PMID- 27509845 OWN - NLM STAT- MEDLINE DCOM- 20170614 LR - 20181113 IS - 1545-5017 (Electronic) IS - 1545-5009 (Print) IS - 1545-5009 (Linking) VI - 63 IP - 12 DP - 2016 Dec TI - A pilot study of parent education intervention improves early childhood development among toddlers with sickle cell disease. PG - 2131-2138 LID - 10.1002/pbc.26164 [doi] AB - BACKGROUND: Young children with sickle cell disease (SCD) are at risk for cognitive delay. In addition to biologic risk factors associated with SCD, environmental factors contribute to cognitive dysfunction within this cohort. METHODS: We completed a single-arm, prospective cohort study. Children with SCD between the ages of 3 and 36 months and their caregivers were followed between October 2010 and December 2013. The aim was to describe the role of a home visitation model, the home environment, and socioeconomic status in the development of young children with SCD. Primary outcome measures were the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III) and the Home Observation for Measurement of the Environment (HOME). We hypothesized that the home visitation model, Parents as Teachers((R)) (PAT), would encourage positive parent-child interactions and improve cognitive outcomes. RESULTS: Thirty-five participants had at least two PAT visits and BSID-III assessments. Mean scores within all five subtests of the BSID-III improved between enrollment and exit, with significant changes within cognitive (P = 0.016) and expressive language (EL) domains (P = 0.002). Multivariate modeling found the HOME score associated with the exit results of the cognitive domain. CONCLUSION: We report longitudinal results of the first home visitation program within the early childhood SCD population and show significant improvement in cognitive and EL development. Additionally, home environment was a significant predictor of cognitive development. Randomized controlled trials to test the impact of interventions targeting the home environment are warranted for this vulnerable population. CI - (c) 2016 Wiley Periodicals, Inc. FAU - Fields, Melanie E AU - Fields ME AD - Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri. king_a@wustl.edu. FAU - Hoyt-Drazen, Catherine AU - Hoyt-Drazen C AD - Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. FAU - Abel, Regina AU - Abel R AD - Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. FAU - Rodeghier, Mark J AU - Rodeghier MJ AD - Rodeghier Consultants, Chicago, Illinois. FAU - Yarboi, Janet M AU - Yarboi JM AD - Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee. FAU - Compas, Bruce E AU - Compas BE AD - Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee. FAU - King, Allison A AU - King AA AD - Division of Pediatric Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri. AD - Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri. AD - Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri. LA - eng GR - U54 HD083211/HD/NICHD NIH HHS/United States GR - U54 HD087011/HD/NICHD NIH HHS/United States GR - T32 HD007499/HD/NICHD NIH HHS/United States GR - UL1 TR000448/TR/NCATS NIH HHS/United States GR - K12 HL087107/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, P.H.S. DEP - 20160811 PL - United States TA - Pediatr Blood Cancer JT - Pediatric blood & cancer JID - 101186624 SB - IM MH - Adult MH - Anemia, Sickle Cell/*physiopathology MH - Child MH - *Child Development MH - Cognition MH - Cohort Studies MH - Female MH - Humans MH - Male MH - *Parents MH - *Patient Education as Topic MH - Pilot Projects MH - Prospective Studies MH - Social Class PMC - PMC5344022 MID - NIHMS852111 OTO - NOTNLM OT - cognition OT - development OT - intervention OT - parenting OT - sickle cell disease COIS- Conflict of Interest Research reported in this publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH); the Clinical Hematology Research Career Development Program grant 5K12 HL087107 from the National Heart, Lung and Blood Institute; and by the Human Resources and Services Administration (HRSA) and the Genetic Services Branch of the Maternal and Child Health Bureau grant number H46MC09231. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Allison King, MD, MPH, PhD had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. EDAT- 2016/10/21 06:00 MHDA- 2017/06/15 06:00 PMCR- 2017/03/09 CRDT- 2016/08/12 06:00 PHST- 2016/04/08 00:00 [received] PHST- 2016/06/10 00:00 [revised] PHST- 2016/06/28 00:00 [accepted] PHST- 2016/10/21 06:00 [pubmed] PHST- 2017/06/15 06:00 [medline] PHST- 2016/08/12 06:00 [entrez] PHST- 2017/03/09 00:00 [pmc-release] AID - 10.1002/pbc.26164 [doi] PST - ppublish SO - Pediatr Blood Cancer. 2016 Dec;63(12):2131-2138. doi: 10.1002/pbc.26164. Epub 2016 Aug 11.