Novel Interventions for Neurodevelopmental Disorders
NAMHC Concept Clearance — January 11, 2008
Presenter
Judith M. Rumsey, Ph.D.
Chief, Executive Control and ADHD Program
Neurodevelopmental Disorders Research Branch
Division of Developmental Translational Research
Goal
This initiative will support the development of novel interventions for neurodevelopmental disorders, with the aim of improving various domains of functioning that are impaired across disorders, and of altering developmental trajectories.
Rationale
For purposes of this initiative, “neurodevelopmental disorders” are mental disorders that have their onset during the developmental period. Examples of such disorders include autism spectrum disorders, childhood-onset schizophrenia, pediatric bipolar disorder, attention-deficit hyperactivity disorder, Tourette syndrome, and obsessive-compulsive disorder, as well as neurodevelopmental disorders with a known underlying basis, such as Fragile X and 22q deletion syndrome. In contrast to adult-onset disorders, neurodevelopmental disorders interfere with skill acquisition early in life and can potentially trigger a cascade of events with serious consequences for brain and behavioral development. Deficits that affect attention, learning, social interaction, and emotion regulation, as well as thought disorders, such as anxiety or psychosis, are not only impairing in themselves, but may preclude normal environmental experiences, in turn perturbing experience-dependent brain organization.
Feasibility studies, proof-of-concept trials, and small-scale efficacy trials will be eligible for funding. Innovation will be heavily weighted as a review criterion, although it will be balanced against the potential positive impact of the study. Clinical need (i.e., absence of effective therapies for the specific treatment targets) and potential for altering developmental trajectories of adaptive functioning will also be emphasized.
The following studies are examples of what the initiative might support:
- Novel medications or drug combinations, or new applications of existing medication regimens
- Adjunctive psychosocial and psychoeducational therapies with children and/or families to improve child and family functioning, e.g., by helping parents create an environment that supports and optimizes child functioning
- Adaptive computerized cognitive training or other systematic cognitive approaches for improving basic attention, perception, or problem solving skills
- Innovative reinforcement-based or habituation/desensitization-based behavioral training, e.g., to increase adaptive skills and decrease maladaptive anxiety, obsessions and compulsions
- Neurofeedback using real-time fMRI or other indicators of brain activity
- Noninvasive neurostimulation as an intervention, e.g., using transcranial magnetic resonance imaging
- Therapeutic applications of new technologies, such as virtual reality or robotics, to improve social interaction or to decrease anxiety
- Novel forms of skills training for improving emotion- and self-regulation, organization and planning, and other important life skills
