I am a physician-scientist, with a PhD in molecular biology and post-doctoral training in Pediatrics and Neonatal-Perinatal Medicine. I am completely committed to a career in translational research, with the goal of improving the long-term outcomes of former NICU infants with disabilities. I am currently in my fourth year on the faculty as an Assistant Professor at Vanderbilt, with 80% of my efforts focused on research thanks to generous departmental support. I am fortunate to have an institutional environment such as that at Vanderbilt, which is rich in career development opportunities, resources and multidisciplinary collaborations. The focus of my research has been the influence of intensive-care environmental exposures and neural injury on sensory function in infants and children. Sensory systems provide our view of the world, a view upon which all cognitive processes are dependent. Furthermore, our brain's ability to connect different sensory perceptions is what allows us to see the world and ourselves as more than just the sum of separate parts. I have focused my research on developing new methods of objectively measuring this aspect of brain function in children, in order to predict developmental outcomes and design therapeutic strategies for children with disabilities. While I have benefitted from the opportunities afforded o me thus far, I still need to complete my development towards independent research by filling in the gaps in my training in two specific areas: the neuroscience of multisensory systems and large-scale clinical trials design. My long-term career goal is to develop an independent research program in the evaluation of perinatal brain injury and to develop novel interventions for brain insults with origin in early life. The K23 Mentored Patient-Oriented Research Career Development Award will help me achieve this goal. My primary mentor, Dr. Elisabeth Dykens, is an international leader in patient-oriented developmental disabilities research. Dr. Dykens will guide my career progress to independence and, with my mentorship team, ensure my success in the design of large-scale clinical trials. My co-mentors, Dr. Mark Wallace, a world- renowned expert in multisensory systems neuroscience, and Dr. Jim Bodfish, an authority on objective neurobehavioral measures of sensory perception, will guide my development towards rigorous scientific study design in this field. The members of my mentoring committee have been carefully chosen for their experience and leadership in their chosen fields and represent complementary aspects of my career path. Similarly, my development plan will fill gaps in my training, while my research project will focus my efforts in the specific area of multisensory function. The goal of my K23 research proposal is to address the lack of quantitative tools to measure sensory function in vulnerable infants, by adapting novel tools I have developed and validated in older children over the last three years. The neonatal period is a critical time in brin development, when connections between brain regions are being formed; these connections are highly dependent upon the environment for input and stimulation. Because neonates in intensive care units often experience atypical stimuli, such as constant noise and frequent handling for medical care, their perception of touch and sound can be profoundly altered. We will first use methodologies to objectively measure the brain's perception of speech sounds and light touch in NICU infants across the full spectrum of viable gestational ages at birth, from full term to extremely preterm. We will use a portable methodology to deliver tactile and auditory stimuli at the bedside of infants and quantitatively measure the brain's response with electrical neuroimaging (EEG/ERP) prior to discharge from the hospital. We will test the hypothesis that individual and combined measures of tactile and auditory responses will allow us to identify and quantify deficits in unisensory and multisensory function. We will then validate the utility of the methods developed in the first part of the study to predict sensory and developmental outcomes at 6 and 24 months corrected age. We will evaluate the previously tested infants in the follow-up clinic with established measures of sensory, cognitive, communication and behavioral function, and develop predictive algorithms for outcomes. The information gained from this project will help us determine how deficits in multisensory perception contribute to the development of disabilities in early childhood and will allow us to design and assess effective neuroprotective and rehabilitative strategies.
The prevalence of developmental disabilities in the United States has increased 17% in the last decade, representing an additional 1.8 million children with disabilities; newborns who require intensive care contribute disproportionately to these numbers, representing up to 60% of children with significant motor, cognitive, visual and hearing impairments at school age. The proposed research will improve our understanding of how multisensory perceptions of touch and speech sounds contribute to the development of disabilities in early childhood, and thus holds great relevance and promise for developing interventions. The results will facilitate the rigorous design and testing of therapeutic strategie for children at risk for disabilities while still in the intensive care unit and during infancy, whn treatments are likely to be most effective.
