PROJECT SUMMARY/ABSTRACT
The need for an efficient, low-cost, yet comprehensive measure to evaluate and track infant/toddler
development and treatment outcomes is vital. Such a measure, coupled with a systematic method to gather
this information, does not exist. The NICHD Child Development and Behavior Branch identified this need as a
research priority, further noting the importance of a measure that can be linked with developmental changes in
the brain. We propose the development and testing of a novel measure that collects consistent data from
parents/caregivers to characterize infant/toddler development over time, similar to growth curves for height and
weight. Clinicians currently rely on information caregivers share at well-child visits, which can be difficult to
synthesize when evaluating a young child’s developmental trajectories. Information gathered via our proposed
innovative measure also has potential to become common data elements (i.e., universally accepted and
standardized data) to promote infant/toddler health, setting the stage for identifying the earliest risk indicators
and trajectories of neurodevelopmental disorders. The overall objective of this application is to further develop
and validate PediaTracTM, a web-based measure designed to engage parents/caregivers in the gathering of
longitudinal, real-time, multi-domain data on infant/toddler development beginning at birth. Our long-term goal
is to develop the PediaTrac measure to become a standard for monitoring development and early
detection in the primary clinical care setting. Core domains of early development assessed with PediaTrac
include feeding/eating, sleep, sensorimotor, social-communication/cognition, and attachment. Information also
is obtained about demographic, medical, and environmental factors. Using this approach that systematically
measures these domains during a schedule that corresponds to well-child visits (newborn (NB), 2-, 4-, 6-, 9-,
12-, 15-, 18-months), we will establish trajectories of typical/atypical development across critical domains of
functioning for infants and toddlers. We will meet the objective of the application through these aims: Aim 1:
Using a longitudinal study of 360 parents/caregivers of term infants, we will assess the aforementioned
domains on the well-child visit schedule to refine PediaTrac’s items and scales as well as evaluate PediaTrac’s
ability to reveal expected variation in the population across the domains assessed, providing both valid and
reliable information about infant and toddler development. Aim 2: Using the aforementioned longitudinal
sample plus 240 parents/caregivers of high-risk infants (< 37 weeks gestational age), we will use statistical
modeling methods to demonstrate that PediaTrac can identify subgroups and their unique longitudinal
trajectories. Aim 3: We will examine the ability of the PediaTrac domains at each sampling period to
individually and cumulatively predict overall development at 24 months in a subsample of 100 participants. Our
expected outcome is an easy to use, yet powerful measure and method that could substantially improve the
public health of infants and toddlers by refining our understanding of aggregate and individualized risks and
subsequently inform early intervention.