Faculty Bibliography

Prior ex vivo histological postmortem studies of autism spectrum disorder (ASD) have shown gray matter microstructural abnormalities, however, in vivo examination of gray matter microstructure in ASD has remained scarce due to the relative lack of non-invasive methods to assess it. The aim of this work was to evaluate the feasibility of employing diffusional kurtosis imaging (DKI) to describe gray matter abnormalities in ASD in vivo. DKI data were examined for 16 male participants with a diagnosis of ASD and IQ>80 and 17 age- and IQ-matched male typically developing (TD) young adults 18-25 years old. Mean (MK), axial (AK), radial (RK) kurtosis and mean diffusivity (MD) metrics were calculated for lobar and sub-lobar regions of interest. Significantly decreased MK, RK, and MD were found in ASD compared to TD participants in the frontal and temporal lobes and several sub-lobar regions previously associated with ASD pathology. In ASD participants, decreased kurtosis in gray matter ROIs correlated with increased repetitive and restricted behaviors and poor social interaction symptoms. Decreased kurtosis in ASD may reflect a pathology associated with a less restrictive microstructural environment such as decreased neuronal density and size, atypically sized cortical columns, or limited dendritic arborizations.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adolescents are more likely to report suicidality and worse mental health than their heterosexual peers. We conducted a systematic review to examine the relationship between positive school climate and suicidality and mental health among LGBTQ adolescents. We searched the literature using PubMed, PsycINFO, and CINAHL. Six studies met inclusion criteria, and all had low to moderate risks of bias. Results indicate that LGBTQ students in schools with more positive school climates were at lower risk of suicidality and reported fewer depressive symptoms compared to students in less positive school climates. Being at the forefront of health in schools, school nurses have the opportunity to advocate for changes in school environments that promote positive mental health for all youth, including LGBTQ adolescents.

Flexibility and generativity are fundamental aspects of functional behavior that begin in infancy and improve with experience. How do infants learn to tailor their real-time solutions to variations in local conditions? On a nativist view, the developmental process begins with innate prescribed solutions, and experience elaborates on those solutions to suit variations in the body and the environment. On an emergentist view, infants begin by generating a variety of strategies indiscriminately, and experience teaches them to select solutions tailored to the current relations between their body and the environment. To disentangle these accounts, we observed coordination patterns in 11-month-old pre-walking infants with a range of cruising (moving sideways in an upright posture while holding onto a support) and crawling experience as they cruised over variable distances between two handrails they held for support. We identified infants' coordination patterns using a novel combination of computer-vision, machine-learning, and time-series analyses. As predicted by the emergentist view, the least experienced infants generated multiple coordination patterns inconsistently regardless of body size and handrail distance, whereas the most experienced infants tailored their coordination patterns to body-environment relations and switched solutions only when necessary. Moreover, the beneficial effects of experience were specific to cruising and not crawling, although both skills involve anti-phase coordination among the four limbs. Thus, findings support an emergentist view and suggest that everyday experience with the target skill may promote "learning to learn," where infants learn to assemble the appropriate solution for new problems on the fly.

BACKGROUND:The International Labor Organization (ILO) estimates that 11% of children (ages 5 to 17) worldwide are child laborers. ILO recently drew attention to migrant child laborers as an underreported, but more vulnerable group to adverse outcomes relative to children working locally. Sub-Saharan Africa (SSA) continues to be the continent with the highest rates of child labor, with Ghana registering one of the highest incidence rates at 22%, including unaccompanied child migrants engaged in labor. Adolescent girls make up the majority of unaccompanied rural-to-urban migrants in search of better economic opportunities. Studies document the myriad of serious threats to health and emotional well-being experienced by adolescent girls who migrate to engage in child labor. These threats underline the urgent need for theoretically informed preventive interventions, specifically tailored to address the root causes of female child migrant labor and the needs of girls from economically insecure families and communities. METHODS:A two-arm cluster randomized control trial will be conducted to assess the feasibility, acceptability, and preliminary impact of ANZANSI (family economic empowerment + multiple family groups) among 100 adolescent girls and their caregivers in the Northern Region of Ghana. Ten schools will be randomly selected from a list of eligible schools, and randomized to one of two study arms: (1) control arm (n = 5 schools, n = 50 adolescent-caregiver dyads); (2) treatment arm (n = 5 schools, n = 50 adolescent-caregiver dyads) receiving ANZANSI over a 9-month period. Adolescents (ages 11 to 14) in the same school will be assigned to the same study condition to avoid contamination. DISCUSSION/CONCLUSIONS:The primary aim of the study is to address the urgent need for theoretically and empirically informed interventions that prevent adolescent girls' unaccompanied rural-to-urban migration for child labor. Existing programs are not preventive and primarily target children who already migrated to the city and are living and working on the streets. This study is one of the first studies to pilot test a combination intervention, integrating family economic empowerment targeting household poverty with multiple family groups addressing family cohesion and perceptions on gender norms, child education/labor, all of which are factors, when combined, force girls to drop out of school and migrate. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov ; NCT04231669 ; Registered January 18, 2020.

What is the role of errors in infants' acquisition of basic skills such as walking, skills that require immense amounts of practice to become flexible and generative? Do infants change their behaviors based on negative feedback from errors, as suggested by "reinforcement learning" in artificial intelligence, or do errors go largely unmarked so that learning relies on positive feedback? We used falling as a model system to examine the impact of errors in infant development. We examined fall severity based on parent reports of prior falls and videos of 563 falls incurred by 138 13- to 19-month-old infants during free play in a laboratory playroom. Parent reports of notable falls were limited to 33% of infants and medical attention was limited to 2% of infants. Video-recorded falls were typically low-impact events. After falling during free play in the laboratory, infants rarely fussed (4% of falls), caregivers rarely showed concern (8% of falls), and infants were back at play within seconds. Impact forces were mitigated by infants' effective reactive behaviors, quick arrest of the fall before torso or head impact, and small body size. Moreover, falling did not alter infants' subsequent behavior. Infants were not deterred from locomotion or from interacting with the objects and elevations implicated in their falls. We propose that a system which discounts the impact of errors in early stages of development encourages infants to practice basic skills such as walking to the point of mastery.

Prior research has identified associations between social media activity and psychiatric diagnoses; however, diagnoses are rarely clinically confirmed. Toward the goal of applying novel approaches to improve outcomes, research using real patient data is necessary. We collected 3,404,959 Facebook messages and 142,390 images across 223 participants (mean age = 23.7; 41.7% male) with schizophrenia spectrum disorders (SSD), mood disorders (MD), and healthy volunteers (HV). We analyzed features uploaded up to 18 months before the first hospitalization using machine learning and built classifiers that distinguished SSD and MD from HV, and SSD from MD. Classification achieved AUC of 0.77 (HV vs. MD), 0.76 (HV vs. SSD), and 0.72 (SSD vs. MD). SSD used more (P < 0.01) perception words (hear, see, feel) than MD or HV. SSD and MD used more (P < 0.01) swear words compared to HV. SSD were more likely to express negative emotions compared to HV (P < 0.01). MD used more words related to biological processes (blood/pain) compared to HV (P < 0.01). The height and width of photos posted by SSD and MD were smaller (P < 0.01) than HV. MD photos contained more blues and less yellows (P < 0.01). Closer to hospitalization, use of punctuation increased (SSD vs HV), use of negative emotion words increased (MD vs. HV), and use of swear words increased (P < 0.01) for SSD and MD compared to HV. Machine-learning algorithms are capable of differentiating SSD and MD using Facebook activity alone over a year in advance of hospitalization. Integrating Facebook data with clinical information could one day serve to inform clinical decision-making.

OBJECTIVE:To investigate the spatial patterns and the probable sequences of grey matter atrophy in spinocerebellar ataxia type 3 (SCA3). METHODS:A total of 47 patients with SCA3 and 49 age- and sex-matched healthy control subjects participated in the study. High-resolution T1-weighted magnetic resonance images were examined in all participants. We used the causal network of structural covariance (CasCN) to identify the sequence of grey matter atrophy patterns. This was achieved by applying Granger causality analysis to a grey matter atrophy staging scheme performed by voxel-based morphometry from the network level. RESULTS:Participants in the premanifest stage of the disease showed the presence of focal grey matter atrophy in the vermis. As the disease duration increased, there was progressive grey matter atrophy in the cerebellar, the neostriatum, the frontal lobe, and the parietal lobe. The patients with SCA3 also showed proximal and distal cortical atrophy sequences exerting from the vermis to the regions mainly located in the cerebellum-neostriatum-cortical network. CONCLUSION/CONCLUSIONS:Our results, although preliminary in nature, indicate that the grey matter atrophy in SCA3 lies and extends to involve more regions according to distinct anatomical patterns, mainly in the cerebellum-neostriatum-cortical network. These findings advance our understanding on the natural history of structural damage in SCA3, while confirming known clinical features. This could provide unique insight into the ordered sequential process of regional brain atrophy that targets a particular network.

During a sensitive period associated with attachment, the infant brain has unique circuitry that enables the specialized adaptive behaviors required for survival in infancy. This infant brain is not an immature version of the adult brain. Within the attachment relationship, the infant remains close (proximity seeking) to the caregiver for nurturing and survival needs, but the caregiver also provides the immature infant with the physiological regulation interaction needed before self-regulation matures. Here we provide examples from the human and animal literature that illustrate some of these regulatory functions during sensitive periods, recent advances demonstrating the supporting transient neural mechanisms, and how these systems go awry in the absence of species-expected caregiving.