Role of congenital heart defects in motor skills and language acquisition of infants with Down syndrome

PROJECT SUMMARY Down syndrome (DS) is the most common genetic condition and causes significant development delays and weaknesses in the motor, cognitive, and language domains. About one half of infants with DS have congenital heart defects (CHD), resulting in slower development in infants with DS and CHD (i.e., DS+CHD) than those

with DS without CHD (i.e., DS-CHD). Most of the earlier research used a cross-sectional design to compare the two groups by focusing on the attainment of milestones. Understanding of the process of motor and language skills (i.e., developmental trajectory) remains limited in infants with DS. The objectives of this proposal are to use

mobile technology (smart devices and secure cloud storage) to collect motor (sitting and arm movement) and language (babbling) data in a home environment, employ computer vision software OpenPose to the motor data and behavioral coding to the language data, and examine motor-language interrelation in infants with DS+CHD

and DS-CHD. Our central hypothesis is that sitting posture, rhythmic arm movement, and babbling are correlated in infants with DS, and infants with DS+CHD will show delayed acquisition and higher variability of sitting posture, rhythmic arm movement, and babbling, and a weaker motor-language interaction than those with DS-CHD. Aim

1: Validate mobile technology and computer vision in registering development trajectory of sitting posture and rhythmic arm movement in infants with DS+CHD and DS-CHD from 6 to 15 months of age. We will recruit 36 infants aged 6 months with DS+CHD and DS-CHD (n=18 in each). We will train the parents to collect 5-minute

data of infant sitting and arm movement once a week using a provided iPad at their home. We will use OpenPose (computer vision software for pose estimation) to analyze trunk position and rhythmic arm movement. We will compare the trunk and arm data to that we collected from our monthly home visits to validate the application of

mobile technology and computer vision in infants with DS. We hypothesize that trunk and arm data obtained with mobile technology and computer vision will serve as valid tools to register sitting posture and rhythmic arm movement and that DS+CHD will show a later acquisition of trunk control and arm movement than DS-CHD. Aim

2: Characterize interrelation between motor and language skills in infants with DS. We will record 10 minutes of parent-infant interaction at our monthly home visits to assess the emergence of babbling via behavioral coding. We will conduct multiple linear regression analysis with covariates of participants’ characteristics to examine an

interaction between motor (trunk position and rhythmic arm movement) and language (babbling) in infants with DS. Further, we will utilize functional data analysis (e.g., function-on-function linear regression) to investigate interrelations (predictor and response) and causal effect of trunk position, rhythmic arm movement, and babbling.

We hypothesize that trunk position and arm movement are correlated with babbling, and DS+CHD will display slower and more variable babbling acquisition and a weaker motor-language correlation than DS-CHD.