Behavioral Health Archives

Group therapy approach improves OCD symptoms in youth

March 18, 2026

Pediatric patients showed reduced obsessive-compulsive disorder (OCD) symptom severity after an eight week cognitive group using cognitive behavioral therapy with exposure and response prevention (CBT/ERP), according to a study published in the International Journal of Cognitive Behavioral Therapy. Researchers also found high levels of satisfaction among both patients and caregivers.

“ERP supports youth in facing their OCD thoughts and associated distress without engaging in compulsions or rituals,” Lilia Mucka Andrew, PhD, psychologist at Children’s National Hospital and lead author of the study, said. “This is challenging at first, but over time repeated practice reduces distress and increases patient confidence in facing their OCD.”

The big picture

The study included 14 youths between the ages of 10 and 20 years old and their caregivers. Participants were organized into groups based on age and developmental level: pre-teen, teen and older teen. Led by PhD-level psychologists, each group met weekly for 60 minutes over the course of eight weeks using the format that best met individual needs – virtual, in person or a combination of both. Assessments were completed by youth and caregivers before the program, at the final session and at a follow-up approximately 10 weeks after completion.

The hold-up in the field

Although randomized controlled trials remain the gold standard for establishing efficacy, they require significant time and resources. At the same time, the need for accessible, evidence-based treatment for OCD remains urgent, as families continue to face barriers to care such as provider shortages, long waitlists, geographic limitations, transportation challenges and financial constraints.

“By integrating caregivers into treatment and collaboratively selecting the delivery format, we prioritize patient-centered care and reduce common access barriers that contribute to inconsistent attendance,” Dr. Andrew said. “Importantly, this study also helps address the well-documented research-to-practice gap in OCD treatment, as many families are unable to access CBT/ERP.”

Children’s National leads the way

With the increased transition to virtual care options following the pandemic, the researchers sought to explore how in-person versus virtual formats function for families both logistically and in terms of therapeutic impact. This work is unique in that it examines outcomes within the context of routine clinical care, which may increase access to services while also helping to clarify the complexity of patient- and family-centered needs.

“This model may serve as a great opportunity to provide evidence-based care to more families in our community and beyond,” Dr. Andrew said.

Read the full study, A pilot study of group Exposure Response Prevention for Pediatric Obsessive-Compulsive Disorder: In-Person and Virtual Delivery with Caregiver Involvement, in the International Journal of Cognitive Behavioral Therapy.

Additional authors from Children’s National include: Irene Zhang, PhD, Perrine Heymann, PhD, Tiffany Kichline, PhD, Mi-Young Ryee, PhD, Laura Willing, MD

Training model improves autism knowledge among early childhood educators

February 17, 2026

With 13 million children under age 5 attending an early childhood education program in the United States, early childhood education providers are well positioned to identify early developmental concerns such as autism.

A study published in the Journal of Research in Childhood Education showed that a novel autism training program among early education providers was feasible and well-received. The program, facilitated by specialists at Children’s National Hospital and community agencies, also successfully improved the providers’ knowledge of autism and how to navigate resources to support children with autism.

What it means

Specialists at Children’s National hypothesized that with appropriate training delivered by specialists, providers at community agencies could also train early childhood education care providers to recognize autism in young children and help families access resources to support them.

With 13 million children under age 5 attending an early childhood education program in the United States, early childhood education providers are well positioned to identify early developmental concerns such as autism and support access to early intervention services. Increased knowledge of autism and resource navigation can help ensure quick and equitable access to care.

What’s been the hold-up in the field?

Early childhood education providers themselves have identified several barriers to their support of children with an increased likelihood of autism. These include:

Limited knowledge about autism
Hesitancy among providers to discuss developmental concerns with families
Limitations in knowing how best to engage parents in the diagnostic referral process

Moving the field forward

The study findings demonstrate a successful model that depends on and expands community-based partnerships between hospital specialists and child-serving community agencies. The findings also demonstrate that the program’s train-the-trainer model provides a sustainable approach that increases autism knowledge and improves resource navigation.

While the training was well-received and succeeded in meeting study goals, participants noted that some barriers still exist, and a system for continued training would be needed to maintain the program’s efficacy.

What is exciting about this work?

“It was exciting to co-develop this research with our community partners, who helped ensure that the work is relevant and timely,” says study lead author Serene Habayeb, PhD, a psychologist at Children’s National. “It has been wonderful to see the work sustained by community partners.”

As just one example, DC Public School’s Early Stages evaluation center is now providing regular training workshops with the materials developed through the project.

Children’s National leads the way

This is just one example of the many impactful behavioral health initiatives led by Children’s National. Partnerships created as part of this training program effort were leveraged to expand the reach of other hospital initiatives that aim to increase access to autism-related knowledge. This includes the work of ECHO (Extension of Community Health Outcomes) Autism, a program at Children’s National hosted through the Center for Autism Spectrum (CASD). ECHO Autism at Children’s National offers an innovative tele-mentoring model that creates virtual learning communities between multidisciplinary autism specialists and community professionals, including early childhood education providers. The early childhood education-focused ECHO at Children’s National has been highly successful, as shown by high attendance at training sessions and participant-reported gains in autism-related knowledge. The program’s success reflects both the need and interest of community professionals to improve care for children with autism or related developmental needs.

As a result of the identification of ongoing challenges and needs, a city-wide collaborative, the DC Autism Collaborative (DC-AC), was formed in 2020. More than 90 members from more than 45 different organizations regularly participate in the DC-AC. These members continue working toward increasing early and equitable access to high-quality autism care for all children.

A number of hospital teams are represented in the DC-AC collaborative, including CASD, the Divisions of Psychology and Behavioral Health, Neurodevelopmental Pediatrics, Primary Care, as well as the Community Mental Health CORE (Collaboration, Outreach, Research and Equity). The Community Mental Health CORE leads infrastructure building activities, develops enabling services to connect families to high quality care and launches innovative models to deliver direct services, all anchored in the mission of promoting equal access to health care for all children and families in Washington, D.C.

Read the study, Expanding Autism Knowledge and Access in Early Childhood Education Community-Based Settings, in the Journal of Research in Childhood Education.

Additional authors from Children’s National include: Amanda Hastings, PsyD, Anne Inge, PhD, Olivia Soutullo, PhD, Renee Williams, CHES, MSHEP, Melissa Long, MD, Leandra Godoy, PhD

U.S. News & World Report voting

February 3, 2026

Children’s National is ranked one of the top 10 pediatric hospitals in the nation by U.S. News & World Report. Our faculty and staff are proud of the impact made on the lives of children and families in our community. Your participation in the U.S. News & World Report annual reputational survey validates the quality of care we provide and reflects the mutual respect and trust we share as healthcare professionals.

How to determine your voting eligibility

Voting for the U.S. News & World Report Best Children’s Hospitals rankings can be done only through Doximity.

To participate, physicians must:

Be board-certified and meet the eligibility criteria for the voting categories.
For child and adolescent psychologists, your account must be up to date with your specialty and subspecialty correctly marked.
Be a credential-verified member of Doximity (you must have an active and claimed Doximity profile).
Have all certifications and board documents currently up-to-date in your Doximity profile.

View the full eligibility criteria

How to claim your Doximity profile to vote

You have to claim your profile on Doximity.com to participate in the online survey. If you have not yet claimed your Doximity profile, go to Doximity.com, and click “Find My Profile.”
Once your profile has been claimed, you must confirm your email address and board certifications.
Verified Doximity members will receive an email inviting them to participate in the U.S. News survey.
For more information on how to claim your profile, visit Doximity.com

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Your Doximity profile must have up-to-date licenses, certifications and board documents.

Once you are logged in, your profile will automatically be in “Edit Mode.” You are able to add new items or edit existing information.
Update your Doximity profile and ensure your information is current.

Once registered, users wishing to participate in the online survey should:

Watch for an email from Doximity about the annual member survey.
Even if you don’t see the email, if you are a registered Doximity user, you can still vote by logging in to Doximity.com with your username and password during the voting period.
Once logged in, look for a U.S. News graphic or button on the homepage and click on it.
The survey asks users to name the hospitals that provide the best care in your respective specialty, without consideration to location or cost. Pediatric specialists will list 10 hospitals. The order in which you list the hospitals does not matter.

Please note: Children’s National Hospital is listed as “Children’s National Hospital Washington, DC” on the survey.

Visit Doximity’s FAQs if you have issues or questions about registration or claiming your profile.

How to cast your vote

In February 2026 when voting opens, all survey-eligible physicians will receive a notification on the Doximity app for Android or iOS. If you do not use the Doximity app, you will receive an email when voting opens.

Log in to your Doximity account at doximity.com or via the mobile app.
Click the Notifications icon or tap the “Submit your Nominations” button on the homepage. You can also search for “U.S. News Best Hospitals”
Select 10 hospitals in your respective specialty that you believe provide the best care in the United States.
Submit your vote

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Vote

The 2026 U.S. News & World Report Best Children’s Hospitals reputation voting will open in mid-February. Look for your Doximity notification to vote.

Cast your vote

Members of the Division of Neurology from Children’s National Hospital with fellow neurologists from Washington, D.C.

Shaping the future of epilepsy care: highlights from AES 2025

January 14, 2026

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In early December, several doctors, fellows and faculty from the division of Neurology at Children’s National Hospital attended the American Epilepsy Society (AES) Annual Meeting in Atlanta, Georgia.

This meeting unites a global community of child and pediatric neurologists, neurosurgeons, psychiatrists, neuropsychologists, psychologists, basic translational and clinical scientists, advanced practice providers, advocates and industry professionals to share scientific breakthroughs, foster collaboration and improve outcomes for people living with epilepsy.

Children’s National experts were featured throughout the program, presenting on a wide range of topics in pediatric epilepsy.

Sessions and Workshops

Chima Oluigbo, MD: Epilepsy Surgery Skills Workshop | Overcoming Complications in Epilepsy Surgery
Dana Harrar, MD, PhD: Resident EEG Course
Hua Xie, PhD: Neuroimaging platform | Thalamo-lesional Connectivity Profile Predicting Focal to Bilateral Tonic-Clonic Seizures in Focal Cortical Dysplasia-related Epilepsy
John Schreiber, MD: Investigators Workshop | Mortality in DEEs Across the Lifespan: Timing, Causes and Prevention
Leigh Sepeta, PhD: Investigators Workshop | Hippocampal Long Axis Differentiation in Memory and Seizure Networks
Sara Preisendanz, MS, RD, CSP, LD: Professional Development | Career Pathways: Interprofessional Panel
Syed Anwar, PhD, MS: Pediatric State of the Art Symposium | Pediatric Epilepsy Surgery: It’s Not Just About Resection

Poster Presentations

An Infantile Epileptic Spasms Syndrome Multidisciplinary Program: One Center’s Experience, Kathryn Havens, MS, PA-C, Sun-Young Ahn, MD, Kathleen Bender, BA, Carrin Brandt, LMFT, Hannah Grindling, MMSc, LCGC, Melissa Liggett, PhD, Archana Pasupuleti, MD, Monica Rush, BSN, RN, CPN, Anne Vasiliadis, MSN, CPNP-AC, Sanam Zarei, MD, William D. Gaillard, MD, Wei-Liang Chen, MD
Anxiety in a Multi-site Focal Epilepsy Pediatric Cohort: Predictive Factors and Risk, Hayley Loblein, PhD, Madison Berl, PhD, William D. Gaillard, MD, Chima Oluigbo, MD, Leigh Sepeta, PhD
Characteristics Affecting Decision to Not Offer Epilepsy Surgery Following Presurgical Evaluation Across US Pediatric Epilepsy Centers, Dewi Depositario-Cabacar, MD, Cemal Karakas, MD
Connectivity based Determination of Autism and Epilepsy Shared Neuroanatomical Substrates, Sienna Williams, BS, Samantha Werner, MA, Hua Xie, PhD, Priyanka Venkata Sita Illapani, MSc, Arini Bhargava, BS, Sonya Leikin, BS, Cemal Karakas, MD, Ana Moreno Chaza, BS, Amy Mistri, BS, Madison Berl, PhD
Effects of the Hippocampus, Neighborhood and Seizure lateralization on Memory in Children, Sonya Leikin, BS, Priyanka Venkata Sita Illapani, MSc, Samantha Werner, MA, Hua Xie, PhD, Chima Oluigbo, MD, Marcin Gierdalski, PhD, Hayley Loblein, PhD, Madison Berl, PhD, William D. Gaillard, MD, Leigh Sepeta, PhD
Evaluating dysfunction in glymphatic system in temporal lobe epilepsy with DTI-ALPS, Priyanka Venkata Sita Illapani, MSc, William D. Gaillard, MD, Madison Berl, PhD, Leigh Sepeta, PhD
Evaluating the Role of Functional Network Co-localization in Parent-Reported Depression and Anxiety in FCD-related Epilepsy, Xiaotong Li, BA, Priyanka Venkata Sita Illapani, MSc, Sonya Leikin, BS, Hua Xie, PhD, Chima Oluigbo, MD, Gilbert Vezina, MD, William D. Gaillard, MD, Hayley Loblein, PhD, Perrine Heymann, PhD, Leigh Sepeta, PhD, Madison Berl, PhD, Nathan Cohen, MD
Factors Associated with Invasive Extraoperative Electroencephalography Monitoring in Pediatric Drug-Resistant Epilepsy due to Focal Cortical Dysplasia, Cemal Karakas, MD, Dewi Depositario-Cabacar, MD, William D. Gaillard, MD, Chima Oluigbo, MD, Nathan Cohen, MD
Factors associated with rapid treatment for status epilepticus: Data from the Quality Improvement in Time to Treat Status Epilepticus (QuiTT-SE) baseline cohort, Dana Harrar, MD, PhD, William D. Gaillard, MD
Feasibility of implementation of an age-based guideline for PCPC scoring, Dana Harrar, MD, PhD
Gamma Synchrony Correlating with Less Autistic Severity in Epilepsy Patients: SEEG Evidence from Amygdala-Hippocampal Coherence, Leigh Sepeta, PhD, Samantha Werner, MA, Sienna Williams, BS, Priyanka Venkata Sita Illapani, MSc, Sonya Leikin, BS, Cemal Karakas, MD, Ana Moreno Chaza, BS, Madison Berl, PhD, Nathan Cohen, MD, William D. Gaillard, MD, Chima Oluigbo, MD, Hua Xie, PhD
Graph Learning to Predict Seizure Outcomes in Pediatrics using Thalamic sEEG, William D. Gaillard, MD, Chima Oluigbo, MD
International Consensus on the Evaluation and Management of Hypothalamic Hamartomas: Results from a Modified Delphi Survey, Nathan Cohen, MD, Xiaotong Li, BS, Madison Berl, PhD, Chima Oluigbo, MD, William D. Gaillard, MD
Language Mapping in Pediatric Epilepsy: Concordance of Lateralization Across Bilingual and Monolingual Patients, Ana Moreno Chaza, BS, Sonya Leikin, BS, Xiaotong Li, BS, Priyanka Venkata Sita Illapani, MSc, Hua Xie, PhD, William D. Gaillard, MD, Madison Berl, PhD, Leigh Sepeta, PhD
Outcomes of thalamic neuromodulation in pediatric drug-resistant epilepsy: A multicenter analysis from Pediatric Epilepsy Research Consortium (PERC) Surgery Database, Chima Oluigbo, MD
Prevalence of Comorbid Phenotypic Features in Genetic Epilepsies, Chloe Hooker, BS, Khloe Fleming, Rachel Weaver, MS, John Schreiber, MD
Quantifying Arterial Spin Labeling MRI in Pediatric Focal Cortical Dysplasia-Related Epilepsy, Hua Xie, PhD, Xiaotong Li, BS, Priyanka Venkata Sita Illapani, MSc, Gilbert Vezina, MD, Chima Oluigbo, MD, William D. Gaillard, MD, Nathan Cohen, MD
Thalamo-lesional Connectivity Profile Predicting Focal to Bilateral Tonic-Clonic Seizures in Focal Cortical Dysplasia-related Epilepsy, Hua Xie, PhD, Xiaotong Li, BS, Priyanka Venkata Sita Illapani, MSc, Leigh Sepeta, PhD, Madison Berl, PhD, William D. Gaillard, MD, Nathan Cohen, MD
Zorevunersen Demonstrates Disease-modifying Potential in Patients with Dravet Syndrome with Increases in Seizure-free Days, Improvements in Quality of Life, and Benefits in Overall Functioning, John Schreiber, MD

To learn more about the meeting, visit the AES website for additional information.

Integrating mental health into pediatric care

January 12, 2026

Explore how integrated pediatric mental health care is transforming neuro-oncology at Children’s national Hospital.

Honor bestowed on Leandra Godoy, PhD

January 12, 2026

Children’s National Hospital named Leandra Godoy, PhD, as the A. James & Alice B. Clark Distinguished Professor of Early Childhood Intervention and Advocacy.

Dr. Godoy is a clinical psychologist and the co-director of the Early Childhood Behavioral Health Program and the Community Mental Health Collaboration, Outreach, Research and Equity (CORE) team.

The big picture

Dr. Godoy joins a distinguished group of Children’s National physicians and scientists who hold an endowed chair. Children’s National is grateful to generous donors who have altogether funded 51 professorships.

Professorships support groundbreaking work on behalf of children and their families. They foster discoveries and innovations in pediatric medicine. These appointments carry prestige and honor that reflect the recipient’s achievements and the donor’s commitment to advancing and sustaining knowledge.

Why it matters

Dr. Godoy leads teams that care for young children from birth to age six. Innovation plays a key role in advancing care. Her research aims to improve access to optimal mental healthcare for children and families.

“Funding from this professorship will give my team the flexibility to respond to specific behavioral health needs,” Dr. Godoy says. “These resources will fuel strategic investments so we can help kids get the best start in life.”

Moving the field forward

The A. James & Alice B. Clark Foundation established this professorship as part of its historic investments in the Clark Parent & Child Network. Founded in 2020, the network aims to create the best possible health outcomes for parents, infants and young children.

“The Clark Foundation’s enduring vision and generosity will enable Dr. Godoy and future holders of this professorship to launch bold new initiatives that meet the health needs of young children in the Washington, D.C., region,” says Elizabeth Wells, MD, MHS, executive vice president, chief clinical officer and physician-in-chief.

Dr. Godoy’s work has fueled improvements in care, including reducing wait times for autism evaluations in primary care clinics. She also fosters online support groups for parents of children with behavioral health challenges and leads several citywide initiatives, such as the DC Autism Collaborative.

The best of 2025 from Innovation District

December 24, 2025

In 2025, Innovation District readers gravitated toward stories that explored how research and clinical innovation are reshaping pediatric care in real time. This year’s most popular articles highlighted advances in complex surgical care, evidence-based treatments for chronic and neuropsychiatric conditions and emerging technologies — from wearable data to artificial intelligence — that are changing how clinicians diagnose, treat and support children and families. Read on for our list of the most popular articles we published on Innovation District in 2025.

1. Life-changing care: How Children’s National tackles pediatric cervical spine injuries

The Cervical Spine program at Children’s National Hospital is responsible for treating a range of conditions, including trauma, congenital abnormalities and tumors. These conditions can lead to instability or misalignment of the cervical spine. “There are unique challenges in pediatric cases due to anatomical differences. The cervical spines of children are more at risk for injury because of their developmental stage and structural characteristics,” says Matthew Oetgen, MD, MBA, chief of Orthopaedic Surgery and Sports Medicine at Children’s National.
(2 min. read)

2. Pioneering evidence-based treatments for substance addictions

Increasing evidence-based treatment is a key component of the Addictions Program at Children’s National Hospital, created in 2022 and led by Sivabalaji Kaliamurthy, MD. “We really want to focus on intervening in an evidence-based manner in the primary care setting because that is where most of our patients are going to first access care outside of the emergency room,” explains Dr. Kaliamurthy.
(3 min. read)

3. Breaking barriers in growth disorder treatment for families

For many children with short stature and other rare genetic growth disorders, there have been no next steps after usual treatment options prove ineffective. Researchers at Children’s National Hospital are digging deeper to find the root genetic causes of short stature disorders and creating novel, nuanced treatment options that have the opportunity to change how the field approaches these cases.
(4 min. read)

4. The link between metabolic acidosis and cardiovascular disease in children with CKD

Denver D. Brown, MD, nephrologist at Children’s National, is looking at whether untreated metabolic acidosis could potentially contribute to cardiovascular outcomes in children with chronic kidney disease (CKD). Here, she explains her motivation, findings and future directions for this critical research.
(3 min. read)

5. Therapy approach shows promise for PANS/PANDAS

A multidisciplinary therapy model developed at Children’s National shows promise for children with PANS and PANDAS, significantly reducing symptoms through structured cognitive-behavioral therapy and family-centered care. The approach could offer a new standard for treating these rare, complex neuropsychiatric disorders.
(2 min. read)

6. Wearable tech data shows promise in ADHD detection

A study from Children’s National reveals that common wearable devices like Fitbits may hold the key to improving how we identify Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. By analyzing patterns in heart rate, activity levels and energy expenditure, researchers were able to predict ADHD diagnoses with striking accuracy, offering a glimpse into a future where objective, real-time data supports earlier and more personalized mental healthcare.
(2 min. read)

7. Novel pediatric pacemaker shows safety, effectiveness for fragile infants in multi-center study

A novel implantable pacemaker designed specifically for infants has demonstrated safety and effectiveness in stabilizing heart rhythms for at least two years. The multi-center study of 29 infants showed stable pacing, normal electrical parameters and expected battery life, offering a viable alternative to standard-size devices for the smallest children.
(2 min. read)

8. Socioeconomic disadvantage associated with higher long-term mortality for children after heart surgery

Children who had heart surgery and come from less advantaged neighborhoods in the Washington, D.C., region are much more likely to die in the long term than those from neighborhoods with more wealth and opportunity. The finding was part of a presentation titled, Socioeconomic Disadvantage Is Associated with Higher Long-Term Mortality After Cardiac Surgery, by Jennifer Klein, MD, MPH, cardiologist at Children’s National Hospital, during the Society of Thoracic Surgeons Annual Meeting in Los Angeles.
(2 min. read)

9. Children’s National brings AI into the RHD early diagnosis equation

Experts from Children’s National traveled to Uganda to continue work on a pilot program applying artificial intelligence (AI) to the diagnosis of rheumatic heart disease (RHD). The team created a tool that uses AI to predict RHD by identifying leaky heart valves on handheld ultrasound devices, then prompts a referral for a full echocardiogram.
(2 min. read)

10. Fighting food insecurity with fresh produce and education

Food insecurity is rising in Washington, D.C. and it’s hitting families with children the hardest. That’s why Children’s National Hospital created the Family Lifestyle Program (FLiP) – a multi-layered intervention, which offers Patient Navigation (FLiP-PN) and a Produce Prescription Intervention (FLiPRx). FLiP is a Food Is Medicine, clinical-community initiative that helps families get access to fresh food, build healthy habits and lower their risk of diet-related diseases like diabetes and obesity.
(3 min. read)

Children’s National in the News: 2025

December 23, 2025

In 2025, Children’s National Hospital was featured in major national news outlets for pioneering advances in pediatric care, groundbreaking clinical research and powerful human stories of healing and hope. From gene therapy for sickle cell disease and innovative pacemakers for newborns to breakthrough transplants, cancer trials and emerging mental health concerns like AI psychosis, these stories highlight the hospital’s leadership across the full spectrum of pediatric medicine. The following ten highlights showcase the patients, families and experts behind this impact, as reported by outlets including NBC News, The Washington Post, Good Morning America, USA Today, Healio, ABC News and ESPN.

1. Gene therapy treatment gives new hope to sickle cell patients

Children’s National patient Wedam, 19, begins the first steps for intensive gene therapy for sickle cell disease, discussing his skepticism while his mother expresses her joy and gratitude for the treatment. (NBC News)

2. Little pacemakers ‘reliable’ in stabilizing newborns needing pacing

Charles Berul, MD, pediatric electrophysiologist and emeritus chief of Cardiology, discusses his study highlighting the safety and efficacy of an innovative smaller pacemaker designed for newborns with critical congenital heart disease. (Healio)

3. Why this clinical trial is offering some young cancer patients hope

Catherine Bollard, MBChB, MD, senior vice president and chief research officer, and the NexTGen team are poised to recruit patients for a new clinical trial that will take on an old, implacable foe: children’s solid tumors. (The Washington Post)

4. 11-year-old receives living donor heart valve to replace artificial one in breakthrough surgery

Yves d’Udekem, MD, PhD, chief of Cardiac Surgery, talked to Good Morning America about how an 11-year-old’s groundbreaking partial heart transplant will change his life and the lives of other children in need of valve replacements. (Good Morning America)

5. 9-year-old fights brain cancer with magic in her heart

The Lilabean Foundation along with Brian Rood, MD, medical director of the Brain Tumor Institute, talked about how patients like Kasey Zachman are the motivation behind finding a cure for brain cancer. (ABC News)

6. How Little League helps father-son duo recover from kidney transplant

USA Today Sports spoke with Gavin Brown and his parents, as well as Yi Shi, MD, a pediatric nephrologist at Children’s National Hospital, about their kidney transplant journey. (USA Today)

7. Jayden Daniels surprises Children’s National patient

After Jayden Daniels visited Commanders fan Sarah Addison at Children’s National Hospital while she was being treated for myeloid leukemia, they quickly became friends. (ESPN)

8. At D.C. children’s hospital, opera singers offer light, hope and healing

International opera stars performed for children, their families and employees at Children’s National Hospital. (The Washington Post)

9. ‘Gift of life:’ Tiny heart transplant saves life of Maryland baby

A baby boy in Maryland is back home after being given a second chance at life, just before his first birthday. The boy’s mother and his surgeon, Manan Desai, MD, share the remarkable story of a moment that changed all of their lives. (NBC4)

10. AI psychosis: Kids left delusional and paranoid over conversations with chatbots

Ashley Maxie-Moreman, PhD, clinical psychologist, spoke to ABC7 about what AI psychosis is and what parents need to know. (ABC7)

Podcast: Whole Picture: Integrating Mental Health into Pediatric Care

December 10, 2025

Strengthening advocacy in child and adolescent psychiatry

December 5, 2025

A psychiatrist watches as a child does play therapy

A study found the majority of child and adolescent psychiatry fellowship programs surveyed offer an advocacy experience or curricula, despite it not being a requirement in psychiatry graduate medical education.

A recent study published in Academic Psychiatry found the majority of child and adolescent psychiatry fellowship programs surveyed offer an advocacy experience or curricula, despite it not being a requirement in psychiatry graduate medical education. Through the survey, the authors identified several ways to incorporate advocacy education in child and adolescent psychiatry fellowship programs.

What it means

The study used a web-based survey with multiple-choice questions to assess advocacy education practices in child and adolescent psychiatry fellowship programs during the 2024–25 academic year. Of the 33 program directors who responded, 82% reported offering an advocacy educational experience, which included one or more of the following components:

Advocacy didactics
Grand rounds
State legislative participation
Protected time to attend a legislative conference
An advocacy elective experience
A longitudinal curriculum
An advocacy rotation

Why it matters

The authors state that “because pediatric mental healthcare and the healthcare system at large are directly impacted by policies, regulations and legislation, it is vital that child psychiatrists advocate for their patients, communities and the healthcare system at large.”

“These results highlight why advocacy training should be a standard part of every program’s curriculum,” said Laura Willing, MD, lead author and medical director for Mental Health Policy and Advocacy, Community Mental Health CORE at Children’s National Hospital. “Ensuring access to pediatric mental health care is critical because every young person should receive quality care when they need it.”

What’s next

The authors recommend making advocacy education a required experience for fellows in the field. With the right resources and funding, the survey identified several ways to support training programs:

Establish designated facilitators
Encourage professional organizations to provide training
Publish model experiences or curricula
Conduct research to identify the relative effectiveness of various teaching strategies

The child and adolescent psychiatry fellowship program at Children’s National includes a two-year, longitudinal advocacy curriculum.

Read the full study, Advocacy Education in Child and Adolescent Psychiatry: Results of a National Survey of Child and Adolescent Psychiatry Fellowship Programs, in Academic Psychiatry.

DBT caregiver groups during inpatient stays benefit youth and families

December 1, 2025

Children’s National has adopted a DBT-informed model across its child and adolescent inpatient psychiatry units, ensuring that youth receive consistent exposure to evidence-based skills during their stay.

Families of children and adolescents admitted to inpatient psychiatric units often face significant emotional strain while navigating complex mental health needs. While Dialectical Behavior Therapy (DBT) is a well-established evidence-based treatment for adolescents experiencing suicidality and emotion dysregulation, there has been limited research on how best to involve caregivers in DBT during an inpatient stay. A new study led by psychologist Deborah M. Zlotnik, PhD, from Children’s National Hospital’s Division of Psychology and Behavioral Health, helps fill that gap by evaluating the feasibility and acceptability of a structured DBT skills group designed specifically for caregivers.

The study assessed the implementation of a weekly four-part virtual DBT skills series for caregivers. Using the Quality Improvement Framework, the team reviewed participation patterns, satisfaction levels and qualitative feedback across multiple phases of recruitment and delivery.

Why it matters

Caregivers play a critical role in supporting children and adolescents after discharge, yet barriers such as scheduling, limited space and inconsistent engagement often prevent families from accessing evidence-based resources during hospitalization. Dr. Zlotnik’s study found that caregivers who attended the DBT skills group reported high satisfaction, strong perceived benefit and increased confidence in supporting their child. Participants noted that learning the same skills their child was practicing during their inpatient stay improved communication, allowed them to coach effectively at home and helped create a more validating environment.

One caregiver summarized the impact: “This was very helpful in giving concrete things that we can implement to support our daughter when she comes home to ensure that we are all a part of the treatment team.”

The study also revealed practical insights into feasibility. After incorporating caregiver feedback about timing and accessibility, average attendance increased from 1.83 and 2.84 participants per group in earlier phases to 4.65 participants in the final phase, demonstrating a sustainable path to improving engagement.

Children’s National leads the way

Children’s National has adopted a DBT-informed model across its child and adolescent inpatient psychiatry units, ensuring that youth receive consistent exposure to evidence-based skills during their stay. Dr. Zlotnik’s research builds on these efforts by exploring how to more effectively integrate families into the treatment process, an area that remains underexplored.

By offering a structured, accessible DBT skills group for caregivers, the team identified a promising strategy to strengthen family involvement, enhance continuity of care post-discharge and reduce the emotional burden many families experience during their child’s hospitalization. The findings highlight an opportunity for inpatient units nationwide to more intentionally support caregivers using evidence-based approaches.

Read the study, Implementation of a Dialectical Behavior Therapy Caregiver Skills Group on an Acute Inpatient Unit for Youth, in the journal Evidence-Based Practice in Child and Adolescent Mental Health.

Improving research design in pediatric psychology

October 31, 2025

The authors use examples from their own trials in pediatric Type 1 and Type 2 diabetes and provide guidance on how to align study design with the research question and hypothesis, consider the stage of the research and field, and consider the importance of ensuring that the treatments developed serve all children.

A new study published in the Journal of Pediatric Psychology offers updated guidance to help pediatric psychology researchers design stronger and more equitable intervention studies, focusing on how to choose the right comparator conditions in clinical trials.

Why it matters

When behavioral researchers want to test a developed intervention, they often conduct a randomized controlled trial. In these studies, the new intervention is compared to something else — a comparator or control condition — with participants randomized to receive one of the two options. This approach helps determine if the intervention being tested helps or makes a difference in what was intended.

Comparator conditions can be designed in many different ways. Researchers aim to balance creating a strong study design — so they can be confident in their findings — with ensuring that treatments are developed and tested in ways that are appropriate and helpful for all children, especially those most affected by a particular illness. Choosing the right comparator is critical for conducting good science and developing effective interventions.

“We are hopeful that our paper will help researchers consider how to design studies to be both rigorous and equitable so that we design and use treatments that are well thought out, well tested and make a difference to the children and families we treat,” said Eleanor Mackey, PhD, psychologist at Children’s National Hospital and senior author of the study.

What’s unique

“We wanted to highlight not just how to choose a comparator condition, but why that choice matters in behavioral research,” said Dr. Mackey.

The authors use examples from their own trials in pediatric Type 1 and Type 2 diabetes and provide guidance on how to align study design with the research question and hypothesis, consider the stage of the research and field, and consider the importance of ensuring that the treatments developed serve all children. They also encourage researchers to seek input from patients, families and other stakeholders early in the design process to ensure studies are both scientifically sound and equitable.

Moving the field forward

“The families we serve have to be able to trust the research we conduct and know that we are providing the best possible options for care,” added Dr. Mackey. “Taking the time to consider how these studies are conducted is an important step in that effort.”

Additional Children’s National author – Randi Streisand, PhD, CDCES.

Read the full study, Rigor and equity in intervention study design in pediatric psychology: a focus on comparator conditions from diabetes research, in the Journal of Pediatric Psychology.

Children’s National psychiatry experts to present at 2025 AACAP Annual Meeting

October 17, 2025

Several experts from the Division of Psychiatry and Behavioral Sciences at Children’s National Hospital will showcase their expertise at this year’s American Academy of Child and Adolescent Psychiatry (AACAP) Annual Meeting, taking place October 20–25 in Chicago, Illinois. As the world’s largest gathering of child and adolescent psychiatrists, AACAP provides a forum for sharing research, exchanging knowledge and advancing care for patients worldwide.

Children’s National experts will be featured throughout the program, presenting on a wide range of topics in adolescent psychiatry.

Presentations and sessions

Date	Time (CST)	Presenter(s)	Title
10/20/25	3–5 PM	Justine Larson, MD	Institute 1: Reclaiming Hope: Strengthening Families Through Systems-of-Care Approaches
10/20/25	3:30–5:30 PM	Jennifer Dorr, DO, MPH, Laura M. Willing, MD	Clinical Case Conference 3: How Advocacy Work IS Clinical Work: A Clinical Presentation
10/21/25	8:30–11 AM	Colby Tyson, MD	Member Services Forum 2: The Child and Adolescent Psychiatrist Parent: Navigating Family Planning, Parental Leave, and Early Parenthood
10/21/25	1–3 PM	Justine Larson, MD	Clinical Case Conference 6: Navigating the Storm: A Multidisciplinary Approach to Mood and Behavior Dysregulation in Adolescents
10/22/25	12–2 PM	Adelaide S. Robb, MD	Institute 4.6: Grading the Evidence – Bipolar Disorder and Schizophrenia
10/23/25	7–8:30 AM	Justine Larson, MD	Clinical Consultation Breakfast 4: Anxiety in Adolescents With ASD
10/23/25	7–8:30 AM	Sivabalaji Kaliamurthy, MD	Clinical Consultation Breakfast 8: Engaging Adolescents With Co-Occurring Substance Use and Psychiatric Disorders
10/23/25	9 AM–12 PM	Adelaide S. Robb, MD	Workshop 21: Understanding Video Games: A Child Psychiatrist’s Call of Duty
10/23/25	10 AM–12 PM	Sivabalaji Kaliamurthy, MD	Clinical Case Conference 9: Synthetic vs Nonsynthetic Cannabinoid-Induced Psychosis in Adolescents
10/23/25	12–2 PM	Adelaide S. Robb, MD	Clinical Perspectives 57: Mastering Psychotropic Medication Management in Youth
10/23/25	1:30–4:30 PM	Sivabalaji Kaliamurthy, MD	Workshop 24: Buprenorphine 2.0
10/23/25	7–10 PM	Priya M. Punnoose, MD	Media Theatre 11: Faith, Family, and Teen Religious Identity: Are You There God? It’s Me, Margaret
10/24/25	9–11 AM	Sivabalaji Kaliamurthy, MD	Clinical Perspectives 72.4: Hallucinogen Use Disorder in Adolescents and Transitional-Age Youth
10/24/25	9 AM–12 PM	Jennifer Dorr, DO, MPH	Hot Air, Hot Water, Hot Topics: Child and Adolescent Psychiatrists Leading the Way Through Chaos
10/24/25	12–2 PM	Adelaide S. Robb, MD	Debate: Should High Schools Ban Smartphones?
10/24/25	2–4 PM	Mahdieh Bodaghi, MD	Clinical Case Conference 14: Untangling Disorders of Gut–Brain Interaction With Psychiatric Comorbidities
10/24/25	3–5 PM	Justine Larson, MD	Institute 8.6: Creating Trauma-Informed Systems of Care
10/25/25	11 AM–12:30 PM	Hanife Nur Akal, MD	Special Interest Study Group 10: “Healing After Disaster”: Trauma-Informed, Community-Based Interventions

Abstracts

New Research Poster 5.19: Pilot Study of an Integrated Psychiatry Clinic Within a Pediatric Practice
Melissa Kelley, MD
Friday, October 24 – 10:30 AM-12:30 PM

New Research Poster 6.6: Improving Pediatric Trainees’ Management of Common Pediatric Mental and Behavioral Conditions
Geoffrey Broadbent, MD, Katelyn Gerth, MD, Jeannie Chang Pitter, MD
Saturday, October 25 – 10 AM-12 PM

For more information and to view the full schedule, please visit the AACAP conference website.

Exploring how maternal depression shapes pediatric asthma care

October 16, 2025

A new Children’s National study shows that maternal depression can make managing childhood asthma more difficult.

Asthma affects more than 4 million children in the United States and remains the most common chronic childhood condition. A new study from Children’s National Hospital highlights an overlooked factor in childhood asthma care: a mother’s mental health. Researchers in the Center for Health Outcomes Research & Delivery Science found that maternal depression can make daily asthma management – like tracking medications or spotting flare-ups – more difficult. Through interviews with 12 mothers whose children receive care at IMPACT DC, Children’s National’s community-based asthma program, the study captures how depression shapes caregiving in their own words.

Why it matters

Asthma management depends on consistent, attentive care. When depression drains a caregiver’s energy or focus, even small lapses can lead to more emergency visits, missed school days and worse health outcomes. In this study, mothers also noticed how their mood affected their children emotionally. When a mother was stressed or withdrawn, her child often felt anxious, sometimes enough to trigger an asthma attack. The connection between mental health and asthma was clear on both sides.

More than half of the mothers had clinically significant depressive symptoms and nearly all had experienced those symptoms for over a year. Four mothers also had asthma themselves and almost every child in the study had uncontrolled asthma, underscoring the complexity of care in these families. Together, these numbers paint a picture of how common and intertwined maternal and child health challenges can be.

The big picture

Many mothers described slipping into what they called “super mom mode”, pushing through depression to care for their kids while ignoring their own needs. Several mothers said the pressure to “stay strong” left them feeling guilty or ashamed when they could not do everything perfectly. Even when mothers received treatment, most found it inconsistent or incomplete. Some were taking antidepressant medication, others attended therapy but many still had moderate or severe symptoms. Limited access, long waits and therapist turnover were common barriers.

Children’s National researchers say these findings reinforce that pediatric health cannot be separated from caregiver wellbeing. Integrating behavioral health into pediatric asthma care could change that. Social workers and behavioral health specialists can help mothers manage depressive symptoms, strengthen coping skills and connect to resources, all within the same clinic visit that treats the child’s asthma.

What’s next

Building on this study, Children’s National is testing a brief, evidence-based depression treatment delivered in the IMPACT DC Asthma Clinic. The new clinical trial uses implementation science to determine how integrated care can improve outcomes for both mothers and children.

“By treating maternal depression alongside asthma, we can address the whole family’s needs,” said Rachel Margolis, PhD, LCSW, social work researcher at Children’s National and senior author of the study. “When mothers receive mental health support, children breathe easier. Integrating behavioral health into community-based asthma programs offers a path toward better control, fewer emergencies and greater equity in care.”

Read the full study, “Exploring Black Mothers’ Lived Experiences of Depression and the Relationship to Their Child’s Asthma: A Qualitative Study” in the Journal of Evidence-Based Social Work.

Global study identifies mental health gaps for food allergy patients and caregivers

October 7, 2025

Despite food allergies affecting millions globally, the mental health toll this population faces is still widely underrecognized.

While many patients and caregivers managing food allergies report psychological distress and the need for expert support, access to mental health professionals who also have food allergy (FA) expertise can be challenging.

A study conducted by researchers and clinicians around the world, including Linda Herbert, Ph.D., director of Psychology Research and Clinical Services for the Division of Allergy and Immunology at Children’s National Hospital, gives insights into the experience of FA patients and caregivers and the barriers they face.

The results of the study are guiding food allergy professionals in the development of accessible resources for this specialized patient group.

The big picture

Research into the psychosocial needs of patients with food allergy is still fairly new, but Children’s National has been a leader, with its Division of Allergy and Immunology among the first in the United States to establish a fully integrated psychology clinical and research program.

This study builds on that leadership by uniting experts worldwide to assess patient needs.

“This is the first time that researchers and clinicians in food allergy have come together to assess these needs on a global scale,” Dr. Herbert said.

In the final sample of 1,907 caregivers and 1,329 adults with food allergy from 10 different countries, reports showed that 21.6% of caregivers and 22.8% of adults had received mental health treatment related to FA, with the most common being cognitive-behavioral therapy.

Among the relatively small group who had received treatment, most said they were satisfied with the support they received, though fewer felt their providers had strong knowledge about food allergy:

9% of caregivers and 72.4% of adults were at least somewhat satisfied with their treatment experience.
1% of caregivers and 75.0% of adults found that mental health providers were at least somewhat helpful at addressing FA concerns.
5% of caregivers and 60.06% of adults felt their provider was at least somewhat knowledgeable about food allergy.

Satisfaction also varied from country to country, with caregivers in Portugal and the United Kingdom and adults in Spain, Italy and the United States reporting the highest satisfaction, while caregivers in Brazil and adults in Germany reported the lowest.

What’s next

The characterization of food allergy patients and their mental health treatment needs found through this study have allowed researchers and clinicians in the field to act with the necessary baseline knowledge and evidence.

Now, Food Allergy Coping, Empowerment, Tools & Support (FACETS), a first-of-its-kind free online mental health treatment program is actively being developed and will be tested over the next six months with a small number of participants.

“We’ve been wanting to offer a mental health treatment program for food allergy patients for a long time, and we are excited that we now understand the needs of food allergy patients and caregivers across the world,” Dr. Herbert said.

Read the full findings of the study, A Global Survey of Mental Health Treatment Experiences Among Food Allergy Patients and Caregivers, in JACI: In Practice.

To learn more about the project as a whole, visit the Global Access to Psychological Support (GAPS) for Food Allergy website.

Children’s National Hospital once again ranked among the nation’s best by U.S. News & World Report

October 7, 2025

Children’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2025-26 Best Children’s Hospitals annual rankings. This marks the ninth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

For the fifteenth straight year, Children’s National ranked in 10 specialty services and is the highest U.S. News ranked children’s hospital in Washington, D.C., Maryland and Virginia. Last year, U.S. News introduced pediatric & adolescent behavioral health as a service line in its rankings. While there are no ordinal rankings for behavioral health, the Children’s National program was named one of the top 50 programs in the country for the second year in a row.

“To be named among the nation’s top children’s hospitals for nine years in a row is a reflection of the extraordinary expertise, innovation and heart that our teams bring to every child and family we serve,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “Our leadership in specialties like neurology, cancer, and diabetes and endocrinology underscores the national impact of our work, and we remain focused on setting new standards in pediatric care.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“Being a top-ranked pediatric hospital means more than just excelling in a single specialty — it means being a pillar of outstanding care for your entire region,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Our rankings acknowledge these hospitals for their comprehensive excellence, helping families find the very best care conveniently located within their state and community.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

Neurology and Neurosurgery (No. 4), led by Division Chiefs William D. Gaillard, MD, and Robert F. Keating, MD
Diabetes and Endocrinology (No. 6), led by Division Chief Andrew Dauber, MD, MMSc
Cancer (No. 8), led by Division Chief Eugene Hwang, MD
Nephrology (No. 10), led by Division Chief Marva Moxey-Mims, MD
Orthopedics (No. 10), led by Division Chief Matthew Oetgen, MD, MBA

The other six specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Gastroenterology and GI Surgery, Neonatology, Pulmonology and Lung Surgery, and Urology.

Results from first-of-its-kind mental health intervention for adults with CHD

August 26, 2025

Mindfulness-based interventions have been widely recognized for their effectiveness in managing stress, anxiety and depression, so the team set out to specifically design the virtual EMBRACE program for adults with CHD. It’s the first of its kind for this population.

A first-of-its-kind virtual, real-time group psychosocial intervention successfully demonstrated the promise of mindfulness interventions to address mental health challenges in adults with congenital heart disease (CHD).

The findings from a small pilot study of the Exploring Mind-Body Resilience and Coping/Cognitive Exercises (EMBRACE) program were published in the journal Pediatric Cardiology.

What this means

The study included 31 participants ranging in age from 22 to 74 years old. Collectively the group had a variety of heart conditions involving 47 heart surgeries, seven pacemakers and one implantable cardioverter defibrillator.

Participants showed meaningful improvements after the EMBRACE intervention in anxiety, depression, resilience and mindfulness scores. Also, satisfaction surveys showed that 97% found the program effective. These improvements lasted through a three-month follow-up period.

“What I gained the most from this study was learning that my emotions/feelings did not have to control my life,” says study participant Tabatha Doherty. “The program taught techniques that focused on keeping your mind in the present and not getting caught up in those feelings.”

Additionally, people who participated reported several positive qualitative outcomes, including better community connections and improved focus on self-care and self-management.

“It was impactful to be in a cohort with other patients where we could talk, share stories, offer support, and work towards a common, yet individual, goal of being able to manage daily and CHD-related stressors,” Doherty continued. “It is very rare that CHD patients have the opportunity to interact with each other, but even more rare to have an opportunity to cooperate towards a common goal.”

Why it matters

The authors write that the lifetime prevalence of anxiety and depression in adults with congenital heart disease are significantly higher than the general population – occurring in up to 30 to 50% of adults with CHD versus only 7 to 10% in the general population.

Mindfulness-based interventions have been widely recognized for their effectiveness in managing stress, anxiety and depression, so the team set out to specifically design the virtual EMBRACE program for adults with CHD. It’s the first of its kind for this population.

The study sought to improve mental health, resilience and coping skills for people with CHD while demonstrating feasibility for a large number of people.

“The most comforting aspect was the acknowledgement and validation of the mental health struggles I’ve had my entire life,” Doherty says. “The statistics they shared were not surprising, but more proof/recognition of the CHD patient’s silent struggles.”

What’s next

The program will be adjusted based on feedback from the pilot cohort and further studies will be undertaken to gauge sustainability and long-term benefits.

The work was made possible through a grant from the Adult Congenital Heart Association (ACHA) with generous support from the Meil Family Foundation.

“ACHA is proud to support groundbreaking research initiatives though our Research Program that began in 2019,” says Mark Roeder, president and CEO of ACHA. “Vicki Freedenberg, PhD, RN was awarded the Meil Family Foundation Research Award for Neurocognitive Studies in 2022. This first-of-its-kind mindfulness-based program for adults with CHD demonstrated meaningful improvements in anxiety, depression, resilience, and self-care – highlighting the critical role of mental health interventions in the CHD population.”

Roeder continued, “The EMBRACE study not only addresses the physical realities of living with CHD but also elevates the importance of mental and emotional well-being, something that ACHA will also continue to promote through our educational programming.”

Before publication in Pediatric Cardiology, the data from EMBRACE was presented as a poster at the American College of Cardiology ACC.24 meeting. Additionally, program and study co-author Rachel Steury, NP, was awarded Best Allied Health Research for this work at the International Society of ACHD in June 2024.

Read EMBRACE Study: Outcomes of a Randomized, Mindfulness-Based Intervention for Adults with Congenital Heart Disease in Pediatric Cardiology.

Therapy approach shows promise for PANS/PANDAS

July 11, 2025

PANS and PANDAS are disorders characterized by an abrupt onset of neuropsychiatric symptoms in children that can be challenging to diagnose and treat.

Children diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) experienced substantial symptom reduction following a cognitive-behavioral approach integrating the family system with the support of a multidisciplinary care team, according to a recent case study published in Clinical Case Studies.

The hold up in the field

PANS and PANDAS are disorders characterized by an abrupt onset of neuropsychiatric symptoms in children that can be challenging to diagnose and treat.

“More research is needed to explore PANS/PANDAS as many studies have included small samples or lacked a randomized controlled design,” says Lilia Mucka Andrew, PhD, clinical director, Psychology and Behavioral Health at Children’s National Hospital and corresponding author of the study. “Though therapeutic interventions like cognitive behavioral therapy with exposure response prevention (CBT/ERP) have good evidence for pediatric patients with obsessive-compulsive disorder (OCD), evidence is mixed on effectiveness in PANS/PANDAS patients.”

Moving the field forward

The researchers highlighted specific intervention techniques that worked well to improve behaviors and factors that warrant further exploration. This includes the benefit of early multidisciplinary evaluation for diagnosis and treatment of PANS/PANDAS and the integration of booster sessions to allow for ongoing maintenance and relapse prevention while providing openings for additional patients to be seen. This is critical given the shortage of evidence based behavioral health providers for youth.

The patient benefit

This study highlights effective strategies that support both patients and their families, offering a potential model of care to reduce suffering and improve long-term quality of life.

“We were excited to see that the application of key evidence-based therapy techniques including CBT/ERP and behavioral parent training (BPT) resulted in positive outcomes for patients and that the opportunity to transition to booster sessions was well received,” says Dr. Andrew.

Additional authors from Children’s National include: Julia Dorfman, MD, PhD, psychiatrist, and Elizabeth Wells, MD, senior vice president, Neuroscience and Behavioral Medicine Center.

You can read the full study, Assessment and Treatment of PANS/PANDAS: A Multidisciplinary Approach and Therapeutic Considerations, in Clinical Case Studies.

Mental health care gaps in pediatric emergency rooms

July 9, 2025

Over the past 20 years and beyond, evidence shows inequities in pediatric mental health care in emergency departments.

Mental health disorders affect nearly 20% of adolescents across the United States. There has been accumulating research over the past 20 years and beyond which has documented inequities in pediatric mental health care in emergency departments (EDs). In a recent study published in Pediatrics, researchers at Children’s National Hospital summarized the full breadth of this research to understand the extent of inequities and facilitate further work that addresses these differences in mental health care.

The big picture

Eden Efrem, clinical research coordinator at Center for Translational Research, Monika Goyal, MD, MSCE, pediatric emergency medicine specialist and co-director of the Center for Translational Research, and other researchers examined and summarized research published from 2002 to 2024 to better understand inequities in pediatric mental health care provided in the ED. The team reviewed over 2,100 articles and of those, 50 articles met inclusion criteria for this review.

“Mental health care gaps were reported in ED mental health-related visits, ED disposition – including admission, discharge, transfer, and readmission – outpatient and follow-up care, diagnosis of mental health conditions, ED referral and pre-hospitalization, length of stay and boarding, anxiety care, suicidal ideation/self-harm care and restraint use in EDs,” Efrem said.

Why this matters

These findings aim to guide future research, development and implementation of evidence-based interventions and policies that address the underlying contributing mechanisms of these inequities. This includes looking at clinician implicit bias and barriers to mental health care access.

“By identifying gaps in mental health care access, treatment and outcomes, these findings can guide the development of interventions and policies aimed at reducing these,” Goyal added. “These improvements can help improve the provision of fair mental health care thereby enhancing patient trust, improving communication and ensuring access to quality mental health care. Ultimately, this can lead to improved mental health outcomes for children and youth.”

Moving the field forward

The researchers found that differences exist in many facets of mental health care, from ED utilization to mental health care provision, such as physical restraint use.

“Addressing gaps in care is important because every individual deserves equal access to high-quality, evidence-based healthcare,” Efrem said. “Addressing these can not only enhance patients’ mental health outcomes, but also positively impact other areas of their lives, such as educational performance, social well-being and overall quality of life.

The ADAPT Lab, led by Dr. Goyal at Children’s National, is at the forefront of identifying and addressing gaps in pediatric health care, specifically in EDs. The lab is working to improve quality of health care provision and outcomes in mental health care, asthma care, sexual health and pain management by developing and implementing evidence-based interventions in the ED.

The study was funded by the Jesse Ball DuPont Fund.

Wearable tech data shows promise in ADHD detection

June 5, 2025

Using Fitbit data from the the largest long-term study of brain development and child health in the United States, researchers employed machine learning to test whether physiological markers could accurately predict ADHD diagnoses.

A new study published in Frontiers in Child and Adolescent Psychiatry reveals that common wearable devices like Fitbits may hold the key to improving how we identify Attention-Deficit/Hyperactivity Disorder (ADHD) in adolescents. By analyzing patterns in heart rate, activity levels and energy expenditure, researchers were able to predict ADHD diagnoses with striking accuracy, offering a glimpse into a future where objective, real-time data supports earlier and more personalized mental healthcare.

A fresh approach to a common challenge

ADHD affects approximately 1 in 10 children and adolescents in the United States. It is typically diagnosed based on parent and teacher reports, clinical interviews and behavioral observations. While effective, these methods rely heavily on subjective interpretation and can sometimes miss important nuances in how symptoms appear over time. This study, led by Muhammad Mahbubur Rahman, PhD, and colleagues at Children’s National, sought to determine whether wearable health data could help fill that gap.

Turning Fitbit metrics into meaningful insights

The study used data from 450 adolescents who were part of the larger Adolescent Brain Cognitive Development (ABCD) study, the largest long-term study of brain development and child health in the United States. Each participant wore a Fitbit, which captured three key activity and physiological measures:

Resting Heart Rate (RHR) – the number of heart beats per minute while the body is at rest
Sedentary Time – time spent with little or no physical activity
Energy Expenditure – estimated calories burned through physical activity

When the researchers compared these measures between teens with and without ADHD, they found statistically significant differences. Teens with ADHD had consistently higher resting heart rates and showed distinctive patterns in both their movement and stillness.

To go further, the team applied a machine learning model to test whether these physiological markers could accurately predict ADHD diagnoses. The model performed extremely well with 89% accuracy, 88% precision, 90% recall and a 0.95 area under the curve (AUC). These results suggest that the combination of passive, continuous data and predictive modeling could serve as a valuable screening tool, particularly in settings where full clinical evaluations are difficult to access.

A path toward more accessible mental healthcare

The implications are big. If validated in larger and more diverse populations, wearable-derived data could offer a low-cost, low-burden way to flag teens who might benefit from further ADHD evaluation. This could lead to earlier support, fewer misdiagnoses and more tailored treatment strategies.

Importantly, this approach isn’t about replacing clinicians, it’s about giving them better tools. Real-world, real-time data from wearables could act as an additional layer of insight that supports more precise, individualized care. As wearable technology becomes more embedded in daily life, its role in healthcare, especially adolescent mental health, is poised to grow.

You can read the full study, Unlocking the potential of wearable technology: Fitbit-derived measures for predicting ADHD in adolescents, in Frontiers in Child and Adolescent Psychiatry.