2022 Associates Meeting - Posters

Yale Child Study Center

Poster session highlighting the latest research from investigators and trainees at the Yale Child Study Center. Click on a poster to enlarge, and please leave comments and questions under "Join the Discussion". See more Child Study Center research at the link below.


More info: http://minitalks.childstudy.center
Show Posters:

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Walking on Eggshells: Family Accommodation in Anxious Youth with High and Low Irritability

Rotem S. Budagzad-Jacobson, Regina M. Musicaro, Carla E. Marin, Grace Hommel, Wendy K. Silverman & Eli R. Lebowitz

Abstract
Family accommodation is a significant contributor to the development and maintenance of youth anxiety. Despite the high co-occurrence between anxiety and irritability, there is a knowledge gap regarding the impact of irritability on the association between anxiety and family accommodation in youth, including youth with diagnosed anxiety disorders. The current study compared family accommodation levels between clinic referred anxious youth with high irritability levels, and anxious youth with low irritability. We also examined the influence of irritability on the association between youth anxiety symptom levels and family accommodation levels. Our results indicate that parents of highly irritable anxious youth are more accommodating of their children’s anxiety, relative to parents of anxious youth with low irritability. Moreover, youth anxiety severity was most strongly associated with family accommodation at low levels of irritability. These findings suggest that family accommodation might be intensified in the case of comorbid anxiety and irritability and point to the significance of irritability as an important clinical phenomenon in the context of youth anxiety.
Presented by
Rotem Budagzad-Jacobson <rotem.budagzad-jacobson@yale.edu>

Disruptions in Amygdala-Prefrontal Connectivity is Associated with Anxiety in Autistic Children

Karim Ibrahim, Carla Kalvin, Gregory McCarthy & Denis G. Sukhodolsky

Abstract
Presented by
Karim Ibrahim <karim.ibrahim@yale.edu>

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Hyperactivity and restricted and repetitive behaviors are strongly associated in preschoolers with and without autism spectrum disorder

Boxberger, A., Edgar, E., All, K., Donthireddy, V., Hong, E., Bianco, C., Gordon, B., Vernetti, A., Powell, K., Macari, S., & Chawarska, K.

Abstract
Hyperactivity and restricted and repetitive behaviors (RRBs) are associated in children with and without ASD, however their associations over time remain unstudied. We found stability of these symptoms between 3 and 5 years, and strong associations with each other at each timepoint. Further, elevated hyperactivity at 3 years was predictive of RRBs at 5 years and vice-versa, supporting the idea of similar alterations in brain connectivity contributing to both symptoms, and underscoring the importance of early assessment.
Presented by
Alexandra Boxberger <alexandra.boxberger@yale.edu>

Using human faces as stimuli and smiling as a reward, social reward value learning emerges by 6 months of age

Donthireddy, V., All, K., Edgar, E. V., Bianco, C., Hong, E., Boxberger, A., Gordon, B., Macari, S., Vernetti, A., Wang, Q., Chawarska, K.

Abstract
Reward Value Learning (RVL) is the ability to assign value to stimuli based on experiences (rewards). Infants demonstrate this skill when non-social stimuli are paired with non-social or social rewards. However, it remains unknown whether infants demonstrate RVL when pairing social stimuli with social rewards and when in infancy RVL arises. We found that RVL in the social domain emerges at 6 months of age. RVL may be a prerequisite for the development of social attention skills that emerge at 9-12-months and are impaired in autistic individuals.
Presented by
Veda Donthireddy <veda.donthireddy@yale.edu>

Sex differences in the relationship between depressive symptoms and pupillary light reflex in children with ASD: Results from the ABC-CT Phase One Study

Iqbal, R., Naples, A., Chawarska, K., Dawson, G., Bernier, R., Jeste, S., Nelson, C., Dziura, J., Webb, S., Sugar, C., Shic, F., McPartland, J

Abstract
Presented by
Reeda Iqbal <reeda.iqbal@yale.edu>

Discrepancies Between Parent and Clinician Report of Autism Spectrum Disorder Features: Associations with Demographics, Diagnosis, and Intervention

Azu, M. A., Wolf, J., Naples, A., Chawarska, K., Dawson, G., Bernier, R., Jeste, S., Nelson, C., Dziura, J., Webb, S., Sugar, C., Shic, F, McPartland, J. for the Autism Biomarkers Consortium for Clinical Trials

Abstract
Clinicians rated autism features higher than caregivers for boys and rated autism features lower than caregivers for girls. Additionally, children who received lower ratings from clinicians than they did from caregivers tended to be diagnosed at an older age and to receive less intervention. These findings suggest that when caregiver and clinician ratings of autism features do not align, it may be important to make extra space for caregivers’ ratings to obtain a full picture of the child’s autism features and the support they may need.
Presented by
Margaret Azu <margaret.azu@yale.edu>

Early Executive and Social Functioning Predict Externalizing Problems in Neurodiverse Preschoolers

All, K., Boxberger, A., Bianco, C., Donthireddy, V., Edgar, E. V., Hong, E., Vernetti, A., Macari, S., & Chawarska. K.

Abstract
Externalizing problems such as aggression, defiance, and inattention are elevated in children with developmental disorders and are associated with increased anxiety and depression, peer rejection, and parental stress. Understanding early predictors of externalizing problems is imperative to identifying vulnerable children and implementing preventative interventions. We found that executive functioning impairment and social adaptive functioning at age 3 predict externalizing problems at age 5, particularly in children with lower levels of autism symptoms.
Presented by
Katherine All <katherine.all@yale.edu>

Impact of a Sibling Support Group on Relationship Quality and Siblings’ Knowledge of Autism Spectrum Disorder (ASD)

Julie M. Wolf, Ph.D., Marika Coffman, Ph.D., Megan Braconnier, M.A., Nicole Kelso, M.S. & James McPartland, Ph.D.

Abstract
This study evaluated the effectiveness of a 10-week support group for siblings of children on the autism spectrum. Results demonstrated that, following the support group, siblings showed increased knowledge about autism and increased satisfaction in their relationship with their sibling. Additionally, parents reported a reduction in negative behaviors within the sibling relationship both by the child who participated in the group and by their autistic sibling.
Presented by
Julie Wolf <julie.wolf@yale.edu>

Effects of Anxiety and Social Impairment on Quality of Life in Autistic Children

Julia Zhong, Karim Ibrahim, Carla B. Kalvin, Rebecca Jordan, Abigail Reed, Denis G. Sukhodolsky

Abstract
Presented by
Julia Zhong <julia.zhong@yale.edu>

Comprehensive Therapy for Irritability in Adolescents with Autism: Study Design and Pilot Data

Denis G. Sukhodolsky, Julia Zhong, Megan Rutten, Karim Ibrahim, and Carla Kalvin

Abstract
Approximately 50 percent of children and adolescents on the autism spectrum experience significant irritability, such as being easily frustrated or having frequent and impairing anger outbursts. This presentation describes a treatment study of a novel intervention aimed at helping adolescents develop emotion regulation skills to handle frustration and navigate challenging social situations.
Presented by
Denis Sukhodolsky <denis.sukhodolsky@yale.edu>

Investigation of Autism Spectrum Disorder Diagnosis and Social Anxiety Symptoms as Predictors of Visual Attention to Faces and Eyes

Franke, C., Wolf, J., Naples, A., Johnson, M., Han, G. & McPartland, J.

Abstract
As many as 34% of autistic adolescents also have social anxiety disorder (Kreiser & White, 2014). Because social anxiety can strongly impact the quality of people's lives, it is important to improve our understanding of the relationship between these two conditions (Spain et al., 2018). Eye-tracking allows scientists to see where a participant is looking on the screen, which makes it a useful way to look at social attention in people with and without autism and social anxiety. The current study showed pictures of fearful and happy faces to autistic and non-autistic children with various levels of social anxiety symptoms and measured the average percentage of time that participants looked at the face, as well as specifically at the eyes. The results showed that autistic children looked less at faces than non-autistic children, while children with higher social anxiety looked less at eyes than those with lower social anxiety. Additionally, autistic participants with higher social anxiety looked more at faces than autistic participants with lower social anxiety.
Presented by
Cassandra Franke <cassandra.franke@yale.edu>

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Intensive In-Home Child and Adolescent Psychiatric Services Improves Children’s Quality of Life

Victoria Stob MA, LCSW; Heather Bonitz-Moore, LPC; Soyon Kim, PhD.; Joseph Woolston M.D.

Abstract
Intensive In-Home Child and Adolescent Psychiatric Service (IICAPS) is a well-established, structured intervention offered to high-risk families in Connecticut. The program is delivered primarily to children struggling with severe emotional disturbance and their families and is used as an alternative measure to keep children with significant psychiatric needs from being hospitalized. Often children and families in the program struggle with complex, chronic, and multigenerational trauma and psychosocial vulnerability. IICAPS is effective at reducing psychiatric hospitalization admissions, emergency department visits, and residential stays and improves overall child functioning and decreases symptom severity.
Presented by
Victoria Stob <victoria.stob@yale.edu>

Game-Based Assessment of Cognitive Function among Children and Adolescents: A Systematic Review and Meta-Analysis

Kammarauche Aneni, Isabella Gomati, Megan Jiao, Melissa Funaro, Lynn E. Fiellin

Abstract
The use of games for measuring cognitive function offers an alternative engaging method to traditional forms of cognitive assessments. However, it is unclear how well game-based assessments of cognitive function compare to current traditional cognitive tests among children and adolescents. We conducted a systematic review to examine the validity of game-based assessments of cognitive function. Game-based assessments of cognitive function may be valid alternatives to traditional assessments although factors such as age, sex and prior exposure to games may affect the validity of these assessments.
Presented by
Isabella Gomati <isabella.gomati@yale.edu>

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Motivation Improves Working Memory by Shaping Neural Signals in the Prefrontal and Parietal Cortex

Youngsun T. Cho, Flora Moujaes, Charles H. Schleifer, Martina Starc, Jie Lisa Ji, Nicole Santamauro, Brendan Adkinson, Antonija Kolobaric, Morgan Flynn, John H. Krystal, John D. Murray, Grega Repovs, Alan Anticevic

Abstract
Working memory refers to the ability to temporarily keep information in mind. Working memory continues to improve during childhood, adolescence and young adulthood, but is impaired in psychiatric illnesses such as depression, schizophrenia and substance use disorders. In this study of young adults, working memory performance improved when incentives (money) was provided. When working memory was motivated, increased neural signals were observed in parts of the prefrontal and parietal cortex, regions of the brain important for working memory and executive functioning. We are applying this task to a research study of adolescents with depression to understand how depression impacts brain regions involved in motivated working memory.
Presented by
Youngsun Cho <youngsun.cho@yale.edu>

Modeling the Neurodevelopmental Effects of COVID-19 Infection During Pregnancy

Matthew Yuen; Wesley Tung; Hyesun Cho PhD; Akiko Iwasaki PhD; Kartik Pattabiraman MD, PhD

Abstract
Maternal infection during pregnancy can disrupt fetal brain development and increase the risk of autism and schizophrenia in the offspring. Motivated by the potential risk for children born during the COVID-19 pandemic, we developed a mouse model of SARS-CoV-2 infection during pregnancy. In this animal model, we found that maternal COVID-19 infection during pregnancy can disrupt the expression of genes related to neuronal synapse development in the fetal offspring.
Presented by
Matthew Yuen <matthew.yuen@yale.edu>

Assessing the Validity of the Predictive Adaptive Response and Mismatch in Humans: A Narrative Review

Jenna Hartstein; Kieran J. O’Donnell, PhD

Abstract
There is a persisting influence of the early environment (in-utero environment) on child physical and mental health, as intrauterine signals may program physiological functions that can lead to varied health outcomes in offspring (O’Donnell & Meaney, 2017). The Developmental Origins of Health and Disease (DOHaD) provides the conceptual framework to link the early environment to child mental and physical outcomes by drawing on evolutionary theories, and Predictive Adaptive Response (PAR) helps explain why early life events may be associated with increased risk of diseases such as hypertension, diabetes, and heart disease in humans (Gluckman & Hanson, 2004). We found that the usefulness of Predictive Adaptive Response and the validity of other evolutionary development hypotheses are clear, but the prevalence in present day humans may be questionable. Further, it is necessary to assess if evolutionarily conserved behaviors should always guide public safety, especially in the case of a rapidly industrialized and modern day human society.
Presented by
Jenna Hartstein <jhartstein@g.ucla.edu>

The Infant Gut Microbiome, Rearing Environment, Neurodevelopment, And Cognitive Development in a Non-Human Primate Model (Macaca Mulatta)

Katherine Daiy, Kyle Wiley, Jacob Allen, Michael T. Bailey, Amanda Dettmer

Abstract
Presented by
Amanda Dettmer <amanda.dettmer@yale.edu>

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Dynamic Processes Between Irritability and Trauma Exposure Within the Family System: A Network Approach

Grace Cotter, Kristina Morreale, Amanda Valdegas, Meghan Clough, Rebecca Beebe, Damion Grasso, Carla Stover, & Wan-Ling Tseng

Abstract
Presented by
Wan-Ling Tseng <wan-ling.tseng@yale.edu>

Harnessing Electronic Health Record Data to Examine the Relationship between Adverse Childhood Experiences (ACEs), Medical Morbidity, and Healthcare Utilization

Jelena G. MacLeod, MD, MHS; Pamela E. Hoffman, MD; Zi Jia Ng, PhD; Emily M. Powers, MD, MHS; Angela R. Farren, BS; Carla S. Stover, PhD; Andrea G. Asnes, MD, MSW

Abstract
The Adverse Childhood Experiences (ACEs) questionnaire is a widely used screener for pediatric trauma exposure and general household dysfunction. On a population level, ACEs are cumulative risk factors for a range of mental health and physical conditions. ACEs research has been largely based on self-reported ACEs exposures and health conditions. In contrast, data mined directly from the electronic health record (EHR) allows for more objective analysis and reduces potential harms and limitations of self-report. The objectives of this pilot were to generate and test an algorithm for deriving proxy ACEs values from existing EHR data, and to study the population-level association between derived proxy ACEs, medical morbidity, and healthcare utilization. We generated a dataset of 142,719 patients aged <18 years old who received care at Yale, spot-checked the derivation algorithm, and iterated modifications to obtain their final proxy ACEs scores. Proxy ACEs scores were positively correlated with all medical morbidity and healthcare utilization outcome variables, with the strongest associations for number of medical diagnoses, number of prescribed medications, and number of emergency room visits. Our findings are proof of concept that proxy ACEs scores can be meaningfully derived from the EHR. Future directions include incorporating natural language processing methodology to account for unstructured data stored in the EHR and creating an individual-level risk stratification model using our proxy ACEs dataset.
Presented by
Jelena MacLeod, MD, MHS <jelena.macleod@yale.edu>

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Examining the Relationship Between Technology Use and Negative Affect in Adolescents Across Different Grades

Sean D. McFarland, Tse Yen Tan, Kalee De France, Rachel Baumsteiger, Jessica D. Hoffmann

Abstract
People often assume that more technology is bad for youth mental well-being, but how can we change this dynamic since technology use is only growing in our society? Our study found that schools can help mitigate the adverse impacts of technology use on teens by preparing students to use technology in healthy ways.
Presented by
Sean McFarland <sean.mcfarland@yale.edu>

Yale Children and Adults Research in Early Education Study

Ayse Cobanoglu & Yale-Cares Team

Abstract
Background: Our prior study showed that a large proportion of ECE professionals struggled with clinically relevant depressive symptoms within the first couple of months of the COVID-19 pandemic(Elharake, 2022). In this paper, we aimed to further investigate the current stage of the workforce with the most recent, nationwide survey data. This paper examines two cohorts of ECE professionals working in the USA to estimate nationally representative, weighted proportions of depression.

Method: Data. The data used in this study came from Yale-CARES Surveys, a nationwide survey for early care and education professionals that collects information on the mental, physical and financial well-being of the workforce as well as a wide range of background and program-level characteristics. Survey sent through the contact lists of the National Workforce Registry Alliance and its member state child care registries, the National Association for the Education of Young Children, and Child Care Aware of America, as described in other studies (Gilliam et al., 2021; Murray et al., 2022; Patel et al., 2021; Patel et al., 2021). Cohort 1: Baseline and Follow-up, and overleaping Longitudinal Sample. Baseline data collection occurred between May 22 and June 8, 2020 and survey has been completed by 82,613, and the follow-up occurred between May 26 and June 23, 2021 and has been completed by 21,663 ECE professionals. Cohort 2: Survey links were distributed from June 2021 to August 2021 and of the individuals who click the survey link (N=56,881), 49,245 responded to survey.

Center for Epidemiological Studies – Depression Scale (CES-D-10). ECE professionals were asked the frequency of depression-related symptoms in the past week, with the response scale being 0 = Rarely or none of the time; 1 = Some or a little of the time; 2 = Occasionally or a moderate amount of the time; 3 = All of the time. CES-D-10 scores ranged from 0 to 30. Cut off score for depressive symptoms was 10. Analysis. We conducted weighted, descriptive analyses to estimate nationally representative proportions and 95% confidence intervals (CI) with multiply imputed data. We estimated the prevalence and 95% CIs of depression symptoms among ECE professionals across background characteristics in May-June 2020 (Cohort 1- Baseline), May-June 2021 (Cohort-1 Follow-up), and July-August 2021 (Cohort-2).

Results: Overall, the prevalence of US ECE professionals with clinically relevant depression symptoms was 45.68% (95% CI: 38.14,53.23) in May/June 2020, 39.02% (95% CI: 37.57,40.48) in May/June 2021, and 45.82%, (95% CI: 36.56,55.08) in July/August 2021. Among ECE professionals in this sample, the prevalence of clinically relevant depression symptoms was 44.97% (95% CI=44.07,45.88) in baseline and 39.02% (95% CI=37.57,40.48) in follow-up. Overall, higher prevalence of depression were observed across all demographic categories in baseline compared to follow-up. However, we found similar patterns of depression symptomology across demographic categories for both baseline and follow-up. For instance, prevalence of depression were 45% for female, 41.23 for male, 76.73 for Non-binary/ Transgender/Intersex/Others and 37.30 for participants preferred not to answer in baseline. Similarly, prevalence of depression were 39.19% for female, 34.1% for male, 78.95 for non-binary and 38.58 for participants preferred not to answer in follow-up. With the 62.76% (95% CI: 49.52,76.00) prevalence rate, American Indian or Alaskan Native has the highest prevalence of depression among all racial groups. Prevalence of depression among Hispanic ECE professionals was 51.87% (95 % CI: 41.07,62.67). Large proportion of non-binary/transgender/intersex ECE professionals, 72.37% (95% CI: 60.77,83.97) had depression in Cohort-2. As can be seen in Table 4, with age there was a decrease in proportion of ECE professionals with depression and individuals in 18-24 age group had the highest prevalence rate of 57.14% (95% CI: 42.16,72.12). Similar to Cohort-1, the highest proportions of depression was observed for workers from nanny or in-home child care with 61.61% (95% CI:40.37,82.85). Half of the ECE professionals with below $35,000 and $50,000-74,999 had depression.

Conclusion: This study reports nationally representative estimates of mental health outcomes in the USA's early care and education professionals since the beginning of the COVID-19 pandemic and provides critical evidence from the very first, comprehensive, nationwide ECE workforce dataset. Considering the ongoing children’s mental health crisis, the prevalence of depression among child care and education professionals who work with this population is alarming. Results clearly demonstrate that there is an urgent need to support ECE workforce wellbeing who have limited or no access to mental health consultation.
Presented by
Ayse Cobanoglu <ayse.cobanoglu@yale.edu>

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Identifying Post-Zygotic Single Nucleotide Genetic Variants in Tourette Syndrome

Sarah Abdallah, MD; Emily Olfson, MD, PhD; Thomas Fernandez, MD

Abstract
Presented by
Sarah Abdallah <sarah.abdallah@yale.edu>

Child maltreatment, epigenetic ageing, and the impact of an early intervention

Paula López Ramos, BSc; Hung Pham, MSc; David Olds, PhD; Michael Meaney, PhD; Kieran O’Donnell, PhD

Abstract
Presented by
Paula Lopez Ramos <paula.lopezramos@yale.edu>