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HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE

HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE. Krueger, C., Behnke, M., Gerhardt, K., DeCasper, A., vanOostrom, H. Pilot Study funded through the Biobehavioral Research Center General Clinical Research Center University of Florida. Premature Infants. Learning Disabilities

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HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE

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  1. HEART RATE VARIABILITY AND LEARNING IN THE 28-34 WEEK PREMIE Krueger, C., Behnke, M., Gerhardt, K., DeCasper, A., vanOostrom, H. Pilot Study funded through the Biobehavioral Research Center General Clinical Research Center University of Florida

  2. Premature Infants • Learning Disabilities • Delayed Speech and Language • Neurological Disorders

  3. Survival Rates Have Increased Incidence of Disabilities has Stagnated

  4. Interventions are preceded by complete descriptions of normal development Thus often unreliable and ineffective

  5. RESEARCH QUESTIONS • What are the developmental changes in HRV? • What are the developmental changes in the learning capabilities? • Are there interactions between with HRV as learning occurs?

  6. Heart Rate Variability via Spectral Analysis • Autonomic Nervous System Development • Chatow • Karin • Kotini • Predict for Later Developmental Delay • DiPietro • Porges

  7. Learning Capabilities as Indicated by Movement and Cardiac Orienting Response • Description of Learning Capabilities • Movement • Lecanuet • Kiselevsky • Cardiac Orienting Response • DeCasper • Krueger

  8. Interactions Between Learning and HRV PolyVagal Theory HF

  9. PURPOSE Describe longitudinal changes in HRV and the learning capabilities of the premature infant (28-34 wk)

  10. CONCEPTUAL MODEL A Systems Approach to Behavioral Development

  11. A Systems Approach to Behavioral Development Environmental Behavioral Neural Genetic Individual Development

  12. A Systems Approach to Behavioral Development Environmental MATERNAL VOICE Behavioral Neural Genetic

  13. A Systems Approach to Behavioral Development Environmental MATERNAL VOICE Behavioral COR MOVEMENT Neural Genetic

  14. A Systems Approach to Behavioral Development Environmental MATERNAL VOICE Behavioral COR MOVEMENT Neural HRV Genetic

  15. A Systems Approach to Behavioral Development Environmental MATERNAL VOICE Behavioral COR MOVEMENT Neural HRV Genetic

  16. Subjects and Setting • Convenience sample • 28 premature infants • Neonatal Intensive Care Unit • General Clinical Research Center

  17. Inclusion Criteria • 28 weeks post menstrual age • English as native language • Dubowitz confirmation of age • Exclusion Criteria • Abnormal head ultrasound • Cardiac abnormality • Viral/bacterial infection • Sensorineural hearing loss

  18. Independent Variable • Nursery Rhyme • Dependent Variable • Heart Rate Variability • Via spectral analysis • Cardiac Orienting Response • Movement

  19. In jumping and tumbling we spend the whole day, till night by arriving has finished our play. What then. One and all. No more to be said. As we tumbled all morning, so we tumble to bed.

  20. Gestational Age in Weeks 28 29 30 31 32 33 34 Group 1 Group 2

  21. CD Recording of Maternal Recitation Twice a day 15 min after meal Quiet CD Recording of Unfamiliar Female Once a week 15 min after meal Quiet Nursery Rhyme 55 + 5 dB 20cm from ear

  22. WEEKLY TEST SESSIONQuiet Rhyme HRV COR HRV Movement

  23. 4 3 1 2 5 Computer Door Door Sink 6 Sink 9 7 8 General Work Station Layout of NICU

  24. 28 week Auditory Stimulus 57-59 dB

  25. 28 weeks Auditory Stimulus 51-54 dB

  26. Challenges Encountered • Technological • Physiological • Environmental

  27. Developmental Changes in HRV

  28. Total Power via Spectral Analysis

  29. High Frequency Component of HRV

  30. Developmental Changes

  31. Learning Capabilities • Cardiac Orienting Response • Movement

  32. 32 Weeks Post-Menstrual Age

  33. 33 Weeks Post-Menstrual Age

  34. 34 Weeks Post-Menstrual Age

  35. Arm Movements Before During After Maternal 32 weeks: total 9, mean 0.10, range 0-5 Maternal 34 weeks: total 29, mean 0.54, range 2-5 Non-maternal 32 weeks: total 36, mean 0.2, range 2-6 Non-maternal 34 weeks: total 40, mean 0.74, range 3-6

  36. Mouth Movements Before During After Maternal 32 weeks: total 6, mean 0.07, range 0-4 Maternal 34 weeks: total 36, mean 0.70, range 2-5 Non-maternal 32 weeks: total 14, mean 0.19, range 0-4 Non-maternal 34 weeks: total 7, mean 0.13, range 0-4

  37. Respiratory Movements Before During After Maternal 32 weeks: total 7, mean 0.07, range 0-4 Maternal 34 weeks: total 1, mean 0.02, range 0-1 Non-maternal 32 weeks: total 10, mean 0.14, range 0-3 Non-maternal 34 weeks: total 20, mean 0.37, range 0-4

  38. Interactions Between Learning and HRV HF

  39. Interactions Between Learning and HRV

  40. Program of ResearchFetus Premie

  41. TENTATIVE CONCLUSIONS • Experience • Maturation of ANS • Interactions across levels of analysis • Maternal voice • Premature Infant

  42. FUTURE RESEARCH • 28-40 weeks gestation (R-15) • Memory • Underlying behavioral process (NSF)

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