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Developmental insult and intervention

Program leader: Louise Crowe, PhD

A developmental insult is when normal brain development is interrupted. This could occur through an injury such as a traumatic brain injury or stroke, or could be due to other causes such as epilepsy, exposure to medication prenatally or a genetic disorder. Early childhood is a time of intense brain and skill development. If brain development is interrupted it can have a long-term impact on function, with young children often particularly vulnerable to poor outcome. The research in this group is focused on the outcomes of these insults in cognitive, behavioural and social areas. Research is also focused on the benefits of intervention for children following developmental insult. 

The goal of our team is to enhance the understanding of how an insult can influence development in early childhood and the vulnerabilities of young children. Additionally, we are focused on tailoring and administering interventions for young children with brain injuries and insults. 

Research

The research activities of our team are motivated by a desire to improve understanding about the impact of these insults to the brain and the functional consequences. Current projects include:

Project 1:  Longitudinal consequences of traumatic brain injury

Commencing in 1990, we recruited and followed a large group of children who sustained a traumatic brain injury (TBI) between birth and 12 years for 20 years. To date our findings have confirmed poorest outcome for i) children injured in infancy and early childhood; ii) those with more severe injury; iii) those experiencing social disadvantage. Our work has characterised the pattern of brain pathology and metabolic biomarkers following early brain insult and their links to outcomes. The study continues with a number of targeted projects currently underway with long-term follow up of the group. This project has also led us to focus on the social and behavioural difficulties, with these problems one of the most common consequences of TBI sustained in early childhood. 

Our research has led to a number of intervention studies using family and child-based interventions with the aim to improve quality of life and function in children with TBI.  

Project 2: Child stroke outcomes

Program Lead: Dr Mardee Greenham

In collaboration with the Royal Children’s Hospital Child Stroke Program, our team are studying the impact of stroke on the developing brain and how children recovery after a stroke. In the first study to systematically track recovery across multiple health domains, we followed a group of children for 5 years after diagnosis of a stroke. We found that recovery differs depending on the child’s age and that impairments may not emerge until long after the stroke, particularly in babies and preschool aged children. Our results suggest that children require an individualised approach to care and rehabilitation and need to be monitored long-term. We have also found that the family environment, particularly parent mental health, is an important factor in determining outcomes after child stroke. Our team are motivated by improving outcomes for children affected by stroke and their families. In 2019, we developed Australia’s first clinical guideline for the Subacute Rehabilitation of Childhood Stroke to provide health professionals with recommendations for care. Our current research is focused on discovering ways to identify children most at risk of developing problems and developing effective treatments.

Psychological Assessment

The Brain and Mind group offers psychological and neuropsychological testing (data collection) services to research groups within the Murdoch Children’s Research Institute (MCRI) and commercially funded clinical trials. We have a team of psychologists who are trained and experienced in the standardised administration, scoring and interpretation of psychological assessments. The Psychological Assessment team also offer additional research services to investigators including consultation regarding research protocol development.
Please contact us to discuss your psychological assessment needs and fees associated prior to applying for funding. 

Contact us
Dr Mardee Greenham
E: mardee.greenham@mcri.edu.au
T: (03)9936 6627

Relevant publications:

  1. Catroppa C, Crossley L, Hearps S, et al. Social and behavioural outcomes following childhood traumatic brain injury: What predicts outcome at 12 months post-insult? Journal of Neurotrauma, 2017;34:1439-47
  2. Ryan N, Catroppa C, Beare R, et al. Theory of mind mediates the prospective relationship between abnormal social brain network morphology and chronic behaviour problems after pediatric traumatic brain injury. Social Cognitive and Affective Neuroscience, 2016;11(4):683-92.
  3. Catroppa C, Stone K, Hearps S, et al. Evaluation of an attention and memory intervention post-childhood acquired brain injury: Preliminary efficacy, immediate and 6 months post-intervention. Brain Injury 2015;29(11):1317–24.
  4. Botchway E, Godfrey C, Anderson V, et al. Outcomes of subjective sleep-wake disturbances 20 years after traumatic brain injury in childhood. Journal of Neurotrauma, 2019;36(5):669-78. 
  5. Cooper A, Anderson V, Greenham M, et al. Motor function daily living skills 5 years after paediatric arterial ischaemic stroke: a prospective longitudinal study. Developmental Medicine & Child Neurology, 2019:61(2):161-7. 
  6. Crowe L, Yaplito-Lee J, Anderson V, Peters H. Cognitive and behaviour profiles of children with mucopolysaccharidosis Type II. Cognitive Neuropsychology, 2017:34(6):347-356. 
  7. Crowe L, Catroppa C, Babl F, et al. Timing of traumatic brain injury in childhood and intellectual outcome. Journal of Pediatric Psychology, 2012:37(7):745-54. 
  8. Greenham M, Anderson V, Mackay M. (2017). Improving cognitive outcome for childhood stroke. Current Opinion in Neurology, 30, 127-132.
  9. Greenham M, Gordon, A, Anderson, V, Mackay M. (2016). Outcome in childhood stroke. Stroke, 47, 1159-1164.

Grant Funders

The work of this team is supported by funding from the National Health and Medical Research Council (NHMRC) including a Centre for Research Excellence (Moving Ahead) and Project Grants. Dr Crowe holds an NHMRC Early Career Fellowship. We are also supported by funding from the Victorian Neurotrauma Initiative, Ontario Neurotrauma Foundation, Royal Children’s Hospital Foundation, Transport Accident Commission, Foundation for Children, Preston and Loui Geduld Trust Fund, Collier Chartable Foundation, Telematics Course Development Fund  and the RACV Sir Edmund Herring Memorial Scholarship, National Stroke Foundation and Victorian Stroke Clinical Network.

Positions available

We are currently recruiting high quality students with a background in psychology or neuroscience who wish to undertake postgraduate research into developmental insults or intervention. Interested applicants should email: louise.crowe@mcri.edu.au

Team Members:

  • Dr Louise Crowe, Team Leader and Research Fellow, MCRI; Honorary Psychologist, RCH Psychology; Honorary Staff, Behavioural Science, University of Melbourne
  • Associate Professor Cathy Catroppa, Research Fellow, MCRI; Educational and Developmental Psychologist, 
  • Associate Professor Amanda Wood, Research Fellow and Neuropsychologist, MCRI 
  • Dr Mardee Greenham, Research Officer and Psychologist, MCRI
  • Dr Nicholas Ryan, Research Officer, MCRI
  • Dr Celia Godfrey, Research Officer, MCRI
  • Dr Cheryl Soo, Research Officer, MCRI

PhD students: Nikita Tuli, Noor Khan, Janeen Bower, Madison Choma, Erin McKay, Joy Yumul,