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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: Health and development following paediatric arterial ischaemic stroke 

Program Lead: Dr Mardee Greenham

Contrary to commonly held views, children do not recover better than adults after stroke. The key difference between children and adults is that paediatric stroke results in changed ability to achieve, rather than the loss of, functional independence. The extent of functional impairment may not be immediately apparent following stroke, particularly in newborns and preschool children, who typically grow into their deficits. This is the first prospective, longitudinal study to examine the trajectory of recovery following paediatric stroke across multiple domains including cognition, language, motor ability, social skills, mental health and quality of life. Greater understanding of consequences of paediatric stroke will result in better-informed parents and health professionals, more targeted interventions, and better outcomes for children.

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, Gordon A, Cooper A, et al. Social functioning following pediatric stroke: Contributions of neurobehavioral impairment. Developmental Neuropsychology, 2018:43(4):312-28.
  9. Greenham M. Cognitive functioning in children after haemorrhagic stroke. Developmental Medicine and Child Neurology, 2017;59(11), 1104.

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. 

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,