Executive Function in Preschoolers: Characteristics and Response to Treatment

Stanford University, Stanford CA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): The aim of this proposal is a comprehensive 5-year plan for a Mentored Patient-Oriented Research Career Development Award for the CANDIDATE, Irene M. Loe, MD, and Instructor in Developmental Medicine at Stanford University. As a developmental-behavioral pediatrician, her long-term research objectives are to (1) elucidate neurobiological and developmental mechanisms underlying executive function (EF), attention, and behavior problems in children at risk for neurodevelopmental disorders, (2) design, implement, and evaluate innovative clinical treatments that can be applied in early childhood to prevent, treat, and improve outcomes in children at risk for EF and attention impairments, and (3) document long-term impact of interventions on functional outcomes and neural organization. The CAREER DEVELOPMENT plan includes didactic work and tutorials in biostatistics and randomized clinical trials (RCT); mentored training; and experimental research. The research supports Dr. Loe's development of expertise in EF in preschool children; implementation of advanced statistical methods; and experience in designing and implementing an RCT. The ENVIRONMENT at Stanford University provides outstanding resources for education and training of researchers in academic medicine. Dr. Heidi Feldman, developmental-behavioral pediatrician, and Dr. Susan Landry, developmental psychologist, both child development experts with expertise in EF and RCTs serve as co-mentors. Consultants are Drs. Philip Lavori, Linda Pfiffner, and David Stevenson, all experienced in RCT, and who bring expertise in biostatistics, EF and attention-deficit/hyperactivity disorder (ADHD), and preterm children, respectively. The RESEARCH evaluates two highly prevalent populations at risk for EF impairment: (1) preterm children (preterm-risk) and (2) children with first-degree family member with ADHD (family-risk). This innovative research plan is divided into 2 parts: Part 1. EF Characteristics/EF Profiles study is designed to compare EF skills in groups with (1) preterm- risk, (2) family-risk, and (3) matched full-term controls. We compare groups to each other directly, hypothesizing poor working memory in preterm-risk and poor response inhibition in family-risk. Part 2. Response to Treatment study is an RCT of placebo or home-based computerized training for preterm preschoolers with EF impairment. The training targets working memory, and the main outcome measure is performance on untrained working memory tasks.