I am a developmental psychologist and tenured Associate Professor of Pediatrics at the George Washington University School of Medicine and Health Sciences and Director of the Child Development Program in the Division of Behavioral Medicine, Department of Psychiatry & Behavioral Sciences. Initially, I came to CNMC to work on my doctoral dissertation in the NICU and while completing that became aware of the initiation of the ECMO program whereby critically ill infants would have the right common carotid artery and jugular vein permanently ligated. I was hired by Dr. Billie Short in 1984 to provide followup developmental evaluations for the Neonatal ECMO Program and later helped develop the national standards for followup. I became Director of the NICU Followup Clinic in 1987 which subsequently became the Child Development Program. The name change more fully represents our clinical expertise beyond NICU "high risk" infants to the broad range of patients routinely referred from multiple medical subspecialists, community physicians, early intervention programs and preschool programs. The change in name also reflects our strong community advocacy efforts through parent groups and frequent requests from the media for expertise in early child development issues. Our program serves as a teaching site for pediatric interns, psychology interns, and graduate students from the wider metropolitan area, in addition to psychology postdoctoral trainees. I also serve as part of the Neurobehavioral/Psychosocial Evaluation Core for Children's GCRC, which provides research consultation around design and instrumentation of studies involving developmental outcomes of children prior to age 4 years.
My research interests have generally focused on biological and environmental perturbations of the developing brain. My doctoral dissertation, "The effect of bright continuous light in the NICU on the developing visual system of the preterm infant" which I completed in 1984, involved a comparison of two levels of ambient light in the NICU (standard bright light vs light reduction strategies) on the incidence of retinopathy of prematurity, alteration of sleep states, and dysmaturity of visual information processing at 4 months past term. The retinopathy results were published in the New England Journal of Medicine, received national and international attention, and led to modification of NICU environments. I subsequently published a chapter in Neonatology: Pathophysiology & Management (G Avery, ed), "The vulnerable neonate in the NICU environment", which was concerned with early development of all the sensory systems and the impact of atypical environment on early brain development. I continue to present on this broader topic at national and international meetings.
I was the PI for an RO1 (NIH/NINDS) five-year study to conduct comprehensive neuropsychological and neuromotor testing of 150 5-year-old children treated as neonates with ECMO and 50 normal control children. The results of three separate analyses (neurodevelopmental status at age 5 years, outcome by brain injury severity, and the pattern of neuropsychological deficit following unilateral brain injury) were published in major journals (Pediatrics, Developmental Medicine/Child Neurology, and Brian and Language). I wrote and revised a chapter for the ECMO manual, presented at numerous national and international meetings on ECMO outcome, and continue to chair the Followup Session at the annual ECMO meeting. I am actively collaborating in early outcomes research, including multi-institutional studies of hypothermia, Neurofibromatosis, and Sickle Cell anemia.
My most recent research effort is in the area of early autism. This stems from my long experience with this clinical population, initially in collaboration with Dr Ann Wagner , who is now at NIMH, and more recently with Dr Marie Weissbourd, who has had similar experience with this population in Chicago. The majority of the 1200 children evaluated each year in the Developmental Clinic are referred because of concerns about social communication and language deficits or developmental delay of unknown cause, in addition to known neurological and genetic disorders. The current RAC proposal is essential to support the necessary pilot study for an R21 proposal. The intention is for the R21 to serve as preliminary data for an RO1. Attaining a 2nd NIH funded study is part of my longterm career goal of academic promotion to full professor.
