Behavioral Health

Monika Goyal, M.D., MSCE

Q&A with Dr. Goyal: Trailblazing equity work leads to election to ASCI

Monika Goyal, M.D., MSCE, associate division chief of Emergency Medicine and Trauma Services

Monika Goyal, M.D., MSCE, associate division chief of Emergency Medicine and Trauma Services, is joining The American Society for Clinical Investigation (ASCI), one of a small cadre of pediatric emergency medicine physicians elected to the premier medical honor society for physician-scientists. Dr. Goyal considers her new honor a pivotal opportunity to represent pediatric emergency medicine, which is often underrepresented in research.

Interim Chief Academic Officer Catherine Bollard, M.D., M.B.Ch.B., nominated Dr. Goyal to ASCI because of her nationally renowned work as an equity science scholar, having published more than 130 peer-reviewed manuscripts and securing more than $25 million in funding from the National Institutes of Health (NIH). “From the very beginning of her career, Dr. Goyal has been a trailblazer as it relates to her research interests,” said Dr. Bollard, also an ASCI member.

Dr. Goyal serves as the inaugural chair for Women in Science and Medicine and associate division chief for Academic Affairs and Research at Children’s National Hospital. Her academic work has focused on disparities in the emergency setting, where she has studied the impacts of gun violence, pain management, sexual health and more. In 2023, the journal Pediatrics named a Children’s National manuscript on gun violence one of the 12 most significant papers in its 75-year history. Dr. Goyal was the first author and remains tremendously proud of the impact science can make on society.

Q: How did you find yourself investigating the science of gun laws?

A: A half-dozen years ago, three other pediatric emergency medicine physicians and I had been caring for countless numbers of children who had been victims of gun violence and felt motivated to act. I started SAFER at Children’s National – Safer through Advocacy, Firearm, Education and Research – which is now an institution-wide initiative to address gun violence within our community and beyond. More than 50 individuals at Children’s National are now active in our organization.

We’ve been able to publish a lot of research in this area, including our national study looking at the association between the strictness of gun laws with firearm-related deaths in children. We found that children are more likely to die from gun violence in states with less strict gun laws. It’s not surprising, yet the recognition by the American Academy of Pediatrics demonstrates the importance of using science to understand this, and it shows how far we’ve come in the medical community. Until recently, this issue has been under-recognized and under-supported, despite it being a massive public health crisis for our children and our country.

Q: Given the pace of emergency medicine, how did you find your way to research?

A: Early in my career, much of my work focused on adolescent sexual health. I kept finding that there was racial bias in terms of who we considered to be at risk for sexually transmitted infections. This finding then motivated me to investigate and understand whether racial bias impacted other aspects of care delivery across various clinical conditions in the Emergency Department.

I started by looking at whether differences existed in pain management based on a patient’s race. In evaluating data on children nationwide who are diagnosed with appendicitis, we found that Black children are less likely to receive appropriate pain management compared to white children, even after we adjusted for pain score and illness severity. We have found similar themes with respect to pain management among children diagnosed with fractures.

Q: What can be done?

A: We are grateful to have been awarded additional NIH funding to develop and test interventions to mitigate inequities. Currently, we are studying the impact of audit and feedback through the provision of what we are calling ‘equity report cards’ and clinical decision support embedded in the electronic health record to improve racial, ethnic and language equity in pain management.

Hundreds of studies have demonstrated that this is an issue at hospitals across the country. I am proud of Children’s National for having the humility for this self-reflection and the courage to do something about it. Our work here is helping to inform efforts across the country, and I am proud of our institution’s leadership in advancing health equity through community-informed, evidence-based interventions.

Newborn baby in a crib

Pioneering research center aims to revolutionize prenatal and neonatal health

Catherine Limperopoulos, Ph.D., was drawn to understanding the developing brain, examining how early adverse environments for a mother can impact the baby at birth and extend throughout its entire lifetime. She has widened her lens – and expanded her team – to create the new Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital.

“Despite the obvious connection between mothers and babies, we know that conventional medicine often addresses the two beings separately. We want to change that,” said Dr. Limperopoulos, who also directs the Developing Brain Institute. “Given the current trajectory of medicine toward precision care and advanced imaging, we thought this was the right moment to channel our talent and resources into understanding this delicate and highly dynamic relationship.”

Moving the field forward

Since its establishment in July 2023, the new research center has gained recognition through high-impact scientific publications, featuring noteworthy studies exploring the early phases of human development.

Dr. Limperopoulos has been at the forefront of groundbreaking research, directing attention to the consequences of maternal stress on the unborn baby and the placenta. In addition, under the guidance of Kevin Cook, Ph.D., investigators published a pivotal study on the correlation between pain experienced by premature infants in the Neonatal Intensive Care Unit and the associated risks of autism and developmental delays.

Another area of research has focused on understanding the impact of congenital heart disease (CHD) on prenatal brain development, given the altered blood flow to the brain caused by these conditions during this period of rapid development. Led by Josepheen De Asis-Cruz, M.D., Ph.D., a research team uncovered variations in the functional connectivity of the brains of infants with CHD. In parallel, Nickie Andescavage, M.D., and her team employed advanced imaging techniques to identify potential biomarkers in infants with CHD, holding promise for guiding improved diagnostics and postnatal care. Separately, she is investigating the impact of COVID-19 on fetal brain development.

In the months ahead, the team plans to concentrate its efforts on these areas and several others, including the impact of infectious disease, social determinants of health and protecting developing brains from the negative impacts of maternal stress, pre-eclampsia and other conditions prevalent among expectant mothers.

Assembling a team

Given its robust research plan and opportunities for collaboration, the center pulled together expertise from across the hospital’s faculty and has attracted new talent from across the country, including several prominent faculty members:

  • Daniel Licht, M.D., has joined Children’s National to build a noninvasive optical device research group to better care for children with CHD. Dr. Licht brings decades of experience in pediatric neurology, psychiatry and critical care and is recognized internationally for his expertise in neurodevelopmental outcomes in babies with CHD.
  • Katherine L. Wisner, M.S., M.D., has accumulated extensive knowledge on the impact of maternal stress on babies throughout her career, and her deep background in psychiatry made her a natural addition to the center. While Dr. Wisner conducts research into the urgent need to prioritize maternal mental health, she will also be treating mothers as part of the DC Mother-Baby Wellness Initiative — a novel program based at Children’s National that allows mothers to more seamlessly get care for themselves and participate in mother-infant play groups timed to align with their clinical appointments.
  • Catherine J. Stoodley, B.S., M.S., D.Phil., brings extensive research into the role of the cerebellum in cognitive development. Dr. Stoodley uses clinical studies, neuroimaging, neuromodulation and behavioral testing to investigate the functional anatomy of the part of the brain responsible for cognition.
  • Katherine M. Ottolini, M.D., attending neonatologist, is developing NICU THRIVE – a research program studying the effects of tailored nutrition on the developing newborn brain, including the impact of fortifying human milk with protein, fat and carbohydrates. With a grant from the Gerber Foundation, Dr. Ottolini is working to understand how personalized fortification for high-risk babies could help them grow.

Early accolades

The new center brings together award-winning talent. This includes Yao Wu, Ph.D., who recently earned the American Heart Association’s Outstanding Research in Pediatric Cardiology award for her groundbreaking work in CHD, particularly for her research on the role of altered placental function and neurodevelopmental outcomes in toddlers with CHD. Dr. Wu became the third Children’s National faculty member to earn the distinction, joining an honor roll that includes Dr. Limperopoulos and David Wessel, M.D., executive vice president and chief medical officer.

Interim Chief Academic Officer Catherine Bollard, M.D., M.B.Ch.B., said the cross-disciplinary collaboration now underway at the new center has the potential to make a dramatic impact on the field of neonatology and early child development. “This group epitomizes the Team Science approach that we work tirelessly to foster at Children’s National,” Dr. Bollard said. “Given their energetic start, we know these scientists and physicians are poised to tackle some of the toughest questions in maternal-fetal medicine and beyond, which will improve outcomes for our most fragile patients.”

mother kissing newborn baby

Evidence review: Maternal mental conditions drive climbing death rate in U.S.

mother kissing newborn baby

More than 80% of maternal deaths in the United States are preventable, particularly the nearly 1 in 4 maternal fatalities that are attributable to mental health disorders.

Painting a sobering picture, a research team led by Children’s National Hospital culled years of data demonstrating that maternal mental illness is an under-recognized contributor to the death of new mothers. They are calling for urgent action to address this public health crisis in the latest edition of JAMA Psychiatry.

Backed by dozens of peer-reviewed studies and health policy sources, the journal’s special communication comes as maternal mortality soars in the United States to as much as three times the rate of other high-income countries.

“The contribution of mental health conditions to the maternal morbidity and mortality crisis that we have in America is not widely recognized,” said Katherine L. Wisner, M.D., associate chief of Perinatal Mental Health and member of the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National. “We need to bring this to the attention of the public and policymakers to demand action to address the mental health crisis that is contributing to the demise of mothers in America.”

The evidence review laid out the risks facing new mothers: More than 80% of maternal deaths in the United States are preventable, particularly the nearly 1 in 4 maternal fatalities that are attributable to mental health disorders. Overdose and other maternal mental health conditions are taking the lives of more than twice as many women as postpartum hemorrhage, the second leading cause of maternal death. For non-Hispanic Black mothers, the mortality rate is a striking 2.6 times higher than non-Hispanic White mothers.

Yet the research team found that recent national efforts to combat maternal mortality have failed to address maternal mental health as “the public health crisis that it represents.” Even methodologies to measure maternal health statistics are inconsistent, which challenges efforts to shape health policy.

In examining 30 recent studies and another 15 historical references, the team – which included Caitlin Murphy, MPA, PNP, research scientist at the Milken School of Public Health at George Washington University, and Megan Thomas, M.D., FACOG, obstetrician at the University of Kansas School of Medicine – found ample data to support the need to elevate maternal mental health as a priority. Some examples:

  • Multiple studies show that the perinatal period puts women at higher risk for new and recurrent psychiatric disorders, with 14.5% of pregnant mothers having a new episode of depression and another 14.5% developing an episode three months after birth.
  • Nationwide, more than 400 maternity healthcare centers closed between 2006 and 2020, creating “maternity care deserts” that left nearly 6 million women with limited or no access to maternity care.
  • Mental health conditions such as suicide or opioid overdose are to blame for nearly 23% of maternal deaths in America, according to reports from three dozen Maternal Morbidity and Mortality Review Committees, which are state-based organizations that review each maternal death within a year of pregnancy. That’s followed by hemorrhage (13.7%), cardiac conditions (12.8%) and infection (9.2%).

Even with these sobering statistics, Dr. Wisner says that only 20 percent of women are screened for depression postpartum. “Given that this is a time that many mothers have contact with healthcare professionals, it’s critically important that all mothers are screened and offered treatment,” she said. “Mental health is fundamental to health — of the mother, the child and the entire family.”

Dr. Wisner is board-certified in general and child psychiatry. Throughout her research career, she has conducted research on maternal-infant interactions and family health. She recently joined the new Center for Prenatal, Neonatal & Maternal Health Research because of its vision to improve outcomes for the entire family by understanding the relationship between mothers and their babies.

“Throughout my career, I have fought hard against these silos that try to lock psychiatry into certain age categories,” Dr. Wisner said. “At Children’s National, we have a huge interest in reunifying the family. We want to ensure that we’re caring for unborn babies, infants and toddlers, while focusing on maternal health and the family in its broader context.”

Bear Institute PACK logo

Winners of the third annual Bear Institute PACK Event

Bear Institute PACK logoOracle Health and Children’s National Hospital, announced the winners of the third annual Bear Institute’s Pediatric Accelerator Challenge for Kids (Bear PACK), a start-up competition aimed at fostering digital health innovation for children. The winners — Bend Health Inc., Kismet Health, RareCareNow, and Thynk Inc. — were recognized across four innovation tracks for their efforts to improve child health outcomes, enhance the care experience for patients, family, and clinicians and reduce the cost of care for patients and health systems.

With more than 250 standalone pediatric hospitals in the U.S. today, there is a significant opportunity for technology startups focused on pediatric care to overcome unique funding and go-to-market challenges to more successfully build and sustain their businesses and have a positive impact on the lives of thousands of children and their families.

“Bear PACK targets the entire pediatric healthcare community to help close the gap in innovative solutions dedicated to helping children, said Jessica Herstek, M.D., chief medical information officer, Children’s National Hospital. “Together, Oracle Health and Children’s National Hospital are helping startups accelerate innovation and technology adoption by showcasing new products and connecting startups with pediatric healthcare providers and administrators.”

“With less than one percent of global digital health funding being allocated for children’s health1, the Bear PACK challenge has never felt more important or needed,” said Nasim Afsar, M.D., MBA, MHM, senior vice president and chief health officer, Oracle Health. “Working with Children’s National Hospital, we’re continuing to make meaningful progress on bringing more digital health solutions for kids to market, helping to improve pediatric patient experience and health outcomes globally.”

The 2023 winners in each category are:

Using a telehealth platform, RareCareNow is helping patients who have been diagnosed and are seeking treatment for rare and genomic diseases in the U.S. With molecular diagnostics integrated earlier in the care process, patients can more quickly identify and connect with a specialist using RareCareNow’s network of physicians providing care specific to their needs. Patients will not only receive genetic counseling and treatment plans but will have a long-term provider for ongoing care coordination and symptom management.

“Our goal is to reimagine how genomic medicine is practiced by bringing cutting edge molecular diagnostics into the care process earlier and then providing ongoing care and coordination for all patients so they can benefit from their genomic results. While we’re improving access to care for patients with genomic and rare diseases, we also aim to ease the uncertainty of the diagnosis and the diagnostic odyssey. By embracing telehealth and technology, we will enable patients and families to be more proactively involved in their own care.” — Alexander Katz, chief medical officer and co-founder, RareCareNow

Designed by and for providers, Kismet Health’s pediatric virtual care platform offers a digital playspace that allows clinicians to communicate with patients through their language of play, increasing overall patient engagement and effectiveness. Kismet’s collaborative care technology allows providers to bring healthcare access to families where and when they need it most, allowing for longitudinal care throughout the entire year and more equitable outcomes.

“It’s an honor to be selected for this innovative program with like-minded individuals who are also passionate about revolutionizing the future of pediatric healthcare. Kismet has launched with digital health companies and smaller clinics, with the goal now to integrate with EHRs like Oracle Health’s to expand to children’s hospitals, health systems, and government programs — ultimately meeting families where they are and closing the gap in care access.” — Christie Sander, co-founder, president and COO, Kismet Health

Thynk Inc. developed an immersive game designed to help children improve cognitive skills and overall mental wellness in a safe and fun environment. Youth play an adventure game on a mobile device while wearing a headset that uses proprietary EEG technology that reads brainwaves to determine their level of focused attention. This measured focus level also controls the speed and success of the in-game character as it completes various missions, and the difficulty level adjusts accordingly. With regular use, children can improve 13 cognitive skills including focused attention, impulse management, and develop their self-regulation skills, all of which are important for academic success and personal growth.

“Our product has proven lasting effects in improving focus and attention for children who may be struggling with such skills. The outcomes of eight successful clinical studies with more than 300 users of our product have shown improvements in behavior, test scores, homework completion, and math and reading fluency. In addition to teaming with healthcare organizations, we’re working to also reach underserved populations who may lack access to the tools needed to improve cognitive skills.” — Christopher Tracy, co-founder, board director and chief operating officer, Thynk Inc.

Bend Health designed a virtual mental health platform for kids and their families to increase access, reduce wait times, and decrease costs of pediatric mental healthcare. As the only provider using the Collaborative Care Model in partnership with pediatric primary care, Bend’s data-driven platform allows primary care providers to easily refer and connect patients with virtual therapists. They then receive regular updates on care progress, more closely aligning medical and behavioral care. Offering services such as coaching, therapy, and expedited psychiatric care, Bend integrates virtual video visits, chat messaging, and digital experiences to achieve better outcomes through measurement-based care. Collaborating with leading insurers, employers, health systems, and providing self-pay options, Bend Health ensures widespread accessibility to its services.

“At Bend Health, pediatricians receive regular patient progress updates, empowering them to make informed care decisions based on timely mental health measures. Bend’s collaborative care teams enable practitioners to accurately diagnose children and provide a holistic approach that consistently achieves clinically significant results for both kids and their families. Our six peer-reviewed studies demonstrate these positive outcomes, with 80% of kids showing improvement in 60-90 days, and 4 out of 5 caregivers reporting reduced stress within a month of joining Bend.” — Dr. Monika Roots, President and Co-Founder, Bend Health

More information on this year’s winners can be found on the Bear Institute PACK website.

1Children’s digital health innovation received less than 1% ($167 million) of global digital health funding ($22 billion) in 2020, according to StartUp Health’s annual report on digital health funding.

collage of news outlet logos

Children’s National in the News: 2023

collage of news outlet logos
Explore some of the notable medical advancements and stories of bravery that defined 2023, showcasing the steadfast commitment of healthcare professionals at Children’s National Hospital and the resilient spirit of the children they support. Delve into our 2023 news highlights for more.

1. COVID during pregnancy dramatically increases the risk of complications and maternal death, large new study finds

According to a study published in British Medical Journal Global Health, women who get COVID during pregnancy are nearly eight times more likely to die and face a significantly elevated risk of ICU admission and pneumonia. Sarah Mulkey, M.D., prenatal-neonatologist neurologist, discussed findings based on her work with pregnant women and their babies.

2. Rest isn’t necessarily best for concussion recovery in children, study says

A study led by Christopher Vaughan, Psy.D., pediatric neuropsychologist, suggests that — despite what many people may presume — getting kids back to school quickly is the best way to boost their chance for a rapid recovery after a concussion.

3. Pediatric hospital beds are in high demand for ailing children. Here’s why

David Wessel, M.D., executive vice president, chief medical officer and physician-in-chief, explained that one reason parents were still having trouble getting their children beds in a pediatric hospital or a pediatric unit after the fall 2022 respiratory surge is that pediatric hospitals are paid less by insurance.

4. Anisha Abraham details impact of social media use on children: ‘True mental health crisis’

Anisha Abraham, M.D., M.P.H., chief of the Division of Adolescent and Young Adult Medicine, joined America’s Newsroom to discuss the impact social media access has had on children’s mental health.
(FOX News)

5. Saving Antonio: Can a renowned hospital keep a boy from being shot again?

After 13-year-old Antonio was nearly killed outside his mom’s apartment, Children’s National Hospital went beyond treating his bullet wounds. Read how our Youth Violence Intervention Program team supported him and his family during his recovery.
(The Washington Post)

6. Formerly conjoined twins reunite with doctors who separated them

Erin and Jade Buckles underwent a successful separation at Children’s National Hospital. Nearly 20 years later they returned to meet with some of the medical staff who helped make it happen.
(Good Morning America)

7. Asthma mortality rates differ by location, race/ethnicity, age

Shilpa Patel, M.D., M.P.H., medical director of the Children’s National IMPACT DC Asthma Clinic, weighed in on a letter published in Annals of Allergy, Asthma & Immunology, asserting that the disparities in mortality due to asthma in the United States vary based on whether they occurred in a hospital, ethnicity or race and age of the patient.

8. How one Afghan family made the perilous journey across the U.S.-Mexico border

After one family embarked on a perilous journey from Afghanistan through Mexico to the U.S.-Mexico border, they eventually secured entry to the U.S. where Karen Smith, M.D., medical director of Global Services, aided the family’s transition and provided their daughter with necessary immediate medical treatment.

9. When a child is shot, doctors must heal more than just bullet holes

With the number of young people shot by guns on the rise in the U.S., providers and staff at Children’s National Hospital are trying to break the cycle of violence. But it’s not just the physical wounds though that need treating: young victims may also need help getting back on the right track — whether that means enrolling in school, finding a new group of friends or getting a job.
(BBC News)

10. This 6-year-old is a pioneer in the quest to treat a deadly brain tumor

Callie, a 6-year-old diagnosed with diffuse intrinsic pontine glioma, was treated with low-intensity focused ultrasound (LIFU) at Children’s National Hospital and is the second child in the world to receive this treatment for a brain tumor. LIFU is an emerging technology that experts like Hasan Syed, M.D., and Adrianna Fonseca, M.D., are trialing to treat this fatal childhood brain tumor.
(The Washington Post)

11. F.D.A. approves sickle cell treatments, including one that uses CRISPR

The FDA approved a new genetic therapy, giving people with sickle cell disease new opportunities to eliminate their symptoms. David Jacobsohn, M.B.A., M.D., confirmed that Children’s National Hospital is one of the authorized treatment centers and talked about giving priority to the sickest patients if they are on Vertex’s list.
(The New York Times)

12. 6-year-old fulfils wish to dance in the Nutcracker

After the potential need for open-heart surgery threatened Caroline’s Nutcracker performance, Manan Desai, M.D., a cardiac surgeon, figured out a less invasive procedure to help reduce her recovery time so she could perform in time for the holidays.
(Good Morning America)

girl using cell phone

Online discrimination and suicidal ideation through PTSD in Black youth

girl using cell phone

New findings show online racial discrimination predicts suicidal ideation through PTSD symptoms in Black adolescents.

Does individual online racial discrimination predict suicidal ideation through post-traumatic stress disorder (PTSD) symptoms in Black adolescents?

New findings show that, yes, there exists an indirect association between individual online racial discrimination and suicidal ideation through PTSD symptoms. And more than ever, Black youth are feeling the repercussions.

The findings, which are part of a cross-sectional study that included 525 Black adolescents, are published in JAMA Psychiatry. Experts noted the increased suicide rates among Black youth in the past two decades and are calling out the critical need for research on suicidal ideation and the unique risk factors for this population.

“As a Black person and a psychologist, I feel a personal and professional commitment to illuminate the negative impact of racism on Black youth and explore protective factors that will buffer this negative impact,” says Ashley Denise Maxie-Moreman, Ph.D., pediatric psychologist at Children’s National Hospital and co-author of the study. “We only recently began looking at linkages between racial discrimination and suicidal ideation in particular.”

This is the first known study to date assessing how racial discrimination online is linked to suicidal ideation. Notably, there has been a dearth of NIH funding and attention to research focused on the health of Black youth, and especially research projects that are led by scholars from diverse and underrepresented backgrounds who have committed their scholarly work to this topic area.

The big picture

The etiology of suicidal ideation remains unclear, especially for Black youth. Opara et al’s (2020) Interpersonal Psychological Theory of Suicide and Intersectionality argues that racial minority-specific stressors – such as racial discrimination – may be risk factors for suicidal ideation and suicide behaviors. This new study provides support for this theory, highlighting online racial discrimination as a potential risk factor for suicidal ideation, warranting further exploration.

Why it matters

Out of the total 525 participants, 265 were girls (50.5%) and 251 were boys (47.8%). Overall, the findings indicated that online racial discrimination was a significant predictor of suicidal ideation through PTSD symptoms.

A child may experience trauma symptoms associated with exposure to online racial discrimination. These PTSD symptoms could include intrusive thoughts of the event, avoidant behaviors, negative alterations in cognition/thoughts, and psychological distress and hyperarousal. Additionally, there are previous studies showing links between online racial discrimination and other psychological symptoms like depression and anxiety.

What’s next

Given the increasing suicide rates among Black youth, the authors urge online platforms to be aware of the links between online racial discrimination, PTSD symptoms, and suicidal ideation, and create safer spaces for Black adolescents by proactively monitoring and reducing hate speech.

The goal is to further explore associations between online racial discrimination and suicidal ideation (as well as other psychological and physiological symptomatology) in larger samples and with innovative methodology. The authors are also exploring culturally specific protective factors that may buffer the negative impact of online racial discrimination. More funding and institutional support is needed for scholars doing similar research.

2023 with a lightbulb

The best of 2023 from Innovation District

2023 with a lightbulbAdvanced MRI visualization techniques to follow blood flow in the hearts of cardiac patients. Gene therapy for pediatric patients with Duchenne muscular dystrophy. 3D-printed casts for treating clubfoot. These were among the most popular articles we published on Innovation District in 2023. Read on for our full list.

1. Advanced MRI hopes to improve outcomes for Fontan cardiac patients

Cardiac imaging specialists and cardiac surgeons at Children’s National Hospital are applying advanced magnetic resonance imaging visualization techniques to understand the intricacies of blood flow within the heart chambers of children with single ventricle heart defects like hypoplastic left heart syndrome. The data allows surgeons to make critical corrections to the atrioventricular valve before a child undergoes the single ventricle procedure known as the Fontan.
(3 min. read)

2. Children’s National gives first commercial dose of new FDA-approved gene therapy for Duchenne muscular dystrophy

Children’s National Hospital became the first pediatric hospital to administer a commercial dose of Elevidys (delandistrogene moxeparvovec-rokl), the first gene therapy for the treatment of pediatric patients with Duchenne muscular dystrophy (DMD). Elevidys is a one-time intravenous gene therapy that aims to delay or halt the progression of DMD by delivering a modified, functional version of dystrophin to muscle cells.
(2 min. read)

3. New model to treat Becker Muscular Dystrophy

Researchers at Children’s National Hospital developed a pre-clinical model to test drugs and therapies for Becker Muscular Dystrophy (BMD), a debilitating neuromuscular disease that is growing in numbers and lacks treatment options. The work provides scientists with a much-needed method to identify, develop and de-risk drugs for patients with BMD.
(2 min. read)

4. First infants in the U.S. with specially modified pacemakers show excellent early outcomes

In 2022, five newborns with life-threatening congenital heart disease affecting their heart rhythms were the first in the United States to receive a novel modified pacemaker generator to stabilize their heart rhythms within days of birth. Two of the five cases were cared for at Children’s National Hospital. In a follow-up article, the team at Children’s National shared that “early post-operative performance of this device has been excellent.”
(2 min. read)

5. AI: The “single greatest tool” for improving access to pediatric healthcare

Experts from the Food and Drug Administration, Pfizer, Oracle Health, NVIDIA, AWS Health and elsewhere came together to discuss how pediatric specialties can use AI to provide medical care to kids more efficiently, more quickly and more effectively at the inaugural symposium on AI in Pediatric Health and Rare Diseases, hosted by Children’s National Hospital and the Fralin Biomedical Research Institute at Virginia Tech.
(3 min. read)

6. AAP names Children’s National gun violence study one of the most influential articles ever published

The American Academy of Pediatrics (AAP) named a 2019 study led by clinician-researchers at Children’s National Hospital one of the 12 most influential Pediatric Emergency Medicine articles ever published in the journal Pediatrics. The findings showed that states with stricter gun laws and laws requiring universal background checks for gun purchases had lower firearm-related pediatric mortality rates but that more investigation was needed to better understand the impact of firearm legislation on pediatric mortality.
(2 min. read)

7. Why a colorectal transition program matters

Children’s National Hospital recently welcomed pediatric and adult colorectal surgeon Erin Teeple, M.D., to the Division of Colorectal and Pelvic Reconstruction. Dr. Teeple is the only person in the United States who is board-certified as both a pediatric surgeon and adult colorectal surgeon, uniquely positioning her to care for people with both acquired and congenital colorectal disease and help them transition from pediatric care to adult caregivers.
(3 min. read)

8. First-of-its-kind holistic program for managing pain in sickle cell disease

The sickle cell team at Children’s National Hospital received a grant from the Founders Auxiliary Board to launch a first-of-its-kind, personalized holistic transformative program for the management of pain in sickle cell disease. The clinic uses an inter-disciplinary approach of hematology, psychology, psychiatry, anesthesiology/pain medicine, acupuncture, mindfulness, relaxation and aromatherapy services.
(3 min read)

9. Recommendations for management of positive monosomy X on cell-free DNA screening

Non-invasive prenatal testing using cell-free DNA (cfDNA) is currently offered to all pregnant women regardless of the fetal risk. In a study published in the American Journal of Obstetrics and Gynecology, researchers from Children’s National Hospital provided context and expert recommendations for maternal and fetal evaluation and management when cfDNA screening is positive for monosomy X or Turner Syndrome.
(2 min. read)

10. Innovation in clubfoot management using 3D anatomical mapping

While clubfoot is relatively common and the treatment is highly successful, the weekly visits required for Ponseti casting can be a significant burden on families. Researchers at Children’s National Hospital are looking for a way to relieve that burden with a new study that could eliminate the weekly visits with a series of 3D-printed casts that families can switch out at home.
(1 min. read)

11. Gender Self-Report seeks to capture the gender spectrum for broad research applications

A new validated self-report tool provides researchers with a way to characterize the gender of research participants beyond their binary designated sex at birth. The multi-dimensional Gender Self-Report, developed using a community-driven approach and then scientifically validated, was outlined in a peer-reviewed article in the American Psychologist, a journal of the American Psychological Association.
(2 min. read)

12. Cardiovascular and bone diseases in chronic kidney disease

In a study published by Advances in Chronic Kidney Disease, a team at Children’s National Hospital reviewed cardiovascular and bone diseases in chronic kidney disease and end-stage kidney disease patients with a focus on pediatric issues and concerns.
(1 min. read)

Adelaide Robb

Changing the game in pediatric psychopharmacology

Adelaide Robb

“I realized adequate treatment in youth can prevent many of the harmful outcomes in adults who were never treated properly for their symptoms,” says Adelaide Robb, M.D.

Over three decades ago, Adelaide Robb, M.D., sat in her office with a clear goal in mind: follow a career in adult psychiatry. Her patients displayed all sorts of symptoms: generalized anxiety, depression, bipolar disorder, autism, schizophrenia.

“In the early 1990s, my patients would tell me other doctors didn’t believe in their children having bipolar disorder,” she says.

These adult patients had been sick for 5, 10 and even 15 years but had not been diagnosed or treated properly. Eventually, they started bringing their children with them, who also had similar symptoms.

“I realized adequate treatment in youth can prevent many of the harmful outcomes in adults who were never treated properly for their symptoms,” Dr. Robb says.

She soon came to another realization: there was a massive gap in the health care world – pediatric psychopharmacology. She felt the need to bridge this gap and help children, motivating her to change the course of her career. Since joining Children’s National Hospital in 1994, she’s been an unstoppable force in the pediatric psychopharmacology world, quickly changing the rules of the game.

The big picture

Pediatricians in the United States continue to grapple with a mental health crisis that was exacerbated by the COVID-19 pandemic and declared a national emergency in 2021.

Mental health plays a key role in a child’s mental, emotional and behavioral well-being. It affects the way they think, feel and act while also impacting how they handle stress, relate to their peers and make choices.

According to the Centers for Disease Control and Prevention, attention deficit hyperactivity disorder (ADHD), anxiety, behavior problems and depression are the most commonly diagnosed mental health disorders in children. While available treatments vary, over the years, data has proven how medications can play a role in improving most mental health conditions.

Children’s National leads the way

For decades, Dr. Robb has led research focused on pediatric psychopharmacology with more than 80 clinical trials. Children’s National is one of only a few sites nationwide to participate in federally funded mental health clinical trials. Major trials she has led include:

  • Lexapro for major depression in youth
  • Prozac for obsessive compulsive disorder
  • Abilify for pediatric bipolar and schizophrenia
  • Latuda for pediatric bipolar depression
  • Concerta for ADHD

Dr. Robb also co-chaired the American Academy of Child and Adolescent Psychiatry’s Pediatric Psychopharmacology Initiative Committee for more than 8 years. She has also been active for more than 15 years in the American Academy of Pediatrics Committee on drugs (pharmacology).

“Since its inception in the ‘90s, pediatric psychopharmacology has changed in two major ways: First, we started to do regular testing of new medications in children and not just adults. Second, there’s been congressional and FDA mandates for testing of all medications that can be used in kids,” says Dr. Robb. “It’s no longer a guessing game – we have an evidence-based approach to children with mental illness using psychopharmacology.”

Currently, Dr. Robb is the principal investigator on several open clinical trials at Children’s National, including a study that compares the effectiveness of treating a parent with ADHD medication plus behavioral parent training (BPT) versus BPT alone on their child’s ADHD related symptoms.

Moving the field forward

Earlier this year, Dr. Robb moderated a panel on mental health and precision genomics which touched on what we know about depression, anxiety and other disorders and the future of pediatric behavioral health care.

“The goal is to give people with depression and other mental health illnesses the opportunity to go to school and function, whether they have depression, ADHD or any other disorder. This can make a huge difference in someone’s life,” Dr. Robb says.

Children’s National is uniquely positioned with a dedicated pharmacokinetic clinical team – which has greatly aided its ADHD and Learning Differences Program and most recent Addictions Program.

“We changed how ADHD was treated because our patients had early access to new trialed drugs,” says Dr. Robb. “This makes a big difference and gives children the opportunity to have better control of their symptoms so they’re paying attention and learning in school.”

Read more about our advances in Behavioral Health.

mother with newborn baby

Perinatal Mood and Anxiety Lab to launch at Children’s National

mother with newborn baby

The hospital has been working for years on improving screenings and support for perinatal mood and anxiety disorders.

Physician researchers at Children’s National Hospital secured a $1.8 million grant from the Agency for Healthcare Research and Quality (AHRQ) that will fund a Perinatal Mood and Anxiety Patient Safety Lab. Neonatologists, pediatric emergency medicine physicians, psychologists, computer scientists and the Perinatal Mood and Anxiety Disorder team from Children’s National will partner with systems engineers at Virginia Tech and Human Factors experts at MedStar Patient Safety Institute to set up a learning lab. The lab will improve mental health screening, referral and treatment of parents and caregivers at the hospital.

The need

“After multi-month admission to our NICU, 45% of parents screen positive for depression. I can’t think of any other disorder or disease that screens positive at 45%. This can’t be ignored,” says Lamia Soghier, M.D. M.Ed., M.B.A., neonatologist and medical director of the Neonatal Intensive Care Unit (NICU) at Children’s National. “Our goal is to provide safe, comprehensive, point-of-care access to mental health services for caregivers of infants treated at our hospital. I can’t think of a better team on the cutting edge that’s qualified to tackle this issue.”

The big picture

The new grant will tackle three major aims:

  • Optimize screening, referral and treatment for postpartum depression in the NICU and the Pediatric Emergency Department (ED).
  • Design and develop a novel software dashboard for real-time tracking of the screening, referral and treatment stages for eligible mothers.
  • Implement new solutions and evaluate latent safety threats related to missed screening, referral or treatment in current and future systems.

Researchers from the Center for Prenatal, Neonatal & Maternal Health Research and population health experts from the Child Health Advocacy Institute at Children’s National will also support this work.

Leading the way

“Children’s National is truly an innovator in this space,” says Dr. Soghier. “There are very few pediatric hospitals working with families to screen for mental health in the NICU, and fewer tackling the problem in the ED. Our team is dedicated to paving this path.”

The hospital has been working for years on improving screenings and support for perinatal mood and anxiety disorders, which was originally made possible by an investment from the A. James & Alice B. Clark Foundation to Children’s National aimed at providing families with greater access to mental health care and community resources. This new AHRQ grant will support the trajectory and goals of this work.

children sitting at the kitchen counter

New intervention program can help children with food allergies

children sitting at the kitchen counter

Kids with food allergies can experience stress related to daily food allergy management.

Adolescence is a challenging developmental period associated with risky food allergy behaviors. Kids with food allergies can experience stress related to daily food allergy management. In fact, some kids report that they have anxiety about allergic reactions and get bullied for their allergies.

The big picture

In a new study published in the Annals of Allergy, Asthma and Immunology, a team of experts developed the Food Allergy Mastery Program (FAM), a six-session telehealth program led by a counselor that promotes food allergy self-management and adjustment for youth ages 10-14 years.

“We then conducted focus groups with families in our food allergy clinic to get their opinions on the program, made changes and conducted a pilot study with additional food allergy families,” said Linda Herbert, Ph.D., director of Psychology Research and Clinical Services for Allergy and Immunology and psychologist at Children’s National Hospital and author of the study. “When we compared kids’ food allergy knowledge, self-efficacy and social support before and after completing the FAM Program, we saw improvements in food allergy knowledge, greater self-efficacy and more social support after the program.”

What’s been the hold-up in the field?

To date, there are no behavioral interventions that promote food allergy self-management and adjustment for youth. However, Herbert said such an intervention is critically needed because adolescence is a higher-risk period for allergic reactions.

“Adolescents are typically diagnosed when they are young and may not have sufficient food allergy knowledge about how to engage in food allergy self-management,” Herbert said.

They also spend an increasingly greater amount of time with peers, so they are more responsible for their food allergy, she added.

What’s exciting about the findings?

Youth who completed all six sessions rated the FAM Program as relevant and enjoyable on the post-program evaluation. They also reported having better knowledge related to allergen avoidance, allergic reaction symptom recognition and allergic reaction treatment.

“The FAM Program is a promising intervention for youth with food allergies,” the authors wrote.

What’s next?

From here, the team is conducting a large-scale randomized clinical trial to fully evaluate the FAM Program’s impact on kids funded by the National Institute of Allergy and Infectious Diseases. This trial is evaluating the impact of the FAM Program on primary outcomes of interest, such as food allergy knowledge, skills, behavior and psychosocial functioning, and distal outcomes of interest, such as healthcare utilization.

American Academy of Child & Adolescent Psychiatry Meeting Logo

Children’s National at the American Academy of Child & Adolescent Psychiatry Meeting

Several experts from Children’s National Hospital will be sharing their knowledge at the upcoming American Academy of Child & Adolescent Psychiatry Meeting in New York City, October 23-28. Here’s a sample of what you can expect.

  • Mahdieh (Emmie) Bodaghi, M.D., a child and adolescent psychiatrist with expertise in telepsychiatry, will be on a clinical case conference panel about assessing and treating adolescents with comorbid catatonia. The presentation will feature a review of the current understanding of catatonia in the adolescent population and the assessment and management of catatonic features in bipolar disorder across inpatient and outpatient settings.
  • Jennifer Dorr, D.O., M.P.H., will be chairing a workshop on advocating purposefully, in which participants learn about the new advocacy toolkit developed by the AACAP Advocacy Committee. Laura Willing, M.D., will also be presenting in the workshop. Additionally, Dr. Dorr and Meghan Schott, D.O., will be presenters in a member services forum on effectively engaging in public discourse and advocacy.
  • Kriti Gandhi, M.D., Ayman Saleh, M.D., and Adelaide Robb, M.D., are presenting a poster on factors and implementations to decrease no-show rates for follow-up appointments at child psychiatry clinics.
  • Dr. Robb, who is division chief of Psychiatry and Behavioral Services at Children’s National, is also co-presenting in a sold out workshop and a clinical case conference. The workshop will look at various psychopharmacological decision-making strategies and allow participants to identify their personal strengths and areas for improvement by completing a self-assessment. The clinical case conference will discuss deprescribing — the process of reducing or withdrawing medications that pose higher risks than benefits — and include real-life examples of deprescribing to support young patients from diverse cultural backgrounds.
  • Priya Punnoose, M.D., and Dr. Schott will be presenting a clinical perspective on psychodynamic psychiatry in the inpatient setting.
  • Dr. Schott, who is medical director of Psychiatric Emergency Services at Children’s National, will be chairing a forum, that includes Dr. Robb, and is geared towards early and mid-career child and adolescent psychiatrists in academia who want to learn more about academic promotion. Dr. Schott will also be participating in two other forums — on personal finance and public advocacy — as well as chairing a discussion on the coming-of-age animated movie Luca and having conversations about life transitions with patients and their families.
  • Irene Chatoor, M.D., director of the Infant and Toddler Mental Health Program at Children’s National, will be chairing a clinical perspective on the diagnosis, treatment and follow-up of lack of interest in eating or food, as well as presenting her research during that time.
Date Time Presenter(s) Title
10/24/23 7:00 pm Meghan Schott, D.O. A Fish Out of Water: Reflections on Transitions and the “Other” in Luca
10/25/23 8:00 am Irene Chatoor, M.D. The Diagnosis, Treatment, and Follow-up of Avoidant/Restrictive Food Intake Disorder Subtype: Lack of Interest in Eating or Food
10/25/23 8:00 am Jennifer Dorr, D.O., M.P.H., and Laura Willing, M.D. How to Advocate Purposefully: Introducing AACAP’s Advocacy Toolkit
10/26/23 8:00 am Adelaide Robb, M.D. Helping You Know What You Don’t Know: A Self-Assessment Review of Psychopharmacology
10/26/23 1:30 pm Meghan Schott, D.O., and Adelaide Robb, M.D. Instructor to Professor: A Roadmap to Academic Promotion
10/27/23 8:00 am Adelaide Robb, M.D. Developmental Dynamics in De-prescribing for Children, Adolescents, and Transitional-Age Youth
10/27/23 1:30 pm Mahdieh (Emmie) Bodaghi, M.D. More Than Mania: Assessment and Treatment of Adolescents With Comorbid Catatonia Across Treatment Settings
10/27/23 n/a Kriti Gandhi, M.D., Ayman Saleh, M.D., and Adelaide Robb, M.D. Factors and Implementations to Decrease No-Show Rates for Follow-Up Appointments at the Child Psychiatry Clinic
10/27/23 n/a Priya Punnoose, M.D., and Meghan Schott, D.O. Psychodynamic Psychiatry in the Inpatient Setting


10/28/23 8:30 am Meghan Schott, D.O. From Residency Rags to Riches: A Physician’s Primer on Personal Finance, Paying Off Debt, and Preparing for the Future
10/28/23 1:00 pm Jennifer Dorr, D.O., M.P.H., and Meghan Schott, D.O. A Developmental Approach to the Child and Adolescent Psychiatry Advocate: Finding Your Stride and Making It Count
child being evaluated for autism

Using a multisystem approach to improve access to autism care in Washington, D.C.

child being evaluated for autism

Children with autism face significant barriers to accessing evaluations and intervention services.

An article in the journal Pediatrics reviews the outcomes from a collective, targeted advocacy approach to improving access to autism supports and resources for children and their families in Washington, D.C. The effort was led by Children’s National Hospital and engaged a multidisciplinary team from within the hospital and across a wide range of community sectors.

What this means

Children’s National and DC Autism Parents worked collaboratively with a coalition of organizations from the broader District of Columbia community to address some of the biggest challenges and barriers that prevent autistic children and their families from receiving the resources and support they need in the nation’s capital.

Why it matters

Children with autism face significant barriers to accessing evaluations and intervention services often because of confusing referral processes, lack of centralized coordination across organizations serving children with autism, insurance coverage gaps, multiyear waitlists for diagnostic services and limited provider knowledge about autism. Racism and systemic inequities also persist in autism care across the United States.

Long and growing wait times in autism diagnostic clinics and lack of centralized care coordination for autistic children are prevalent across the District of Columbia, and as a result, many children and families in the region continue to lack access to the support they need.

What’s unique

The study describes multiyear efforts (2017–2022) to improve autism care throughout the District of Columbia using a collective impact framework to unite organizations from different sectors. This approach features the creation of a common agenda (including defining goals and priorities), shared measurement, mutually reinforcing activities, continuous communication and infrastructure support.

Together, the group members sought to address barriers and overcome challenges at multiple levels of the healthcare system at the same time by focusing advocacy in three specific areas:

  • Infrastructure-building initiatives/system-level approaches.
  • Population- and community-level services to build capacity and connect providers and families to needed resources.
  • Direct services that provide innovative, gap-filling supports to children and families as a stopgap until the necessary supports can be more sustainably provided across the board.

Bottom line

While more work is needed to continue expanding the availability of needed services, the findings from this initial effort can inform the next steps in Washington, D.C., and serve as a model for a collective framework approach for autism services in other parts of the United States.

You can read the full study “A Multisystem Approach to Improving Autism Care” in the journal Pediatrics.

More information and resources about these autism initiatives can be found at:

Sickle Cell Anemia 3D Illustration

New telemedicine-based behavioral intervention program eases pain of patients with SCD

Sickle Cell Anemia 3D Illustration

Telemedicine-based behavioral interventions can reduce pain-related functional impairment in youth with SCD.

Sickle cell disease (SCD) pain is often associated with functional impairment and treatment is often limited to pharmacological approaches with unwanted side effects. Behavioral interventions are common for non-SCD pain populations, but interventions designed to address pain-related impairment in SCD are lacking.

In a recent study published in Pediatric Blood & Cancer, researchers conducted a pilot of a 4-week behavioral pain intervention for youth with SCD delivered via telemedicine known as the Balance Program.

Using an innovative combination of cognitive-behavioral therapy and acceptance-based approaches, researchers found that the intervention was feasible, evidenced by youth and caregiver ratings of high acceptability and satisfaction and excellent treatment completion rates. In addition, youth and their caregivers both reported significant reductions in the degree to which SCD pain interfered with daily activities after the treatment.

What’s been the hold-up in the field?

Researchers and clinicians know that there is a strong psychological component to all experiences of pain and there has been growing evidence in recent decades regarding the effectiveness of behavioral therapies for reducing pain and improving functioning.

“However, sickle cell disease presents unique challenges because unlike many pain presentations, it is common for patients with sickle cell disease to experience both acute and chronic pain, making treatment recommendations less clear,” said Megan Connolly, Ph.D., psychologist at Children’s National Hospital and the study’s lead author. “Previous studies have rarely focused on reducing pain-related disability, which is important for optimizing quality of life.”

How does this work move the field forward?

This study demonstrated the feasibility and acceptability of a telemedicine-based behavioral intervention to reduce pain-related functional impairment in youth with SCD. Nearly all youth and their caregivers rated the intervention as moderately or highly acceptable and 90% of patients completed the full treatment program.

“Moreover, the Balance Program resulted in significant reductions in the extent to which sickle cell disease pain interfered with daily activities,” Dr. Connolly added.

What about the findings is exciting?

This research explains what experts can be doing to reduce the impact of pain on the lives of children and adolescents with SCD. Through their findings, researchers learned that a telemedicine-based behavioral pain intervention, which is often more convenient for families than traveling to the hospital for weekly visits, can meaningfully reduce the impact of pain on daily living.

“It is one thing to develop a program that you think will be helpful, but it’s another thing to develop a program that families will be interested in and doesn’t add unnecessary stress to their lives,” Dr. Connolly said. “Although this study had a relatively small sample, I was also excited to see the magnitude of improvements in pain-related impairment, which was quite large. We plan to continue refining this treatment based on patient and caregiver feedback and looking for ways to increase accessibility to these types of treatments for sickle cell disease pain.”

girl being examined by doctor

Pediatric hospitals underutilize systems to get at social challenges impacting health


girl being examined by doctor

Physicians treating hospitalized children rarely use a coding system established in 2015 for flagging social challenges and stressors that may be impacting patient health, according to new research from Children’s National Hospital.


Physicians treating hospitalized children rarely use a coding system established in 2015 for flagging social challenges and stressors that may be impacting patient health, according to new research from Children’s National Hospital published in Pediatrics. Known as social determinants of health (SDOH), these factors include food insecurity, homelessness and adverse childhood events like substance abuse at home, and they can greatly affect a child’s well-being.

“We only get so many touchpoints with our patients,” said Kaitlyn McQuistion, M.D., pediatric hospital medicine fellow at Children’s National and co-lead author of the paper. “Our research shows the screening itself provides valuable insight into our patients, making identification an important part of inpatient and post-discharge care. With this information, doctors can help families tap into social workers, community supports and other resources aimed at providing a more holistic approach to child health.”

The big picture

The American Academy of Pediatrics advises screening for unmet social needs and using the codes laid out in the International Classification of Disease, 10th Revision (ICD-10), to flag risk factors for some of a hospital’s most vulnerable patients. In 2018, the American Hospital Association (AHA) clarified that the coding can be added by any healthcare professional accessing the chart, including nurses, social workers, case managers and physicians. The study looked at data from 4,000 hospitals in 48 states and the District of Columbia and found that use of the codes has remained low, even with the AHA’s clarification.

In practice, physicians know that screening and documentation are the essential first steps to help families find resources. Yet less than 2% of pediatric inpatients were coded as needing support. Most commonly, “problems related to upbringing” – a broad category indicating social needs and adverse childhood events – was used.

What’s ahead

Some providers are using these SDOH codes, or Z Codes, more often to address and improve health disparities. “Our mental health colleagues and those working with the Native American population, in particular, are using these tools more often to capture and disseminate critical information related to their patients’ social needs,” said Stacey Stokes, M.D., a hospitalist at Children’s National and co-lead author on the paper.  “Their innovative approaches to address and improve health disparities may provide learning opportunities for institutions.”

The researchers said that more work needs to be done to take these successes to other populations, find ways to incentivize this work in billing and ensure that providers have community resources to address the needs that they uncover.

“The ultimate goal of this work is to identify patients with social needs affecting their health and connect them with resources,” said Kavita Parikh, M.D., director for the Research Division of Hospital Medicine. “There are many avenues to explore to find ways to better utilize this tool, including language learning models, improved training and stronger community resources.”

child in hospital bed

$96 million philanthropic investment will transform rare pediatric brain tumor research and care

child in hospital bedChildren’s National Hospital announced a $96 million investment from an anonymous donor family to transform rare childhood brain tumor research and care. The donation, which strengthens our globally recognized leadership in the field, is one of the largest in the hospital’s history.

Children’s National will harness the investment to recruit more top talent and advance the most promising research. This will produce safer, more effective treatments. It also will elevate standards of care to help children with rare brain tumors thrive for a lifetime.

The big picture

Brain tumors are the most common solid tumors affecting children. They are especially challenging in kids because their brains are still developing. The disease and current treatments can put them at risk for lifelong complications.

The anonymous family’s investment provides new hope for patients who face rare and often challenging brain tumor diagnoses — in the Washington, D.C., community and around the world.

“This incredible partnership will lift up one of the nation’s top pediatric brain tumor programs into the stratosphere,” said Kurt Newman, M.D., president and CEO of Children’s National. “It will immediately propel our best-in-class research and care, allowing us to bring new therapies to children with brain tumors. This fundamentally changes the healthcare journey and long-term outcomes for children and their families.”

Why it’s important

This transformational investment will have a far-reaching impact on our ability to save and improve the lives of children with brain tumors. Funds will fuel collaborative breakthroughs across a range of scientific and psychosocial approaches.

The partnership will supercharge highly individualized and promising treatments for children with brain tumors. We will radically transform the research landscape with a focus on:

  • Low intensity focused ultrasound (LIFU) – Advancing laboratory research and a clinical program designed to treat childhood brain tumors with LIFU therapy
  • Cellular immunotherapy – Testing new gene-engineered immune cell products and accelerating their integration into standards of care
  • Rare Brain Tumor Program – Propelling new clinical trials through the hospital’s national and global leadership in pediatric brain tumor consortia. Already, Children’s National is leading a new collaborative with hospitals in North America, South America and Europe to better understand and find novel treatments for these rare diseases
  • Neurosurgery innovation – Exploring multiple ways to perform safer, more effective neurosurgery and developing new methods to enhance drug/agent delivery
  • Precision medicine – Recruiting leading scientists to advance biology-informed therapies that can be targeted for children across a spectrum of brain tumors
  • Good Manufacturing Practices (GMP) facility – Expanding our GMP, one of the first standalone facilities at a children’s hospital in the country, to translate new discoveries into clinical trials more rapidly
  • Additional priorities including expansion of clinical research infrastructure and growth of bioinformatics, brain tumor repository and molecular diagnostics initiatives

The partnership also transforms how we approach care. It will power our pursuit of psychosocial, behavioral health and neuroscientific initiatives to help kids live well and cope with the unique circumstances of their diagnosis. We will focus on:

  • Lifetime health and wellness – Building a world-class research and clinical care program to shape a new paradigm for supporting a child’s physical and emotional health during and long after cancer treatment
  • Child Mental Health & Behavioral Brain Tumor Lab – Establishing a robust neuro-oncology mental health program that delivers timely interventions and specialized psychiatric care for patient well-being
  • Additional priorities including a new Neuroscience Nursing Excellence Program and growth of psychosocial support activities that bring comfort and encouragement to children during their treatment journey

Children’s National is proud to lead the way to a better future for pediatric rare brain tumor patients and expand our internationally recognized capabilities for neuro-oncology care.

U.S. News Badges

Children’s National Hospital ranked #5 in the nation on U.S. News & World Report’s Best Children’s Hospitals Honor Roll

U.S. News BadgesChildren’s National Hospital in Washington, D.C., was ranked #5 in the nation on the U.S. News & World Report 2023-24 Best Children’s Hospitals annual rankings. This marks the seventh 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 thirteenth straight year, Children’s National also ranked in all 10 specialty services, with eight specialties ranked in the top 10 nationally. In addition, the hospital was ranked best in the Mid-Atlantic for neonatology, cancer, neurology and neurosurgery.

“Even from a team that is now a fixture on the list of the very best children’s hospitals in the nation, these results are phenomenal,” said Kurt Newman, M.D., president and chief executive officer of Children’s National. “It takes a ton of dedication and sacrifice to provide the best care anywhere and I could not be prouder of the team. Their commitment to excellence is in their DNA and will continue long after I retire as CEO later this month.”

“Congratulations to the entire Children’s National team on these truly incredible results. They leave me further humbled by the opportunity to lead this exceptional organization and contribute to its continued success,” said Michelle Riley-Brown, MHA, FACHE, who becomes the new president and CEO of Children’s National on July 1. “I am deeply committed to fostering a culture of collaboration, empowering our talented teams and charting a bold path forward to provide best in class pediatric care. Our focus will always remain on the kids.”

“I am incredibly proud of Kurt and the entire team. These rankings help families know that when they come to Children’s National, they’re receiving the best care available in the country,” said Horacio Rozanski, chair of the board of directors of Children’s National. “I’m confident that the organization’s next leader, Michelle Riley-Brown, will continue to ensure Children’s National is always a destination for excellent 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.

“For 17 years, U.S. News has provided information to help parents of sick children and their doctors find the best children’s hospital to treat their illness or condition,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals that are on the Honor Roll transcend in providing exceptional specialized care.”

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

The other two specialties ranked among the top 50 were cardiology and heart surgery, and urology.

Panel members at the NIAID symposium

CN-NIAID Symposium seeks ways to promote child health amid challenges

Panel members at the NIAID symposium

More than 30 million children seek emergency care each year, but 80 percent of these visits happen at hospitals that aren’t designed for pediatrics — a daunting figure during pandemics and other crises in healthcare. This considerable hurdle is one of many challenges that leaders in pediatric health came to discuss during a two-day symposium on promoting child health, hosted by Children’s National Hospital, the National Institute of Allergy and Infectious Diseases and the Pediatric Pandemic Network (PPN).

The symposium laid out a multitude of issues facing children and their doctors: growing mental health diagnoses, shrinking access to care in rural areas, asthma and eczema, winter respiratory surges and more.

Joelle Simpson, M.D., chief of emergency medicine at Children’s National and PPN principal investigator, said the network is drawing on expertise from 10 pediatric hospitals to ensure communities are better prepared for whatever challenges lie ahead, through training and support, collaboration among pediatric specialists, education on best practices and the promotion of equity and inclusion.

Built on a Health Resources and Services Administration grant, the network is focusing on four key areas: infectious disease and disease outbreaks, emergency and disaster management, mental and behavioral health, and health equity and community engagement. “This year, we know we are boiling the ocean as we come together,” Simpson said.

Miss the symposium? Check out the recordings available on YouTube, including the closing Q&A with many of the panelists and Sheryl Gay Stolberg, health policy reporter with the New York Times.

Day 1 of the 6th Annual Children’s National Hospital – NIAID Symposium

Day 2 of the 6th Annual Children’s National Hospital – NIAID Symposium


stressed pregnant mom

Pandemic stress reshapes the placentas of expectant moms

stressed pregnant mom

Elevated maternal stress during the COVID-19 pandemic changed the structure, texture and other qualities of the placenta in pregnant mothers.

Elevated maternal stress during the COVID-19 pandemic changed the structure, texture and other qualities of the placenta in pregnant mothers – a critical connection between mothers and their unborn babies – according to new research from the Developing Brain Institute at Children’s National Hospital.

Published in Scientific Reports, the findings spotlight the underappreciated link between the mental health of pregnant mothers and the health of the placenta – a critical organ that develops during pregnancy to nourish and protect babies. The long-term neurodevelopmental impact on their children is under investigation.

“During the pandemic, mothers were exposed to a litany of negative stressors including social distancing, fear of dying, financial insecurity and more,” said Catherine Limperopoulos, Ph.D., chief and director of the Developing Brain Institute, which led the research. “We now know that this vital organ was changed for many mothers, and it’s essential that we continue to investigate the impact this may have had on children who were born during this global public health crisis.”

The big picture

Dr. Limperopoulos’s team compared magnetic resonance imaging (MRI) of 165 women who were pregnant before March 2020 to 63 women who became pregnant during the pandemic. Those pregnant during the pandemic were not knowingly exposed to COVID-19, and they collectively scored significantly higher on questionnaires measuring stress and depression. They were recruited at Children’s National as part of a clinical trial aimed at reducing pregnant women’s elevated stress levels during the pandemic.

The placenta is a temporary organ that grows during pregnancy to provide oxygen, nutrients and immunological protection to babies, and its health is vital to the well-being of the developing fetus. The data showed key changes in how the placenta grew and developed among women pregnant during the pandemic, especially when compared to placental growth and development among women who were pregnant before the pandemic. Changes in placental development also were associated with the infant’s birth weight at delivery. Importantly, these changes seem to be connected to maternal stress and depression symptoms.

Taken as a whole, the findings suggest that the disturbances measured on placental development in the womb may influence the placenta’s ability to support fetal health and wellness. “We are continuing to follow up on these mother-baby dyads to determine the long-term functional significance of these placental changes in utero,” Dr. Limperopoulos said.

Studies have shown that the placenta adapts to negative changes in the maternal environment and mental health status, and disruptions in placental function impact infant brain development and children’s neurobehavior and temperament.

The patient benefit

Dr. Limperopoulos’s research studying childbirth amid the pandemic builds on her extensive work investigating the impact of maternal stress on unborn children, including its adverse effect on brain structure and biochemistry. She’s also working on treatments and interventions to better support new families. Her program, DC Mother-Baby Wellness, brings together community partners to provide wrap-around care to expectant and new moms with elevated scores for stress, anxiety and depression.

“When identified early, maternal stress is a modifiable risk factor that can be treated with psychotherapy, social support and other personalized, evidence-based interventions,” Dr. Limperopoulos said. “We look forward to continued research in this area to better understand the mechanisms behind these biological changes and the needs of mothers and children who are born during pandemics, natural disasters and other significantly stressful events.”

Drs. Wells and Kenworthy

Center for Neuroscience and Behavioral Medicine announces new leaders

Drs. Wells and Kenworthy

Elizabeth M. Wells, M.D., M. H. S., was named Senior Vice President of the Center for Neuroscience and Behavioral Medicine, and Lauren Kenworthy, Ph.D., was named division chief of Neuropsychology.

The Center for Neuroscience and Behavioral Medicine at Children’s National Hospital recently announced the appointment of two new leaders. Elizabeth M. Wells, M.D., M. H. S., was named Senior Vice President of the Center for Neuroscience and Behavioral Medicine, and Lauren Kenworthy, Ph.D., was named division chief of Neuropsychology.

Dr. Wells obtained her undergraduate degree in psychology and biology at Harvard University and her medical degree at the George Washington University School of Medicine and Health Sciences. She was an Intramural Research Training Award fellow at the National Institute of Mental Health and holds a master’s in Health Science from the NIH/Duke Clinical Research Training Program. She completed pediatrics and neurology training at Children’s National and joined the faculty in the Brain Tumor Institute in 2011.

Dr. Wells has led the Children’s National Inpatient Neurology program and developed the hospital’s multidisciplinary Neuro-immunology program into a destination program for unsolved neuroinflammatory diseases. She serves on numerous national and international associations and working groups and is a member of the scientific selection committee for the Child Neurology Society.

Dr. Wells has served in leadership roles for the Clinical and Translational Science Institute at Children’s National and the District of Columbia Intellectual and Developmental Disabilities Research Center. She is principal investigator for a 10-year translational research study within the Children’s National partnership with the National Institute of Allergy and Infectious Diseases and was the Children’s National Hospital Medical Staff President from 2020-2022.

Dr. Kenworthy received a B.A. from Yale University and Ph.D. from the University of Maryland. She completed her internship and residency training in clinical psychology/pediatric neuropsychology at Harvard Medical School, Children’s Hospital Boston, Johns Hopkins Medical School and Mount Washington Pediatric Hospital. She has been on the faculty at Children’s National and GW since 1995. She is a national leader in autism research, as well as a distinguished author and speaker.

Gender Self-Report seeks to capture the gender spectrum for broad research applications

form with check boxes for genderA new validated self-report tool called the Gender Self-Report provides researchers a way to characterize the gender of research participants beyond their binary designated sex at birth.

The multi-dimensional Gender Self-Report, developed using a community-driven approach and then scientifically validated, is outlined in a peer-reviewed article in the American Psychologist, a journal of the American Psychological Association.

The big picture

“This is the first broadly validated tool that allows us to measure inner gender experience across a large group of people in a rigorous way that doesn’t require a person to understand specialized gender-related terms,” says John Strang, Psy.D., who directs the Gender and Autism Program at Children’s National Hospital. He co-authored the journal article about the measure and co-led the initiative to develop it. “Typical gender assessments are fixed check boxes, which is problematic for capturing gender in people who are not familiar with many of the self-descriptors, which vary in their use and meaning.”

Strang notes that even open-field gender assessments can be problematic for people who experience gender diversity but are not aware of nuanced gender-related language.

Why it matters

This new gender characterization and inclusion method will allow researchers from a broad array of fields (e.g., social sciences, medicine, education) to model their participants’ inner gender experience more equitably in research. The resulting studies will be able to provide deeper understanding of how a person’s gender can play a role in study outcomes.

Senior author and statistical lead for the project, Ji Seung Yang, Ph.D., from University of Maryland Department of Human Development and Quantitative Methodology, foresees this tool as an important addition to the research toolkit for people studying neuroimaging, genetics and any other research that requires a more accurate and detailed picture of an individual’s gender experience.

What’s unique

The Gender Self-Report tool is the first of its kind to be developed and validated by researchers together with the gender diverse and neurodiverse communities directly. These efforts align with work in many fields of clinical research to ensure that study findings reflect the insights and experiences of the people who are being studied, rather than simply capturing the researcher’s external perspective of those participants.

The tool is appropriate for use by youth (as young as 10 years of age) and adults, gender diverse and cisgender individuals, and non-autistic and autistic people. The focus on inclusivity for autistic people is in keeping with the common intersection of autism and gender diversity (i.e., 11% of gender-diverse people are estimated to be autistic).

Gregory Wallace, Ph.D., co-author of the measure and associate professor in the Department of Speech, Language & Hearing Sciences at The George Washington University, calls the tool a “game changer for any research that needs to understand specifics about how gender experience can impact health-related or developmental differences.”

The Gender Self-Report: A Multidimensional Gender Characterization Tool for Gender-Diverse and Cisgender Youth and Adults, appears in the American Psychologist.