Faculty Bibliography

Social skills are important for both social development and integration. However, few studies have looked at these behaviors in the context of severity of autism spectrum disorder (ASD) symptoms and comorbid psychopathology in young children. Three hundred twenty eight infants and toddlers between 18 and 36 months of age diagnosed with ASD were studied. More severe symptoms of ASD and various forms of emotional distress such as tantrums and inattention/impulsivity were associated with greater difficulties in social behavior. (C) 2014 Elsevier Ltd. All rights reserved.

The aim of this investigation was to evaluate how parental anxiety predicted change in pediatric anxiety symptoms across four different interventions: cognitive-behavioral therapy, medication (sertraline; SRT), their combination (COMB), and pill placebo. Participants were 488 youths (ages 7-17) with separation anxiety disorder, generalized anxiety disorder, and/or social phobia and their primary caregivers. Latent growth curve modeling assessed how pre-treatment parental trait anxiety symptoms predicted trajectories of youth anxiety symptom change across 12 weeks of treatment at four time points. Interactions between parental anxiety and treatment condition were tested. Parental anxiety was not associated with youth's pre-treatment anxiety symptom severity. Controlling for parental trait anxiety, youth depressive symptoms, and youth age, youths who received COMB benefitted most. Counter to expectations, parental anxiety influenced youth anxiety symptom trajectory only within the SRT condition, whereas parental anxiety was not significantly associated with youth anxiety trajectories in the other treatment conditions. Specifically, within the SRT condition, higher levels of parental anxiety predicted a faster and greater reduction in youth anxiety over the acute treatment period compared to youths in the SRT condition whose parents had lower anxiety levels. While all active treatments produced favorable outcomes, results provide insight regarding the treatment-specific influence of parental anxiety on the time course of symptom change.

This study found that within a non-referred community pediatrics clinic sample, the severity of mothers' trauma-related psychopathology, in particular, their interpersonal violence-related (IPV) posttraumatic stress, dissociative, and depressive symptoms predicted the degree of negativity of mothers' attributions towards their preschool age children, themselves, and their own primary attachment figure. Results also showed that mothers with IPV-related posttraumatic stress disorder (PTSD) as compared to non-PTSD controls showed a significantly greater degree of negativity of their attributions toward their child, themselves and their primary attachment figure during childhood. The study finally found a significant reduction in the degree of negativity of mothers' attributions only towards their child following a three-session evaluation-protocol that included a form of experimental intervention entitled the "Clinician Assisted Videofeedback Exposure Session(s)" (CAVES), for mothers with IPV-PTSD as compared to control-subjects.

Formation of operational neural networks is one of the most significant accomplishments of human fetal brain growth. Recent advances in functional magnetic resonance imaging (fMRI) have made it possible to obtain information about brain function during fetal development. Specifically, resting-state fMRI and novel signal covariation approaches have opened up a new avenue for non-invasive assessment of neural functional connectivity (FC) before birth. Early studies in this area have unearthed new insights about principles of prenatal brain function. However, very little is known about the emergence and maturation of neural networks during fetal life. Here, we obtained cross-sectional rs-fMRI data from 39 fetuses between 24 and 38 weeks postconceptual age to examine patterns of connectivity across ten neural FC networks. We identified primitive forms of motor, visual, default mode, thalamic, and temporal networks in the human fetal brain. We discovered the first evidence of increased long-range, cerebral-cerebellar, cortical-subcortical, and intra-hemispheric FC with advancing fetal age. Continued aggregation of data about fundamental neural connectivity systems in utero is essential to establishing principles of connectomics at the beginning of human life. Normative data provides a vital context against which to compare instances of abnormal neurobiological development.

Studies of resting state fMRI have shown that BOLD signals giving rise to temporal correlation across voxels (or regions) are dominated by low frequency fluctuations in the range of approx. 0.01 - 0.1 Hz. These low-frequency fluctuations have been further divided into multiple distinct frequency bands (slow-5 and -4) based on earlier neurophysiological studies, though low sampling frequency of fMRI (~0.5 Hz) has substantially limited the exploration of other known frequency bands of neurophysiological origins(slow 3, -2 and -1). In this study, we use resting state fMRI data acquired from 21 healthy subjects at higher sampling frequency of 1.5 Hz to assess the presence of resting state functional connectivity (RSFC) across multiple frequency bands: slow-5 to slow-1. The effect of different frequency bands on spatial extent and connectivity strength for known resting state networks (RSNs) was also evaluated. RSNs were derived using independent component analysis and seed based correlation. Commonly known RSNs such as the default mode, the fronto-parietal, the dorsal attention and the visual networks were consistently observed at multiple frequency bands. Significant inter-hemispheric connectivity was observed between a seed and its contralateral brain region across all frequency bands, though overall spatial extent of seed based correlation maps decreased in slow-2 and slow-1 frequency bands. These results suggest that functional integration between brain regions at 'rest' occurs over multiple frequency bands and RSFC is a multi-band phenomenon. These results also suggest further investigation of BOLD signal in multiple frequency bands and related cognitive processes.

OBJECTIVE: To explore correspondences between the trajectories of symptoms and impairments in youth with attention-deficit hyperactivity disorder (ADHD) being treated by in primary care settings. METHODS: Parents of youth (n = 1976) rated their child's symptoms of inattention and hyperactivity/impulsivity, and impairment across a variety of domains. Multilevel models were estimated to characterize the trajectories of symptoms and impairment and to determine whether changes in symptom dimension trajectories corresponded to changes in impairment trajectories over time. RESULTS: Results indicated that symptom dimensions initially improved, then leveled off, and then decreased minimally. However, impairment domains remained largely stable (i.e., neither improved nor worsened). Improvement in inattention symptoms were associated with improved ratings of writing impairment, and improved ratings of hyperactivity/impulsivity symptoms were associated with improved relationship with peers. CONCLUSIONS: Youths with ADHD who are treated by their community pediatrician tend to initially improve in their symptom presentation, although this symptom reduction plateaus and is not associated with corresponding improvements in most areas of impairment.

The phenotype of attenuated mucopolysaccharidosis type II (MPS II), also called Hunter syndrome, has not been previously studied in systematic manner. In contrast to the "severe" phenotype, the "attenuated" phenotype does not present with behavioral or cognitive impairment; however, the presence of mild behavior and cognitive impairment that might impact long-term functional outcomes is unknown. Previously, significant MRI abnormalities have been found in MPS II. Recent evidence suggests white matter abnormalities in many MPS disorders. METHODS: As the initial cross-sectional analysis of a longitudinal study, we studied the association of brain volumes and somatic disease burden with neuropsychological outcomes, including measures of intelligence, memory, and attention in 20 patients with attenuated MPS II with a mean age of 15.8. MRI volumes were compared to 55 normal controls. RESULTS: While IQ and memory were average, measures of attention were one standard deviation below the average range. Corpus callosum volumes were significantly different from age-matched controls, differing by 22%. Normal age-related volume increases in white matter were not seen in MPS II patients as they were in controls. Somatic disease burden and white matter and corpus callosum volumes were significantly associated with attention deficits. Neither age at evaluation nor age at starting treatment predicted attention outcomes. CONCLUSIONS: Despite average intelligence, attention is compromised in attenuated MPS II. Results confirm an important role of corpus callosum and cortical white matter abnormality in MPS II as well as the somatic disease burden in contributing to attention difficulties. Awareness by the patient and caregivers with appropriate management and symptomatic support will benefit the attenuated MPS II patient.

Hispanic Americans make up the largest minority group in the United States. The Hispanic community is heterogeneous, composed of individuals from various regions of Central and South America, Mexico, and the Caribbean Islands, all with different cultures, language proficiency, and economic status. The Hispanic community is heterogeneous, composed of individuals from various regions of Central and South America, Mexico, and the Caribbean Islands, all with different cultures, language proficiency, and economic status.

With the emergence of food allergy as an important public health problem, it has become clear that there is an unmet need in regard to treatment. In particular, IgE-mediated food allergy that is associated with risk of fatal anaphylaxis has been the subject of multiple studies in the past decade. The growing body of evidence derived from multiple centres and various study designs indicates that for IgE-mediated food allergy, immunomodulation through food immunotherapy is possible; however, the extent of protection afforded by such treatment is highly variable. At this time, the capacity for food immunotherapy to restore permanent tolerance to food has not been demonstrated conclusively. This review will discuss these topics as they apply to the most important studies of food oral immunotherapy.