By Aisling Maki
The Memphis-based Urban Child Institute is recruiting the final participants in what will ultimately be an intensive eight-year study focused on the cognitive development of young children in Shelby County.
The CANDLE Study, which stands for Conditions Affecting Neurocognitive Development and Learning in Early Childhood, follows locally born infants from their second or third trimester in utero through the children's third birthdays to decipher the ways in which environment affects neurocognitive development and early childhood learning.
Katie Midgley, community outreach and public policy associate at the Urban Child Institute - a nonprofit organization consisting of a coalition of community researchers, strategists, and practitioners dedicated to the well-being of young children in Memphis and Shelby County - said people usually have to rely on national studies.
'The reason we're doing the CANDLE study is to make sure we've got local data and information on our kids,' she said. 'Memphis is unique, and the wealth of data and the wealth of information we're collecting is just bar-none. … We hope it will help us understand the dynamics here in the city so we can advocate for what's best for our kids.'
Recruitment for the CANDLE study began at the Regional Medical Center at Memphis in December 2006, and expanded to include partner University of Tennessee Health Science Center and several local hospitals and health care providers.
'We could not have done anything without the cooperation of these wonderful hospitals,' said CANDLE research study manager Patricia Simpson, whose background is in industrial organizational psychology. 'It's their knowledge that they're doing something important for the community, and we really appreciate them.'
The mothers recruited for the study come from all walks of life, ethnicities, marital statuses, socio-economic and education attainment levels.
'Our initial hope was to match the census track in Shelby County, and we're very close to that,' Simpson said.
All participants must be between ages 16 and 40, and between 16 and 28 weeks into their pregnancy, which must be considered low-risk. The women are required to reside in Shelby County and must deliver their babies at The MED, Baptist Memorial Hospital for Women, Methodist Le Bonheur Germantown Hospital or Saint Francis Hospital-Memphis.
The study's goal is to enroll 1,500 women; so far more than 1,300 have enrolled.
As an incentive, participating mothers receive $500 worth of gift cards for the purchase of baby and household items over a period of time, and Simpson said the dropout rate has been surprisingly low.
Over a period of more than three years, researchers study numerous factors - including genetics, demographics, nutrition (mothers keep food diaries of what their children consume), environmental toxins, neighborhood effects and social support - to help determine their effects on children's brain development.
The study also includes psychological assessments of the mothers, which may include things like maternal depression.
'There has been some preliminary data that suggests that there's a link between a mother's depression and her interactiveness with baby, and that's certainly been showing up in the data,' Simpson said.
In addition to cognitive development, markers measured include adaptive functioning and receptive and expressive language.
Staff members say the major strength of the CANDLE study lies in its depth and scope. In addition to home visits, phone interviews and logs kept by the children's mothers, the study also includes a bio-repository at UTHSC that houses placenta tissue, blood cord, maternal blood and urine and other samples for study.
'We are collecting those samples and freezing them right away,' Simpson said. 'They stay that way until another scientist would like to use them for his or her own research. If they have a hypothesis or question they'd like to ask of this data, they can contact us and request our data. Usually it's not just the biological data, but some of the other data that we have, as well.'
Researchers hope the study's future analysis and findings will have a significant impact locally and possibly nationally and globally, as a number of academic institutions - including the University of Southern California, Tulane University, Emory University, University of North Carolina-Chapel Hill and the University of British Columbia - have expressed interest in CANDLE data.
'We want scientists to come to us and give us their questions and hypotheses so we can start getting some of this data out to the public,' said Simpson, who added that the CANDLE research has the potential to impact public policy down the road.
She said researchers have kept up with the first group of children, now age four, through phone calls, and the hope, depending on funding, is that the CANDLE study can be expanded to follow children through age five.
'We can accurately assess school readiness; we can bring a lot to the table there,' Simpson said. 'We would love to go further.'