Neurodevelopmental Biology of Neglected Children

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DESCRIPTION (provided by candidate): The overall aim of this application is to prepare the candidate for a patient oriented research career exploring neurobiologic sequelae associated with child neglect. The candidate's training in child psychiatry and pediatrics, expertise in child maltreatment, and childhood brain disorders provides an excellent foundation for this proposal. The primary mentor has expertise in the exploration of the hypothalamic-pituitary-adrenal (HPA) axis, stress, substance use and grantsmanship and is a Midcareer Investigator award recipient devoted to mentoring individuals with an interest in patient-oriented research. Secondary mentors are clinical researchers experienced in neuroendocrinology, pediatric endocrinology, and pediatric brain development associated with child maltreatment and risk factors associated with child neglect. The training plan includes topic-specific mentoring, completion of a Masters of Science in Clinical Research, and supervised research experience in the General Clinical Research Center (GCRC). The ultimate goal of this application is to transition the candidate from mentored researcher to independent patient-oriented researcher focused on the neurobiology of neglect and abuse in children. In order to effect this transition, protected time for training in neglect, neuroendocrine systems, young child assessment, research design, and recruitment is essential. Subjects will include children, ages 3 to 6 years old, that have been recently reported to the Charleston County (SC) Department of Social Service for physical neglect. The control group will include age, gender, race, and socio-economically matched children recruited from an academic primary care clinic. Measurement of chronicity, severity and comorbidity of other types of maltreatment will be obtained. Pilot data will explore whether neurobiologic markers in a group of children that have been neglected (many of which will have experienced co-morbid maltreatment) demonstrate evidence of HPA dysregulation and hypopituitarism. The research plan will provide experience in recruitment and assessment of healthy and neglected children, generate pilot data on neuroendocrine and noradrenergic function, general health, cognitive, language, and psychiatric measures in this population, using state of the art measurement tools. The pilot study will be used to determine if these markers show promise as tools to increase our understanding of medical, and neurodevelopmental sequelae in children that have been neglected and abused. A better understanding of this area is necessary to assist in understanding resilience in children facing adverse circumstances and in addressing the reversibility of these impairments. It is hoped that pilot data obtained will support development of an Research Project application for longitudinal studies to further study the effects of child neglect on the developing brain and neurobiologic systems.