During my pediatric neuropsychology fellowship I developed clinical expertise in neurobehavioral aspects of pediatric disease, in particular the cognitive late effects of cancer. Now in the Pediatric Clinical Research Office, 70% of my time has been devoted to practical experience in the design and conduct of neuropsychology research protocols within the context of pediatric disease, including clinical trials. I have a growing interest in neurodegenerative diseases of childhood, which stems from my work in juvenile neuronal ceroid lipofuscinosis (JNCL). There are few pediatric neuropsychologists with expertise in this field. I will need additional skills and knowledge to accomplish my major goal: to be a leading neuropsychologist in neurodegenerative disorders of childhood. My short term goals are to 1) increase my knowledge of research design and statistical methods for analysis of longitudinal and outcomes data, including in an experimental therapeutics context, 2) gain skills for reliable evaluation of disease-specific outcomes, 3) better understand neurological and neuropathological biomarkers pediatric neurodegenerative disease, and 4) improve knowledge of disciplines relevant to collaborative research in this field (biochemistry, genetics, neurology). My research focus during this K23 award period is to comprehensively determine the neurobehavioral phenotype and natural history of JNCL. Limited data suggests that neurobehavioral deficits precede onset of other clinical symptoms in some affected children. Research on the emergence of neurobehavioral deficits and their relationship to other aspects of disease has been limited. Thus, the specific research aims are to 1) better characterize the natural history and progression of neurobehavioral symptoms in JNCL, 2) understand the relationship among neurobehavioral function and other aspects of disease and disease progression, and 3) establish and longitudinally study the first cohort of children at-risk for JNCL. These findings will lead to standardized methods to evaluate treatment outcomes in future experimental therapeutics trials, and for current symptomatic treatments, even during the earliest phases of clinical disease. More broadly, this research will serve, as a model for investigations in other pediatric neurodegenerative diseases, and will facilitate my development as an independent investigator and leader in this field.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
NST-2 Subcommittee (NST)
Program Officer
Morris, Jill A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Rochester
Schools of Dentistry
United States
Zip Code
Adams, Heather R; Rose, Katherine; Augustine, Erika F et al. (2014) Experience, knowledge, and opinions about childhood genetic testing in Batten disease. Mol Genet Metab 111:197-202
Adams, Heather R; Mink, Jonathan W; University of Rochester Batten Center Study Group (2013) Neurobehavioral features and natural history of juvenile neuronal ceroid lipofuscinosis (Batten disease). J Child Neurol 28:1128-36
de Blieck, Elisabeth A; Augustine, Erika F; Marshall, Frederick J et al. (2013) Methodology of clinical research in rare diseases: development of a research program in juvenile neuronal ceroid lipofuscinosis (JNCL) via creation of a patient registry and collaboration with patient advocates. Contemp Clin Trials 35:48-54
Mink, Jonathan W; Augustine, Erika F; Adams, Heather R et al. (2013) Classification and natural history of the neuronal ceroid lipofuscinoses. J Child Neurol 28:1101-5
Cialone, Jennifer; Adams, Heather; Augustine, Erika F et al. (2012) Females experience a more severe disease course in Batten disease. J Inherit Metab Dis 35:549-55
Cialone, Jennifer; Augustine, Erika F; Newhouse, Nicole et al. (2011) Parent-reported benefits of flupirtine in juvenile neuronal ceroid lipofuscinosis (Batten disease; CLN3) are not supported by quantitative data. J Inherit Metab Dis 34:1075-81
Cialone, J; Augustine, E F; Newhouse, N et al. (2011) Quantitative telemedicine ratings in Batten disease: implications for rare disease research. Neurology 77:1808-11
Kwon, J M; Adams, H; Rothberg, P G et al. (2011) Quantifying physical decline in juvenile neuronal ceroid lipofuscinosis (Batten disease). Neurology 77:1801-7
Adams, Heather R; Beck, Christopher A; Levy, Erika et al. (2010) Genotype does not predict severity of behavioural phenotype in juvenile neuronal ceroid lipofuscinosis (Batten disease). Dev Med Child Neurol 52:637-43
Lande, Marc B; Adams, Heather; Falkner, Bonita et al. (2010) Parental assessment of executive function and internalizing and externalizing behavior in primary hypertension after anti-hypertensive therapy. J Pediatr 157:114-9