Behavioral Health

pregnant woman holding sonogram

New review prioritizes maternal mental health during pregnancy

pregnant woman holding sonogram

A new review emphasizes the importance of treating major depression during pregnancy and prioritizing maternal mental health.

Treating depression during pregnancy is essential to protecting the health of mothers, babies and families, according to a new review led by Children’s National that calls for a renewed focus on maternal mental health and access to evidence-based care.

The study, published in JAMA Psychiatry, examines the role of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine inhibitors (SNRIs) in treating major depressive disorder during pregnancy. In the U.S., 5% to 6% of pregnant patients are treated with SSRIs, primarily for major depressive disorder, which affects about 12% of pregnant patients.

Psychiatric conditions are a leading cause of maternal morbidity and mortality. The review emphasizes that major depressive disorder is a complex brain disease shaped by genetic, environmental and epigenetic factors. Untreated, or undertreated, the illness can affect fetal and infant outcomes.

Key findings include:

  • SSRIs are an essential component of perinatal mental health care for many patients with major depressive disorder.
  • Evidence defining the benefits of SSRI treatment in pregnancy is more limited than evidence describing risks, but several studies show adverse effects when treatment is discontinued in patients with moderate to severe depression.
  • Evaluating SSRI safety during pregnancy is challenging because observational studies can be confounded by the underlying illness and related factors.
  • When the effects of medication are separated from those of depression and its consequences, accumulated evidence suggests SSRIs carry little or no risk for serious adverse outcomes.
  • The field is shifting toward prioritizing treatment of major depressive disorder to optimize maternal health.

“For too long, conversations about depression treatment during pregnancy have focused narrowly on medication exposure, rather than the very real risks of untreated illness,” said Katherine Wisner, MD, MS, associate chief of Perinatal Mental Health at Children’s National and lead author of the study. “Our review reinforces that maternal mental health is central to the health of two generations. Patients deserve balanced, evidence-based guidance that helps them weigh the benefits of treatment alongside potential risks.”

The authors call for coordinated improvements in clinical care and research, including expanded access to maternity, child health and psychiatric services, particularly in communities with limited care options. They also emphasize the importance of structured decision-making that considers the risks of untreated or undertreated illness, the benefits of treatment and the risks associated with SSRI exposure.

Podcast host Clara Faria, PhD, and Lauren Kenworthy, PhD

Executive function interventions may be critical to long-term mental health in autism

People with autism who struggle with challenges related to executive function are more likely to suffer poor mental health outcomes, according to findings from a large-scale longitudinal study published in The Journal of Child and Adolescent Psychiatry.

Lead author of the study, Lauren Kenworthy, PhD, division chief of Neuropsychology at Children’s National, recently appeared on Mind the Kids, a podcast hosted by the Association for Child and Adolescent Mental Health (ACAMH), to discuss the findings. Dr. Kenworthy touched on why interventions targeted to address executive function challenges, like Unstuck and On Target, may be critical tools to ensure better mental health outcomes for autistic youth and young adults.

What it means

Executive functions are higher order cognitive abilities that allow people to regulate their thoughts, feelings and behaviors to meet the demands of their environment. People with executive function challenges often struggle with several areas of self-regulation that can truly impact daily life, such as inhibition, flexibility and working memory.

“We’ve known for a long time now that executive functions are strongly linked to mental health, including depression, anxiety and aggression, for all of us,” Dr. Kenworthy told podcast host Clara Faria, PhD. “We’ve also known for a long time that executive functions and mental health are really challenging areas for a lot of people with autism.”

Despite the significance of executive function in autism,  studies examining the trajectory and impact of these challenges long term have been difficult to complete in a comprehensive way. Small sample sizes and/or limited age ranges have prevented researchers from capturing a true notion of how executive function and mental health outcomes develop over time.

Why it matters

This study is the first large-scale longitudinal study of executive function and mental health in autism. It shows the lasting effect of executive function challenges on autistic people, especially drilling into specific subcategories of symptoms such as aggression, anxiety and depressive mood and finding that many of these symptoms only worsen over time.

Children’s National leads the way

Dr. Kenworthy and her study co-authors concluded from the findings that interventions targeting executive function skills, especially flexibility, in autistic children are critical to a child’s well-being throughout their lives. The right interventions may reduce the burden of both the executive function challenges themselves and their impact on a child’s mental health over time.

Unstuck and On Target, a set of tools created by Dr. Kenworthy and a team of researchers from Children’s National and Children’s Hospital Colorado, is one example of an evidence-based intervention that is ready to be deployed in schools and clinics.

“We developed executive function interventions designed to improve kids’ ability to be flexible, make plans and set goals,” Dr. Kenworthy notes in the podcast. “And we’ve designed them to be delivered in the public school system with fidelity by classroom teachers and special educators because every kid gets to go school. Some of their most important work occurs in school so it’s also the real-world setting where they need the help.”

Listen to the ACAMH podcast, Beyond the Diagnosis: Supporting Executive Function to Improve Autism Mental Health, and read the full study, Executive function challenges persist into young adulthood and predict mental health outcomes in autism.

brain scans

Study links brain network interactions to depression risk in pediatric epilepsy

brain scans

A new Children’s National study reveals that depression risk in pediatric epilepsy may be tied to how brain lesions interact with the brain’s default mode network — not just where those lesions are located.

A multidisciplinary team at Children’s National has identified a potential neurobiological marker for depression risk in children with epilepsy by studying how brain lesions interact with large-scale functional networks. Conducted through the NIH-funded Focal Cortical Dysplasia Research Program, the study brought together experts from the divisions of Neurology, Neurosurgery, Neuropsychology, Neuroradiology, Psychiatry and Behavioral Sciences and Psychology and Behavioral Health.

Using focal cortical dysplasia (FCD), the most common cause of surgically treatable, drug-resistant epilepsy in children, investigators found that greater overlap between lesions and the brain’s default mode network (DMN) is associated with increased depressive symptoms, particularly during adolescence.

Dive deeper

FCD disrupts cortical development and functional connectivity, making it a powerful model for understanding how focal brain abnormalities affect distributed neural systems.

In this study, researchers analyzed children with FCD-related epilepsy who completed the Child Behavior Checklist, linking parent-reported psychiatric symptoms with advanced imaging. They mapped FCD lesions from MRI and measured how those lesions overlapped with major functional brain networks, then used statistical models accounting for age and gender to examine how network-level brain organization related to real-world psychiatric symptoms.

The results showed that greater overlap between FCD lesions and the default mode network was associated with higher depressive symptom scores, even after accounting for age and gender. Female sex was also associated with increased depressive symptoms. These associations were stronger in adolescents, suggesting that network maturation amplifies risk during this developmental stage.

“By anchoring depression risk to a specific brain network, we’re starting to connect the biology of epilepsy with the lived experience of patients in a much more direct way,” said Xiaotong Li, BA, first author of the study and clinical research coordinator with the Focal Cortical Dysplasia Research Program. “This kind of approach helps move the field toward identifying measurable markers that could eventually guide more personalized care.”

By contrast, overlap with the limbic network was not associated with depressive symptoms, and no meaningful relationship was found between network overlap and anxiety.

What this means

The findings support a shift from region-based to network-based models of pediatric epilepsy and its comorbidities.

“Rather than thinking of psychiatric symptoms as separate from epilepsy, this work suggests they may arise from the same underlying network disruptions that drive seizures,” said Nathan T. Cohen, MD, corresponding author and director of the Focal Cortical Dysplasia Research Program.

The default mode network is involved in self-referential processing and emotional regulation, aligning with broader evidence linking DMN dysfunction to depressive disorders.

The absence of a relationship with anxiety suggests that depression and anxiety in pediatric epilepsy may arise through distinct mechanisms. Overall, the results indicate that lesion–network colocalization contributes to depression vulnerability and that DMN involvement may serve as a neurobiological marker of risk, particularly in adolescence.

Why this matters

By showing that depression risk is tied to how lesions engage functional brain networks, this study provides a more precise framework for understanding psychiatric comorbidity in epilepsy.

The identification of DMN involvement as a potential marker of depressive symptoms opens the door to future work focused on individualized, network-informed diagnostics and therapies.

Together, these findings highlight how Children’s National is advancing a more integrated view of pediatric brain disease—one that connects imaging, behavior and clinical care to move toward more personalized treatment strategies.

Additional authors from Children’s National include: Ty Charde, Priyanka Illapani, MS, Sonya M. Leikin, BS, Hua Xie, PhD, Chima O. Oluigbo, MD, L. Gilbert Vezina, MD, William D. Gaillard, MD, Hayley J. Loblein, PhD, Perrine Heymann, PhD, Madison M. Berl, PhD, Adelaide S. Robb, MD, Leigh Nicole Sepeta, PhD.

Read the full study “Network Colocalization Correlates of Depression and Anxiety in Pediatric Focal Cortical Dysplasia-Related Epilepsy” in the Annals of Neurology here.

coronavirus and DNA

New research reveals COVID-19’s long-term impact on kids

coronavirus and DNA

The research teams behind these three papers examined overall symptom burden, behavioral health and cardiology outcomes in hundreds of children and adolescents, comparing those who had COVID-19 with those who did not.

New research from Children’s National Hospital and the National Institutes of Health (NIH) is offering one of the most comprehensive insights yet into how COVID-19 affects children over time, highlighting both areas of concern and reassuring findings for families and clinicians.

The Pediatric COVID Outcomes Study (PECOS) led by Roberta DeBiasi, MD, MS, chief of the division of Pediatric Infectious Diseases at Children’s National and Gina Montealegre Sanchez, MD, MS, pediatric rheumatologist at NIH’s National Institute of Allergy and Infectious Diseases (NIAID), provides crucial guidance for understanding pediatric COVID-19 outcomes.

The research teams behind these three papers examined overall symptom burden, behavioral health and cardiology outcomes in hundreds of children and adolescents, comparing those who had COVID-19 with those who did not.

“This study included mostly children with mild COVID-19 similar to what was seen during the pandemic period and results should be interpreted accordingly,” said study author and co-principal investigator, Dr. Montealegre Sanchez.

Long-COVID symptoms identified and tracked

As the first and largest study of its kind in the U.S. to publish longitudinal data, researchers reported on symptoms that children experienced in the first 12 months after enrollment in the study. They identified 20 symptoms more commonly reported in those who had COVID-19, including headaches, fatigue, forgetfulness, gastrointestinal issues, malaise and respiratory issues. Symptoms varied by age, with some appearing early and others persisting or emerging months later.

“This study helps us understand how post-COVID symptoms in children evolve over time, and importantly, across different age groups,” said Alexandra Yonts, MD, infectious diseases specialist at Children’s National and co-lead author of the study. “Since childhood is such a dynamic period of growth and development, tracking these symptoms at multiple time points and in children of many different ages is critical to know what the true long-term impacts of SARS-CoV-2 infection look like in the pediatric population.”

Physical health impacted, but mental health effects widespread

In another research project conducted with more than 800 youth who participated in the broader PECOS study, researchers found that children who had COVID-19 reported worse global health, reduced physical and cognitive functioning, and increased fatigue, pain and sleep disturbances. However, rates of anxiety and depression were similar between infected and uninfected children.

“The pandemic has affected all children’s mental health, not just those who were infected,” said research paper author Linda Herbert, PhD, director of Psychology Research and Clinical Services, Allergy and Immunology at Children’s National. “These findings highlight the broad impact of this experience on an entire generation.”

No evidence of heart damage in children

In reassuring news, a third prospective project found no evidence that COVID-19 causes long-term heart damage in children. Using advanced imaging, researchers observed no differences in cardiac function between infected and uninfected youth or even before and after infection. Children reporting symptoms such as chest pain or fatigue also had normal heart function.

“While some children experience these seemingly cardiac symptoms, our findings show these are not linked to underlying heart dysfunction,” said research paper author Michael He, MD, cardiology fellow at Children’s National.

A clearer path forward for care

Together, these findings help distinguish between the direct effects of COVID-19 infection and the broader impacts of the pandemic itself. The findings will help guide screening, clinical care and reassurance for families navigating post-COVID concerns.

You can learn more about these findings by clicking the links to each paper below:

package of buprenorphine

At-home buprenorphine initiation could improve access for adolescents

Headshot of Sivabalaji Kaliamurthy, MD

A recent study led by Sivabalaji Kaliamurthy, MD, director of the Addictions Program at Children’s National Hospital, revealed that adolescents diagnosed with opioid use disorder (OUD) can successfully start buprenorphine treatment at home within one week.

A recent study led by Sivabalaji Kaliamurthy, MD, director of the Addictions Program at Children’s National Hospital, revealed that adolescents diagnosed with opioid use disorder (OUD) can successfully start buprenorphine treatment at home within one week.

Published in the Journal of Child and Adolescent Psychopharmacology, the study also found that some patients who did not initiate at-home treatment within the first week were able to do so at later follow-up attempts.

“Adolescents face significant barriers to accessing medications for OUD,” said Dr. Kaliamurthy, lead author of the study. “Our results suggest that supported at-home buprenorphine initiation may offer a safe, feasible and accessible pathway to treatment.”

The big picture

The study evaluated 19 patients aged 18 years and younger between 2022 and 2024 who had a diagnosis of moderate or severe OUD. A clinic physician provided education on at-home buprenorphine initiation, including instructions for use and discussion of associated risks. Adolescents were instructed to begin buprenorphine when they reached their maximum tolerance for withdrawal symptoms or when their subjective opioid withdrawal scale (SOWS) score exceeded 17.

On day 1, participants initiated treatment with 2/0.5 mg buprenorphine/naloxone, with one repeat dose after 30 minutes, followed by additional 2/0.5 mg doses every 2 hours as needed, up to a maximum dose of 8/2 mg. On day 2, participants began with the total dose taken on day 1, followed by 2/0.5 mg every 2 hours as needed based on subjective cravings, up to a maximum daily dose of 16 mg. On day 3, participants were instructed to continue taking the total dose reached on day 2 through their 1-week follow-up appointment with the physician. Supportive medications were also given to take as needed.

By the 1-week follow-up, 10 of the 19 adolescents had successfully initiated treatment at home. An additional 3 adolescents were later successful in initiating treatment at home at a later date. Six participants did not continue.

The hold up in the field

This is the first study to evaluate at-home buprenorphine initiation in adolescents 18 years and under. Researchers also identified several barriers to successful treatment initiation, including insurance coverage, transportation and housing instability and relapse. At the same time, the authors noted that multiple aspects of the protocol likely contributed to successful at-home initiation, including bilingual materials, SOWS-guided timing and anticipatory guidance to reduce discomfort or misuse, such as avoiding smoking or vaping before dosing.

Children’s National leads the way

The Addictions Program at Children’s National is one of the only pediatric substance use disorder programs in the region and continues to advance treatment options for children and adolescents with addiction. Dr. Kaliamurthy and colleagues have led multiple studies focused on youth and opioid use disorder, helping build evidence for innovative approaches to care. Read more about their related research:

What’s next

While larger studies are needed to confirm efficacy and define best practices, the authors say the findings offer early support for more accessible treatment models, including home initiation.

“This work highlights an important shift toward models that expand access and meet youth where they are, especially when higher levels of care are not available,” said Dr. Kaliamurthy.

Additional authors from Children’s National include – Emma Straton, BA.

Read the study, Home Initiation of Buprenorphine in Adolescents with Opioid Use Disorder: A Preliminary Feasibility Study, in the Journal of Child and Adolescent Psychopharmacology.

bottle of narcan

Expanding naloxone access could reduce adolescent overdose deaths

bottle of narcan

Naloxone, an opioid antagonist available as a nasal spray, rapidly reverses overdose by blocking opioid receptors.

Opioid-related deaths continue to remain high among adolescents. Naloxone, an opioid antagonist available as a nasal spray, rapidly reverses overdose by blocking opioid receptors. The medication is easy to administer, has minimal side effects and produces no effect if opioids are not present. Despite these advantages, naloxone is often not used even when another person is present during an adolescent’s overdose event.

In a recent clinical perspective in JAACAP Connect, researchers recommend that clinicians prescribe naloxone more broadly to adolescents and advocate for fewer restrictions on carrying the medication in schools and communities.

“Naloxone is a lifesaving intervention with minimal risk, yet many adolescents who could benefit from it do not have timely access,” said Sivabalaji Kaliamurthy, MD, director of the Addictions Program at Children’s National Hospital and lead author of the article. “Expanding prescribing practices and reducing stigma around naloxone are critical steps in preventing avoidable overdose deaths.”

The hold-up in the field

Several barriers continue to limit naloxone access for adolescents. Some school policies restrict students from carrying the medication, instead storing it in nurses’ offices, which may delay response during emergencies that occur outside the classroom or off campus. Stigma also remains a concern, with some administrators and community members believing that providing naloxone encourages substance use.

Confidentiality and consent laws can create additional challenges. Because regulations governing adolescent consent for substance use treatment vary by state, prescribing naloxone may sometimes require parental involvement, which can discourage youth from seeking care.

Moving toward solutions

The authors emphasize that evidence does not support the idea that increased naloxone availability leads to increased drug use. Studies examining expanded naloxone access laws have not found meaningful increases in heroin or injection drug use, suggesting that broader distribution can improve safety without worsening substance use.

To improve access, clinicians can screen adolescents routinely for overdose risk factors, prescribe naloxone more broadly and educate families and school personnel about the medication’s safety. Writing notes that allow students to self-carry naloxone, connecting patients with community distribution programs and advocating for clearer school and state policies may also help reduce barriers.

With overdose deaths continuing to be high among adolescents, the authors conclude that improving naloxone access is a practical and evidence-based way to reduce preventable fatalities.

Additional Children’s National authors include Laura Willing, MD.

Read the full clinical perspective, Prescribing Nasal Naloxone in Pediatrics: A Clinical Perspective on Reducing Overdose Deaths, in JAACAP Connect.

chart showing ERP for OCD

Group therapy approach improves OCD symptoms in youth

chart showing ERP for OCDPediatric 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

Wooden blocks spelling out the word Autism

Training model improves autism knowledge among early childhood educators

Wooden blocks spelling out the word Autism

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

US News 2025-26 Honor Roll badge

U.S. News & World Report voting

Badge that says: Best Children's Hospitals, US News & World Report, Honor Roll 2025-2026.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.

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

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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

  • Dr. Syed Anwar presents at AES 2025
  • Dr. Hua Xie presents research findings during poster session
  • Dr. Nathan Cohen and Xiaotong Li presents research poster
  • Dr. John Schreiber and Chloe Hooker present research during poster session
  • Dr. Hua Xie presents at AES 2025
  • Dr. Cemal Karakas presents a research poster alongside fellow neurologist
  • Dr. Syed Anwar presents research findings at poster session
  • Members of the Division of Neurology from Children’s National Hospital with fellow neurologists from Washington, D.C.
PreviousNext

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

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

Doctor looking at a brain scan

Integrating mental health into pediatric care

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

Read more
Leandra Godoy, PhD

Honor bestowed on Leandra Godoy, PhD

Leandra Godoy, PhDChildren’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.

2025 with a lightbulb instead of a zero

The best of 2025 from Innovation District

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

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

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A psychiatrist watches as a child does play therapy

Strengthening advocacy in child and adolescent psychiatry

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.

Children's National inpatient psych unit

DBT caregiver groups during inpatient stays benefit youth and families

Children's National inpatient psych unit

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.

Mother checking child's blood glucose levels

Improving research design in pediatric psychology

Mother checking child's blood glucose levels

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.

2025 American Academy of Child and Adolescent Psychiatry (AACAP) Annual Meeting logo

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

2025 American Academy of Child and Adolescent Psychiatry (AACAP) Annual Meeting logoSeveral 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

DateTime (CST)Presenter(s)Title
10/20/253–5 PMJustine Larson, MDInstitute 1: Reclaiming Hope: Strengthening Families Through Systems-of-Care Approaches
10/20/253:30–5:30 PMJennifer Dorr, DO, MPH, Laura M. Willing, MDClinical Case Conference 3: How Advocacy Work IS Clinical Work: A Clinical Presentation
10/21/258:30–11 AMColby Tyson, MDMember Services Forum 2: The Child and Adolescent Psychiatrist Parent: Navigating Family Planning, Parental Leave, and Early Parenthood
10/21/251–3 PMJustine Larson, MDClinical Case Conference 6: Navigating the Storm: A Multidisciplinary Approach to Mood and Behavior Dysregulation in Adolescents
10/22/2512–2 PMAdelaide S. Robb, MDInstitute 4.6: Grading the Evidence – Bipolar Disorder and Schizophrenia
10/23/257–8:30 AMJustine Larson, MDClinical Consultation Breakfast 4: Anxiety in Adolescents With ASD
10/23/257–8:30 AMSivabalaji Kaliamurthy, MDClinical Consultation Breakfast 8: Engaging Adolescents With Co-Occurring Substance Use and Psychiatric Disorders
10/23/259 AM–12 PMAdelaide S. Robb, MDWorkshop 21: Understanding Video Games: A Child Psychiatrist’s Call of Duty
10/23/2510 AM–12 PMSivabalaji Kaliamurthy, MDClinical Case Conference 9: Synthetic vs Nonsynthetic Cannabinoid-Induced Psychosis in Adolescents
10/23/2512–2 PMAdelaide S. Robb, MDClinical Perspectives 57: Mastering Psychotropic Medication Management in Youth
10/23/251:30–4:30 PMSivabalaji Kaliamurthy, MDWorkshop 24: Buprenorphine 2.0
10/23/257–10 PMPriya M. Punnoose, MDMedia Theatre 11: Faith, Family, and Teen Religious Identity: Are You There God? It’s Me, Margaret
10/24/259–11 AMSivabalaji Kaliamurthy, MDClinical Perspectives 72.4: Hallucinogen Use Disorder in Adolescents and Transitional-Age Youth
10/24/259 AM–12 PMJennifer Dorr, DO, MPHHot Air, Hot Water, Hot Topics: Child and Adolescent Psychiatrists Leading the Way Through Chaos
10/24/2512–2 PMAdelaide S. Robb, MDDebate: Should High Schools Ban Smartphones?
10/24/252–4 PMMahdieh Bodaghi, MDClinical Case Conference 14: Untangling Disorders of Gut–Brain Interaction With Psychiatric Comorbidities
10/24/253–5 PMJustine Larson, MDInstitute 8.6: Creating Trauma-Informed Systems of Care
10/25/2511 AM–12:30 PMHanife Nur Akal, MDSpecial 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.

little girl using asthma inhaler

Exploring how maternal depression shapes pediatric asthma care

little girl using asthma inhaler

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.