SE problems increased. Mother Demographics (by percent) for First 1196 CANDLE Enrollees Variable US Shelby Co. CANDLE Race African American 16 60 68 Caucasian 58 27 29 Other 25 10 3 % of Births to Single Mothers 34 61 61 % Born to Mothers Aged 20-35 y 73 77 81 Education Completed < High School 18 29 13 High School, Some College, or Technical School 55 51 56 Bachelor’s Degree 18 13 19 Graduate/ Professional 10 7 11 Income Status Low Income (<200% Poverty Level or < $35000) 33 58 58 Middle ($35000-$74999) 27 12 16 High (>$75000) 26 16 15 Unknown 15 14 11 Geomapping capabilities allow CANDLE to examine neighborhood characteristics associated with child and family outcomes. In this map, living in distressed or vulnerable neighborhoods is associated with multiple moves in the child’s first year of life. (Courtesy Phyllis Betts, PhD) Courtesy Ron Adkins, PhD
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Transcript of Abstract Infant and child development is a complex interaction between environmental, biological,...
AbstractInfant and child development is a complex interaction between environmental, biological, social, cultural, and familial factors influenced by neighborhood and community context and operating from preconception, through gestation, infancy, and childhood.
The CANDLE Study (Conditions Affecting Neurocognitive Development and Learning in Early Childhood) is a longitudinal cohort study designed to follow 1,500 pregnant women and their children living in Memphis/Shelby County, TN from the second trimester into childhood. The study is constructed to investigate the wide range of genetic, epigenetic, demographic, and social factors influencing child development across urban and suburban neighborhoods of Memphis/Shelby County, Tennessee. CANDLE data include biological samples; demographic, health and nutritional measures of mother and infant; infant cognitive, language, socioemotional, and adaptive outcomes at 12, 24 and 36 months; screening for specific disabilities (e.g., autism); maternal mental health and cognition; and maternal-infant interactions.
CANDLE grew from a broad partnership of university and community resources committed to improving the health, development and well-being of Memphis/Shelby County children. It is grounded in Life Course Model principles that: today’s experiences and exposures shape tomorrow’s health/development; health/development trajectories are strongly influenced during early sensitive periods; and the biologic, physical, and social environment greatly affects the capacity to be healthy and develop optimally.
This poster outlines the CANDLE study design and structure. It highlights the multidisciplinary collaboration and the critical sponsorship role of The Urban Child Institute, a Memphis non-profit organization committed to improving the lives of children and families by focusing on brain development from conception to 3-years of age. The poster reviews the key roles of the UCEDD/LEND in developing and implementing outcome evaluations, including the significant roles of UCEDD/LEND trainees. Selected early basic and clinical research findings are presented to illustrate the broad potential of CANDLE. Opportunities for researchers from other programs to collaborate with CANDLE are available.
Selected MeasuresSelected Maternal Measures:• Brief Symptom Inventory (BSI) [maternal psychological problems]• Edinburgh Postnatal Depression Scale (EPDS)• Parenting Stress Index (PSI)• Temperament Evaluation of Memphis, Pisa, Paris, San Diego
(TEMPS)Selected Infant Measures:• Bayley Scales of Infant &Toddler Development-Screener (Bayley)• Brief Infant-Toddler Social and Emotional Assessment (BITSEA)• Scales of Independent Behavior-Revised (SIB-R)• Children with Special Healthcare Needs (CSHCN) ScreenerParent-Child Interaction Measure:• Parent-Child Interaction Teaching Scale (PCI)
Conclusions• CANDLE will ultimately follow 1500 Memphis/Shelby County children,
their mothers, and families into early childhood.
• CANDLE is research based on Life Course Theory. It has the capacity to examine key biological, physical and social determinants of health and development in children and families.
• As the cohort is evaluated through infancy and early childhood, CANDLE provides the opportunity to track individual, family, and community trajectories over time.
• CANDLE offers opportunities for other researchers to collaborate in areas of their interest.
Acknowledgements• CANDLE Participants: Parents and their children
• CANDLE Staff: Patti Simpson MS, Maureen Miller MPH
• LEND/UCEDD Cognitive Examiners: Colby Butzon PhD, Christina Warner-Metzger PhD, Bruce Keisling PhD, Cynthia Klubnick PhD, Danijela Zlatevski MS, Kristin Hoffman PhD, Jessica Myszak PhD, Pamela Najera PsyD, Caroline Gardner MA, Rachel Minelli BA, Lauren Benner MS, Jennifer Maynard BA, Tera Traylor BA.
• Collaborators from UTHSC, U Memphis, Vanderbilt, UAB, UNC, Tulane, U British Colombia, Texas Tech
The CANDLE Study: A Multidisciplinary, Multi-University Research PartnershipFrederick B. Palmer MD, J. Carolyn Graff PhD, Laura E. Murphy EdD, Frances A. Tylavsky PhD
The Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) Study
Boling Center for Developmental Disabilities and Department of Preventive Medicine, University of Tennessee Health Science Center
The Urban Child Institute, Memphis, TN
Design and Sample Selected Results
0
0.1
0.2
0.3
0.4
0.5
2 3 4 5 6 7
African American
Other
Estimated probably of SE problem associated with EPDS score CV1 and race
EPDS score at CV (12 months)
Est
imat
ed P
rob
abil
ity
Model Predicting Socioemotional (SE) Problems at 12 Months (N=228)
Variable Chi-square statistic
P
EPDS score CV1 14.97 <.001TEMPS cyclothymic score M1 8.28 .004Birth head circumference M3 5.25 .022Race 1.13 .288Race*EPDS score CV1 4.10 .043
Selected Maternal and Infant Measures by Visit (see Handout for more)Measure M1
>15 wkM2
27-42 wkM3
BirthHV
4 wkCV
12 moCV
24moCV
36mo
Demographics X X X X
Bayley X X X
BSI X X X X
BITSEA X X
PCI X X
EPDS X X
PSI-SF X X X
SIB-R X X X
TEMPS X X
CSHCN Screener X X X
Maternal blood X X X
Maternal urine X X X
Cord blood X
Placental tissue X
The Urban Child InstituteThe Urban Child Institute is a non-profit organization dedicated to the well-being and health of children from conception to three years old in Memphis and Shelby County. Organizationally, it is a data-driven, results-oriented coalition of community researchers, strategists, and practitioners who share a common vision of turning research into actionable knowledge. The Institute is working to become a recognized leader in child advocacy research, a trustworthy community partner, and a place of choice for expertise, advice, and collaboration for those who want to improve the lives of children in Memphis, Tennessee. The Urban Child Institute enthusiastically supports and sponsors CANDLE and its aims.
Newborn DNA Methylation Levels Decrease as Maternal Age Increases
• Adding methyl groups to DNA is one principal mechanism for controlling gene expression.• An individual’s levels of DNA methylation decrease with increasing age.
• In cord blood of 168 CANDLE newborns we measured the level of methylation at 27,578 sites from 14,495 genes using a microarray from Illumina (Humanmethylation27).• At most sites there was no relationship between the age of the mother and methylation.• However, at a subset of sites a significant negative correlation (<1.8x10-6) was found between DNA methylation and maternal age: as maternal age increased the level of methylation decreased.•This is the first indication that there is also a relationship between maternal age and levels of DNA methylation in the next generation.
• Although speculative, it is possible that thistrend plays a role in the increased risk ofnegative outcomes that children of oldermothers experience, such as autism, obsessive-compulsive disorder, cancers, diabetes and schizophrenia.
Maternal depression at 12 months was the best predictor of SE problems in 12 month old infants. However, an interaction between race and maternal depression is noted: as depression scores for African American mothers increased, the probability of these mothers reporting infant SE problems increased.
Mother Demographics (by percent) for First 1196 CANDLE EnrolleesVariable US Shelby Co. CANDLE
RaceAfrican American 16 60 68Caucasian 58 27 29Other 25 10 3
% of Births to Single Mothers 34 61 61
% Born to Mothers Aged 20-35 y 73 77 81
Education Completed< High School 18 29 13High School, Some College, or Technical School
55 51 56
Bachelor’s Degree 18 13 19Graduate/Professional 10 7 11
Income StatusLow Income (<200% Poverty Level or < $35000)
33 58 58
Middle ($35000-$74999) 27 12 16High (>$75000) 26 16 15Unknown 15 14 11
Geomapping capabilities allow CANDLE to examine neighborhood characteristics associated with child and family outcomes. In this map, living in distressed or vulnerable neighborhoods is associated with multiple moves in the child’s first year of life. (Courtesy Phyllis Betts, PhD)
Courtesy Ron Adkins, PhD
