Adaptive behavior

适应性行为
  • 文章类型: Journal Article
    母亲抑郁症会促进母亲炎症和后代神经发育障碍的风险,但是炎症在后代抑郁与神经发育之间的关系中的作用尚未在人类中得到广泛研究。本研究旨在探讨母体炎症在母体抑郁与婴儿神经发育关系中的中介作用。从天津市妇幼保健教育和服务队列(天津MCHESC)中确定了146对母婴对。通过流行病学研究中心抑郁量表和爱丁堡产后抑郁量表对产妇抑郁进行了调查,通过潜在的阶级增长分析确定了抑郁的轨迹。用酶联免疫测定法评估三个三个月的炎症生物标志物。使用2016年儿童神经心理和行为量表修订版测量婴儿的神经发育。进行主成分分析以鉴定炎症状况。使用逐步多元线性回归分析和中介分析来确定母亲抑郁之间的关联。母体炎症和婴儿神经发育。低度和中度产妇抑郁组的后代表现出比高度产妇抑郁组更高的适应性行为发育商。孕早期炎症急性期母体C反应蛋白水平较高,炎症水平较高,中度母亲抑郁与婴儿较低的适应行为商数有关。孕早期炎症急性期的炎症水平显著介导了母亲抑郁与婴儿适应性行为发育之间的关联,解释了11.85%的关联。母亲抑郁可通过炎症损害婴儿的适应性行为发育。
    Maternal depression promotes maternal inflammation and the risk of neurodevelopmental disorder in offspring, but the role of inflammation on the association between depression and neurodevelopment in offspring has not been extensively studied in humans. This study aims to examine the mediating role of maternal inflammation on the relationship between maternal depression and neurodevelopment in infants. 146 mother-child pairs were identified from Tianjin Maternal and Child Health Education and Service Cohort (Tianjin MCHESC). Maternal depression was investigated by the Center for Epidemiologic Studies Depression Scale and the Edinburgh Postnatal Depression Scale, and depressive trajectories were identified by latent class growth analysis. Inflammatory biomarkers in the three trimesters were assessed with enzyme-linked immunoassay. The Children Neuropsychological and Behavior Scale-Revision 2016 was used to measure neurodevelopment in infants. Principal component analysis was performed to identify inflammatory condition. Stepwise multiple linear regression analysis and mediation analysis were used to identify association among maternal depression, maternal inflammation and neurodevelopment in infants. Offspring in the low and moderate maternal depression groups exhibited higher adaptive behavior development quotient than those in the high maternal depression group. Higher maternal c-reactive protein level and higher inflammatory level in acute-phase of inflammation in the first trimester, and moderate maternal depression were associated with lower adaptive behavior quotients of infants. Inflammatory level in acute-phase of inflammation in the first trimester significantly mediated the association between maternal depression and adaptive behavior development of infants, with explaining 11.85% of the association. Maternal depression could impair adaptive behavior development in infants by inflammation.
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  • 文章类型: Journal Article
    位置信息是粒子根据其在外部浓度梯度中的位置来适应其行为的关键,从而自我组织成复杂的模式。这里,显示了在pH梯度中自组织的漂浮表面活性剂液滴的位置依赖性行为,利用Marangoni效应将表面活性分子的梯度转化为运动。首先,产生表面活性剂微升液滴的场,漂浮在水面上的水滴驱动局部,外向Marangoni在表面活性剂溶解后流动,并伴随髓鞘细丝生长。接下来,引入了基于可水解酰胺的竞争性表面活性剂,其比髓磷脂表面活性剂更具表面活性,从而抑制了局部Marangoni流和来自液滴的髓磷脂生长。引入pH梯度后,酰胺表面活性剂在酸性区域水解,以便重新建立当地的Marangoni流和髓鞘生长。由此产生的局部和全局表面张力梯度的组合产生了一个髓鞘生长的液滴区域和一个髓鞘生长被抑制的区域,被紧密堆积的液滴的波前隔开,其位置可以通过pH梯度控制。因此,它显示了“法国国旗”模式,在通常来自反应-扩散系统的合成环境中,也可以通过表面活性剂液滴系统建立。
    Positional information is key for particles to adapt their behavior based on their position in external concentration gradients, and thereby self-organize into complex patterns. Here, position-dependent behavior of floating surfactant droplets that self-organize in a pH gradient is demonstrated, using the Marangoni effect to translate gradients of surface-active molecules into motion. First, fields of surfactant microliter-droplets are generated, in which droplets floating on water drive local, outbound Marangoni flows upon dissolution of surfactant and concomitantly grow myelin filaments. Next, a competing surfactant based on a hydrolysable amide is introduced, which is more surface active than the myelin surfactant and thereby inhibits the local Marangoni flows and myelin growth from the droplets. Upon introducing a pH gradient, the amide surfactant hydrolyses in the acidic region, so that the local Marangoni flows and myelin growth are reestablished. The resulting combination of local and global surface tension gradients produces a region of myelin-growing droplets and a region where myelin growth is suppressed, separated by a wave front of closely packed droplets, of which the position can be controlled by the pH gradient. Thereby, it is shown how \"French flag\"-patterns, in synthetic settings typically emerging from reaction-diffusion systems, can also be established via surfactant droplet systems.
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  • 文章类型: Journal Article
    占据较高营养水平的动物会对生态系统的结构和功能产生不成比例的影响,对环境的复杂行为反应,但是行为适应对水生生态系统动力学的影响表现不足,特别是在模型研究中。这里,我们探讨了鱼类的适应性行为如何影响水生生态系统的动态。我们在取食和捕食之间的中心权衡的背景下构建鱼类行为,计算由环境食物供应和捕食风险决定的最佳喂养水平。为了探索鱼类行为的整个生态系统后果,我们将我们的行为模型嵌入水生态系统工具(WET)中,当代端到端的水生生态系统模型。最优性原理为表示与复杂模型相关的动物行为提供了一个强大的机械框架,并且可以对模型动力学提供稳定作用。该模型预测了类似于HollingIII型的紧急功能反应,但具有更丰富的动力和更严格的理论基础。与没有最佳行为的控制模型相比,我们展示了自适应鱼类行为如何稳定食物网动态,以及改变潜在权衡的强度如何对营养控制和食物网结构产生深远的影响。此外,我们展示了如何包含鱼类行为允许模型系统对营养增强形式的环境扰动的整体更现实的响应。我们讨论了真实生态系统中行为适应的结构化效应,以及像这样的方法如何有益于水生生态建模。我们的研究进一步强调了如何在复杂的操作模型中成功实施基于理论生态学概念的机械方法,从而改善了动力学和描述性能力。
    Animals occupying higher trophic levels can have disproportionately large influence on ecosystem structure and functioning, owning to intricate behavioral responses to their environment, but the effects of behavioral adaptations on aquatic ecosystem dynamics are underrepresented, especially in model studies. Here, we explore how adaptive behavior of fish can affect the dynamics of aquatics ecosystems. We frame fish behavior in the context of the central trade-off between feeding and predation, calculating the optimal level of feeding determined by ambient food availability and predation risk. To explore whole-ecosystem consequences of fish behavior, we embed our behavioral model within the Water Ecosystems Tool (WET), a contemporary end-to-end aquatic ecosystem model. The principle of optimality provides a robust and mechanistic framework for representing animal behavior that is relevant for complex models, and can provide a stabilizing effect on model dynamics. The model predicts an emergent functional response similar to Holling type III, but with richer dynamics and a more rigorous theoretical foundation. We show how adaptive fish behavior works to stabilize food web dynamics compared to a control model with no optimal behavior, and how changing the strength of the underlying trade-off has profound effects on trophic control and food web structure. Furthermore, we demonstrate how including fish behavior allows for an overall more realistic response of the model system to environmental perturbation in the form of nutrient enhancement. We discuss the structuring effects of behavioral adaptations in real ecosystems, and how approaches like this one may benefit aquatic ecological modeling. Our study further highlights how a mechanistic approach based on concepts from theoretical ecology can be successfully implemented in complex operational models resulting in improved dynamics and descriptive power.
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  • 文章类型: Journal Article
    脆性X综合征(FXS)是遗传性智力残疾的主要原因,也是与自闭症密切相关的流行疾病。FXS的特点是社会行为发生了实质性的变化,包括社会退缩,避免眼神接触,社交焦虑加剧,提高唤醒水平,语言障碍,以及调节情绪的挑战。传统的行为评估主要集中在受控环境中的短期互动。在这项研究中,我们在三天的时间内对Fmr1KO雄性小鼠的适应性群体行为进行了全面检查,不引入实验性干预措施或基于任务的评估。数据揭示了复杂的行为异常,在对陌生环境的初始适应过程中表现出最显著的变化。值得注意的是,随着时间的推移,某些行为表现出逐渐回归典型模式。这种动态的Fmr1KO表型表现出增强的活性,以增加探索为特征,放大的社会兴趣,以及一种非常规的社交互动方法,其特征是较高频率的较短参与。这些发现有助于人们对FXS个体的社会行为的日益理解,并强调了在各种环境背景下理解他们的适应性反应的重要性。
    Fragile X Syndrome (FXS) stands out as a prominent cause of inherited intellectual disability and a prevalent disorder closely linked to autism. FXS is characterized by substantial alterations in social behavior, encompassing social withdrawal, avoidance of eye contact, heightened social anxiety, increased arousal levels, language deficits, and challenges in regulating emotions. Conventional behavioral assessments primarily focus on short-term interactions within controlled settings. In this study, we conducted a comprehensive examination of the adaptive group behavior of Fmr1 KO male mice over a three-day period, without introducing experimental interventions or task-based evaluations. The data unveiled intricate behavioral anomalies, with the most significant changes manifesting during the initial adaptation to unfamiliar environments. Notably, certain behaviors exhibited a gradual return to typical patterns over time. This dynamic Fmr1 KO phenotype exhibited heightened activity, featuring increased exploration, amplified social interest, and an unconventional approach to social interactions characterized by a higher frequency of shorter engagements. These findings contribute to the growing understanding of social behavior in individuals with FXS and underscore the significance of comprehending their adaptive responses in various environmental contexts.
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  • 文章类型: Journal Article
    自闭症谱系障碍患者的执行功能(EF)受损及其与消极学术,适应性,在过去的20年里,社会功能的结果得到了广泛的报道。然而,在学龄前期间仍然缺乏对自闭症患者EF的了解,几个关键能力(包括EF)出现的年龄。因此,本研究试图记录患有自闭症的学龄前儿童的日常EF及其与其他临床特征的关联。父母对自闭症学龄前儿童的EF进行了评分(M=30-65个月,N=288)使用执行功能学龄前版本的行为评级量表(BRIEF-P;Gioia,G.A.,Espy,K.A.,&Isquith,P.K.(2003年)。执行功能行为评级清单-学龄前版本。心理评估资源。).智商,适应性行为,和自闭症症状的严重程度也进行了评估。患有ASD的学龄前儿童在日常EF中表现出障碍,特别是与抑制和工作记忆有关。EF的更大挑战与较低水平的适应行为和较严重的自闭症症状密切相关。在较小程度上,EF挑战也与智力功能水平较低有关。早期评估和检测ASD学龄前儿童的EF困难可能有助于制定和整合特定的干预目标,以提高现有ASD早期干预计划中的这些基本能力。这可能有助于最大限度地提高他们的效率,并限制这些孩子在成长过程中可能面临的困难程度。
    Impairments in executive function (EF) among individuals with autism spectrum disorder and their association with negative academic, adaptive, and social functioning outcomes have been widely reported over the past 20 years. However, there remains a lack of understanding of EF in autism during the preschool period, an age at which several crucial abilities (including EF) emerge. The present study therefore sought to document everyday EF in preschool-aged children with autism and its associations with other clinical characteristics. Parents rated the EF of their preschool-aged child with autism (M = 30-65 months, N = 288) using the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P; Gioia, G. A., Espy, K. A., & Isquith, P. K. (2003). Behavior Rating Inventory of Executive Function-Preschool Version. Psychological Assessment Resources.). Intellectual quotient, adaptive behavior, and autism symptom severity were also assessed. Preschoolers with ASD displayed impairments in everyday EF, particularly in relation with inhibition and working memory. Greater challenges in EF were strongly associated with lower levels of adaptive behavior and a higher severity of autistic symptoms. To a lesser extent, EF challenges were also associated with lower levels of intellectual functioning. The early assessment and detection of EF difficulties in preschoolers with ASD may assist in developing and integrating specific intervention targets to improve these essential abilities within existing early intervention programs for ASD. This could help to maximize their effectiveness and limit the extent of difficulties these children may face growing up.
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  • 文章类型: Journal Article
    本研究描述了适应行为评估系统(ABAS-3)对巴西葡萄牙语的跨文化适应,它评估了三个主要自适应领域内的11个技能领域:概念,社会,实用。翻译是由两名独立的翻译人员完成的,随后由两名专家对翻译进行综合,然后由来自健康和教育领域的33名专家(每个子量表3名)对综合进行分析,这些专家是ABAS-3评估的领域的专家。在五个ABAS-3表格的1121个项目中,82(7.31%)需要修订。专家们在大多数项目上都有很好的共识,只需要进行微小的调整。有很好的证据表明内容的有效性和适应性在概念上,惯用的,以及乐器项目的语义方面。这种跨文化适应的初始过程是必要的,因为适应行为受到社会经济地位和文化等环境因素的强烈影响。
    This study describes the cross-cultural adaptation to Brazilian Portuguese of the Adaptive Behavior Assessment System (ABAS-3), which assesses 11 skills areas within three major adaptive domains: the conceptual, social, and practical. The translation was performed by two independent translators, which was followed by the synthesis of the translations by two experts and then an analysis of the synthesis by 33 specialists from the areas of health and education (three per subscale) who were experts in the domains evaluated by ABAS-3. Of the 1121 items of the five ABAS-3 forms, 82 (7.31%) needed revision. There was good agreement between the specialists in respect of most items, with only minor adjustments being required. There was good evidence of content validity and the adequacy of the adaptation in respect of the conceptual, idiomatic, and semantic aspects of the items of the instrument. This initial process of cross-cultural adaptation was necessary because adaptive behavior is strongly influenced by environmental factors such as socioeconomic status and culture.
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  • 文章类型: Journal Article
    二甲双胍已被用作靶向治疗,以潜在地改善认知并减缓脆性X综合征(FXS)个体在发育过程中发生的典型智商下降。在这项后续研究中,我们关注的是在一项开放标签试验中接受二甲双胍临床治疗的FXS患者1~3年内智商和适应行为变化的轨迹.
    FXS年龄6至25岁(平均13.15±5.50)和非语言智商平均57.69(±15.46)的个体治疗1-3年(1.88±0.63)。在二甲双胍开始之前,他们都使用Leiter-III非语言认知评估和Vineland-III适应性行为评估进行了基线智商测试。重复Leiter-III和Vineland-III在二甲双胍至少1年后完成(500-1,000mg/剂,每天两次)。
    在FDR<0.05时,非语言智商或适应性行为测量没有显着变化。到目前为止的研究结果表明,智商和适应性行为都是稳定的,我们没有看到任何一项措施的显著下降。
    总的来说,小样本量和短随访时间限制了二甲双胍对认知发育和适应功能影响的解释.存在个体差异,但总体而言,该组的智商或适应性行为没有显着下降。
    UNASSIGNED: Metformin has been used as a targeted treatment to potentially improve cognition and slow the typical IQ decline that occurs during development among individuals with fragile X syndrome (FXS). In this follow-up study, we are following the trajectory of IQ and adaptive behavior changes over 1 to 3 years in individuals with FXS who are clinically treated with metformin in an open label trial.
    UNASSIGNED: Individuals with FXS ages 6 to 25 years (mean 13.15 ± 5.50) and nonverbal IQ mean 57.69 (±15.46) were treated for 1-3 years (1.88 ± 0.63). They all had a baseline IQ test using the Leiter-III non-verbal cognitive assessment and the Vineland-III adaptive behavior assessment before the start of metformin. Repeat Leiter-III and Vineland-III were completed after at least 1 year of metformin (500-1,000 mg/dose given twice a day).
    UNASSIGNED: There were no significant changes in non-verbal IQ or in the adaptive behavior measurements at FDR < 0.05. The findings thus far indicate that both IQ and adaptive behavior are stable over time, and we did not see a significant decline in either measure.
    UNASSIGNED: Overall, the small sample size and short follow-up duration limit the interpretation of the effects of metformin on cognitive development and adaptive functioning. There is individual variability but overall for the group there was no significant decline in IQ or adaptive behavior.
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  • 文章类型: Journal Article
    全面调查SETBP1单倍功能不全障碍(SETBP1-HD)和SETBP1相关障碍(SETBP1-RD)的神经发育概况和临床特征。我们报告了34个人的遗传结果,根据SETBP1-HD的22例和SETBP1-RD的5例的行为和临床数据,通过评估病史访谈和标准化适应性的结果,临床,和西蒙斯探照灯提供的社会措施。所有SETBP1-HD和SETBP1-RD患者均表现出神经系统损害,包括智力障碍/发育迟缓(IDD)。注意力缺陷/多动障碍,自闭症谱系障碍,和/或癫痫发作,以及语音和语言延迟。虽然有限的利益和重复的行为带来了挑战,在两个队列中观察到社会动机的相对强度.SETBP1-RD患者报告了心脏问题的风险,与SETBP1-HD相比,骨科和躯体问题的风险更大,肠道控制难度更大。据报道,SETBP1-HD患者的新生儿喂养困难和高热惊厥发生率更高。其他突出的特征包括睡眠,愿景,和肠胃问题,低张力,和高疼痛耐受性。表型重叠(IDD,演讲挑战,自闭症患者,和注意力缺陷特征)和不同的神经发育障碍SETBP1-HD和SETBP1-RD之间的区别(SETBP1-RD的躯体和心脏问题风险)对于医疗管理和诊断至关重要。
    To comprehensively investigate the neurodevelopmental profile and clinical characteristics associated with SETBP1 haploinsufficiency disorder (SETBP1-HD) and SETBP1-related disorders (SETBP1-RD). We reported genetic results on 34 individuals, with behavior and clinical data from 22 with SETBP1-HD and 5 with SETBP1-RD, by assessing results from medical history interviews and standardized adaptive, clinical, and social measures provided from Simons Searchlight. All individuals with SETBP1-HD and SETBP1-RD exhibited neurological impairments including intellectual disability/developmental delay (IDD), attention-deficit/hyperactivity disorder, autism spectrum disorder, and/or seizures, as well as speech and language delays. While restricted interests and repetitive behaviors present challenges, a relative strength was observed in social motivation within both cohorts. Individuals with SETBP1-RD reported a risk for heart issues and compared to SETBP1-HD greater risks for orthopedic and somatic issues with greater difficulty in bowel control. Higher rates for neonatal feeding difficulties and febrile seizures were reported for individuals with SETBP1-HD. Additional prominent characteristics included sleep, vision, and gastrointestinal issues, hypotonia, and high pain tolerance. This characterization of phenotypic overlap (IDD, speech challenges, autistic, and attention deficit traits) and differentiation (somatic and heart issue risks for SETBP1-RD) between the distinct neurodevelopmental disorders SETBP1-HD and SETBP1-RD is critical for medical management and diagnosis.
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  • 文章类型: Journal Article
    文献尚未审查自然环境教学(NET)和离散试验教学(DTT)对适应技能的不同影响。142名年龄在16至35个月之间被诊断患有ASD的儿童的样本接受了DTT,NET,或两种干预措施(NET+DTT)。使用Bayley婴儿和幼儿发育量表(BSID)自适应子量表和言语行为里程碑评估和安置计划(VB-MAPP)障碍评估作为基线和后测指标。与DTT条件相比,接受NET和NETDTT条件的儿童表现出显着改善,表明NET的添加导致参与者的适应技能增加和障碍行为减少。DTT也可能为有更严重延误的儿童发挥必要的基础作用。这些结果为在基于社区的早期干预中结合使用教学策略提供了支持,并完善了向患有ASD的幼儿教授适应技能的协议。
    The literature has yet to review the differential effects of Natural Environment Teaching (NET) and Discrete Trial Teaching (DTT) on adaptive skills. A sample of 142 children diagnosed with ASD between the ages of 16 and 35 months received either DTT, NET, or both interventions (NET+ DTT). The Bayley Scales of Infant and Toddler Development (BSID) Adaptive Subscale and the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Barriers Assessment were used as baseline and posttest measures. Children who received NET and NET+DTT conditions showed significant improvements compared to the DTT condition indicating that the addition of NET leads to increased adaptive skills and decreased barrier behaviors in participants. DTT may also play a necessary foundational role for children with more significant delays. These results provide support for the use of a combination of teaching strategies in community-based early intervention and refine protocols for teaching adaptive skills to toddlers with ASD.
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  • 文章类型: Journal Article
    背景:智力和发育障碍(IDD)与认知挑战和概念困难有关,社会,和实际的生活领域,通常称为自适应行为(DSM-5)。尽管在IDD人群中已经报道了智力或认知与适应性行为之间的横断面关联,迄今为止,还没有研究研究认知的发展变化是否有助于或追踪适应行为的变化。本研究试图检查认知领域纵向发展变化的关联(NIH工具箱认知电池,NIHTB-CB)和自适应行为领域(Vineland自适应行为量表-3;VABS-3),包括社会化,Communication,和日常生活技能(DLS)在一个大样本的儿童,青少年和年轻人患有IDD。
    方法:招募三组,包括患有脆性X综合征的患者,唐氏综合症,和其他/特发性智力障碍。符合条件的参与者(n=263)包括在第1次访问时年龄在6至26岁之间(mage=15.52,sd=5.17)的参与者,或怀疑智力残疾(ID),包括边界线ID,精神年龄至少为3.0岁。参与者在两年内的两个时间点接受认知和适应行为评估(m=2.45年,范围=1.27至5.56年)。为了检查认知和适应行为领域之间的发展变化的关联,双变量潜在变化评分(BLCS)模型适合于比较NIHTB-CB(流体认知,结晶认知,总认知)和VABS-3测量的三个自适应行为域(通信,DLS,和社会化)。
    结果:在两年的时间里,认知(结晶和总复合材料)的变化与日常生活技能的变化显着正相关。此外,基线认知水平预测适应性行为的增长,然而,在任何模型中,基线适应性行为都不能预测认知的增长.
    结论:本研究表明,认知和适应行为的发展变化与儿童和年轻人患有IDD有关,表明干预的跨领域效应的潜力。值得注意的是,DLS的改善是适应性行为的主要领域,与认知改善呈正相关。这项工作为临床提供了证据,NIHTB-CB在IDD中检测到的认知变化的“现实生活”意义,并为NIHTB-CB作为适合该人群的基于绩效的结果度量提供了经验支持。
    BACKGROUND: Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living, commonly referred to as adaptive behavior (DSM-5). Although cross-sectional associations between intelligence or cognition and adaptive behavior have been reported in IDD populations, no study to date has examined whether developmental changes in cognition contribute to or track with changes in adaptive behavior. The present study sought to examine associations of longitudinal developmental change in domains of cognition (NIH Toolbox Cognition Battery, NIHTB-CB) and adaptive behavior domains (Vineland Adaptive Behavior Scales-3; VABS-3) including Socialization, Communication, and Daily Living Skills (DLS) over a two year period in a large sample of children, adolescents and young adults with IDD.
    METHODS: Three groups were recruited, including those with fragile X syndrome, Down syndrome, and other/idiopathic intellectual disability. Eligible participants (n = 263) included those who were between 6 and 26 years (mage = 15.52, sd = 5.17) at Visit 1, and who had a diagnosis of, or suspected intellectual disability (ID), including borderline ID, with a mental age of at least 3.0 years. Participants were given cognitive and adaptive behavior assessments at two time points over a two year period (m = 2.45 years, range = 1.27 to 5.56 years). In order to examine the association of developmental change between cognitive and adaptive behavior domains, bivariate latent change score (BLCS) models were fit to compare change in the three cognitive domains measured by the NIHTB-CB (Fluid Cognition, Crystallized Cognition, Total Cognition) and the three adaptive behavior domains measured by the VABS-3 (Communication, DLS, and Socialization).
    RESULTS: Over a two year period, change in cognition (both Crystallized and Total Composites) was significantly and positively associated with change in daily living skills. Also, baseline cognition level predicted growth in adaptive behavior, however baseline adaptive behavior did not predict growth in cognition in any model.
    CONCLUSIONS: The present study demonstrated that developmental changes in cognition and adaptive behavior are associated in children and young adults with IDD, indicating the potential for cross-domain effects of intervention. Notably, improvements in DLS emerged as a primary area of adaptive behavior that positively related to improvements in cognition. This work provides evidence for the clinical, \"real life\" meaningfulness of changes in cognition detected by the NIHTB-CB in IDD, and provides empirical support for the NIHTB-CB as a fit-for-purpose performance-based outcome measure for this population.
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