Translational Science – Advancing our Understanding of Child Development and Mental Illness in Childhood

Dr. Joel Stoddard directs the Emotion and Development Laboratory. They study the brain basis of negative emotions in children and adolescents, especially irritability and anxiety. They use what they learn to develop new behavioral treatments and figure out who might benefit from them. For example, the lab group found that children who have severe irritability tend to misjudge ambiguous social signals as threatening. This led the group to develop a novel treatment for irritability that trains children to see more positive emotions in neutral faces. They developed a corresponding computer program that assesses how well a person can learn and benefit from this type of training. 

Dr. Aviva Olsavsky studies the impact of early life stress on the brain, both in children and as those children grow up and become parents. Mothers and children with mental health disorders or stressful experiences early in life process faces differently in the brain. The amygdala is a brain area that influences which things we pay attention to around us, including people with whom we have a strong emotional bond. Previously, Dr. Olsavsky and colleagues found that, in children who lived in institutional settings (e.g., orphanages) prior to adoption, the amygdala responded indiscriminately to their adoptive mother versus a stranger. Those with a more indiscriminate amygdala response were more likely to be adopted at an older age and more likely to readily approach unfamiliar adults. More recently, she and her colleagues found that mothers who were maltreated during their own childhood had lower amygdala activation when viewing infant faces. This is important because those with higher amygdala activation demonstrated greater sensitivity to their own infants while playing together.

Dr. Jacob Holzman researches how individual factors (for example, temperament) as well as contextual factors (for example, parenting) contribute to the development of behavioral health concerns in young children. In a recent study, he found that infants who display more negative emotions at 6 months (compared to infants who display less negative emotions) exhibit less approach toward pleasurable activities specifically if exposed to negative parenting practices (for example, harsh, controlling behavior). Since approaching enjoyable experiences protects against developing behavioral health concerns, these findings suggest that infants who are already vulnerable (because they experience more negative emotions) may be at an even greater risk when exposed to negative parenting behaviors. Similarly, Dr. Holzman investigates factors that may contribute to stressful experiences for parents. Another recent study demonstrated how a parent’s use of ineffective emotion regulation strategies (for example, suppressing emotions) as well as their child’s display of negative emotions predicted increased anxiety and depression for the parent. This work is all aimed at finding possible ways to improve early childhood treatments to help parents as well as their young children.


Treatment Research – Developing and Improving Clinical Practice

Dr. Laura Anthony conducts community-based participatory research and specializes in evaluating the effectiveness of treatments for children and adolescents with autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). Her evidence-based intervention Unstuck and On Target has helped parents and teachers learn techniques that can be used to improve the executive functioning skills (planning, setting goals, adapting to change) of youth with ASD and ADHD. With PCORI funding, Dr. Anthony and colleagues will be creating an online teacher training to support implementation of Unstuck and On Target in schools across Colorado and Virginia. Unstuck and On Target is available to the public as a book, a curriculum, or an online course. Through NIH funding, she is evaluating biases in the assessment of autism, which is critical to understand not only because autism presents differently in females than males but also because research study participants may differ from the general population of people with autism.

Dr. Judy Reaven specializes in identifying and treating co-occurring mental health conditions in children and adolescents with autism spectrum disorder (ASD). She developed a cognitive behavioral therapy group intervention – called Facing Your Fears – based on 16 years of funded research. The intervention helps children and adolescents with ASD manage their anxiety symptoms. Currently, her research has been focused on implementing the program in public school settings through a “train-the-trainer” approach. The clinic-based program is available as a workbook for children and parents and a facilitator manual for mental health professionals. 

Dr. Emily Muther has developed a number of interventions aimed at increasing adherence to the intensive medical regimes required by those with cystic fibrosis (CF). For example, she recently co-developed a virtual coaching intervention for adolescents and adults with CF. After the coach identifies the patient’s barriers to medical adherence, the intervention is tailored to help the patient overcome these barriers. In another line of work, she developed an online curriculum as well as a video tutorial to train pediatric providers on how to use an evidence-based intervention called motivational interviewing. The goal of the intervention is to help parents quit smoking in order to reduce exposure to secondhand smoke for their children.

Dr. Jessica Hawks evaluates transdiagnostic clinical interventions, which are used to treat patients with more than one psychiatric disorder by targeting their shared mechanisms (for example, problems regulating emotions). Most recently, she adapted the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) for the treatment of pediatric irritability and behavioral concerns in children. This treatment uses an exposure-based model that supports children and their parents in exposing themselves to situations that activate strong negative emotions and learning ways to navigate these situations more effectively. Pilot data provide initial evidence of the program’s acceptability, feasibility, and effectiveness.

Dr. Sarah Kennedy studies emotional disorders in children and adolescents and develops transdiagnostic interventions to target issues common across these disorders. Her most recent work has focused on identifying “trajectories of change” – or groups of children and adolescents with emotional disorders who have similar patterns of response to treatment. In a recent publication, she and colleagues identified three different patterns of response for youth receiving transdiagnostic treatment: a group with high symptom levels that experienced rapid improvement and groups with low and moderate symptom levels who experienced slower improvement. Factors like age, gender, and type of diagnosis (for example, social anxiety or OCD) predicted the likelihood of being in one group or another. The goal of this work is to understand different patterns of response to treatment in order to develop more personalized approaches to treating youth with emotional disorders. Dr. Kennedy and colleagues have made their intervention widely available as a therapist manual and workbooks for children and adolescents.


Services Research – Improving Mental Health Care in the Community

Dr. Bruno Anthony investigates ways to improve access to mental health services and develops, evaluates, and implements innovative treatments within community settings. His current work focuses on understanding and addressing the needs of parents who have children with behavioral and developmental difficulties. For instance, along with Dr. Laura Anthony and other collaborators, he studied the impact of the “Sesame Street and Autism: See Amazing in All Children” initiative, which features a new character with autism. Their research found that parents of autistic and non-autistic children alike increased their knowledge as well as their acceptance of autism, and parents of autistic children felt more hopeful about involving their children in the community. He also studies the impact of parent peer support (PPS), which pairs parents with “lived experience” of raising children with mental health problems with parents who are struggling with similar challenges. PPS helped parents recognize and deal with their child’s challenges, obtain relevant supports, and reduce their own stress.

Dr. Douglas Novins conducts research that is critical for improving the mental health of American Indian and Alaska Native children, adolescents, and adults. His research includes ongoing and completed studies in the areas of psychiatric epidemiology, developmental psychopathology, and mental health services. His recent research publications have addressed issues such as the design and implementation of early childhood services, assessing for and addressing trauma and posttraumatic stress disorder in primary care settings, and the impacts of telepsychiatric services in residential substance abuse treatment settings. His current research focuses on increasing access to medication-assisted treatment in treatment systems serving American Indian and Alaska Native people.