Transcript Powerpoint template for scientific posters (Swarthmore

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
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 maternalinfant interactions.
CANDLE grew from a broad partnership of university and community
resources committed to improving the health, development and wellbeing 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.
Design and Sample
Selected Results
Selected Maternal and Infant Measures by Visit (see Handout for more)
Measure
M1
>15 wk
CV
12 mo
CV
24mo
CV
36mo
X
X
X
X
X
X
X
X
X
BITSEA
X
X
PCI
X
X
Demographics
M2
27-42 wk
M3
Birth
HV
4 wk
X
Bayley
BSI
X
EPDS
X
• 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.
X
PSI-SF
X
X
X
SIB-R
X
X
X
TEMPS
X
• Although speculative, it is possible that this
trend plays a role in the increased risk of
negative outcomes that children of older
mothers experience, such as autism,
obsessive-compulsive disorder, cancers,
diabetes and schizophrenia.
X
CSHCN Screener
X
Maternal blood
X
X
X
Maternal urine
X
X
X
Cord blood
X
Placental tissue
X
X
X
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)
Mother Demographics (by percent) for First 1196 CANDLE Enrollees
Variable
US
Shelby Co.
CANDLE
Race
African American
Caucasian
Other
16
58
25
60
27
10
68
29
3
% of Births to Single Mothers
34
61
61
% Born to Mothers Aged 20-35 y
73
77
81
Education Completed
< High School
High School, Some College,
or Technical School
Bachelor’s Degree
Graduate/Professional
Income Status
Low Income (<200% Poverty
Level or < $35000)
Middle ($35000-$74999)
High (>$75000)
Unknown
Newborn DNA Methylation Levels Decrease as
Maternal Age Increases
18
55
29
51
13
56
18
10
13
7
19
11
33
58
58
27
26
15
12
16
14
16
15
11
Courtesy Ron Adkins, PhD
Estimated probably of SE problem associated with EPDS
score CV1 and race
Model Predicting Socioemotional (SE) Problems at
12 Months (N=228)
Variable
EPDS score CV1
TEMPS cyclothymic score M1
Birth head circumference M3
Race
Race*EPDS score CV1
Chi-square
statistic
14.97
8.28
5.25
1.13
4.10
P
<.001
.004
.022
.288
.043
0.5
Estimated Probability
Abstract
0.4
African
American
0.3
0.2
Other
0.1
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.
0
2
3
4
5
6
7
EPDS score at CV (12 months)
The Urban Child Institute
Selected Measures
Conclusions
Acknowledgements
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, resultsoriented 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.
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) Screener
Parent-Child Interaction Measure:
•Parent-Child Interaction Teaching Scale (PCI)
•
CANDLE will ultimately follow 1500 Memphis/Shelby County children,
their mothers, and families into early childhood.
•
CANDLE Participants: Parents and their children
•
CANDLE Staff: Patti Simpson MS, Maureen Miller MPH
•
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.
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.
•
CANDLE offers opportunities for other researchers to collaborate in
areas of their interest.
•
Collaborators from UTHSC, U Memphis, Vanderbilt,
UAB, UNC, Tulane, U British Colombia, Texas Tech