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Randi Streisand

Randi Streisand, Ph.D. to be honored with the Michael C. Roberts Award for Outstanding Mentorship

Randi Streisand

Randi Streisand, Ph.D., chief of Psychology and Behavioral Health at Children’s National Health System, will be honored with the Michael C. Roberts Award for Outstanding Mentorship by the  Society of Pediatric Psychology (SPP), a Division of the American Psychological Association. This award honors pediatric psychology faculty who go above and beyond to mentor students and provide professional advice and guidance through students’ various training phases.

The Society of Pediatric Psychology will present the award at their Annual Conference held on Apr. 4-6, 2019 in New Orleans, La.

Streisand was selected for the award based on her exceptional mentorship in the areas of research, clinical work and overall career development through graduate school, postdoctoral fellowships and early career stages.

“I’m very honored to be selected for this distinguished award,” says Streisand. “Working with students, fellows and junior faculty members has been the highlight of my career. I really enjoy helping guide people on their own career paths. I have been fortunate to mentor many truly talented individuals, several of whom I now get to work with as valued colleagues.”

Streisand has served as a primary mentor on funded career development awards, research fellowships and dissertations. Her impressive track record of mentoring behavioral researchers has benefited six faculty members by moving Children’s fellows into tenure-track and clinical faculty positions. Furthermore, her research assistants have been accepted into leading graduate programs in psychology and health including the University of Florida, Loyola University Chicago, Georgia State University and UT Southwestern Medical Center.

“Dr. Streisand’s approach to mentorship is comprehensive, and she goes the extra mile for each intern, colleague and researcher she works with,” says Roger J. Packer, M.D., senior vice president at Children’s Center of Neuroscience and Behavioral Medicine. “She has already made a major impact on the field of pediatric psychology through her superb mentorship and will continue to do so for the years to come.”

Shayna Coburn

Shayna Coburn, Ph.D., receives APA Achievement Award for Early Career Psychologists

Shayna Coburn

Shayna Coburn, Ph.D assistant professor and psychologist at Children’s National Health System.

Shayna Coburn, Ph.D., assistant professor and psychologist at Children’s National Health System, has been awarded an American Psychological Association (APA) Achievement Award for Early Career Psychologists.

APA’s Committee on Early Career Psychologists announced the award for early career members who work in all areas of psychology (education, practice, public interest and science) to attend the APA Annual Convention August 2018 in San Francisco.

“At this early stage in my career, the recognition of my achievements thus far is highly valuable as I expand my body of work and strive to advance my career,” Coburn says.

The awards program was designed to reduce barriers to early career members’ attending APA conventions and to support their ability to make meaningful connections and engage in professional development. As a recipient of the award, Coburn received reimbursement up to $400 for convention-related expenses that could cover travel, lodging, meals and/or convention registration fees.

Throughout her career, Coburn has been passionate about clinical and research excellence as well as advocacy. In her current position in the celiac disease program, she has been involved with establishing a new psychosocial health program that combines multidisciplinary clinical service, research and community outreach.

During a previous APA convention, Coburn was able to attend as an exhibitor to promote a free continuing education program. This year was the first time she was featured as a presenter, speaking about celiac disease and psychosocial challenges associated with the disease.

Coburn presented data from Children’s National celiac disease multidisciplinary clinic to report the incidence rates of symptoms that patients experience such as anxiety, depression and stress from a gluten-free diet.

“The most important aspect of the award was having the largest organization of psychologists recognize that during the early stages of my career, I have been involved in work that is meaningful to the community,” Coburn says. “It’s always helpful to have extra support to attend a conference that is across the country from my home in Maryland,” she adds.

The leader and collaborator in a range of scientific, clinical and community-based activities thanks the award for being invaluable in facilitating her attending the conference and being able to participate in career-building and networking opportunities that will help enable her to build professional relationships nationwide.

Connecting allied health professionals in pediatric nephrology

With the meeting in Washington this year, Children’s National Health System will be the local host, a distinct honor for an academic medical center that treats hundreds of nephrology patients each year, says pediatric Nephrologist Asha Moudgil, M.D., who directs Children’s kidney transplant service.

Pediatric nephrology is a relatively small specialty worldwide, encompassing just a few hundred doctors in the U.S. For each allied health field that provides collaborative care with these physicians – including nutrition, child-life, psychology and social work – the numbers of providers are even smaller. There are no national meetings for these individual subspecialty fields and no venues to meet new like-minded colleagues or learn about new research or protocols.

Six years ago, the American Society of Pediatric Nephrology (ASPN) aimed to help resolve this dilemma by launching a new multidisciplinary symposium that brings together allied health professionals of all kinds within pediatric nephrology.

Each year, the “ASPN Multidisciplinary Symposium” changes locations, allowing the meeting to target different regional groups of allied health professionals based on geography. With the meeting in Washington this year, Children’s National Health System will be the local host, a distinct honor for an academic medical center that treats hundreds of nephrology patients each year, says pediatric Nephrologist Asha Moudgil, M.D., who directs Children’s kidney transplant service.

There are multiple advantages to having the symposium in Washington, Dr. Moudgil explains. One is access to Children’s experts in this field, who have a wealth of experience in managing issues that affect patients who live in the greater Washington area. For example, the keynote address scheduled for the meeting’s opening night will be delivered by Jennifer Verbesey, M.D., Children’s surgical director of pediatric kidney transplantation, focusing on living donation in minority populations. Living kidney donors and recipients who are minorities have unique issues that can affect organ longevity, explains Dr. Moudgil, which may not be well known by all clinicians.

Children’s speakers also focus prominently in the main session on the second day, including:

  • Angela Boadu, RD, LDN/LD, a registered dietitian, and Kaushalendra Amatya, Ph.D., a psychologist, are giving a talk about nutrition and the psychosocial aspects of obesity
  • Surgeon Evan Nadler, M.D., director of Children’s Bariatric Surgery Program, is speaking about bariatric surgery before and after transplantation
  • Nurse Practitioner Christy Petyak, CPNP-PC, and Social Worker Heidi Colbert, LICSW, CCTSW, NSW-C, are leading breakout sessions about the practical aspects of immunosuppressive therapy and resources for uninsured patients
  • Amatya, the Children’s psychologist, also is leading a breakout session on internalizing psychological disorders in pediatric renal patients and
  • Registered Dietitian Kristen Sgambat, Ph.D., RD, and Dr. Moudgil are co-leading a breakout session on nutritional challenges and enteral supplementation in chronic kidney disease.

Another advantage to holding the meeting in the nation’s capital is its close proximity to government research and federal regulatory agencies, such as the Food and Drug Administration (FDA) and the National Institutes of Health (NIH). Speakers from both agencies will be present, talking about how the FDA approves medicines for pediatric patients and offering details about the NIH’s rare disease program.

Besides the abundance of more formal knowledge-sharing, Dr. Moudgil adds, there will be plenty of opportunities for attendees to network, making connections within and outside their own respective fields.

“This is a platform for making long-term professional relationships,” Dr. Moudgil says. “Even if you’re the sole clinician representing your specialty at your own institution, you’ll be able to connect with other specialists at institutions across the country. You’re not only acquiring new information, you’re acquiring a group of colleagues you can connect with this year and those professional relationships can extend far into the future.”

Randi Streisand

Randi Streisand, Ph.D., appointed Chief of Psychology and Behavioral Health at Children’s National Health System

Randi Streisand

Children’s National Health System announces that Randi Streisand, Ph.D., will become the chief of Psychology and Behavioral Health within the Center for Neuroscience and Behavioral Medicine. Dr. Streisand is a behavioral scientist, child health researcher and certified diabetes educator. She is a tenured professor of Psychology and Behavioral Health, and Pediatrics at The George Washington University School of Medicine and Health Sciences, and serves as the director of Psychology Research for Children’s National Health System.

“Dr. Streisand’s acceptance of this leadership position will play an integral role in our approach to improve research methods and providing comprehensive approaches to psychological treatments” says Roger J. Packer, M.D., senior vice president of the Center for Neuroscience and Behavioral Medicine.

As chief, Dr. Streisand will lead our team of nationally recognized educators, research leaders and specialists who are experts in the care of children and teens with emotional and behavioral disorders. She will also continue to lead an extensive research portfolio, focusing on parent-child adjustment to chronic disease, behavioral interventions to prevent and control disease and treatment complications and adherence to pediatric medical regimens.

Before joining the faculty at Children’s National in 2000, Dr. Streisand received her doctorate in clinical psychology from the University of Florida, completed her internship at Brown University and a fellowship at the Children’s Hospital of Philadelphia. She has written numerous publications in the areas of child health and serves on several grant review committees through Children’s National, NIH and the American Diabetes Association. At Children’s National, she is an active participant in the psychology training program, and mentors undergraduates, graduate students, interns, fellows and junior faculty members.

Maureen Monaghan

Using text messages and telemedicine to improve diabetes self-management

Maureen Monaghan

Maureen Monaghan, Ph.D., C.D.E., clinical psychologist and certified diabetes educator in the Childhood and Adolescent Diabetes Program at Children’s National Health System, awarded nearly $1.6 million grant from American Diabetes Association.

Adolescents and young adults ages 17-22 with Type 1 diabetes are at high risk for negative health outcomes. If fact, some studies show that less than 20 percent of patients in this population meet targets for glycemic control, and visits to the Emergency Department for acute complications like diabetic ketoacidosis peak around the same age.

The American Diabetes Association (ADA) awarded Maureen Monaghan, Ph.D., C.D.E., clinical psychologist and certified diabetes educator in the Childhood and Adolescent Diabetes Program at Children’s National Health System, nearly $1.6 million to evaluate an innovative behavioral intervention to improve patient-provider communication, teach and help patients maintain self-care and self-advocacy skills and ultimately prepare young adults for transition into adult diabetes care, limiting the negative adverse outcomes that are commonly seen in adulthood.

Dr. Monaghan is the first psychologist funded through the ADA’s Pathway to Stop Diabetes program, which awards six annual research grants designed to spur breakthroughs in fundamental diabetes science, technology, diabetes care and potential cures. Dr. Monaghan received the Accelerator Award, given to diabetes researchers early in their careers, which will assist her in leading a behavioral science project titled, “Improving Health Communication During the Transition from Pediatric to Adult Diabetes Care.”

“Behavior is such a key component in diabetes care, and it’s wonderful that the American Diabetes Association is invested in promoting healthy behaviors,” says Dr. Monaghan. “I’m excited to address psychosocial complications of diabetes and take a closer look at how supporting positive health behavior during adolescence and young adulthood can lead to a reduction in medical complications down the road.”

During the five year study, Dr. Monaghan will recruit patients ages 17-22 and follow their care at Children’s National through their first visit with an adult endocrinologist. Her team will assess participants’ ability to communicate with providers, including their willingness to disclose diabetes-related concerns, share potentially risky behaviors like drinking alcohol and take proactive steps to monitor and regularly review glucose data.

“The period of transition from pediatric to adult diabetes care represents a particularly risky time. Patients are going through major life changes, such as starting new jobs, attending college, moving out of their parents’ homes and ultimately managing care more independently,” says Dr. Monaghan. “Behavioral intervention can be effective at any age, but we are hopeful that we can substantially help youth during this time of transition when they are losing many of their safety nets.”

Study leaders will help participants download glucose device management tools onto their smartphones and explain how to upload information from patients’ diabetes devices into the system. Participants will then learn how to review the data and quickly spot issues for intervention or follow-up with their health care provider.

Patients also will participate in behavioral telemedicine visits from the convenience of their own homes, and receive text messages giving them reminders about self-care and educational information, such as “Going out with your friends tonight? Make sure you check your glucose level before you drive.”

At the study’s conclusion, Dr. Monaghan anticipates seeing improvements in psychosocial indicators, mood and transition readiness, as well as improved diabetes self-management and engagement in adult medicine.

Adolescent brain scan from obesity study

Imaging captures obesity’s impact on the adolescent brain

Adolescent brain scan from obesity study

For the first time, a team of researchers led by Chandan Vaidya, Ph.D., chair of the Department of Psychology at Georgetown University, has used functional magnetic resonance imaging (fMRI) to capture the brain function of a small population of adolescents with obesity, both before and after bariatric surgery.

Obesity affects the whole body, from more obvious physical impacts on bones and joints to more subtle, internal impacts on organs like the brain.

For the first time, a team of researchers has used functional magnetic resonance imaging (fMRI) to capture the brain function of a small population of adolescents with obesity, both before and after bariatric surgery. The goal is to better understand the neural changes that occur when an adolescent is obese, and determine the effectiveness of interventions, such as vertical sleeve gastrectomy, at improving brain function as weight is lost.

The study, published as the November Editors’ Choice in the journal Obesity, found that executive and reward-related brain functions of study participants with obesity improved following the surgical procedure and initial weight loss.

How bariatric surgery changes the teenage brain from Research Square on Vimeo.

“We’ve known for some time that severe obesity has negative consequences on some neurocognitive function areas for adults,” says Chandan Vaidya, Ph.D., chair of the Department of Psychology at Georgetown University and a senior author of the study. “But for the first time, we’ve captured fMRI evidence in young patients, and also shown that surgical intervention and the resulting weight loss can reverse some of those deficits.”

“For me, this early evidence makes a strong case that when kids are struggling with severe obesity, we need to consider surgical intervention as an option sooner in the process,” notes Evan Nadler, M.D., director of the Bariatric Surgery Program at Children’s National Health System, who also contributed to the study. “The question that remains is whether the neurocognitive function improves more if surgery, and thus weight loss, happens earlier – and is there a time factor that should help us determine when to perform a procedure that will maximize improvements?”

The preliminary study included 36 participants and was conducted using patients recruited from the Children’s National Bariatric Surgery program, one of the first children’s hospitals to achieve national accreditation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

“We asked these questions because we know that in the kids we see, their behavioral, brain, and physical health are all very closely related to one another and have an impact on each other,” adds Eleanor Mackey, Ph.D., study senior author and co-principal investigator on the National Institute of Diabetes and Digestive and Kidney Diseases grant that funded the project. “We expected that as physical health improves, we might see corresponding improvements in brain and behavior such as cognitive and school performance.”

The study also pointed out some technical and practical challenges to studying this particular young population. Anyone with a BMI greater than 50 was not able to fit within the MR bore used in the study, preventing fMRI participation by those patients.

“In addition to future studies with a larger sample size, we’d like to see if there are neuroimaging markers of plasticity differences in a population with BMI greater than 50,” says Dr. Vaidya. “Does the severity of the obesity change how quickly the brain can adapt following surgery and weight loss?”

The abstract was selected by the journal’s editors as one that provides insights into preventing and treating obesity. It was featured at the Obesity Journal Symposium during Obesity Week 2017 in Washington, D.C., as part of the Obesity Week recognition, and a digital video abstract was also released about the findings.

Transgender adolescents on the autism spectrum, and the first clinical guidelines for care

Evidence indicates a link between transgenderism and autism spectrum disorders (ASD). John Strang, Psy.D., a neuropsychologist in the Center for Autism Spectrum Disorders at Children’s National Health System, has dedicated his career to learning more about this co-occurrence and led a group of experts who recently released the first clinical guidelines for the care of transgender adolescents with ASD.

Through a comprehensive international search procedure, the research team, led by Dr. Strang, identified 22 experts in the care of transgender youth with autism. The expert group from around the world worked together for one year to create guidelines, putting processes in place to avoid interpersonal influence or bias.

The findings, published in the Journal of Clinical Child and Adolescent Psychology, outline the first initial clinical guidelines for treating transgender adolescents with ASD.

With overall 89.6 percent consensus achieved among the identified experts, key recommendations include the importance of assessing for ASD among transgender youth, and assessing for gender concerns among youth on the autism spectrum.

More study findings and recommendations

The study also indicates that gender-related medical treatments, including cross-sex hormone therapy, are appropriate for some youth with ASD, but emphasizes the importance of providing more extended time and supports in many cases to allow an adolescent with autism to explore a range of options regarding gender.

The guidelines emphasize that for many transgender youth with autism, parents must play a more active role. “Teens on the autism spectrum often struggle understanding how others perceive them,” Dr. Strang said. “Our study found that many transgender youth on the autism spectrum require specific coaching and supports in how to achieve their gender-related needs regarding gender presentation.”

Several risks for transgender adolescents with autism were emphasized in the study, including around physical safety and obtaining employment. “Trans youth are at increased risk for bullying, persecution, and violence in the community, and those on the autism spectrum are at even higher risk, as they often struggle to read social cues and recognize potentially dangerous social situations,” Dr. Strang said.

The importance of this study

The study group did not achieve consensus around specific guidelines for when an adolescent is appropriate for commencing medical gender treatments (e.g., cross-sex hormones). A majority (about 90 percent) of the expert participants elected to identify themselves as co-authors of the study, including many well-known clinicians across the United States as well as clinicians from The Netherlands.

“Until now, care for individuals with autism and gender concerns has been a matter of individual clinician judgment. This study has allowed for dialogue and discernment between the world’s experts in this field to establish the first recommendations for care,” Dr. Strang said.

Dr. Strang is currently working on a follow-up study to more directly capture the voices and experiences of youth with this co-occurrence, as key stakeholders and collaborators in the research.