Improving the Diagnosis of Otitis Media (Ear Infection) in Pediatric Patients the Diagnosis of Otitis Media (Ear Infection) in Pediatric Patients2021-11-29T06:00:00Z<p>​Waking up in the middle of the night to a crying child suffering from an ear infection is an all too familiar event for many parents. In fact, most parents would not be surprised to learn that otitis media (ear infection) is the No. 1 cause for pediatric office visits, the No. 1 cause for antibiotic use in children, and the No. 1 cause for surgery in children. </p><p>Boys Town National Research Hospital is leading the way to discover new techniques that can determine the level and type of fluid in a child's middle ear, as well as whether the cause is bacteria, a virus, or fluid build-up due to anatomical differences in a child's middle ear. Having improved diagnostic tools will help physicians deliver the most accurate diagnosis and care plan for their patients. </p><h2> <strong>Improving Otitis Media Care and Treatment</strong></h2><ul><li>Placing tubes in a child's ear, while a common procedure, is still a big deal for the child and parents. At Boys Town Ear, Nose and Throat, we deal with this every day. With the help of volunteer families, our researchers were able to gain valuable knowledge by examining and testing children before and after tubes were placed. We'll <a href="" target="_blank"> <span style="text-decoration:underline;">use this research</span></a> to better understand how fluid in the ear affects hearing, and to determine the best treatments for ear infections.</li><li>To ensure proper treatment, getting an accurate diagnosis is vital, but making that diagnosis as simple and objective as possible is important when dealing with young children. The Boys Town research team is <a href="" target="_blank"> <span style="text-decoration:underline;">studying a new objective middle-ear test</span></a> that involves simply placing an ear tip with a microphone in a child's ear. This new method gives us valuable information about middle-ear status, lessening the chance for a misdiagnosis.</li><li>Lastly, we are researching ways to refine the information we get from our <a href="" target="_blank"> <span style="text-decoration:underline;">advanced diagnostic techniques</span></a>. This involves applying computational models to the data we get from an exam on a child with an ear infection to further improve the new diagnostic tools we are developing.</li></ul><h2> <strong>Accurate Diagnosis Means Improved Outcomes</strong></h2><p>Getting the diagnosis right is of the utmost importance. While doctors do an admirable job of diagnosing and treating otitis media, there's a need for more accurate measures that can determine the level and type of fluid in a child's middle ear, as well as whether the cause is bacteria, a virus, or fluid build-up due to the dysfunction of the child's middle ear.</p><p>The Boys Town Center for Hearing Research is leading the way to discover new techniques. </p><p>"We want to better understand ear infections and differentiate between causes more effectively," said <a href=""> <span style="text-decoration:underline;">Gabrielle Merchant, Au.D., Ph.D.</span></a>, Director of the Translational Auditory Physiology and Perception Laboratory. "By improving the diagnosis, we are improving the treatment and ultimately improving the lives of children." </p><h2> <strong>Three Recent Research Papers</strong></h2><p>The Center for Hearing Research recently published three papers on improving diagnostic testing for otitis media.</p><p>"Our goal is to find objective ways to say 'yes, there's an ear infection' or 'no, there is not bacteria present' or 'it is caused by a virus,'" Dr. Merchant said. "Ultimately, we want to avoid unnecessary surgeries or unnecessary use of antibiotics while ensuring the child is properly treated."</p><p>The first paper, “<a href="" target="_blank"><span style="text-decoration:underline;">Audiologic Profiles of Children with Otitis Media with Effusion</span></a>," illustrates research done with children recruited from ear, nose and throat clinics who were having tubes placed. </p><p>The researchers first perform a battery of standard hearing tests, including tympanometry and behavioral audiometric testing, following up with experimental tests that are FDA-approved.</p><p>After the tubes are placed, the effusion is studied for the type and amount of fluid present, which is then compared to the results from testing. This work found that the amount, or volume, of effusion is an important determinant of the impact a given episode of otitis media has on a child's hearing. </p><p>The second paper, “<a href="" target="_blank"><span style="text-decoration:underline;">Improving the Differential Diagnosis of Otitis Media with Effusion Using Wideband Acoustic Immittance (WAI)</span></a>," utilizes a relatively new diagnostic tool called wideband acoustic immittance (WAI). WAI measures how the ear drum is moving in an affected ear. This, in turn, can tell us things about what is happening behind the ear drum. This paper found that WAI could determine the volume of effusion in a child's ear. This is particularly significant given the findings of the first paper, which demonstrated that volume is an important factor as to how a child is hearing. </p><p>"It's quick and easy," Dr. Merchant said. "We place a microphone in a child's ear, press a button, then take it out."</p><p>Dr. Merchant said that larger sample sizes are needed before moving this diagnostic tool to clinical settings. The advantage of WAI is that it takes the subjectivity out of assessment of ear drum and middle-ear status. </p><p>The third paper, “<a href="" target="_blank"><span style="text-decoration:underline;">The Influence of Otitis Media with Effusion on Middle-Ear Impedance Estimated from Wideband Acoustic Immittance Measurements</span></a>," takes WAI testing further by applying computational models to the findings from the first and second papers to improve the diagnostic utility of WAI further. The models estimate characteristics of the ear canal and help isolate the influence of the effusion and ear infection on the ear drum motion, all to drive and maximize precision and accuracy.</p>
Boys Town Receives Three Best of Omaha Recognitions Town Receives Three Best of Omaha Recognitions2021-11-17T06:00:00Z<p> <img class="ms-rtePosition-2" alt="Best of Omaha logo" src="" style="margin:5px;width:200px;" />Boys Town is excited to announce that Boys Town Center for Behavioral Health; Boys Town Ear, Nose and Throat Clinic and Boys Town Pediatrics physician, Dr. Kelli Shidler, were voted the Best of Omaha.</p><p>That's right, the best of Omaha is right here at Boys Town!</p><p>“Best of Omaha" is an annual recognition program run by Omaha Magazine that dates back to 1992. Individuals cast their votes for as many as 320 categories. </p><p>Congratulations to the staff at Boys Town Center for Behavioral Health; Boys Town Ear, Nose and Throat Clinic and Dr. Kelli Shidler for receiving this honor! </p><ul><li> <a href="/services/behavioral-health/center-for-behavioral-health">Boys Town Center for Behavioral Health</a></li><li> <a href="/services/ear-nose-throat-institute">Boys Town Ear, Nose and Throat</a></li><li> <a href="/physicians/kelli-shidler">Kelli J. Shidler, M.D.</a></li></ul><p style="text-align:center;"> <img alt="Best of Omaha" src="" style="margin:5px;" /> </p>
Dr. Michael Dawson Awarded the Caring Kind Award Michael Dawson Awarded the Caring Kind Award2021-11-11T06:00:00Z<p>​​​​​Michael Dawson, M.D., a pediatrician at Boys Town National Research Hospital, was the recipient of the 2021 Caring Kind Award.<br></p><p>Dr. Dawson is a well-regarded clinician, but his peers will tell you that it's not just his diagnostic ability that earned him this accolade – it's his down-to-earth demeanor and the way he touches the lives of those around him.<br></p><p>When it was time to submit nominations for the Caring Kind Award, stories for Dr. Dawson's nomination poured in. There were accounts of how he'll sit on the floor to meet his pediatric patients where they're comfortable, praises for his focus on making sure the parents of patients have the self-care and well-being resources they need too, grateful recounts of how he's always the first to spearhead a fundraiser for a friend in need or recognize a co-worker's achievements.</p><p>“Amazing, humble, above and beyond – these are just a few of the phrases used to describe Dr. Dawson's compassionate and family-centered care," said Jason Bruce, M.D., Executive Vice President of Healthcare and Director of Boys Town National Research Hospital and Clinics. “He makes everyone he interacts with feel as though they are the only person in the world that matters. He's truly one-of-a-kind, and it is a joy to see him recognized for his service to our patients and their families!"</p><p>Since 1971, the Nebraska Hospital Association has presented the Caring Kind Award to Nebraska's most caring and dedicated health care employees. The recipients of this prestigious award go above and beyond to demonstrate compassion for patients and dedication to service excellence in their job responsibilities. They ensure that care is safe, quality-driven, and cost-effective for consumers as well as the organizations they represent.</p><p>Congratulations to Dr. Dawson on receiving this prestigious award! He is truly one of a kind and Boys Town is very thankful for his contributions in changing the way America cares for children and families!​<br></p>
Unlike Any Other Physical Therapy Clinic – Introducing Boys Town’s Center for Human Performance Optimization Any Other Physical Therapy Clinic – Introducing Boys Town’s Center for Human Performance Optimization2021-11-08T06:00:00Z<p>​The Center for Human Performance Optimization at Boys Town National Research Hospital is a place where adolescents who have a physical disability are surrounded by dedicated physical therapists, leading researchers and the most advanced motion technology and equipment to create a unique hybrid in neuroscience care.  This collaborative research style makes the center and the institute unique, not only in Omaha but also nationwide.</p><p>“We have built a world-class environment where we can research cutting-edge physical therapy interventions and training," said Brad Corr, PT, DPT, Associate Director of the Center for Human Performance Optimization (CHPO). “Father Flanagan recognized the importance and strong influence environment has in how we think, perform and learn. The environment in the CHPO is designed to feel more like a fitness or sports facility than a medical clinic."</p><div class="embed-container"> <iframe width="560" height="315" src="" frameborder="0"></iframe> </div> <p>This 2,300-square-foot physical therapy center is filled with equipment that has been specially chosen to enhance skills for kids of all abilities, such as the 60+ foot track with overhead robotics to optimize walking and provide safely guided fall strategies without risk of injury, and specialized split belt and curved treadmills to increase leg power and improve gait. With the Institute for Human Neuroscience next door, collaboration will focus on developing rapid prototypes of technology and therapeutics so that every individual can have a breakthrough in improving their mobility. It is very unusual to find a scenario where science and clinical practices are almost indistinguishable from each other.</p><p>“Our mission is to change the way America cares for children and families," said Ryan McCreery, Ph.D., Vice President of Boys Town Research. “Research plays a major role in that change. Boys Town has a unique approach of blending research and clinical care that generates new and better ways to improve and transform lives. It's what we do every day across all our research, guiding us to better outcomes and helping more children, everywhere." </p><p>Learn more about <a href=""><span style="text-decoration:underline;">Center for Human Performance Optimization</span></a>.</p>
Boys Town Hospital Preschool Inspires Deaf and Hard of Hearing Children to be Superheroes Town Hospital Preschool Inspires Deaf and Hard of Hearing Children to be Superheroes2021-11-05T05:00:00Z<p style="text-align:center;">​<em>​“I'M THE HULK!" “SPIDERMAN!" “BATMAN!" “SUPERMAN!"</em></p><p>Boys Town National Research Hospital's preschool program for children who are deaf or hard of hearing inspires them to be anything and everything they want to be, including superheroes! </p><p>The program is focused on empowering children to reach their highest potential. Serving children since the late 1970s, its goal is to educate children to help them transition into a kindergarten placement with age-appropriate skills in every developmental area. </p><h2> A Superhero Lesson Project</h2><p>In the preschool, learning projects are based on students' interests. And there is always a lot of interest around superheroes. So, a project was developed around the topic. </p><p> <strong>See our creative project, in action:</strong></p><div class="embed-container"> <iframe width="400" height="400" src="" frameborder="0"></iframe> </div><p>“The preschool uses art as part of the program because art brings attention to the unique and varied ways that children can express themselves, and it highlights their ability to represent how they view themselves and the world around them," said Cathy Carotta, Ed.D., Director of Clinical and Educational Programs at Boys Town's Center for Childhood Deafness Language and Learning. “Art is instrumental in supporting each child's growth as it provides a vehicle whereby their thoughts, their emotions, and their imaginations are made visible.  It helps children to demonstrate, using multiple mediums, who they are right now and who they are dreaming to become in the future. </p><p>The art program is under the direction of art therapist, Jill Dibbern Manhart.</p><p>A recent fun and empowering role model for the preschool children is included in the new Marvel movie, “Eternals," with lead actor, Lauren Ridloff, who is deaf in real life and the movie. The film includes sign language as part of its dialogue and adaptive techniques were used behind-the-scenes to help Ridloff on the set. </p><p>Adaptive communication strategies and sign language are used every day in Boys Town's preschool program to support the child's individual development. The family's values and culture drive the types of communication methods that are used.  Teachers use a range of approaches including listening and spoken language, sign language, and picture communication systems with children who have cochlear implants and hearing aids. </p><p>The inclusivity of the first deaf Marvel superhero character is inspiring to our preschool children and other children who are deaf or hard of hearing. </p><p>“The Marvel movie is an art form," Carotta said. “And we are happy to see deaf superheroes. This is exactly what we are sharing with our children – that they have unique, wonderful attributes to give to the world." </p><p>The preschool children completed a “Heroes Project" where they learned through a lesson plan that involved superheroes learning about the values of inclusivity and helping themselves and others reach their highest potential, values that are important to and align with Boys Town. In addition, the kids had a blast! </p><p>The Boys Town preschool, teachers and the lessons they create and teach, like the Heroes Project, empower young children to be everything they can be, an important lesson for them to learn when they are young. </p><p> <a href="/services/center-for-childhood-deafness-language-learning/preschool-program">Learn more about the Boys Town National Research Hospital's preschool program.</a></p>
Dr. Sharad Kunnath Named Crohn’s & Colitis Foundations Medical Champion Sharad Kunnath Named Crohn’s & Colitis Foundations Medical Champion2021-11-02T05:00:00Z<p>​​​<img src="" alt="Sharad Kunnath, M.D., Gastroenterologist, Receives Foundation Award" class="ms-rtePosition-2" style="margin:5px;width:300px;height:296px;" />On Saturday, Oct​ober 23, Boy Town Gastroenterologist Sharad Kunnath, M.D., was honored as the 2021 Medical Champion for the Crohn's & Colitis Foundation Nebraska/Iowa Chapter at the Night of Champions Gala in downtown Omaha.</p><p>This award is bestowed on a member of the medical community who assists the Foundation in advancing the mission to find a cure for inflammatory bowel disease (IBD) and to increase the quality of life for people living with Crohn's disease and ulcerative colitis.</p><p>Dr. Kunnath is a professional member of the Crohn's & Colitis Foundation. He has shared his expertise at Foundation patient education events, supported and participated in the Take Steps annual fundraising walk and encouraged many patients to attend Camp Oasis, a camp created so children with IBD can experience camp and learn that they are never alone in their journey. He is a strong advocate for pediatric patients and their families, connecting them to Foundation resources and providing excellent care on their IBD journey. </p><p>“I thank the Foundation for this honor," Dr. Kunnath said in his acceptance speech Saturday evening. “And I really thank God for each of my IBD patients. I think it's a privilege that I have: to walk this journey with them. I believe I have given a little bit to them, but they have given a lot more to me."</p><p>Congratulations, Dr. Kunnath, for receiving this prestigious recognition! We are grateful for all that you do to change the way America cares for children with IBD, and we are proud to call you a part of the Boys Town family.</p>​<br>
The Dizzy Child Dizzy Child2021-10-14T05:00:00Z<p>​​​While <a href="" target="_blank"><em>The Dizzy Child</em></a>, the title of a new paper published in the <em>Otolaryngologic Clinics of North America</em>, by Elizabeth Kelly, M.D., Neurotologist, Kristen Janky, Au.D., Ph.D., Clinical Audiologist and Research Scientist, and Jessie Patterson, Au.D., Ph.D., Clinical and Research Audiologist at Boys Town National Research Hospital, may sound somewhat lighthearted, up to 15% of children have problems with dizziness. </p><p>Unfortunately, most children with dizziness are diagnosed with "unspecified dizziness", which highlights the difficulty many practitioners have in determining the cause of dizziness in children. Therefore, understanding the cause of dizziness in children is a growing area of research.</p><h2>Difficulty in Diagnosing</h2><p>Young children have trouble communicating their symptoms, thus inhibiting medical provider's from making an accurate diagnosis. Balance problems can cause children a great deal of discomfort and stress because they can affect gross motor development and visual acuity. It's no surprise that balance disorders can then impact children's schoolwork, social life, and interactions with family. The longer dizziness goes on, the more a child is negatively impacted. Thus, it's important for caregivers to be aware of changes in a child's behavior or motor function.</p><h2>Aids for Caregivers</h2><p>Two pediatric questionnaires, the <a href="" target="_blank">Pediatric Dizziness Handicap Inventory</a> and the <a href="">Pediatric Vestibu​lar Symptom Questionnaire​</a>​ are both available for children age 6 and older to determine the severity of vestibular symptoms. The results garnered from these tools can help a child's medical provider identify the severity of dizziness and monitor changes in symptoms following treatment. </p><h2>Vestibular Evaluation in Children</h2><p>Vestibular loss often results in delayed gross motor skills, such as sitting, standing, and learning to walk. Thus, the medical history can play a critical role in determining whether a child has an underlying vestibular disorder. Children with hearing loss are more likely to have vestibular loss; therefore, children with history of gross motor delay and with history of hearing loss are good candidates for a vestibular evaluation. </p><p>There are a variety of reasons children can become dizzy. For example, vestibular migraines are the most common cause of dizziness in children. Thankfully, some modifications medical and vestibular assessments can be completed in children.</p><p>Learn more about our <a href="/services/ear-nose-throat-institute/hearing-balance/balance-vestibular-evaluations">Balance and Vestibular Evaluations</a> and the <a href="/services/ear-nose-throat-institute/hearing-balance/vestibular-tests-treatments">Vestibular Tests and Treatments</a> offered at Boys Town National Research Hospital. </p><p>To read the full article, <a href="" target="_blank"></a>.</p>
Annual Research Project Review Showcases Collaboration Research Project Review Showcases Collaboration2021-09-28T05:00:00Z<p>​We know knowledge is power and that when you collaborate with others it can lead to important insights and discoveries. That's the goal behind the External Advisory Committee at Boys Town's Center for Perception and Communication in Children.<br></p><p>Each year, a group of Boys Town scientists present their research projects during a two-day meeting with an external advisory group that includes five members who are national leaders in their field of study. Boys Town researchers gain valuable input and feedback from committee members, as well as experience presenting and discussing their research.</p><p>Our 2021 research presentations included: </p><ul><li> <strong> <em>Improving the Diagnosis of Ear Infections</em></strong><br> by <a href="">Gabrielle Merchant, Au.D., Ph.D.</a>, Director of Translational Auditory Physiology and Perception Laboratory</li><li> <strong><em>Understanding How Face Masks Affect Speech Perception </em></strong> <br>by <a href="">Kaylah Lalonde, Ph.D.</a>, Director of Audiovisual Speech Processing Laboratory</li><li> <strong><em>Development of Online Tool for Speech-Language Genetics Research </em></strong> <br>by <a href="">Hope Sparks Lancaster, Ph.D.</a>, Director of Etiologies of Language and Literacy Laboratory</li><li> <strong><em>Studying Self-Talk in Children </em></strong> <br>by <a href="">Angela AuBuchon, Ph.D.</a>, Director of Working Memory and Language Laboratory </li></ul><p> <a href="">Watch videos</a> on the four projects that were presented, and learn more about the External Advisory Committee supporting the Center for Perception and Communication in Children.</p><p>External Advisory Committee members include:  </p><ul><li>Lisa Bedore, Ph.D., a leading expert in developmental language disorders and language learning in children who are Spanish-English bilinguals</li><li> <a href="" target="_blank">Lisa Goffman, Ph.D.</a>, known for her work investigating how the integration of language, speech, and motor interactions impacts typical and atypical language development. </li><li> <a href="" target="_blank">Kevin Munhall, Ph.D.</a>, recognized for his work on the multisensory processes and brain structures involved in face-to-face communication.</li><li> <a href="" target="_blank">Andrew Oxenham, Ph.D.</a>, respected for his work on auditory and speech perception, addressing questions related to pitch, speech recognition with acoustic and/or electric hearing, and auditory scene analysis.</li><li> <a href="" target="_blank">Robert Shannon, Ph.D.</a>, known for his work on the perception of speech and non-speech sounds by people with cochlear implants, brainstem implants, and midbrain implants. </li></ul>
Three Boys Town Research Projects Receive ASHA Award Boys Town Research Projects Receive ASHA Award2021-09-23T05:00:00Z<p>​<strong>​Three Boys Town Research Projects Receive the Distinguished Editor's Award from the American Speech-Language-Hearing Association (ASHA) </strong></p><p>To have one researcher paper recognized for this award is impressive, but we are extremely proud to announce that three publications by four Boys Town researchers have received the Editor's Award from the American Speech-Language-Hearing Association (ASHA).</p><p>Congratulations to Lori Leibold, Director, Ph.D., Director of the Center for Hearing Research; Heather Porter, Ph.D., Research Scientist at the Human Auditory Development Laboratory; Karla McGregor, Director of the Center for Childhood Deafness, Language and Learning; and Krystal Werfel, Ph.D., Research Scientist III, Written Language Laboratory, for receiving this highly esteemed award. </p><p>“We are honored to be recognized for our collaborative work, and hope that it shines some light on the communication challenges children face in noisy environments such as classrooms.," said Dr. Leibold. </p><p>Receiving an Editor's Award is one of the highest honors an individual can receive. It is presented to the editor's choice of the most commendable single article appearing in each journal in 2020. Winning articles are selected by the editorial team, including the editor-in-chief, based on experimental design, teaching-education value, scientific or clinical merit, contribution to the professions, theoretical impact, and/or other indices of merit. </p><p>“Being recognized by leaders in my profession is an honor but being recognized for work that was a product of my heart as well as my brain...even more so," said Dr. McGregor. “I am passionate about raising awareness of Developmental Language Disorder and maybe this award will shine a bit of light in that direction."</p><p>“We are honored to be recognized for this work addressing the complexities of literacy intervention for children with hearing loss and hope that this award will help to inspire and advance other research that addresses this critical issue," stated Dr. Werfel. </p><p>The following articles by Boys Town researchers were selected for this award: </p><p> <em><strong>Language, Speech, and Hearing Services in Schools</strong></em><br><strong>Editor-in-Chief: Holly Storkel</strong><br><a href="" target="_blank">How We Fail Children With Developmental Language Disorder</a><br> Karla K. McGregor</p><p> <em> <strong>Journal of Speech, Language, and Hearing Research</strong></em><strong>—Hearing Section</strong><br><strong>Editor-in-Chief: Peggy Nelson</strong><br><a href="" target="_blank">The Clear-Speech Benefit for School-Age Children: Speech-in-Noise and Speech-in-Speech Recognition</a><br> Lauren Calandruccio, Heather L. Porter, Lori J. Leibold and Emily Buss</p><p> <em> <strong>Perspectives of the ASHA Special Interest Groups</strong></em><br><strong> </strong><strong>Editor-in-Chief: Brenda Beverly</strong><br><a href="" target="_blank">Teaching Vocabulary to Improve Print Knowledge in Preschool Children With Hearing Loss</a><br> Emily Lund, Carly Miller, W. Michael Douglas and Krystal Werfel</p><p>Congratulations to Dr. Lori Leibold, Dr. Heather Porter, Dr. Karla McGregor and Dr. Krystal Werfel on this prestigious award! </p>
Deepak Madhavan, M.D., MBA, Appointed Chief Medical Officer and Vice President of Medical Affairs at Boys Town National Research Hospital Madhavan, M.D., MBA, Appointed Chief Medical Officer and Vice President of Medical Affairs at Boys Town National Research Hospital2021-09-22T05:00:00Z<p>​​Boys Town is pleased to announce the appointment of Deepak Madhavan, M.D., MBA, to the position of Chief Medical Officer and Vice-President of Medical Affairs at Boys Town National Research Hospital.</p><p>Dr. Madhavan joined Boys Town National Research Hospital as the Executive Medical Director of the Pediatric Neuroscience Initiative in May 2019. Over the past two years, he has worked diligently to create the largest, most comprehensive pediatric neuroscience program in the area and increase access to neurological care for children across the Midwest and beyond. </p><p>As Chief Medical Officer and VP of Medical Affairs, Dr. Madhavan will be extending his team- and department-building skills hospital-wide. His duties will include patient safety and accreditation activities within the hospital and among the medical staff. Additionally, Dr. Madhavan will be involved in strategic planning for the hospital, as well as physician recruitment and retention.</p><p>“Dr. Madhavan's dedication to Boys Town's mission is inspiring," said Jason Bruce, M.D., Executive Vice President of Healthcare and Director of Boys Town National Research Hospital and Clinics. “His vision, strategy and expertise will help guide Boys Town Hospital to the next level in the region, bringing life-changing care and hope to more children and families." </p><p>As Dr. Madhavan moves into this position at Boys Town Hospital, he will continue his operational and leadership involvement in the pediatric neuroscience program.</p><p>Prior to joining Boys Town Hospital, Dr. Madhavan was the Director of the Nebraska Comprehensive Epilepsy Program at the University of Nebraska Medical Center. He is board certified in neurology and epilepsy. He received his medical degree from the University of Nebraska Medical Center and completed his neurology residency at the University of Iowa Hospitals and Clinics. He completed a fellowship in clinical neurophysiology and a fellowship in epilepsy, both at New York University.</p>
New Clinic Created Specifically for First-Time Seizures in Kids Clinic Created Specifically for First-Time Seizures in Kids2021-09-16T05:00:00Z<p>​​​We're pleased to introduce <strong>Boys Town's First-Time Seizure Clinic, designed specifically for children who have experienced their very first seizure</strong>. </p><p>Watching a child experience a seizure can strike fear into any parent's heart and finding where to get answers may feel overwhelming.  Now, families have place dedicated specifically for children with first-time seizures, to be seen quickly, with far <strong>less time from call to care</strong>.</p><p> <strong>Boys Town's First-Time Seizure Clinic</strong> is staffed by a team of pediatric neurologists with experience and expertise in epilepsy care. Children are evaluated by pediatric neurologists who specialize in epilepsy care to help identify the cause of the child's first seizure and help the family establish a management or treatment plan if necessary. If needed, diagnostic imaging is available on site, so there's less waiting involved.</p><p>“Our goal with the<strong> </strong>First-Time Seizure Clinic is to see children quickly," said Deepak Madhavan, M.D., Executive Medical Director of Boys Town Pediatric Neuroscience.<strong> “</strong>This is important in first-time seizures because we want the child to receive appropriate medical care as soon as possible if the seizure is serious. And even when it isn't serious, we want parents and children reassured to relieve that stress and concern."</p><p>Parents can <strong>call <a class="tel">531-355-7420</a></strong> to schedule an appointment for a child who has had his/her <em>first</em> seizure within the last month, or is waiting on a referral to a neurologist, and has not yet seen a neurologist or been diagnosed with epilepsy or seizure disorder.</p><p>It is estimated that five to 10 percent of children will have at least one seizure. Not all need ongoing medical care, however Boys Town pediatric neurologists say all children who experience a seizure need to be seen and evaluated by a medical provider. </p><p>Parents waiting for their child to see a neurologist after an emergency room, urgent care clinic or pediatrician visit are encouraged to call for a timely appointment at 531-355-7420. The clinic is located at Boys Town Pediatric Neurology, 14080 Hospital Road on Boys Town Campus.</p><div class="embed-container"> <iframe width="560" height="315" src="" frameborder="0"></iframe>  <br></div>
Register for MyBoysTown Today for MyBoysTown Today2021-08-31T05:00:00Z<p> <strong>​​​​​​MyBoysTown</strong> is a new and improved patient portal experience – connecting your medical, hospital and behavioral health care across all Boys Town services into one record.</p><p>With <strong>MyBoysTown</strong>, you can message your provider, request appointments, review lab results, review and request prescription refills, download school and sports physicals, get health and appointment reminders, review and pay bills and more.</p><p> <em>After hearing from some of our patients, we have made modifications to our enrollment process. Your child's social security number will no longer be needed for enrollment. We want to thank those who reached out to us. Our top priority is the health and safety of children and we will continue to provide the care you have come to know and trust from us.</em></p><h2>Sign Up for MyBoysTown Today!</h2><ul><li>Visit <a href="" target="_blank"></a>.</li><li>Click the "Register Now" button. </li><li>Complete the registration form and create your username and password.</li><li>Provide further verification such as your billing number from your Boys Town statement or​ insurance number located on your insurance card. </li><li>If we can verify your information, you will receive an email to verify we have your correct email address.</li><li>Click the link provided to complete your registration process.</li></ul><p> <strong>Need help?</strong> Call us M-F, 8am-5pm at <a>1-855-364-7945</a> for assistance.</p><h2>Stay Connected with the MyChart App!</h2><p style="text-align:center;"> <img alt="MyChart logo" src="" style="margin:5px;" /> </p><p style="text-align:center;"> <a href=""><img alt="Google Play store" src="" style="margin:5px;width:184px;" /></a> <a href=""><img alt="apple store" src="" style="margin:5px;width:164px;" /></a><br></p>​<br>
Cerebral Palsy: Microstructural Changes in the Spinal Cord Tied to Hand Motor Control Palsy: Microstructural Changes in the Spinal Cord Tied to Hand Motor Control2021-08-30T05:00:00Z<p>​While the study of brain structure and function in individuals with Cerebral Palsy (CP) is fairly common, until recently, the spinal cord has not been studied as closely due to difficulties with the spasticity caused by CP and the need to remain motionless during Magnetic Resonance Imaging (MRI).</p><div style="width:100%;text-align:center;font-size:10px;margin-right:1rem;float:left;display:block;max-width:400px;"> <img alt="spinal cord image" src="" style="width:100%;display:block;" />Researchers at the Boys Town PoWER Laboratory have published research that ties microstructural changes in the spinal cord, including reduced grey matter in the cross-sectional areas, to deficits in manual dexterity.</div><p>But now, researchers at the Boys Town PoWER  (Physiology of Walking and Engineering Rehabilitation) Laboratory have published research that ties microstructural changes in the spinal cord, including reduced grey matter in the cross-sectional areas, to deficits in manual dexterity.</p><p>“Not only were we able to successfully image the spinal cord in adults with Cerebral Palsy, which has its challenges, but we were able to identify microstructural changes in the upper spinal cord and to connect these changes with hand functioning as measured by a clinical test," said Michael Trevarrow, a Postdoctoral Research Fellow at the PoWER Lab. </p><p>“By identifying alterations within the upper spinal cord and directly connecting those to sensory-motor impairments of the upper extremities, we are providing an avenue for future work to establish what other roles the spinal cord plays within this population," Trevarrow said. </p><p>For more information on this exciting new study from the PoWER Lab, visit: <a href=""><span style="text-decoration:underline;"></span></a> </p>
New MRI Study: Reduced Threat Responsiveness Corresponds with Aggressive Behavior MRI Study: Reduced Threat Responsiveness Corresponds with Aggressive Behavior2021-08-24T05:00:00Z<p>​​​​​​​​In a first-of-its-kind study, researchers at Boys Town National Research Hospital Center for Neurobehavioral Research have linked reduced threat and reduced emotional responsiveness to recorded aggressive behavior in researched adolescents during their first three months in the Boys Town residential setting.​​</p><p>Previous studies have attempted to examine relationships between brain responses and self-reported aggression. But this study is the first to have an <em>objective</em> (observed and recorded) measure of aggressive incidents, as judged by trained Family-Teachers® in the Boys Town program.</p><div style="text-align:center;font-size:10px;float:left;display:block;max-width:280px;width:100%;margin-right:1rem;"> <img alt="snake image" src="" style="width:100%;display:block;" />Researchers used images of human and animal figures that were neutral or aggressive to measure threat or emotional response. </div><p>Researchers recruited adolescents shortly after arrival at the Boys Town residential program and measured their threat and emotional response to pictured human and animal figures that were neutral or aggressive as they loomed toward or moved away in the adolescent's field of view. The responses were recorded using an MRI scanner and looking at the reactions in segments of the brain, including the inferior frontal gyrus and the amygdala.  Those brain responses were then related to the number of aggressive incidents shown during the first 3 months of stay at Boys Town.</p><p>Many factors can make a child/adolescent more prone to aggressive behavior, including economic deprivation, poor parenting, maltreatment and even ADHD. But this study looks beyond those factors to neurocognitive dysfunctions that may make an individual more inclined to aggression. The reduced reaction to threat and reduced emotional responsiveness directly (as measured in <strong>M</strong>agnetic <strong>R</strong>esonance <strong>I</strong>maging) correlated to increased recorded episodes of aggressive behavior. </p><p>The researchers hypothesized two potential reasons for this increase. The first being a lack of ability to formulate the consequences of aggressive acts and the second may be related to reduced empathetic responsiveness. Though that wasn't part of this study, the underlying architecture for threat is the same as that for empathy.</p><div style="text-align:center;font-size:10px;float:right;display:block;max-width:280px;width:100%;margin-left:1rem;">​ <img alt="Brain MRI Image" src="" style="width:100%;display:block;" />The responses were recorded using an MRI scanner and looking at the reactions in segments of the brain, including the inferior frontal gyrus and the amygdala. </div><p>​“What we clearly do show in this study is that lack of emotional response or reduced response to threat is a risk factor," said Dr. James Blair, Ph.D., one of the researchers and the Director of the Center for Neurobehavioral Research. “And we can understand why it is a risk factor with respect to poor decision making and corresponding empathic issues."</p><p>Asked about the future of this study and its findings, Dr. Blair stated, “We need better risk assessment tools – for aggression, self-harm and other mental health concerns.  This study is an early step in developing the next stage of assessment tools for aggression risk."</p><p>To learn more about the study and its findings, go to:​ <a href="" target="_blank">10.1093/scan/nsab058 </a></p>​<br>
Researchers from Madonna Rehabilitation Hospitals Visit Institute for Human Neuroscience from Madonna Rehabilitation Hospitals Visit Institute for Human Neuroscience2021-08-23T05:00:00Z<p>​​We were happy to welcome research colleagues from the Institute for Rehabilitation Science and Engineering at Madonna Rehabilitation Hospitals for a tour at our Institute for Human Neuroscience on Boys Town campus. What an inspiring visit with so many smart minds in the room who work every day to advance research that improves the lives of patients, children and families.</p><div style="width:100%;text-align:left;font-size:10px;margin-right:1rem;display:block;max-width:830px;"> <img alt="Madonna Tour Participants" src="" style="width:100%;display:block;" /> <strong>Pictured Left to Right:</strong> Arash Gonabadi, MS, Assistant Research Director Rehabilitation Engineering Center, Madonna; Thad Buster, MS, Chief Research Analyst, Madonna; Judith M. Burnfield, PhD, PT, Director Institute for Rehabilitation Science and Engineering, Director Movement and Neurosciences Center, Madonna; <a href=""> Tony Wilson, Ph.D., Director, Institute for Human Neuroscience</a>, Boys Town; Guilherme Cesar, PhD, PT, Assistant Research Director Movement and Neurosciences Center, Madonna; Susan Fager, PhD, CCC-SLP, Director Communication Center, Madonna; Dr. Jason Bruce, Executive Vice President of Healthcare and Director of Boys Town National Research Hospital and Clinics; Dr. Deepak Madhavan, Executive Medical Director, Boys Town Pediatric Neuroscience; <a href=""> Ryan McCreery, Ph.D., Director of Research, Boys Town;</a><a href=""> Karla McGregor, Ph.D., Director, Center for Childhood Deafness, Language and Learning, Boys Town</a> </div>​<br>
COVID-19 Vaccines Available for Patients 5+ Vaccines Available for Patients 5+2021-08-20T05:00:00Z<p>​​We've seen the reports across the country of the elevated COVID‑19 diagnoses and hospitalizations and the surge of the Delta variant. To help in the fight against this virus, Boys Town physicians and the Centers for Disease Control and Prevention recommend that those 5 years and older receive the COVID‑19 vaccine as soon as possible. </p><p>Boys Town Pediatrics and Boys Town Internal Medicine are <span style="text-decoration:underline;">currently scheduling appointments for the COVID‑19 vaccine for patients ages 5 and older</span> and their family members. To schedule your vaccine appointment, call <a class="tel">531-355-1234</a> or call your primary care clinic. </p><p>Boys Town Medical Clinics is issuing the Pfizer-BioNTech COVID‑19 vaccine, which is the only vaccine FDA-authorized for children 5 years and older.</p><h2>What You Need to Know</h2><ul><li>COVID-19 vaccines are safe and effective at preventing COVID‑19 disease, especially severe illness and death.</li><li>COVID-19 vaccines reduce the risk of people spreading the virus that causes COVID‑19.</li><li>You may have side effects after vaccination. These are normal and should go away in a few days.</li><li>It typically takes 2 weeks after vaccination for the body to build protection (immunity) against the virus that causes COVID-19. You are not fully vaccinated until 2 weeks after the second dose of a 2-dose vaccine or 2 weeks after a single-dose vaccine.</li></ul><p>For answers to common parent questions, please review this page we created just for you: <br> <a href="/knowledge-center/covid-vaccines-for-kids">What Parents Need to Know about Kids and the COVID‑19 Vaccine</a></p><p>Contact your provider any time you have questions or concerns about your health or your child's health.  </p>
Boys Town National Research Hospital Announces Collaboration with Mayo Clinic in Pediatric Cardiology Care Town National Research Hospital Announces Collaboration with Mayo Clinic in Pediatric Cardiology Care2021-07-28T05:00:00Z<p>Boys Town National Research Hospital is pleased to announce a new collaboration with Mayo Clinic to provide cardiology care for children in Omaha and surrounding communities.</p><p>Beginning August 2, the pediatric cardiology outreach clinic will provide diagnosis, care and treatment for a range of heart conditions such as murmurs and palpitations, syncope (fainting), chest pain, abnormal heart rhythm and various other congenital defects and heart diseases. </p><p>“We are thrilled to begin this collaboration with our colleagues from Mayo," said Jason Bruce, M.D., Executive Vice President of Health Care and Director of Boys Town National Research Hospital and Medical Clinics. “To provide a comprehensive patient care approach, we bring together multiple specialists to form the child's care team, addressing the physical, developmental and mental health care of the child. Collaborating with Mayo Clinic allows us to bring their expert cardiology care to our patients and community." </p><p>Mayo Clinic cardiologists will see patients at Boys Town Medical Clinics, located on Boys Town campus, at 139<sup>th</sup> and Pacific Street. To learn more about pediatric cardiology, <a href="/services/pediatric-cardiology">request an appointment online</a> or refer a patient by calling <a class="js-phone">(531) 355-6980</a>. </p><p>Mayo Clinic is the second national collaboration with Boys Town National Research Hospital in two years. In 2019, Boys Town Hospital began a collaborative project with Shriners Healthcare for Children-Twin Cities serving as an outreach clinic for their Nebraska patients to receive care closer to home. </p>
Boys Town’s Morgan Busboom Awarded Foundation for Physical Therapy PODS I Scholarship Town’s Morgan Busboom Awarded Foundation for Physical Therapy PODS I Scholarship2021-07-26T05:00:00Z<p> <img src="" alt="Morgan Busboom headshot" class="ms-rtePosition-2" style="margin:5px;width:300px;height:300px;" />Morgan Busboom, PT, DPT, of the Institute for Human Neuroscience at Boys Town National Research Hospital, was recently awarded a PODS I Mildred Wood Award from the Foundation for Physical Therapy. Funding from the foundation was provided to 21 of the most promising physical therapist researchers to help these new investigators begin their research careers and complete doctoral studies. </p><p>The award provides professional development opportunities for Busboom, as well as supports her dissertation work that she will be doing at Boys Town. Busboom, a Ph.D., student at the University of Nebraska Medical Center, is working at Boys Town's Institute for Human Neuroscience in the <a href="">Physiology of Walking and Engineering Rehabilitation (PoWER) Laboratory</a> under the direction of Max Kurz, Ph.D. </p><p>With the help of this scholarship, Busboom will be focusing her dissertation on a project titled: Robotic Exoskeleton Gait Training in Adolescents with Cerebral Palsy. Through her research, Busboom will be studying new or better ways for patients with cerebral palsy to walk using robotic exoskeleton therapy and how the clinically relevant changes are connected with improvements in the brain and spinal cord activity. </p><p>“We're using the robotic exoskeleton in a way that is a little bit different than you would think. A robotic exoskeleton is used a lot of times in rehab to assist or support a patient as they perform gait training. I am proposing to use the robot to perturb the leg movements during physical therapy to enhance the nervous systems exploration of new and better ways to walk," explained Busboom of her dissertation work. </p><p>Having grown up in Nebraska, Busboom was familiar with Boys Town and is excited to be working in the Institute for Human Neuroscience. “I grew up in Nebraska and had heard about Boys Town. I wasn't aware of all the research opportunities here so that's been the most exciting thing - learning about Dr. Kurz and Dr. Wilson coming to Boys Town and their 'why' for coming here, as well as seeing all of the resources available at Boys Town and the excitement around research," said Busboom. </p><p>In addition to her work at Boys Town, Busboom also is a contracted pediatric physical therapist. “It's interesting to see both the hospital side of physical therapy and the research side. Seeing both helps me to develop new ideas for research." </p><p>“Morgan is extremely creative in her thought process and has a knack for disentangling the source of the movement challenges seen in the patients she treats. She is very deserving of this award and is well on her way towards making an impact on the treatment strategies used at Boys Town and across the clinics in the United States," said Dr. Kurz.</p><p> <em>The </em> <a href=""> <em>Institute for Human Neuroscience</em></a><em> at Boys Town National Research Hospital opened in March 2021. Located on Boys Town campus in Omaha, Nebraska, it is one of the most cutting-edge neuroscience research facilities in the nation and the only site in the world with two next-generation MEG (magnetoencephalography) systems.</em></p>
Change Lives and Earn Money Lives and Earn Money2021-07-21T05:00:00Z<p>You can earn money, help advance science and change lives by participating in research studies this summer at Boys Town! Boys Town is looking for participants from all age groups to join our life-changing research studies. Participants can earn at least $15 per hour for their time. Studies are non-invasive and fun – and can help change the lives of children with hearing, communication, developmental, behavioral and mental health challenges.  We need participants with and without these challenges.</p><p> <a href="">Browse our list of current openings</a> and sign up today! This is a great summer break activity for kids and adults alike! <strong>Don't see a study that fits you?</strong> Boys Town is always looking for research participants<a href="">; sign up</a> to be notified of future studies. </p>
Let the Children Talk (to Themselves) - It Helps Memory the Children Talk (to Themselves) - It Helps Memory2021-07-19T05:00:00Z<p>​​​​It's the middle of your remote workday. You leave your home office, but the moment you enter the kitchen, you've completely forgotten what you wanted in the first place. You muse aloud "why did I come in here?" and proceed to talk yourself through the sequence of events that led to your arrival in the kitchen. Adults commonly use these self-talk strategies to remember and problem solve. However, in these days of remote learning, you may have noticed that your children's memory lapses are less often accompanied by self-talk. In fact, it's long been thought that children younger than 7 are unable to use a self-talk tool called rehearsal to help them remember lists of things. But thanks to a modernized version of five-decades-old study, we now have a much better idea of when rehearsal develops.</p><p> <img src="" alt="Study participants point to the pictures, just as they did in the original Flavell study." style="margin:5px;" /> <br> </p><div> <span class="ms-rteStyle-References">Study participants point to the pictures, just as they did in the original Flavell study</span>.</div><div> <br> </div><div>In 1966, Flavell, Beach, and Chinksy showed 60 children --5, 7, and 10-year-olds -- sequences of hand drawn pictures. After each sequence, the researchers laid out the pictures and asked the child to point to the pictures in the order. Meanwhile, another researcher discretely watched the child's mouth for subtle movement that indicate the child was talking to herself. In the original study, only the 7- and 10-year-olds spontaneously took advantage of rehearsal to help remember the lists.</div><p> <img src="" alt="The participants vision was obstructed during the delay period prior to recall, just as was done in the 1966 study." style="margin:5px;" /> <br> </p> <span class="ms-rteStyle-References">The participants vision was obstructed during the </span> <span class="ms-rteStyle-References"></span> <span class="ms-rteStyle-References">delay period prior to recall, just as was done in the 1966 study.</span> <p> <span class="ms-rteStyle-References"></span> <br></p><p>Fast forward to 2017. Dr. Emily Elliott of Louisiana State University, Dr. Candice Morey of Cardiff University and Dr. Angela AuBuchon of Boys Town National Research Hospital® struggled to reconcile the results from 1966 with new research from their colleague Dr. Chris Jarrold at the University of Bristol. Dr. Jarrold used different methods than the 1966 study, but his results suggested that 5- and 6-year-olds might also be using very simple forms of rehearsal on memory tests. </p><p> <img src="" alt="Care was taken to replicate the obstruction of vision during delay periods." style="margin:5px;" /> <br> </p> <span class="ms-rteStyle-References">Care was taken to replicate the obstruction of vision during delay periods.</span> <p> <br> </p><p>Drs. Elliott, Morey, and AuBuchon decided to find out if the inconsistency could be explained by either the differing methods or the passage of time, so they proposed to lead a multi-site registered replication report of the 1966 study. After their proposal was accepted by the journal Advances in Methods and Practices in Psychology Science (AMPPS), they made all of their materials – from the study protocol and experimental program to the data analysis code – available on Open Science Framework (OSF). They invited researchers around the world to conduct the experiment in the own labs and contribute data. Ultimately, the replication included 977 children from 17 labs – including the three lead authors' and Dr. Jarrold's – representing not only the United States and the United Kingdom, but also Turkey, Norway, New Zealand, Germany, Costa Rica, Switzerland, Italy, and Austria.</p><p> <img src="" alt="Study participants from 17 sites worldwide were observed as they provided verbal labels for items presented on the computer scre" style="margin:5px;" /> <br> </p> <span class="ms-rteStyle-References">Study participants from 17 sites worldwide were observed as they provided verbal labels for items presented on the computer screen.</span> <p> <br> </p><p>Careful attention was paid to preserving key elements of the original study. However, the replication was modernized to reflect current research practices. For example, pictures were presented on a computer to standardize the experiment across of the labs. They also video recorded the children, when possible, to assure that lip movements were reliably monitored.  The new study also included a subset of 6-year-olds to better asses the presumed transition from non-verbal memorization in younger children to rehearsal in older children.</p><p>The replication upheld the core of Flavell and colleagues 1966 finding – fewer 5- and 6-year-olds than 7- and 10-year-olds used self-talk. Importantly, though, many more 5- and 6- year-olds used self-talk than would have been predicted by the original 1966 study.  With the expanded study size, 75% of 5-year-olds were found to verbalize as a memory tool at least part of the time, versus 10% in the Flavell study. The updated research also suggests that increased verbalization led to increased memory span performance in the participating children regardless of the participants' age. The benefits of pointing and verbalizing in these memory exercises were particularly prominent in 6-year-olds, who were added to the replication study and were not present in Flavell's original study.</p><p> <a href="" target="_blank">Click here</a> to read the newly published replication study.</p><p><a href="" target="_blank"></a></p>​<br>
Boys Town Researchers Find Generalized Anxiety Disorder in Adolescents Can Significantly Impair Quality of Life Town Researchers Find Generalized Anxiety Disorder in Adolescents Can Significantly Impair Quality of Life2021-07-02T05:00:00Z<p>​​​​​​​​<img src="" alt="GAD" class="ms-rtePosition-2" />A quality life is where our goals and aspirations flourish.  But a quality life is more challenging for adolescents to achieve if they have generalized anxiety disorder (GAD) and are plagued with constant worries​ about almost everything.</p><p>This suffering is especially poignant for researchers at Boys Town, where 30% of the adolescents in the Family Home Program arrive with some level of generalized anxiety disorder. Until recently, GAD in adolescents has seen very little neuroimaging research.</p><p>“A major problem we see in adolescents with GAD is the recruitment of the brain regions involved in response control and attention," explained Karina Blair, Ph.D., Director of the Program for Trauma and Anxiety in Children (PTAC) at Boys Town National Research Hospital. “Response control and attention are what allows us to concentrate on useful activities. That part of the brain (top-down attentional control) helps us reduce distraction and lets us focus on what is necessary and what we need to do to achieve our goals in life."</p><p>Researchers believe that the difficulties that adolescents with GAD have in engaging top-down brain functions cause them to be more prone to distractions, especially distractions that are worrying. It is also possible that consistent worry interferes with their ability to control responses and attention, so the worry-distraction, distraction-worry scenario may be a two-way path.</p><p>Investigations like this one may pave the way for ​future brain-level studies that index treatment response. By understanding the brain-level difficulties face​d by adolescents with GAD, one can develop biomarkers of those difficulties so that we can be sure whether a treatment has helped or whether additional remedies need to be considered.</p><p>To read the full article, <a href="" target="_blank">click here</a>.<br></p> <style> .ms-rtePosition-2 { width:450px; height:auto; float:right; } @media only screen and (max-width: 600px) { .ms-rtePosition-2 { display:block; float:none; } } </style>​<br>
Boys Town Pediatric Neuroscience Continues to Grow, Announces Rare Disease and Neurogenetics Care for Kids Town Pediatric Neuroscience Continues to Grow, Announces Rare Disease and Neurogenetics Care for Kids2021-05-04T05:00:00Z<p>​Boys Town National Research Hospital is proud to announce the addition of the <a href="/services/pediatric-neuroscience/neurogenetics">Neurogenetics and Rare Disease Clinic</a> as part of Boys Town's growing Pediatric Neuroscience program to help patients and primary care doctors alike who have been searching for answers to rare medical conditions.</p><p>Boys Town Neurogenetics and Rare Disease Clinic is led by <a href="/physicians/dinesh-lulla">Dinesh Lulla, M.D.​</a>, pediatric neurologist and neurogeneticist. Dr. Lulla specializes in the diagnosis and treatment of rare diseases that includes genetic epilepsies, leukodystrophy (white matter disorders of the brain), ataxia (balance disorders in children) and, a variety of different movement disorders, in addition to complicated genetic diseases and disorders that cause neurodevelopmental delays and regression in children.</p><p>In the United States, a disease is considered rare if it affects less than 200,000 people, or one in 1,500 individuals.</p><p>When asked what made him want to open the clinic, Dr. Lulla, whose calm and comforting demeanor is so reassuring to anxious patients, said, “When I was training as a general pediatric neurology resident, there were many patients with undiagnosed rare conditions. The way it impacts patients in terms of the physical burden of the disease itself, the emotional burden on the patient and the family, and the economic burden is difficult. I wanted to be an advocate for these patients in finding hope and a cure for some conditions, or just being there for them to explain a difficult diagnosis."</p><h2>A Comprehensive Clinic for Neurological Puzzles</h2><p>Treating rare diseases is often like putting together the pieces of a puzzle. Clinical presentations of rare diseases are not always clear – individual symptoms may lead a patient from one specialist to another. The goal of Dr. Lulla's clinics is to provide advocacy and hope for patients who have long been looking for answers.</p><p>“Often, a child with a rare disease will have multiple organ systems involved in addition to the brain," said Dr. Lulla. “Sometimes, they are seeing multiple specialists. But what is really important for them is to have a specialist in place who zooms out and looks at the bigger picture. I don't look at the body as 'this is just the heart' or 'this is a problem with the stomach,' but I'm looking at you as a whole person and connecting the dots to find the bigger picture."</p><p>Boys Town Neurogenetics and Rare Disease Clinic provides Omaha and the surrounding regions a place where patients can receive this type of comprehensive assessment. With each new patient, Dr. Lulla conducts a comprehensive assessment that includes a thorough physical examination, any necessary lab work and a review of the patient's family history. Supporting him is a dedicated neuroscience genetic counselor who helps the patient and family through a very detailed three-generation family history. Plus, the clinic works on authorizing tests with the insurance companies, so families don't end up with unexpected bills.   </p><h2>World Class Care in Nebraska</h2><p>Boys Town Hospital is positioning itself to be the region's premier pediatric neuroscience provider. Prior to the recent founding of Boys Town Pediatric Neuroscience, Nebraska and the region have been historically underserved in this specialty.</p><p>“One thing that really got me interested in Nebraska is that it has been underserved, not only in neurogenetics but also in general child neurology care, which is my passion," said Dr. Lulla. “We want families to know that we do see rare diseases here," he said. “They don't have to travel to Colorado or Kansas City to look for an answer. We have the support team available here to help our patients go through that diagnostic journey."</p><p>Boys Town ​Neurogenetics and Rare Disease Clinic is open at the Downtown Medical Campus at 555 North 30<sup>th</sup> Street (30<sup>th</sup> and Dodge). Patients have access to the comprehensive team of pediatric neurologists and genetic specialists, as well as the neurology, neurosurgery and neurodevelopment programs that make up Boys Town Pediatric Neuroscience. </p><div class="embed-container"><iframe width="560" height="315" src="" title="YouTube video player" frameborder="0"></iframe> </div>
Boys Town Hospital Announces New Surgery Clinic Town Hospital Announces New Surgery Clinic2021-04-26T05:00:00Z<p>​Boys Town Pediatric General and Thoracic Surgery has opened a new clinic at Boys Town Medical Clinics on 30<sup>th</sup> and California Street to provide greater access to general surgical care for children in eastern Omaha and southwestern Iowa. Led by pediatric surgeon Robert Cusick, M.D., the clinical team at this location is bilingual in English and Spanish. </p><p>Boys Town Pediatric General and Thoracic surgery can see new patients within days, and emergencies are seen immediately. The surgical team specializes in the diagnosis, treatment and management of conditions in the esophagus, stomach, intestine, appendix, colon, bile ducts, liver, pancreas, spleen, lungs and mediastinum and other common procedures. The team provides surgeries related to:</p><ul><li>Weight management</li><li>Cancer and tumors</li><li>Colon, rectum and bowel</li><li>Lungs and chest</li><li>Thyroid and endocrine systems</li><li>Hernias and reproductive organs</li></ul><p>“We strive to serve as a community resource," said Jason Bruce, M.D., Executive Vice President of Healthcare at Boys Town and Director of Boys Town National Research Hospital and Medical Clinics. “With more clinic locations, telemedicine visits and physician consultations, we're keeping our patients first, providing them with increased access to the care that families, physicians and providers have come to trust."</p><p>The surgical team at Boys Town Hospital also includes boa​rd-certified physician anesthesiologists, board-certified pediatric anesthesiologists and pediatric trained nurses. Should a patient need additional care, we are backed by a team of pediatric intensivists and pediatric hospitalists in our inpatient and advanced care units.</p><p>Learn more about <a href="/services/pediatric-general-thoracic-surgery">Boys Town Pediatric General and Thoracic Surgery</a>. </p><h2>New Clinic Video Walkthrough<br></h2><div class="embed-container"><iframe width="560" height="315" src="" title="YouTube video player" frameborder="0"></iframe> </div>
Boys Town Names New Executive Vice President of Healthcare Town Names New Executive Vice President of Healthcare2021-04-13T05:00:00Z<p>Boys Town is pleased to announce the appointment of Jason Bruce, M.D., as Executive Vice President of Healthcare and Director of Boys Town National Research Hospital and Clinics. </p><p>“Dr. Bruce is a trusted and compassionate physician with a long-standing commitment to service in our community," said Rod Kempkes, CEO at Boys Town. “His leadership and heart will help guide our efforts in shaping the way America cares for children, families and patients."</p><p>As interim Executive Vice President of Healthcare, Dr. Bruce was instrumental in helping the organization navigate a global pandemic while also ensuring hospital operations continued to thrive through many changes. </p><p>Dr. Bruce joined Boys Town in 2006 as a pediatrician. Throughout the last 15 years, he has held various leadership roles within Boys Town National Research Hospital, including Medical Director of Same Day Pediatrics, Pediatric Practice Leader for Boys Town Pediatrics, Associate Medical Director for Primary Care, and most recently serving as Chief Medical Officer and interim Executive Vice President and Director of Boys Town National Research Hospital. </p><p>Dr. Bruce earned his Doctor of Medicine from Creighton University in 2003. He is a current participant in the Certified Physician Executive (CPE) Program with the American Association for Physician Leadership. </p><p>He continues to be involved in the Omaha community as an active member of Metro Omaha Medical Society and volunteer for his church and his children's school and youth athletic teams. In addition, he volunteered at several professional organizations, including volunteer physician for the Institute for Latin American Concern (ILAC), volunteer parenting class teacher for Essential Pregnancy Services, and committee member for Building Bright Futures – Omaha. </p>
Introducing a Ground-Breaking New Institute at Boys Town National Research Hospital a Ground-Breaking New Institute at Boys Town National Research Hospital2021-03-29T05:00:00Z<p>​​Boys Town National Research Hospital® is revolutionizing child and teen brain research at the new <a href="">Institute for Human Neuroscience</a>, which opened in March 2021. The Institute is in a brand-new 15,000+ square foot research facility specifically built for this group of researchers and their state-of-the-art equipment. As one of the most cutting-edge neuroscience research facilities in the nation, it includes a high-performance research-grade Siemens Prisma MRI and two next-generation MEG (magnetoencephalography) systems. </p><p> <a href="">Tony Wilson, Ph.D.</a>, tapped to lead the new Institute, has also been named the Patrick E. Brookhouser Endowed Chair in Cognitive Neuroscience at Boys Town National Research Hospital.  </p><p>“One of the main reasons we came to Boys Town was the opportunity to build an incredible institute in an amazing environment. As the only site in the world with two next-generation MEG Neo systems, we'll have twice the capacity for major discoveries in pediatric neuroscience and neurotherapeutics and be able to impact the lives of children and families directly," said Wilson.</p><p>Wilson brings a team of almost 50 research scientists and staff who will work to understand how the brain changes as kids move through puberty and into young adulthood. The group will also study the impact of traumatic experiences on brain development and the brain changes associated with the emergence of psychiatric conditions like anxiety disorders, depression or schizophrenia. </p><p>The Institute of Human Neuroscience aligns directly with Boys Town's mission and growth of its Pediatric Neuroscience program. The emphasis will be on pediatric brain health and contribute directly to improved outcomes in children receiving care from our neurologists, neurosurgeons and behavioral health teams.  </p><p>For example, MEG is FDA-approved for use in identifying the focus of epileptic seizures. It creates the opportunity for neuroscience researchers to pinpoint the origin of such seizures, which can then be removed through surgery to maximize positive outcomes.</p><p>When the Institute is fully operational it will house nine to 10 different laboratories and 100 to 120 researchers, all under one roof. Each lab will focus on different sub-areas of human neuroscience using MRI, MEG and other state-of-the-art methods. Each laboratory will function independently, studying ​different disorders, different populations and different therapeutics.</p><p>“We're so excited to work in such a collaborative environment," noted Wilson. “We think it's going to give rise to a lot of​ great science that wouldn't have otherwise occurred."</p><p>“At Boys Town National Research Hospital our mission is to change the way America cares for children and families – and to do that, we've brought together the nation's best scientists to develop new and better treatments and intervention methods," said Ryan McCreery, Ph.D., Director of Boys Town Research. “Dr. Wilson and his team bring that expertise in neuroscience. What is learned in the lab will directly apply to our clinical care so that more children and families can benefit from this life-changing research."</p><div class="embed-container"> <iframe src="" title="YouTube video player" width="560" height="315" frameborder="0"></iframe> </div>
Tony W. Wilson, Ph.D., Named Patrick E. Brookhouser Endowed Chair in Cognitive Neuroscience W. Wilson, Ph.D., Named Patrick E. Brookhouser Endowed Chair in Cognitive Neuroscience2021-03-28T05:00:00Z<p> <a href="">Tony W. Wilson, Ph.D.</a>, Director of the new <a href="">Institute for Human Neuroscience at Boys Town National Research Hospital</a>, has been named the first recipient of the Patrick E. Brookhouser Endowed Chair in Cognitive Neuroscience. </p><p>Dr. Wilson is nationally recognized for his work utilizing neuroimaging to investigate typical and atypical brain development and use those findings to predict long-term outcomes and derive therapeutics.  He brings a team of almost 50 research scientists and staff who will work to understand how the brain changes as kids move through puberty and into young adulthood, which is obviously a period of major cognitive and emotional change.</p><p>Translating research to improve lives has been at the core of Boys Town Hospital since opening in 1977. Founding hospital director, Patrick E. Brookhouser, M.D. was a gifted physician and surgeon, and dedicated his life to being a steward of Father Flanagan's dream to help children. He was recognized across the U.S. for the ground-breaking research he initiated in the treatment and prevention of hearing loss and other communication disorders.  </p><p>“One of the unique things about holding the Brookhouser Endowed Chair is that I was fortunate enough to meet him when I first moved to Omaha", said Wilson. “Brookhouser believed that ground-breaking research wasn't enough. The findings need to be used to improve medical care and make lives better for children and families. One of the main reasons we came to Boys Town was the opportunity to build an incredible institute in an amazing environment to directly impact the lives of children and families. Boys Town has the infrastructure and a history of doing things like this and we are excited to carry on this critical mission. I think Dr. Brookhouser would have been excited about the unique opportunities that this Institute presents for pediatric brain health."</p><p>The Institute for Human Neuroscience is in a brand-new 15,000+ square foot research facility specifically built for this group of researchers and their state-of-the-art equipment. As one of the most cutting-edge neuroscience research facilities in the nation it includes a high-performance research-grade Siemens Prisma MRI and two next-generation MEG (magnetoencephalography) systems.</p>
Boys Town Leads National Research Efforts with Twice the Capacity for Major Discoveries in Pediatric Neuroscience Town Leads National Research Efforts with Twice the Capacity for Major Discoveries in Pediatric Neuroscience2021-03-27T05:00:00Z<p> <em>​​“As the only site in the world with two next-generation MEG Neo systems, we'll have twice the capacity for major discoveries in pediatric neuroscience and </em> <em>neurotherapeutics</em><em> and be able to directly impact the lives of children and families. Boys Town has the infrastructure and a history of doing things like this and we are excited to carry on this critical mission," said </em> <a href=""> <em>Tony Wilson, Ph.D.</em></a><em>, Director of the </em> <a href=""> <em>Institute for Human Neuroscience</em></a><em> and Patrick E. Brookhouser Endowed Chair in Cognitive Neuroscience. </em></p><p>MEG (magnetoencephalography) is unique in that it can see what is happening in the brain at a very fast millisecond level – meaning that it will allow researchers to image the brain at the speed of thought. With MEG, it is possible to see thoughts and sensations evolving in the brain as one processes their environment.</p><p>“In some of our MEG experiments, we show individuals a picture of a word, then we can watch the portion of their brain that controls vision activate or light up," said Wilson.  “And from there, we can watch it progress through the brain and activate different regions as the person sounds out the word, then understands the meaning of the word, and then vocalizes the word."</p><p>MEG technology uses highly sensitive magnetic sensors that are configured into a helmet to measure brain function. The helmet is comfortable, and participants are typically seated with their head within the helmet throughout the study. MEG studies are noninvasive, totally quiet, and are often a better fit for children than an MRI given the comfort factor.</p><p>An example of a practical application is for patients who have brain tumors. In the case of a brain tumor, surgery is performed to remove the tumor. But outcomes are much better if important functions such as the motor control of hands, feet and face can be accurately mapped. Further, mapping the location of the person’s language function with MEG can help ensure the patient does not have a major language deficit following the surgery. The MEG map of these essential functions is passed on to the neurosurgeon so that these parts of the brain can be spared to the extent possible during the surgery.<br></p><p>The <a href="">Institute for Human Neuroscience</a> is one of the most cutting-edge neuroscience research facilities in the nation, and includes a high-performance research-grade Siemens Prisma MRI, two next-gene​ration MEG systems, a mock Prisma MRI scanner, and other state-of-the-art instruments for human neuroscience research. This technology supports the work of the research team to define normal brain development in children and identify the impact of traumatic experiences on brain development, as well as the brain changes associated with the emergence of psychiatric conditions like anxiety disorders, depression or schizophrenia.</p><h2>What is MEG (magnetoencephalography)?</h2><div class="embed-container"> <iframe width="560" height="315" src="" title="YouTube video player" frameborder="0"></iframe> </div><h2>Cutting-Edge Neuroscience Technology</h2><div class="embed-container"><iframe width="560" height="315" src="" title="YouTube video player" frameborder="0"></iframe> </div>
Building a Center of Excellence in Neuroscience Research a Center of Excellence in Neuroscience Research2021-03-27T05:00:00Z<p>​​With the opening of The Institute for Human Neuroscience, Boys Town National Research Hospital is setting the pace for neuroscience research. </p><p>Unlike an already existing research center, the faculty at the Institute for Human Neuroscience had lots of input into creating this unique new workspace. They worked with the architects to make the building fit their vision for the best way to have patients and instruments all in the same spaces. Part of the plan was to develop a lab that would allow epilepsy patients to have a MEG and an MRI all in one visit. And having a research institute directly onsite means translating research to improve care can happen at a faster rate and help change the way America cares for children and families, everywhere.</p><p>“One of the main reasons we came to Boys Town was the opportunity to build an incredible institute in an amazing environment," said Wilson. “As the only site in the world with two next-generation MEG Neo systems, we'll have twice the capacity for major discoveries in pediatric neuroscience and neurotherapeutics and be able to directly impact the lives of children and families. Boys Town has the infrastructure and a history of doing things like this and we are excited to carry on this critical mission."</p><p>Also unique to this field of study is the work environment at Boys Town. When the Institute is fully operational it will house nine to ten different laboratories and between 100 to 120 researchers, all under one roof. Each of these labs will focus on different sub-areas of human neuroscience using MRI, MEG, and other state-of-the-art methods.</p><p>“All of us are different, we're experts in different things, and the niche that we know better than anything else is unique amongst all of us. We're excited to work in such a collaborative environment," noted Wilson. “We think it's going to give rise to a lot of great science that wouldn't have otherwise occurred."</p><h2>Six Neuroscience Research Labs…and Growing</h2><p>The breadth of study available from the moment the Institute opens will be impressive. With six key labs already conducting research on Boys Town campus with room to grow. </p><p>The <a href="">Dynamic Imaging of Cognition & Neuromodulation (<strong>DICoN</strong>) Laboratory</a>v uses multimodal brain imaging to investigate the neural dynamics that underlie visual processing, attention and motor control in children and adults. A key goal is to determine how these brain dynamics predict cognitive performance in real time.</p><p>The primary aim of the <a href="">Brain Architecture, Imaging and Cognition (<strong>BrAIC</strong>) Laboratory</a> is to investigate the architecture of the brain and its association with cognition in health and disease, using a combination of behavioral and neuroimaging techniques. The goal is to use an integrative approach to map the brain networks that support cognitive abilities, and understand how different factors, such as age, environment and disorders, impact their interactions. </p><p>The <a href="">Physiology of Walking & Engineering Rehabilitation (<strong>PoWER)</strong> Laboratory</a> primarily focuses on how humans process/attend to sensory information, produce motor actions and learn new motor skills. The laboratory uses a blend of MEG/EEG neuroimaging and advanced biomechanical engineering analyses. The outcomes are directed at the development of new technologies for rehabilitation and therapeutic approaches for improving the mobility of patients with developmental disabilities. </p><p>The <a href="">Developmental Clinical Neuroscience (<strong>DCN</strong>) Laboratory</a> seeks to better understand how serious behavioral problems, particularly aggression, dev​elop and to better understand why trauma and PTSD play a large role triggering serious behavioral problem in some, but not all, youth. The lab examines changes in the brain and in endocrine function (hormones) and how those changes can lead to understanding the origins of serious behavioral problems.</p><p>The overarching goals of the <a href="">Cognitive and Sensory Imaging <span><span>(<strong>CASI</strong>)</span></span> Laboratory</a> are to understand the interactions between sensory experience and higher-order cognition such as working memory and executive function, and to characterize what these interactions look like in the brain. Current research focuses on the impact of hearing loss, and the quality and frequency of subsequent hearing interventions, on cognitive and neural development in children and adolescents.</p><p>The <a href=""><strong>Neurodiversity</strong> Laboratory</a> is dedicated to studying individual variability in neurocognitive development during childhood and adolescence. Development is a dynamic process that is continually modulated by one's environment and experiences. This lab uses advanced statistical modeling techniques and cutting-edge neuroimaging to explain the complex interactions between brain, behavior and environment, with the goal of producing knowledge that helps families and individuals thrive.  </p><div class="embed-container"><iframe width="560" height="315" src="" title="YouTube video player" frameborder="0"></iframe> </div>
Physical Therapy May Hold the Key to Brain-Based Changes in Adults with Cerebral Palsy Therapy May Hold the Key to Brain-Based Changes in Adults with Cerebral Palsy2021-03-26T05:00:00Z<p>A recent study conducted by the <a href="">Power of Walking & Engineering Rehabilitation (PoWER) Laboratory</a>, part of the Boys Town National Research Hospital® Institute for Human Neuroscience, used MEG (magnetoencephalography) imaging to study the brain activity of people with cerebral palsy to sensations applied to the leg.  </p><p>“This study measures what happens as individuals move into adulthood, which is a critical window that changes their mobility and motor actions," said <a href="">Max Kurz, Ph.D.</a>, director of the PoWER Laboratory. “What we've found is that when those sensations are applied, the brain is not as active as it is for the general population."</p><p>As people age, they do not register sensations as acutely as when they were younger. This study finds that the population with cerebral palsy has an accelerated downward trajectory in their nervous system. Essentially, people with cerebral palsy have nervous systems that age faster. </p><p>That can have detrimental effects on the lives of patients with cerebral palsy since even everyday activities like the ability to button a shirt or brush their teeth can become difficult.</p><p>“So, we've identified these deficits," said Kurz. “Now the question is how we alter them? How can we make the decline not so steep so that it becomes more normalized and maybe their nervous system doesn't age as fast?" </p><p>Currently, the PoWER lab uses physical therapy for patients with cerebral palsy to keep sensations flowing to the brain, improving the brain's flexibility and maintaining its ability to register sensations. </p><p>For example, if you sit in a chair all day long, your muscle tone diminishes. If people with cerebral palsy move less as they enter adulthood, their brain loses tactile acuity, which makes registering sensations even more difficult. The effects of this loss can be spiraling. The less confident a person is in their ability to read sensations, the less likely they are to move and the more out-of-practice the brain becomes at interpreting the signals it does get.</p><p>“We've done a small study which is physical therapy-based. And what we're seeing is that the brain's reactivity and registry of sensations is improved," said Kurz. “ We're looking to start a larger clinical research project soon that will champion the use of physical therapy. We hope to understand the key ingredients for making these brain-based changes."</p><p>For more information about the study just published, visit: <a href="" target="_blank"></a></p>
Boys Town National Research Hospital & Rush University Medical Center Receive a Shared NIH Research Grant Town National Research Hospital & Rush University Medical Center Receive a Shared NIH Research Grant2021-03-18T05:00:00Z<p>​Anyone who has ever spent time in a highly interactive school environment knows how noisy all that input and feedback can be.  </p><p>That's why researchers <a href="">Katherine Gordon, Ph.D.</a>, Research Scientist in the Center for Childhood Deafness, Language and Learning at Boys Town National Research Hospital®, and Tina Grieco-Calub, Ph.D., Assistant Professor in the Department of Psychiatry & Behavioral Sciences at Rush University Medical Center, are studying how constant noise affects children's ability to learn and retain new words. This work is being funded by a grant through the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH).</p><div style="width:500px;margin:0px auto;display:table;"><div style="display:table-row;text-align:center;"> <span style="display:table-cell;"><img src="" alt="" style="border-radius:8px;width:200px;" /></span><span style="display:table-cell;"><img src="" alt="" style="border-radius:8px;width:200px;" /></span></div><div style="display:table-row;text-align:center;"><p style="display:table-cell;text-align:center;">Katherine Gordon, Ph.D.</p><p style="display:table-cell;text-align:center;"> Tina Grieco-Calub, Ph.D.</p></div></div><h2>A New Focus Brings New Collaboration</h2><p>Boys Town Hospital has been a leader in childhood hearing research since its inception in 1977. In recent years, interdisciplinary research questions on the relation between hearing and language arose. As a result, a team of language researchers was assembled to complement the team of hearing researchers, leading to many collaborative projects. </p><p>“In 2017, Boys Town National Research Hospital began building a program devoted to research in language science. Dr. Gordon was our first hire, and she continues to be an essential part of that program. Her newly funded project with Dr. Grieco-Calub marries our more recent focus on language with our traditional focus on hearing. I can't imagine a better team for advancing our understanding of the effect of noise on children's language learning," explained <a href="">Karla McGregor, Ph.D.</a>, and Director at the Center for Childhood Deafness, Language and Learning at Boys Town Hospital.</p><p>The two researchers were introduced by Lori Leibold, Ph.D., Director of the Center for Hearing Research at Boys Town Hospital, who felt that their unique sets of skills would work well together. </p><p>“After learning of their research interests, I told both that I thought they should meet. Dr. Grieco-Calub visited Boys Town National Research Hospital in person and we set up a meeting between Katie [Dr. Gordon] and Tina [Dr. Grieco-Calub]. The rest is history," recalls Leibold. Leibold serves as a consultant on the grant.</p><h2> Language and Noise</h2><p>Language learning is an established field, but for years it has not included the noise component. Research has been primarily conducted in quiet settings. On the other side is hearing science, which has mostly focused on how people perceive words they already know, not how they learn new words in noisy environments. Both fields have gaps in knowledge, and Gordon and Grieco-Calub are targeting those gaps together to figure out how children learn new words in noisy environments.  </p><h2> Noise and Environment</h2><p>Different types of environments contain different types of background noise. This grant will allow Boys Town Hospital and Rush University Medical Center to look at how those different types and intensities of noise affect word learning. For example, in a classroom, there might be a fan running and kids talking in the background; right now, the effects of these factors on new language acquisition are unknown. </p><p>Children live, play and learn in environments that are often noisy. To understand language development, it is essential to understand how children learn language in different types of noise. Furthermore, there are some children who may particularly struggle with learning language in noise, such as children who are hard-of-hearing and children with language disorders. This study's long-term goal is to determine factors that can be changed to support word learning in the typical classroom environment. This should benefit all children, but especially benefit children who are strongly affected by the noise in their environments. </p><p>For more information on the study parameters, see <a href="" target="_blank">Effects of background noise on word learning in preschool-age children</a>. As this study progresses, watch for Boys Town Hospital and Rush University Medical Center to publish additional updates. </p>
Do You Run Down the Mountain or Descend? That All Depends on Your Native Language! You Run Down the Mountain or Descend? That All Depends on Your Native Language!2021-03-18T05:00:00Z<p>​Have you ever wondered why a foreign language may sound “wrong" when you've translated it into English?  It's because that language may express certain parts of speech differently. Different groups of languages use verbs to express different aspects of motion, and the people who speak these different languages <span style="text-decoration:underline;">expect</span> to hear motion described in a certain way. </p><p> <img src="" alt="Samantha Emerson Lecture" class="ms-rtePosition-1" style="margin:5px;width:285px;height:445px;" />Samantha Emerson, Ph.D., conducted a study focused on what listeners' expectations were for the expression of motion. For example, what does an English speaker expect to hear, versus what a Spanish speaker expects to hear, when discussing someone headed down the mountain? </p><p>An English speaker expects the manner of the motion (or how the motion verb is carried out) to be included in the verb or come first, hence, the phrase “run down the mountain." 'Run' describes how the subject is moving (the manner), and 'down' describes where the subject is moving (or, the path of the verb). A Spanish speaker, on the other hand, expects the path to be the important part; therefore, a phrase like “descend the mountain running" is used.  'Descend' tells us where the subject is going (the path), and 'running' tells us how the subject is moving (the manner).</p><p>“The important thing about this paper is it's the first one to show that not only do we talk about motion differently, but it effects the way we <span style="text-decoration:underline;">think</span> about motion, even though physical motions happen the same way regardless," noted Emerson, who is now a researcher at the Center for Childhood Deafness, Language and Learning at Boys Town National Research Hospital®. </p><p>The answers to these questions are important. The findings from this research could eventually help those trying to learn a second language. It could also assist people with developmental language disorder in understanding patterns beyond the basic rules of grammar in their native language. </p><p>“They tell us something about learning a new language," said Emerson. “Learning to speak a language fluently involves more than just the rules of grammar. This (study) provides a neural basis for observations about how we prefer to talk about motion, but also affects how easy it is to process other people's speech."</p><p>Learn how the researchers created this <a href="" target="_blank">fascinating study</a>.</p>
Lockdowns Increase Insomnia and Jeopardize Mental Health Increase Insomnia and Jeopardize Mental Health2021-03-10T06:00:00Z<p>At the end of March 2020, more than 1.3 billion people in India entered a stringent 21-day lockdown due to the COVID-19 pandemic. </p><p> <a href="">Sahil Bajaj, Ph.D.</a>, Director of the Multimodal Clinical Neuroimaging Laboratory (MCNL) at the <a href="">Center for Neurobehavioral Research</a> at Boys Town National Research Hospital®, saw the need to quickly study how this would affect Indian residents' sleep health and how that could relate to millions of people across the world who were experiencing the same lockdown conditions.</p><p>The study looked at gender, age, income level and how worried respondents were about becoming ill using a Worry Scale, a Sleep-Quality Scale, and a Depression Symptom Scale. Residents completed the scales only during the weeks of lockdown. </p><p>A hefty 53% of respondents rated themselves as having low to severe insomnia during the COVID-19 lockdown.</p><p>Bajaj and his team wanted to make sure the insomnia was related to the COVID-19 pandemic and wasn't simply a pre- existing condition. The researchers considered that typically, 18.6% of the population suffers from insomnia, meaning that 34% of the insomnia reported could be directly related to the COVID-19 lockdown.</p><p>“People get worried. Worry leads to insomnia. Insomnia leads to depression. Our conclusion was if we can improve people's sleep during this pandemic situation, then that can lead to better mental health and less depression," said Bajaj.</p><p>Unfortunately, sleep studies tied to the pandemic have received little attention. </p><p>“It is very difficult to treat depression, so it's better if people understand that poor sleep and depression are related to each other," noted Bajaj. “The more we can raise awareness of this relationship, the more likely we are to create a positive impact on mental health during the pandemic."</p><p> <em>To find out which groups of people suffered the most insomnia, click the link below and read Dr. Bajaj's complete study.</em></p><p> <a href="" target="_blank"></a></p>
Boys Town Physicians Voted Best Doctors in America Town Physicians Voted Best Doctors in America2021-02-25T06:00:00Z<p>Every year, Omaha Magazine releases a list of the Best Doctors i n America®. This list includes the nation's most respected specialists and outstanding primary care physicians. Boys Town National Research Hospital is honored to have 37 physicians and community partners make the 2021 list.</p><p>“As Boys Town Hospital continues to grow, we strive to be a community resource that can provide life-changing care to the Omaha-area and surrounding communities," said Jason Bruce, M.D., Boys Town Chief Medical Officer and Interim Executive Vice President and Hospital Director. “Having these physicians recognized by their peers endorses our belief that the best physicians and the best care are available right here at Boys Town."</p><p>Congratulations to all the physicians recognized as Best Doctors in America! Thank you for providing life-changing care for our patients and families.</p><h2> <a href="/services/allergy-asthma-immunology">Allergy, Asthma and Immunology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/kevin-murphy"> <img class="custom-is-rounded" src="" alt="Kevin R. Murphy, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Kevin R. Murphy, M.D.</span></span></a></div><div class="column is-4"> <img class="custom-is-rounded" src="" alt="Nicki Nair, M.D." /> <span class="is-block"><span class="is-size-4 has-text-primary">Nicki Nair, M.D.</span></span></div></div><h2> <a href="/services/internal-medicine">Internal Medicine</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <img class="custom-is-rounded" src="" alt="Ariana Bauer, M.D." /> <span class="is-block"><span class="is-size-4 has-text-primary">Ariana Bauer, M.D.</span></span>​</div><div class="column is-4"> <a href="/physicians/jeremiah-gums"> <img class="custom-is-rounded" src="" alt="Jeremiah Gums, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Jeremiah Gums, M.D.</span></span></a></div><div class="column is-4"> <img class="custom-is-rounded" src="" alt="Emily Hill-Bowman, M.D." /> <span class="is-block"><span class="is-size-4 has-text-primary">Emily Hill-Bowman, M.D.</span></span></div><div class="column is-4"> <a href="/physicians/lilli-mauer"> <img class="custom-is-rounded" src="" alt="Lilli K. Mauer, M.D., M.Sc." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Lilli K. Mauer, M.D., M.Sc.</span></span></a></div><div class="column is-4"> <a href="/physicians/lauren-nelson"> <img class="custom-is-rounded" src="" alt="Lauren Nelson, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Lauren Nelson, M.D.</span></span></a></div><div class="column is-4"> <a href="/physicians/robert-schwab"> <img class="custom-is-rounded" src="" alt="Robert J. Schwab, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Robert J. Schwab, M.D.</span></span></a></div></div><h2> <a href="/services/pediatric-neuroscience/neurology">Neurology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/deepak-madhavan"> <img class="custom-is-rounded" src="" alt="Deepak Madhavan, M.D., MBA" /> <span class="is-block"> <span class="is-size-4 has-text-primary">Deepak Madhavan, M.D., MBA</span></span></a></div></div><h2> <a href="/services/orthopaedics-sports-medicine">Orthopaedics</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/thomas-connolly"> <img class="custom-is-rounded" src="" alt="Thomas J. Connolly, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Thomas J. Connolly, M.D.</span></span></a></div></div><h2> <a href="/services/ear-nose-throat-institute">Otolaryngology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/jane-emanuel"> <img class="custom-is-rounded" src="" alt="Jane M. Emanuel, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Jane M. Emanuel, M.D.</span></span></a></div><div class="column is-4"> <a href="/physicians/elizabeth-kelly"> <img class="custom-is-rounded" src="" alt="Elizabeth A. Kelly, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Elizabeth A. Kelly, M.D.</span></span></a></div><div class="column is-4"> <a href="/physicians/w-derek-leight"> <img class="custom-is-rounded" src="" alt="W. Derek Leight, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">W. Derek Leight, M.D.</span></span></a></div></div><h2> <a href="/services/allergy-asthma-immunology">Pediatric Allergy Immunology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <img class="custom-is-rounded" src="" alt="Brian Kelly, M.D." /> <span class="is-block"><span class="is-size-4 has-text-primary">Brian Kelly, M.D.</span></span></div></div><h2> <a href="/services/anesthesiology">Pediatric Anesthesiology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/denise-drvol"> <img class="custom-is-rounded" src="" alt="Denise M. Drvol, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Denise M. Drvol, M.D.</span></span></a></div><div class="column is-4"> <a href="/physicians/jane-kugler"> <img class="custom-is-rounded" src="" alt="Jane A. Kugler, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Jane A. Kugler, M.D.</span></span></a></div><div class="column is-4"> <a href="/physicians/travis-teetor"> <img class="custom-is-rounded" src="" alt="Travis Teetor, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Travis Teetor, M.D.</span></span></a></div></div><h2> <a href="/services/hospital-care/pediatric-intensive-care-unit">Pediatric Critical Care</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/mohan-mysore"> <img class="custom-is-rounded" src="" alt="Mohan Mysore, M.D., FAAP, FCCM" /> <span class="is-block"> <span class="is-size-4 has-text-primary">Mohan Mysore, M.D., FAAP, FCCM</span></span></a></div></div><h2> <a href="/services/pediatric-general-thoracic-surgery/thyroid-clinic">Pediatric Endocrinology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/kevin-corley"> <img class="custom-is-rounded" src="" alt="Kevin P. Corley, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Kevin P. Corley, M.D.</span></span></a></div></div><h2> <a href="/services/pediatric-gastroenterology">Pediatric Gastroenterology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/sharad-kunnath"> <img class="custom-is-rounded" src="" alt="Sharad Kunnath, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Sharad Kunnath, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/anna-trauernicht"> <img class="custom-is-rounded" src="" alt="Anna Trauernicht, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Anna Trauernicht, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/jon-vanderhoof"> <img class="custom-is-rounded" src="" alt="Jon A. Vanderhoof, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Jon A. Vanderhoof, M.D.</span></span>​</a></div></div><h2> <a href="/services/pediatric-general-thoracic-surgery">Pediatric General Surgery</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/shahab-abdessalam"> <img class="custom-is-rounded" src="" alt="Shahab F. Abdessalam, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Shahab F. Abdessalam, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/robert-cusick"> <img class="custom-is-rounded" src="" alt="Robert A. Cusick, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Robert A. Cusick, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/stephen-raynor"> <img class="custom-is-rounded" src="" alt="Stephen C. Raynor, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Stephen C. Raynor, M.D.</span></span>​</a></div></div><h2> <a href="/services/pediatric-ophthalmology">Pediatric Ophthalmology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/andrew-troia"> <img class="custom-is-rounded" src="" alt="Andrew Troia, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Andrew Troia, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/robert-troia"> <img class="custom-is-rounded" src="" alt="Robert Troia, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Robert Troia, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/sebastian-troia"> <img class="custom-is-rounded" src="" alt="Sebastian Troia, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Sebastian Troia, M.D.</span></span>​</a></div></div><h2> <a href="/services/behavioral-health/child-adolescent-psychiatry">Pediatric Psychiatry</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/nicholas-basalay"> <img class="custom-is-rounded" src="" alt="Nicholas P. Basalay, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Nicholas P. Basalay, M.D.</span></span></a></div></div><h2> <a href="/services/pediatric-pulmonology">Pediatric Pulmonology</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/adam-reinhardt"> <img class="custom-is-rounded" src="" alt="Adam Reinhardt, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Adam Reinhardt, M.D.</span></span>​</a></div></div><h2> <a href="/services/pediatrics">Pediatric General</a><br></h2>​ <div class="columns is-multiline has-text-centered"><div class="column is-4"> <a href="/physicians/kent-amstutz"> <img class="custom-is-rounded" src="" alt="Kent R. Amstutz, D.O." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Kent R. Amstutz, D.O.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/michael-dawson"> <img class="custom-is-rounded" src="" alt="Michael G. Dawson, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Michael G. Dawson, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/mark-domet"> <img class="custom-is-rounded" src="" alt="Mark J. Domet, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Mark J. Domet, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/charles-sprague"> <img class="custom-is-rounded" src="" alt="Charles J. Sprague, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Charles J. Sprague, M.D.</span></span>​</a></div><div class="column is-4"> <a href="/physicians/debra-whaley"> <img class="custom-is-rounded" src="" alt="Debra K. Whaley, M.D." /> <span class="is-block"> <span class="is-size-4 has-text-primary">Debra K. Whaley, M.D.</span></span>​</a></div></div><h2>Community Partners</h2><ul><li>​Jason Miller, M.D., DMD, FACS</li><li>Mark Puccioni, M.D., FAANS</li></ul> <br> <p>Great doctors thrive in great environments. We are grateful for ALL of our physicians and medical staff for continuing to be on the front lines providing care for patients throughout this unique time.</p>
Remembering a Visionary, Dr. Pat Stelmachowicz a Visionary, Dr. Pat Stelmachowicz2021-02-09T06:00:00Z<p>​​​​A leader, visionary and scholar in audiology research, Pat Stelmachowcz, Ph.D., will be remembered for her contributions to the field and their translational impact that improved the lives of so many with hearing loss.  </p><p>Pat passed away in January 2021. Her husband and research colleague, Michael Gorga, Ph.D., has established the <strong>Pat Stelmachowicz Audiology/Hearing Research Endowed Fund</strong> to help continue the legacy of Boys Town's nationally recognized translational hearing research. Contributions made in memory of Pat will with designated to the Fund. <a href="" target="_blank">Click here to donate</a>.<br></p><p>Pat began her Boys Town career in 1980. From 1994 until her retirement in 2014, Pat served as Director of Audiology & Vestibular Services. Her work fundamentally changed pediatric hearing aid research, clinical practice, and the design of hearing aids.</p><p>Although she retired from Boys Town in 2014, her legacy lives on through the important clinical and research programs she led in pediatric audiology. Serving as Director of Audiology & Vestibular Services for 20 years, Pat made many contributions to Boys Town Hospital, including her early mentorship of Ryan McCreery, Ph.D., current Director of Research, who started as an audiology intern.</p><p>“Dr. Pat Stelmachowicz was an internationally recognized leader in the field of pediatric audiology. Her research provided an important foundation for how audiologists fit hearing aids for infants and young children today," said Ryan.“She was an outstanding mentor to many audiologists and scientists and built theBoys Town audiology program into one of the best in the nation.  Pat will be greatly missed."</p><p>As a renowned researcher in her field, Pat had close collaborations with many national and international scientists working in the field of audiology research. She served as a mentor for many of the current leaders in pediatric audiology research who work across the United States.</p><p>Pat was recognized nationwide for her groundbreaking research, having received the  D​istinguished Alumnus Award from the University of Iowa and the Lifetime Achievement Award at the 6th International Phonak Sound Foundations Conference in 2013; and in 2015, she was honored by the American Speech-Language-Hearing Association (ASHA) with the Honors of the Association award, which is the highest career achievement award bestowed by the organization. Pat was also a nominee for the 2013 Kleffner Lifeti​me Clinical Career Award by the Nebraska Speech Language and Hearing Association.</p><h2>Continuing Her Legacy – Research Endowed Fund</h2><p>Pat Stelmachowicz Audiology/Hearing Research Endowed Fund has been established to support translational hearing research at Boys Town. Donations in Pat Stelmachowicz's memory can be given in two ways:</p><ol><li>Mail check or cash to:<br> Boys Town<br> Attention: Pat Stelmachowicz Memorial<br> PO Box 8000<br> Boys Town, NE 68010</li> <br> <li> <a href="" target="_blank">Click here to donate.</a> Contributions designated in memory of Pat will be allocated to the Pat Stelmachowicz Audiology/Hearing Research Endowed Fund</li></ol>
$35,000 Research Grant Awarded to Boys Town Hospital Audiologists$35,000 Research Grant Awarded to Boys Town Hospital Audiologists2021-02-05T06:00:00Z<p>A team of research and clinical audiologists at Boys Town National Research Hospital<sup>®</sup> was recently awarded a $35,000 Researcher-Practitioner Collaboration Grant from the American Speech-Language-Hearing Foundation (ASHFoundation).</p><p>The grant money is being used to improve high-frequency auditory brainstem response (ABR) testing. This test is important for identifying and measuring levels of hearing in individuals who are unable to provide reliable behavioral responses to sound, such as infants, very young children and individuals with significant developmental delays. At the time ABR testing was first being evaluated for clinical application, it was thought that high frequencies were not critical for speech understanding. However, more recent research suggests otherwise.</p><p>According to <a href="">Heather Porter, Ph.D.</a>, the study's co-investigator and a research associate, this research has the potential to improve the diagnosis of high-frequency hearing loss, which can be directly applied to hearing aid programming at high frequencies. Jan Kaminski, the study's other co-investigator and coordinator of Boys Town Hospital's Clinical Sensory Physiology Laboratory, was part of the Boys Town team who originally evaluated ABR testing for widespread clinical implementation. She understands first-hand the widespread impact that researcher-clinician collaborations can have on patient care.</p><p>“Our objective is to overcome obstacles to clinical implementation of ABR testing at high frequencies because we now know that high-frequency audibility is important for hearing in daily life," explained Dr. Porter. “A large body of evidence now shows that high-frequency information contributes to successful speech understanding, sound localization and listening in background noise. Many of these important findings came from hearing research done at Boys Town by our former Director of Audiology, Dr. Patricia Stelmachowicz." </p><p>The research is expected to have direct clinical application wherever ABR testing is performed. That is one of the primary reasons the grant was awarded to Boys Town. The ASHFoundation encourages collaborations between researchers and practitioners to increase knowledge that will improve and enhance the care provided to individuals with communication disorders. </p><p>“We are proud to continue the tradition of leadership in translational research established at Boys Town National Research Hospital by those that came before us," Dr. Porter said. “This study would not be possible if not for their example, research findings and development of the infrastructure to support this kind of collaborative translational research." </p><p>In addition to Dr. Porter and co-investigator Jan Kaminski, the research team includes clinical experts in ABR assessment, Drs. Anastasia Grindle, Brenda Hoover, Ashley Kaufman, Natalie Lenzen, Haley McTee and Susan Stangl. The team embraces participation of current audiology trainees Christina Dubas and Abigail Petty, as student involvement is an important investment in inspiring future generations to support translational research to advance evidence-based care for individuals with communication disorders.  </p>
Retrieval-Based and Spaced Learning: Two Strategies to Support Word Learning and Spaced Learning: Two Strategies to Support Word Learning2021-02-02T06:00:00Z<p>​​Sometimes, tried-and-true teaching methods are just that – effective and for good reason. However, in the past that reason may not itself have been tested. That's why the new article: “The Advantages of Retrieval-Based and Spaced Practice: Implications for Word Learning in Clinical and Educational Contexts," is so significant.</p><p>In this article, Katherine Gordon, Ph.D., Director of the <a href="">Language Learning and Memory Laboratory</a> at Boys Town National Research Hospital®, has taken the outcomes of dozens of research studies with individuals who have language disorders and synthesized them to make a case for two of the oldest teaching methods and their use in classroom education. </p><p>Retrieval-based practice and spaced practice are effective learning strategies for children and adults with typical development. However, students who know fewer words can struggle to understand classroom content and miss out on a lot of important information. This is especially the case for students with language disorders, including students with developmental language disorder (DLD). </p><p>A key question of Dr. Gordon's review is whether proven teaching methods support vocabulary learning in children with language disorders. The answer to this question is “yes." </p><p>An essential part of the solution is to use teaching strategies that help children learn words during the lesson and remember the words long-term. Without this, educators are pouring water into a leaky bucket. Children may show good learning in the moment but quickly forget the words once the lesson is over.  </p><h2>Tried-and-True: Testing and Flash Cards</h2><p>During retrieval-based learning, the teacher asks the student to retrieve something that they learned previously from memory. However, this strategy does not need to use formal testing to be effective. Retrieval-based learning can occur anytime a teacher asks a student a question about key information. </p><p>Learning with flashcards is a common and familiar form of retrieval-based learning. The teacher is not just testing the student's knowledge of the information, but also supporting the student's ability to learn the information. By actively trying to remember the key information during a lesson, the student is more likely to remember that information when the lesson is over. </p><p>In the research reviewed by Dr. Gordon, it became apparent that word learning is achieved most effectively through effortful retrieval (testing) instead of passive listening for students with language disorders.  </p><h2>Key Components of Retrieval-Based Learning</h2><p>The literature reviewed by Dr. Gordon showed that retrieval-based learning benefitted adults and children with language disorders and promoted better learning and retention of the material over time. Most of the retrieval-based learning articles Dr. Gordon reviewed shared three key components. </p><h3>1. Opportunity for Effortful Retrieval of the Material Early in the Learning Session</h3><p>Learners do not like to be asked to remember information they've only heard a few times. </p><p>When teaching vocabulary to individuals with language disorders it seems logical to present the key words many times before asking the student about it. However, testing the student's memory for words early in the learning session produces better results. This may seem counterintuitive as students are likely to get the answer wrong if they are asked questions early in the lesson, however, trying to remember key information and getting an answer wrong can actually benefit learning if the student is given feedback. In general, students become more engaged and more aware of what they are getting from the lesson if they are asked questions early and often.</p><h3>2. Providing the Correct Answer Promptly and Explaining it Thoroughly </h3><p>As mentioned above, students are more likely to learn information after getting an answer wrong. They can become aware that they do not yet know the information fully and put in more effort to learn it. </p><h3>3. Providing the Learner Multiple Chances to Retrieve the Learned Information </h3><p>A vital element in this third aspect is having the learner retrieve information multiple times, even if they answered it correctly the first time. Repeated retrievals of learned words increased the chances that the information learned would be retained even after a delay.</p><h2>Cram for That Exam? Not the Best Way to Study.</h2><p>Spaced practice has been strongly shown to support learning in individuals with typical development. In her review, Dr. Gordon found that spaced practice supports word learning in individuals with language disorders. </p><p>When you think of spaced practice learning, think of your parents or junior high teachers telling you, “It's better to study it for 20 minutes every night than to cram for an hour before the test." Recent research demonstrates that they were right. </p><p>Spaced practice occurs when the same information is presented multiple times, but those presentations are spaced across time. A common example is a student studying with flashcards every day the week before an exam. In this way they introduce a space in time between each time the cards are studied. </p><p>Like retrieval-based practice, spaced practice is beneficial because it makes the student put in effort when trying to remember the key information. If a student is asked a question directly after they hear the information, it may be easy for them to remember the information. However, if asked a question after a delay, even a delay as short as 10 minutes, they must work harder to remember the information.</p><p>Educators and clinicians can introduce spaced practice during a lesson by asking about each key word at the beginning of a lesson, providing information about the key words in the middle of the lesson and then asking about each key word again at the end of a lesson. </p><p>Spaced learning can also be introduced across lessons. For example, students can be asked about words they learned yesterday or earlier in the week. Combining retrieval-based practice and spaced practice can be particularly powerful. By spacing out opportunities to retrieve information, educators can increase the likelihood that students, including students with language disorders, will remember the information long-term.</p><h2>Learning that Lasts</h2><p>To change the educational outcomes for individuals with language disorders, it is important to get past pouring water into the leaky bucket. Individuals with language disorders need to develop strong mem​ories for words that they are taught in lessons for them to be able to use those words in the classroom and in their everyday lives. </p><p>As all educators realize, meaningful word learning does not occur in one sitting. Learners need to be exposed to words repeatedly to commit them to memory. Using retrieval-based and spaced practice over repeated classes or language therapy sessions, is the best way to help students learn and remember words. Children with language disorders enrolled in therapy can receive retrieval-based and spaced practice that is more tailored to their individual needs.</p><p>For more information about how spaced and retrieval-based practice can be used to support vocabulary learning, read Dr. Gordon's full paper here: <a href="" target="_blank"></a></p><p><a href="" target="_blank"></a><br></p><p> <strong>Dr. Gordon is continuing </strong>this research line to learn how to further optimize these learning techniques for the benefit of children with language disorders. By giving educators and clinicians the tools to support vocabulary learning that lasts, they can best support academic success for individuals with language disorders.</p>
Supporting Children with Sensory Sensitivity during COVID Children with Sensory Sensitivity during COVID2021-01-22T06:00:00Z<h2>​Boys Town Partners with Omaha Public Schools and Munroe-Meyer Institute</h2>​ <p>​​​Obscu​red mouths. Muffled voices. Concealed emotions. <a href="/knowledge-center/communication-benefits-of-clear-face-masks">Masks have challenged everyone's ability to communicate</a> with and understand others. </p><p>Most adults can overcome some of these obstacles by reading other social cues. However, for young children, especially those with communication delays or sensory-processing difficulties, masks are an unwelcome barrier when trying to express themselves and comprehend the world around them. </p><p>For students in the <a href="/services/center-for-childhood-deafness-language-learning/preschool-program">preschool program</a> at Boys Town National Research Hospital<sup>®</sup>, masks are required. Easing their discomfort and encouraging proper mask-wearing techniques require a combination of patience, understanding and positive reinforcement.  </p><p>According to Kate Kaiser, lead teacher at the preschool, staff members were pleasantly surprised to see most students were ready to wear their masks when in-person school resumed after an extended period of remote learning. Many of the preschoolers are deaf or hard of hearing, and the mask's straps can be irritating when children already have hearing aids, cochlear implant processors and eyeglass frames around their ears. Some of the children also have <a href="/knowledge-center/sensory-processing-disorder">sensory-processing disorders</a> or difficulties, making them overly sensitive to the texture, scent or pressure of face masks. These unpleasant sensations can magnify their distress and overwhelm their bodies, leading to meltdowns and mask removal. </p><p>Kaiser credits parents for teaching their little ones about the importance of masks and getting them used to wearing them. But when a child struggles or has a bad day, Kaiser and her team are grateful for the collaboration and training support they receive from their partners at Omaha Public Schools and the University of Nebraska Medical Center (UNMC) Munroe-Meyer Institute.</p><p>Omaha's Experts Join Forces for Optimal Outcomes</p><p> <a href="/knowledge-center/newborn-occupational-therapy">Occupational therapists</a> from the Munroe-Meyer Institute provide education-related occupational and physical therapy services to Omaha Public Schools students who attend the Boys Town Preschool Program. The therapists also collaborate and lead specialized training sessions with staff, which is an invaluable benefit during these times.  </p><p>Christina Edelbrock, a board-certified pediatric occupational therapist at UNMC's Munroe-Meyer Institute, led a collaborative coaching session where she shared ideas and strategies to help preschool staff calm, reassure and guide children who become overwhelmed, frustrated or frightened by masks. </p><p>“In this pandemic, kids in general are more anxious and scared of things they don't understand, especially children who are deaf and hard of hearing," explained Edelbrock. “They rely on facial expressions, but masks hide that. So, there is increased anxiety because things and people look different." </p><p>To eliminate some of the fear factor, the preschool uses clear masks designed especially for individuals who are deaf and hard-of-hearing, allowing teachers and parents to communicate using facial expressions. The masks also make lip reading possible, which is critical for the children who are just learning to listen, talk or sign.  </p><p>Additional strategies that have helped children with sensory difficulties become more comfortable with masks include:   </p><ul><li>Desensitizing kids by having them hold, feel and press the masks against their skin and face</li><li>Normalizing the situation by putting masks on stuffed animals and other favorite toys</li><li>Reading social stories and using visual aids to walk students through why we wear masks </li><li>Creating routines to increase familiarity and limit impulsive reactions (For example, every morning students exchange the masks they wear from home with school masks. At day's end, they put their school masks in a baggie to be washed and put back on their masks from home.)  </li><li>Using lots of encouragement and positive reinforcement (reassuring words, high fives and thumbs up) to celebrate progress and reinforce expectations</li></ul><p>“We know not all the children will be able to wear their masks for the full three-hour preschool day, so we coach them through the moments when they're having a hard time," said Kaiser. “We use a lot of visual supports, like timers and picture cues, to help them understand the expectations. A lot of positive reinforcement and encouragement goes a long way."</p><p>Both Kaiser and Edelbrock agree that the best things teachers and parents can do for children who have special sensory sensitivities is to show patience, empathy and understanding.</p><p>The Boys Town Preschool is a five-day-a-week early ch​ildhood program that provides comprehensive educational programming to children ages 3 to 5 who are deaf or hard of​ hearing and includes neighborhood friends who are hearing. Highly trained educators and specialists provide intensive differentiated instruction focused on developing listening, spoken language and sign language skills.</p><p>The preschool is located in the <a href="/locations/lied-learning-technology-center">Lied Learning and Technology Center</a>, at 30<sup>th</sup> and Dodge. To learn more, call <a class="js-phone">(531) 355-5000</a>.</p><div class="embed-container"><iframe width="560" height="315" src="" frameborder="0"></iframe> </div>
Boys Town Researchers Featured in ASHA Top 10 Articles of the Year Town Researchers Featured in ASHA Top 10 Articles of the Year2021-01-20T06:00:00Z<p>American Speech-Language-Hearing Association (ASHA) Journals Academy has released their top ten articles of 2020, and three publications by Boys Town researchers earned a spot on the list! </p><p>“This is really an incredible honor," says <a href="">Ryan McCreery, Ph.D.</a>, Director of Boys Town Research. “Having one article on this list is impressive. Having three truly speaks to the innovation, dedication and talent of our speech-language research team and path they are leading to change the way America cares for children with language disorders." </p><h2>Top Articles from Boys Town Research </h2><p> <a href="">Karla McGregor, Ph.D.</a>, Director of the Center for Childhood Deafness, Language and Learning, had two articles featured: </p><ul><li> <a href="" target="_blank">How We Fail Children with Developmental Language Disorder</a></li><li> <a href="" target="_blank">Developmental Language Disorder: Applications for Advocacy, Research and Clinical Service</a></li></ul><p> <a href="">Hope Sparks Lancaster, Ph.D.</a>, Director of Etiologies of Language and Literacy Laboratory, listed for:</p><ul><li> <a href="" target="_blank">Early Speech and Language Development in Children with Nonsyndromic Cleft Lip and/or Palate: A Meta-Analysis</a></li></ul><p>American Speech-Language-Hearing Association is a national professional organization for audiologists, speech-language pathologists and hearing, speech and language researchers and students. </p><p>For more information on the top articles of 2020, <a href="" target="_blank">please click here. </a> </p>
Donation Helps Boys Town National Research Hospital in Eye Tracking/Listening Research Project Helps Boys Town National Research Hospital in Eye Tracking/Listening Research Project2021-01-19T06:00:00Z<p>You may have noticed that it is hard to understand what someone is saying when they are wearing a face mask. That's because in face-to-face conversations, seeing a speaker's mouth move usually helps us understand them, especially in noisy places. Understanding speech in background noise is much more challenging for children than adults, and there is variability in children's ability to use visual speech cues, in other words, lipreading.</p><p>That's why a donation to purchase a Tobii Pro Nano eye tracker to support research on the subject was so appreciated by <a href="">Kaylah Lalonde, Director of the Audiovisual Speech Processing Laboratory</a> at Boys Town National Research Hospital. </p><p>Lalonde received the donation from an anonymous Boys Town donor about a year ago with the assistance of Boys Town development. The tracker, along with software that has been developed, will assist in planned studies that examine how much children and adults look at a speaker's face while listening to speech in noisy environments and to what parts of the face they look. Lalonde said this will help understand children's listening strategies.</p><p>The long-term goals of research in the audiovisual speech perception lab are to provide a unified account of how audiovisual speech perception develops, and ultimately to improve audiovisual communication outcomes for children with hearing loss. Lalonde said children with hearing loss benefit more from visual speech cues than children with normal hearing.</p><p>The eye tracker will be used to explore how much age- and hearing-related differences in audiovisual benefit observed in speech perception studies might be due to differences in looking behavior.</p><p>“Specifically, we will conduct standard auditory and audiovisual speech recognition tests while collecting data about whether and where participants look at or on the screen," Lalonde said. “The study will look at a variety of different age and hearing groups. With eye tracking data, we will determine the extent to which differences in looking behaviors among children explain individual, age-related and hearing-related differences in audiovisual benefit."</p><p>The eye tracker will serve as a control in future experiments in the lab. It will also serve as a tool for testing young children and infants without requiring overt responses. In future research, it will be used for more detailed studies of visual attention during audiovisual speech perception.</p><p>Lalonde said thanks to donations like this, Boys Town Hospital is able to continue its advances in studying how children tie together hearing with visual cues.</p><p>“Donations like this are important to Boys Town, because they allow us to be innovative in our research approach and support our goal of improving outcomes for children with communication difficulties," she said.</p>
Project INCLUDE Introduces Remote Testing Kits Due to Pandemic Constraints INCLUDE Introduces Remote Testing Kits Due to Pandemic Constraints2021-01-14T06:00:00Z<p>Boys Town National Research Hospital® was in the middle of research for <a href="">Project INCLUDE</a>, funded by the National Institutes of Health (NIH), when the pandemic upended how many things were being done nationally, locally and at Boys Town.  </p><p>Project INCLUDE measures language, problem solving and hearing abilities in background noise for children with Down syndrome to identify factors that contribute to successful listening in noisy situations – like classrooms. Because Project INCLUDE is conducting research with children who have Down syndrome, many of whom are medically fragile, project leader <a href="">Heather Porter, Ph.D.</a>, knew they had to find alternatives to in-person research methods.</p><p>“Right in the middle of our Project INCLUDE research, the pandemic hit, and we had to switch to remote testing to protect our participants and lab staff," said Dr. Porter Research Scientist in the Human Auditory Development Lab.</p><p>The first remote project tried sending a program over the internet for test participants to download and use on their personal computer using whatever headphones they had at home. However, this system proved to be unreliable. Some participants had results that were very different from other participants. Although it was most likely because of the various types of computer hardware being used across the test population, the results couldn't fully be explained and alternative solutions were developed.</p><p>“We developed test kits that included all of the hardware and software needed for the study," said Dr. Porter.  “These kits are being delivered contact-free to each individual's home. The kits include an iPad, two sets of headphones and an instruction binder, plus sanitizing and screen wipes. Lab staff and participants have their safety concerns met. As a bonus, participants can complete the study at their convenience in their own homes. The response has been super positive."</p><p>Once the remote test kits were up and running, it was simply a matter of dropping them off, picking them up, sanitizing them thoroughly and repeating the process. Most importantly, it meant that Project INCLUDE could proceed safely for both participants and researchers.</p><h2>Advancements in Adversity</h2><p>The changes the pandemic instituted are only the beginning for Boys Town Hospital researchers. The challenges of 2020 have pushed forward new ways of doing things, research included, that may have positive impacts in the future.</p><p>“There's always been a push from the NIH to have larger groups of participants included in Down syndrome research, but it can be difficult because there are only so many participants available locally," Dr. Porter said. “Remote test kits have the potential to help us exponentially, allowing us to collect data from all over the country." </p><p>Families of children with Down syndrome are also being interviewed using secure web-based platforms to find out what about listening and communication is most important to them. That information will be included in Boys Town National Research Hospital's next grant submission to the NIH, along with the possibility of expanded research cohorts created by working remotely and conducting research nationwide.</p><p>Additionally, Boys Town Hospital is looking into various remote test kit configurations to further the ability of all research areas to continue conducting remote research during the pandemic and beyond. </p>
Mapping Aging Brain Networks with the Groundbreaking Atlas55+ Aging Brain Networks with the Groundbreaking Atlas55+2021-01-05T06:00:00Z<p>​Brain atlases of various kinds have existed for decades, each mapping various areas and centers of the brain. But up until now, most of these atlases created by various researchers have used subjects in early adulthood (typically 18 to 35 years old) for their studies.</p><p>Yet older individuals represent 15% of the United States population, and that segment is expected t​o continue growing significantly through 2050. This left a vacuum in the research arena when it came to looking at age-related brain changes and diseases, since no atlas for that age group existed, undermining the validity and reliability of neuroimaging research when it came to older adults.</p><p>That is what makes the Atlas55+ brain atlas, mapped by the <a href="">Boys Town Brain Architecture, Imaging and Cognition Lab</a> and its affiliates, so important. Now scientists researching brain and cognition changes in later adulthood have a reliable atlas of the brain networks that has been created using functional MRIs of healthy individuals between the ages of 55 and 95.</p><p>“By providing the first age-adapted brain atlas for late adulthood to the scientific community, this work has the potential to reveal how dysfunction of the brain networks contributes to neurodegenerative conditions like dementia," reported <a href="">Gaelle Doucet, Ph.D.</a>, Director of the Brain Architecture, Imaging and Cognition Lab at Boys Town National Research Hospital®.</p><p>This brain atlas identified five major networks. The study conducted by Dr. Doucet found that three of these networks, the default-mode network (DMN), which is involved in internal-related functions such as thought generation and memory; the executive central network (ECN), which supports working memory, and the salience network (SAL), which helps the transition between different cognitive activities, showed the most changes in functional integrity in older adults, compared to younger adults.</p><p>These three networks “support high-order cognitive activity such as memory, attention and any type of mental activity that helps you work, live and think correctly," explained Dr. Doucet. “Our work showed that these three networks are particularly vulnerable to aging."</p><p>Though further research is needed, this new atlas of the aging brain may help explain why some adults struggle with cognitive decline as they age. This research suggests that interventions to prevent or attempt to reverse cognition loss should focus on the DMN, the ECN and the SAL since these are the major networks that lose functional integrity with aging.</p><p>Atlas55+ has been published and is available for other researchers to consult and use. </p><p>“We are hoping that other neuroscientists in the field of aging will use Atlas55+ as they conduct research with older populations," said Dr. Doucet. “Previously they only had atlases based on younger populations, which may create bias. Now there is an atlas available for working with studies of Alzheimer's, dementia and other age-related cognitive declines."</p><p>The end goal for Atlas55+ is that it can be used as a reference for any population above the age of 55 and that it will be able to aid in the diagnosis of neurodegenerative disorders such as mild cognitive impairment (MCI) or Alzheimer's disease by providing a comparative baseline for what a healthy aging brain networks look like.</p><p>The Atlas55+ research study was funded by the National Institute on Aging (NIA), which is part of the National Institute of Health, the research agency of the DHHS. NIA's mission is to sponsor biomedical, behavioral and social research nation-wide to improve the health of older adults.  </p><p>“We know that age affects the brain throughout life, so my goal is to eventually take the same type of approach with children," said Dr. Doucet. “We need to create these same types of normative reference templates in children since none currently exist. I envision this eventually being done with 10- to 18-year-olds since younger children prove more difficult to get accurate brain scans from."</p><p>Researchers wishing to view the published article in the journal <em>Cerebral Cortex</em>, published by Oxford Academic Journals, should use the following link:  <a href="" target="_blank"></a>.</p><p> <img src="" alt="Atlas 55+ Brain Image Mapping" style="margin:5px;width:900px;height:463px;" /> <br> </p>
Boys Town Hospital’s Kristal Platt Doesn’t Let Blindness Block Her Vision of Helping Others Town Hospital’s Kristal Platt Doesn’t Let Blindness Block Her Vision of Helping Others2021-01-04T06:00:00Z<p>To say that Boys Town's Kristal Platt seems to always be looking out for someone else might be a tremendous understatement.</p><p>With less than five percent vision and considered legally blind, Kristal is a licensed certified genetic counselor and vision program coordinator at the Genetics/Center for Childhood Deafness, Language & Learning at the Boys Town National Research Hospital.</p><p> <img src="" alt="Kristal Platt" class="ms-rtePosition-2" style="margin:5px;width:200px;" />But she has made it her mission during her 30 years in the field to see that others with conditions like hers, especially children, are given the opportunity to experience normal activities they might not otherwise be able to enjoy. And today, she is also advocating for adults with disabilities facing issues with diversity, equity and inclusion in the workplace, working to create paths for them to overcome these challenges.</p><p>Kristal was 9 years old when she was diagnosed with Stargardt disease, a form of juvenile macular degeneration. The macula is the part of the retina responsible for finest acuity. Kristal said originally it was just thought she needed glasses, but as her condition worsened, she was diagnosed with the disease at the University of Wisconsin, the state where she grew up. Her central vision is primarily affected, causing poor recognition of facial features, color vision and difficulty with close work such as reading.</p><p>“If you want an example of what I'm able to see, let's say a computer has a million pixels," Kristal said. “I can see about 1,000."</p><p>While her brother also has Stargardt disease, her parents are both unaffected carriers of the autosomal recessive condition. Kristal also has a sister who does not have the disease.</p><p>Kristal never let her visual impairment slow her down, however. After graduating from high school, she received her bachelor's degree at Iowa State University and then earned her master's degree in Medical Genetics at the University of Wisconsin.</p><p>“At a young age I could explain inheritances and eventually this led to my career choice," Kristal said. </p><p>Landing her first job had a rocky beginning. Originally, she accepted a job in Chicago, only to find out her new employer chose not to honor its commitment. That ended up being a good break, however, as she landed a job at the University of Nebraska Medical Center in December of 1988. She worked there for 15 years until her sister, Shelly Carney, informed her that Boys Town was looking to hire someone for the “vision" component of the department at the Boys Town Hospital. Carney already worked at Boys Town as a preschool teacher and is a certified interpreter for the deaf. She was selected as the National Council for Exceptional Children, Teacher of the Year, in 2019.</p><p>“Coming to Boys Town was an excellent opportunity for me," Kristal said. </p><p>When she first arrived at Boys Town Hospital, she helped with the research laboratories by returning results for participants who had Usher and branchio-oto-renal syndromes. Today, she says she wears two hats, in genetics and vision, her two favorite areas. She presently works in the hearing and neurology clinics.</p><p>“I work with families to explain genetic testing, help them through the process and review test results," she said.</p><p>Kristal says her second hat is developing programs for families with children who are blind or visually impaired. The accessible egg hunt, called the Beeping Easter Egg Hunt, was held for the 13<sup>th</sup> time in 2019.</p><p>“Although it was designed for a child with a visual impairment, our event incorporates activities for families and friends to learn what a child who is visually impaired experiences. It allows them to interact in a fun activity together," Kristal said.</p><p>She also started Camp Abilities Nebraska because there were limited opportunities for youth with visual impairments to participate in sports and recreational activities. In 2019, Boys Town held its 7<sup>th </sup>camp. The camp is run by Boys Town National Research Hospital and Outlook Nebraska.</p><p>"When I was a kid, I couldn't play soccer because of not being able to see the ball," Kristal said. "My goal is to be able to bring this fun activity to the kids, so they get to compete just like their sighted peers."</p><p>Camp Abilities is filled with fun, but the experience the campers get is even more important.</p><p>"Being able to come to camp they can hang out with other kids that get it," Kristal said. "They don't have to explain about their vision, because everybody else lives the experience."</p><p>She says it allows the kids to run, play, fall down and get up, without their parents having to worry.</p><p>“Parents sometimes over-protect a child with a visual disability," Kristal said. “It's understandable. But at camp, the kids and the parents learn they can do more. It's ok to fall down and skin up your knee. That's why we have band-aids."</p><p>As if she doesn't have enough on her plate already, Kristal has also become a strong advocate for people with disabilities in their pursuit of equal opportunities in the workplace.</p><p>She serves on the National Society of Genetic Counselors' Diversity, Equity and Inclusion Advisory Committee. Kristal says many times people with disabilities have a difficult time securing workplace advancements and often struggle even getting in the door. </p><p>“We are making efforts across the country to improve diversity, equity and inclusion, but when everything is said and done, we always seem to look the same," she said. “Minorities and those with disabilities are very under-represented. Societal misconceptions keep companies from hiring these groups."</p><p>Kristal says she is proud of Boys Town for giving herself and others with disabilities opportunities. She said Father Flanagan laid the groundwork and led by example when he accepted all boys, regardless of their race, creed or cultural background.</p><p>“Boys Town has always supported me," she said. “Since I've come here, Boys Town has allowed me to do my job by providing all kinds of assistance. My colleagues make me proud to work here. Everyone is so supportive."</p><p>Kristal met her husband of 27 years, Dan, ballroom dancing. Together, they have three young adult children, Halie, Jacque and Nate.</p>
Boys Town Residential Treatment Center Turns 25 Town Residential Treatment Center Turns 252020-12-23T06:00:00Z<p>​​​On December 26, 1995, when most of the city was enjoying their holiday presents, Boys Town was overjoyed to give the best gift of all – the gift of a brighter, healthier future for children in need. This year, <a href="">Boys Town Residential Treatment Center (RTC)​</a> is proud to be celebrating 25 years of second chances!</p><h2>A History of Changing the Way America Cares for Children and Families</h2><p>In the early 1990s, Boys​ Town's leaders saw a nationwide need for a unique behavioral health service to help youth who were not successful in the programs being offered at the time. Calling on the organization's expertise and experience with youth care and medical care, the team formed a new model that focused on medically directed behavioral health treatment, specifically for ages 5 to 17. </p><p>“What makes our program unique is that it is a program created for kids – a place with bright colors, high ceilings, indoor and outdoor recreational facilities, home-like living facilities, all staffed with individuals specifically trained to care for the mental and behavioral needs of kids,” Dennis Vollmer, Director of the RTC said. </p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="" alt="Boys Town RTC has served 3,000 children from 7 countries and 30 states" class="inline-image__image" /> <h2 class="is-size-5">25 Years of Life-Changing Care</h2><p>Boys Town Residential Treatment Center</p></div>​ <p>The success of the child-tailored, research-based model led to incredible growth. What began as a 20-bed facility at the downtown Boys Town Hospital grew to 30 beds within a few years. In the early 2000s, the RTC reached full capacity at 47 beds. In October of 2013, a new 36-bed facility opened on Boys Town Campus. Four years later, the RTC expanded to the 80-bed RTC it is today. </p><h2>25 Years of Life-Changing Results</h2><p>The children who come to the RTC receive a safe and beautiful temporary home, a second chance and the knowledge that there is a group of people at Boys Town Hospital who believe they are good kids with valuable futures. These simple gifts produce life-changing results. </p><p>Since opening its doors, the RTC has logged 500,00 patient days, serving 3,000 youth from 30 states and seven countries. Twelve months after leaving the RTC, 85 percent of youth are either in school or have graduated. Under the leadership of Douglas Spellman, M.D., highly trained staff review each youth’s medication regimen and adjust psychotropic prescriptions to ensure the child is receiving the appropriate medication for optimal mental and physical health. </p><p>“This is the place where children with backgrounds of abuse, aggression and unstable homes can get the treatment they need and find hope in their lives," Dr. Spellman said. “We give them a safe and secure environment where they can begin to make positive changes to learn better self-control and social skills." </p><p>And it’s not just the youth who reap the benefits of th​is unique program. </p><p>“One of my greatest joys of being here over the last 25 years is seeing youth that come here very sad, very disgruntled, and then see them in six weeks or a couple months, leaving the RTC extremely happy,” said Pat Connell, Boys Town Healthcare Policy Advocate. “It really brings joy to my heart and I’m so grateful we’ve been able to help so many kids.” </p><h2>The Work Continues</h2><p>Despite the incredible success of the RTC’s 25 years, there is still much to be done. Even with the facility’s rapid growth, there continues to be a waiting list for the program. The behavioral health team continues to update its evidence-based intervention methods to stay on the leading edge of behavioral health care for children with help from programs like the Boys Town Center for Neurobehavioral Research in Children, which strives to learn more about how childhood trauma can impact brain development and function. </p><p>As Father Flanagan said, “The work will continue, you see, whether I am there or not, because it is God’s work, not mine.” For 25 years, the RTC has proven this to be true; and we are thrilled to see what these dedicated employees can accomplish as the program continues. </p><div class="embed-container"> <iframe src="" width="560" height="315" frameborder="0"></iframe> </div></div>
First Boys Town Hospital Employees Receive COVID-19 Vaccine Boys Town Hospital Employees Receive COVID-19 Vaccine2020-12-22T06:00:00Z<p>​​​​​​On Tuesday, December 22, Boys Town National Research Hospital received a delivery of 400 doses of the Moderna COVID-19 vaccine and began vaccinating direct healthcare staff, specifically those working with positive COVID-19 patients. </p><p>“I just got the COVID vaccine, and I’m thrilled to be able to do this for my patients, for myself and for my family – to keep all of us safe,” said <a href="">Mohan Mysore, M.D., Director of the Boys Town Advanced Care Unit​</a>. “We anticipate that this is the beginning of the end, but we still need to maintain social distancing, wear a mask, wash our hands and d​o all the things that we’ve been doing so well over the past several months.”</p><p>With 830 direct care staff working in healthcare settings across the hospital, primary and specialty care clinics and Residential Treatment Center, the first shipment allows Boys Town to provide vaccinations for 48% of direct care staff, with hopes of receiving more vaccines in the coming weeks.</p><h3>Thank you to all who have continued to keep patients and families first throughout this pandemic and to those who are helping us distribute this long-awaited vaccine! </h3><div class="embed-container"><iframe width="560" height="315" src="" frameborder="0"></iframe> </div>
Robots Help Students Learn at Boys Town Residential Treatment Center Help Students Learn at Boys Town Residential Treatment Center2020-12-14T06:00:00Z<p>​Boys Town Residential Treatment Center (RTC) students are now learning from robots.</p><p>Well, sort of.</p><p>Actually, the robots are helping the students get interested in learning.</p><p>Science, technology, engineering and mathematics (STEM) workers play a key role in the growth and stability of the U.S. economy. Now, thanks to a pilot STEM Acellus Robots course for Boys Town RTC students, that exposure could also lead to future job opportunities.</p><p>Alyssa Biskup is Education Coordinator for the RTC at the Boys Town National Research Hospital<sup>®</sup>. She is excited about the opportunity STEM education provides Boys Town kids.</p><p>“STEM education creates critical thinkers, increases science literacy and enables the next generation of innovators," Biskup said. “Because of that, STEM education in school is important to spark an interest in pursuing a STEM career in students."</p><p>Biskup says Boys Town RTC students have not always had the opportunity to experience what these work fields have to offer.</p><p>“Many of our students have missed out on some of these opportunities due to some challenges that they currently face," she said. “Especially for our kids who are highly mobile, they have been in multiple schools, multiple placements or have just not had the opportunity in their communities or school districts. Some of our kids lack the motivation and interest in even going to school. Here at the RTC, we can offer them something new and exciting that may spark their interest or get them excited to come to school."</p><p>Boys Town RTC instructors are more than just teachers.</p><p>“Part of our job, for some kids, is to get them to like school again and to feel confident in the classroom," Biskup said. “For other kids, our job is to get them caught up with their course work and challenge them in such a way that builds confidence for their return to their public school."</p><p>RTC high school students in good academic standing have the option to enroll in an Acellus course for elective credits. The students must show safe behaviors and will sign a robot safety contract. Only 15 youth at a time will be enrolled in the class to give everyone plenty of individual instruction time. New youth will be able to enroll as others complete the course.</p><p>In the Acellus Introduction to Coding course, students are taught how to program using the Blockly coding language. With Blockly, everything is done with little building blocks that snap together in an intuitive way. As students learn to program by snapping blocks together, they are laying a foundation for more advanced programming languages.</p><p>In the first half of the class, the course builds a baseline understanding of the concepts needed to learn coding.<strong> </strong>In the second half of the course, the students are introduced to Cellus Bot, a teaching robot equipped with lights, a motor and sensors, all of which are controlled by block coding modules included as part of the course. Students then progress through different levels of coding and fundamental programming concepts.</p><p>Statistics tell us there are currently millions of job vacancies in the STEM industry, while at the same time only 16% of college students graduate in STEM fields or subjects. Demand for STEM jobs has increased dramatically and continues to grow, with many new fields and professions emerging each day.  This as a tremendous opportunity for RTC students.</p><p>“The fantastic thing about STEM education is that it's ever-expanding," Biskup said. “STEM is so important to kids because technology is all over our world. From the smartphone device to the personal computer and tablet, we utilize technology in new ways every single day. STEM is an area of education that isn't going to fade away; it's merely going to grow larger. Encouraging a creative, motivated problem solver and a kid who can enjoy learning and think outside of the box is the best gift you can ever give our youth as a teacher."</p><p>Boys Town is not only working to help children with their behavioral and mental health problems but helping them continue to grow and learn.</p>
Voice of America Features Boys Town® Researcher Karla McGregor, Ph.D. of America Features Boys Town® Researcher Karla McGregor, Ph.D.2020-12-03T06:00:00Z<p> Recently, Voice of America (VOA), the United States' largest international broadcaster, featured an article about U.S. students with disabilities being afforded reasonable accommodations and the chance to succeed thanks to the 1990 Americans with Disabilities Act.</p><p>Students as young as 3 years of age can access IEPs (individual education programs) that address a multitude of learning issues including developmental language disorder (DLD) and ADHD, as well as other physical, medical and learning disabilities. Reasonable accommodations such as extended test-taking time, dedicated note-takers and sign language interpreters can continue through college to help students reach their full potential.</p><p> <img src="" alt="Karla McGregor, Ph.D." class="ms-rtePosition-2" style="margin:5px;width:200px;" />“We want a diverse student population. And having these students included is super important," Dr. Karla McGregor, Director of the Center for Childhood Deafness, Language and Learning and professor emeritus at the University of Iowa, said in the VOA article. </p><p>However, only 33% of students eligible for reasonable accommodations at a college level receive them. This is due, in part, to the high cost involved in testing for accommodations, as well as the fear of being stigmatized, Dr. McGregor shared in the article.</p><p>Helping students with communication and learning disabilities is what led Dr. McGregor to her current position as Director of the Center for Childhood Deafness, Language and Learning at Boys Town National Research Hospital<sup>®</sup>. Dr. McGregor specializes in DLD, a neurodevelopmental disorder that limits a person's ability to learn, understand and use language.</p><p>DLD affects 7% of the population, which translates to about two children in every classroom. Despite its prevalence and impact on learning, listening and speaking, DLD has historically suffered from a lack of societal awareness and clinical studies. </p><p>Dr. McGregor often describes DLD as “a hidden disorder." Many children with DLD go unnoticed because they have mastered the minimums necessary for communication. DLD goes by many names – language delay, specific language impairment, expressive-receptive language disorder, speech-language impairment or language learning disability – and this, too, hinders understanding of the condition.</p><p>“Many children who are identified with DLD are diagnosed because they have a co-occurring condition such as a speech impairment, or a behavioral concern that is more noticeable to adults than immature language patterns. However, the consequences for academic success with DLD are often greater than those of co-occurring conditions," said Dr. McGregor.</p><p>Raising awareness of DLD is a major objective for Dr. McGregor. She is a founding member of, a website created by a nationwide panel of expert volunteers, with the mission of raising awareness amongst educators, parents and policymakers. <a href="" target="_blank"></a> provides an overview of DLD and articles summarizing the latest DLD research. </p><p>Dr. McGregor is also the U.S. representative on the board of <a href="" target="_blank">Raising Awareness of Developmental Language Disorder</a>. This international organization hosts yearly DLD Awareness Day campaigns and on-going multimedia offers on DLD. The 2021 DLD Awareness Day is scheduled for October 15<sup>th</sup>.</p><p>Together these two organizations, along with researchers like Dr. McGregor, hope to alert parents and educators to the potential signs of DLD, as well as make clear the importance of spoken language development in children's academic and social success. </p>
Boys Town Residential Treatment Center Youth Get Rare Virtual Experience with Dolphins Town Residential Treatment Center Youth Get Rare Virtual Experience with Dolphins2020-12-01T06:00:00Z<p>​Boys Town Residential Treatment Center (RTC) Education Coordinator Alyssa Biskup calls it “a total COVID blessing."</p><p>There's one you don't hear very often.</p><h3>But this story is special.</h3><p>Florida dolphins helping with the treatment of troubled youth in Nebraska.</p><p>Troubled Nebraska youth helping with the treatment of dolphins in Florida.</p><p>It all came about in late October when through a mutual acquaintance, Biskup was put in contact with Missy Johnson, a native of Valley, NE, now working at Island Dolphin Care in Key Largo, FL. The two discussed virtual sessions where Boys Town's RTC students could interact with the dolphins in a fun learning experience.</p><h3>Then COVID hit the Boys Town RTC.</h3><p>“We really had a pretty severe outbreak," Biskup said. “This pandemic is hard, but our kids are away from family and friends with or without a pandemic. Anything to connect them to the outside world, especially dolphins, is amazing not only for them but for us as staff to experience with them. We were able to give our kids an experience that will go into their memory bank as a positive one -- maybe an experience they would otherwise never come close to experiencing in a lifetime."</p><p>What made the relationship special for both parties was that Island Dolphin Care was experiencing its own COVID crisis.</p><p>“Their facility was shut down due to COVID, also," Biskup said. “They couldn't have any visitors into their facility, so our virtual meetings were all each of us had. It was a bad situation, but it fell at exactly the right time for both of us."</p><p>Biskup's staff was challenged to get the virtual meetings set up in the individual student's rooms. Due to the pandemic, they weren't able to do the meetings in larger settings. So, Johnson and Island Dolphin Care trainer, Eli Smith, made plans to stream live interactions between the dolphins and their new friends at the Boys Town RTC in Nebraska.</p><p><img src="" alt="class observing dolphins" class="ms-rtePosition-2" style="margin:5px;width:300px;" />Smith, who has a background in special education, served as a guide for the youth. Holding a camera, he walked through the facility, down to the dock and lagoon where the dolphins live. The sessions lasted 45 minutes. During that time, students learned how the dolphins were cared for and how they can help with the treatment of others. They learned about dolphin anatomy and watched and learned how they are trained.</p><p>The actual virtual interactions with the dolphins included getting a dolphin kiss, feeding the dolphins and learning about their behavior management.</p><p>“Even though they were watching on laptops, these were live, unplanned interactions for our kids," Biskup said. “We had never done anything like this before. It was an incredible opportunity and it really was a nice, relaxing project that helped the kids get through a tough time and gave them a chance to have fun, too."</p><p>Biskup estimated that around 60 students participated in the dolphin experience. She said it also provided something different for her staff.</p><p>“We were all hands on deck due to the COVID outbreak," she said. “It gave our teachers 45 minutes of therapeutic relief. It was a great experience for everyone."</p><p>Biskup said students weren't asked to write any reports or do special school assignments with the dolphin experience. Instead, she said they just wanted everyone to relax and enjoy.</p><p>“It really was never intended to be an academic project," she said. “We just wanted them to enjoy the experience. Afterwards, we just talked about what they had seen and heard. I think it left quite an impression on everyone involved."</p><p>Johnson said the experience was a satisfying one for the staff of Island Dolphin Care, as well.</p><p>“2020 has been an unprecedented year for us here at Island Dolphin Care, just like it has been for so many others," she said. “This year our primary focus is keeping our staff and family of dolphins safe and taken care of until we are able to re-open and safely continue our in-person therapy programs."</p><p>She said being able to work with an organization like Boys Town fits into Island Dolphin Care's philosophy of helping others.</p><p>“Working with organizations such as Boys Town is phenomenal because the passion and love for education and well-being for children is shared," Johnson said. “We were honored to get to be a part of such a life-changing time for the children that Boys Town works with. In times like these, with so many changes to life and what feels 'normal,' we can sometimes forget to notice and appreciate the changes that are positive. In a typical year, we probably would not have had the opportunity to get to know the children you serve at Boys Town, or to share our services, dolphins, or story with all of you."</p><p>Johnson said 2020 is the perfect year for groups to come together and help each other.</p><p>“It is so very important during this pandemic that we as a larger community ban together and share all that we can with one another," she said. “It's important to know there is hope and love still surrounding us, and it's good to have reminders to look for it. In difficult times such as these, we all need as many smiles, giggles and as much hope as we can get our hands on. It's pertinent that we remember children are just as affected by this current climate as adults are. Staying strong together is what will help pull all of us through to the other side of this as better people and a stronger community."</p><p>Island Dolphin Care's Mission Statement states that it is “To provide unique, animal-assisted (dolphin), therapeutic, motivational and educational therapy programs to children, adults with special needs, and their families and caregivers. Through interactive programs, education and research, participants are inspired to value and respect marine mammals and their environment."</p><p>The Boys Town Residential Treatment Center (RTC) provides medically directed care for children ages 5 to 17 who have severe behavioral health problems or mental illness. The Center is licensed as a Psychiatric Residential Treatment Facility (PRTF) by the state of Nebraska and is accredited by The Joint Commission. The troubled children, pre-teens and teens Boys Town serves need systematic and professional treatment for their behavioral, emotional and academic problems. </p>
New App Measures Attention in 2 to 5-Year-Olds App Measures Attention in 2 to 5-Year-Olds2020-11-13T06:00:00Z<p>​Designed with an engaging theme and graphics, the Visual Attention Processing Protocol (VAPP) application collects research data on how children between the ages of 2 and 5 process visual information in their environment.</p><p>Created by Anastasia Kerr-German, Ph.D., Director of the Brain, Executive Function and Attention Research Laboratory at Boys Town<sup>®</sup>, this app measures visual attention and brain processing efficiency during play, while keeping kids entertained and interactive. Available in the App Store, the VAPP application is accessible to researchers wishing to participate in normative data collection.</p><p>In keeping with the under-the-sea game format, the first thing children are asked to do is click on sea creatures as quickly as they see them. In the next tier of the game, children will have to make choices about the direction the fish are going and drag them to the right location on the screen. In the third part of the game, children will sort visual stimuli (sea creatures and sea trash) to the appropriate locations based on their labels.</p><p>This game tells us about how children see things and how they make choices about visual information in their environment. To keep the engagement level high, there are also parts of the game that are just for entertainment like a pop-the-bubbles segment and the ability to earn underwater treasure games. </p><p>The Child Visual Attention Protocol application gauges how children use categorical labels and visual attention to guide decision-making, both in the moment and during a task that requires attention skills. The Protocol tests what children know and how quickly they can process and make decisions about that visual information.</p><p> <img src="" alt="Child Visual Attention Protocol app" class="ms-rtePosition-1" style="margin:5px 15px 5px 5px;width:370px;height:278px;" />For example, in the “<em>Find the Fish"</em> exercise, children can quickly tap a creature with little thought in one portion of the task, which allows us to gauge how quickly they can process those visual stimuli. During <em>“</em><em>Where Are They Going?"  </em>and<em> “Rescue or Recycle?"</em> children must not only see the object but must label it and then do something with it. That is where decision-making comes in. Both pieces are important when understanding the development of attention in young children.</p><p>So far, the Child Visual Attention Protocol has been piloted with a dozen or so 2 to 5-year-olds and the children have been enthusiastic about using the application. There is still a large amount of normative data to collect before this can become a potential diagnostic tool to identify children who may be at risk for developing disorders such as ADHD. But the information collected to date is promising and might eventually help identify risk for ADHD much earlier than is now possible.</p><p>This application may eventually allow for diagnosis and care of those at risk for ADHD long before the behavioral and psychological struggles these children face become disruptive to their day-to-day lives. If interventions could start early, before school age, these children may have an easier time adjusting and there may be less of an impact on their academic achievement and social-emotional health.</p><p>“My hope is that we can use this app to better understand typically developing children prior to school age so that we may begin to understand the evolution of disorders of attention and executive functioning such as ADHD. A portion of our children in the Boys Town Residential Treatment Center, as well as outpatient clinics, have ADHD, and this line of research is aimed at early identification of risk and earlier interventions," said Dr. Kerr-German.</p><p>Researchers interested in helping to collect data for this ongoing project should contact Dr. Kerr-German through the Brain, Executive Function and Attention Research Lab at Boys Town National Research Hospital<sup>®</sup>.​</p> <a href="" target="_blank"><img src="" alt="Download on the iOS App Store" /></a>​<br>
Ears On An Evidence-Based Program to Improve Hearing Device Use in Children On An Evidence-Based Program to Improve Hearing Device Use in Children2020-11-03T06:00:00Z<p>​ <img src="" alt="Child with hearing aid participates in research study" class="ms-rtePosition-2" style="margin:5px 10px;width:344px;height:333px;" />​For children with hearing loss, hearing devices such as hearing aids and cochlear implants provide access to speech sounds that are critical to their development of spoken language. Ho<span class="ms-rteThemeFontFace-1">wever, children m</span>ust regularly wear their devices to receive the full language development benefits [1]. </p><p>Ears On is a program developed and evaluated by Sophie Ambrose, Ph.D., Coordinator of the Clinical Measurement Program and her team at Boys Town National Research Hospital. Ears On is designed to help parents ensure regular device use for their children. The program focuses on educating families of the importance of children consistently wearing their hearing devices and provides practical tips to help with compliance of wearing them. </p><h2>Practical Concerns Affect Hearing Device Use</h2><p>When it comes to getting children to wear hearing devices, there are some common challenges. We know children take them off without parents' knowledge. Parents may choose not to have kids wear their devices during some activities. Other caregivers may not realize the importance of the devices and may fail to encourage or enforce wearing them. And, families sometimes just forget [2-3]. </p><p>Some of these factors are made worse by a lack of understanding of the developmental importance of consistent hearing device use. Hearing the sounds of speech and language during critical developmental periods supports brain development that will affect a child's long-term academic, social and professional success.</p><h2>Ears On Education to Help Families Manage Hearing Device Use</h2><p>Ears On starts with ensuring parents understand their child's individual hearing loss, including the speech sounds their child will miss without amplification and the impact it can have on language development. The intervention also seeks to show parents how much of a difference they can expect in hearing and language development with regular device use and to empower parents to believe they can establish consistent device use.</p><p>To meet these goals, Ears On methods include reviewing the results of the child's previous hearing assessments, using simulations of the child's hearing with and without hearing devices, presenting video examples of the language development of children with hearing losses similar to their child's and discussion of related topics. </p><p>Finally, to help parents improve their child's hearing device use, Ears On includes sessions that support parents in identifying and becoming confident in using strategies to address each of the barriers the family faces in establishing consistent device use. For examples, parents may learn strategies to encourage their child not to remove his or her devices or advocacy strategies to use with other caregivers. </p><h2>Ears On Program Evaluation</h2><p>Dr. Ambrose and her team tested Ears On with three parent-child pairs, with the three children being from 16 to 33 months old at the time of entry into the study. After Ears On, they found that all three improved in hearing aid compliance, with two them meeting the program goal of eight hours of average daily device use [2].  This study shows early promise for supporting parents and children by offering an intensive intervention focused on hearing device use. One of the keys to the success of the intervention was the individualization based on each family's needs. Additional work by the research team has included developing and validating a measure of parents' perceived beliefs, knowledge, confidence, and actions related to supporting their children's hearing device use and language development. This tool, which is available in <a href="" target="_blank">a recent article in the Journal of Early Hearing Detection and Intervention</a>, can help clinicians individualize their efforts to support families in increasing device use. </p><p>Boys Town National Research Hospital is recognized around the world as a leader in hearing and language research. </p><h2>References</h2><ol><li>Ambrose, S. E., Appenzeller, A., Al-Salim, S., & Kaiser, A. P. (2020). Effects of an intervention designed to increase toddlers' hearing aid use. <em>Journal of Deaf Studies and Deaf Education, 25</em>(1), 55-67. doi:10.1093/deafed/enz032</li><li>Moeller, M. P., Hoover, B., Peterson, B., & Stelmachowicz, P. (2009). Consistency of hearing aid use in infants with early identified hearing loss. <em>American Journal of Audiology</em>, <em> </em>(1), 14–23. doi:1059-0889_2008_08-0010</li><li>Muñoz, K., Rusk, S. E. P., Nelson, L., Preston, E.,White, K. R., Barrett, T. S., & Twohig, M. P. (2016). Pediatric hearing aid management: Parent-reported needs for learning support. <em>Ear and Hearing</em>, 37(6), 703–709. doi:10.1097/AUD.0000000000000338</li></ol>
The Scientific Truth about Herd Immunity Scientific Truth about Herd Immunity2020-10-29T05:00:00Z<p>As we enter a crucial stage in the coronavirus pandemic, Nebraska's hospitals and public health agencies want you to know the truth about herd immunity. You may have read about this concept as a way to get us through this difficult time. It would be disastrous for our country, our health care systems, and for millions of fellow Americans. </p><p>The herd immunity concept is based in an assumption that everyone who recovers from COVID-19 is immune from re-infection. That is an assumption that has not been proven. In fact, medical scientists have now reported a number of persons with proven re-infection. With a virus that has existed for less than a year, it is impossible to know whether people can be re-infected on a large scale. </p><p>Let's look at the numbers:</p><p>For herd immunity to take hold, you would need a minimum of 60% of the entire population to be infected. Antibody studies tell us that some small pockets of New York City and Mumbai, India, may have reached 50% infection rates, but cities with major outbreaks have had overall infection rates of less than 25%. Based on CDC testing nationally, we estimate 10% of the U.S. population has experienced COVID-19 coronavirus infection. Given the overall number of confirmed deaths, we can estimate that approximately 0.6% of people with COVID-19 will perish as a result. As of this writing, over 220,000 Americans have already died from COVID-19. So, what would happen if 60% of the population were infected rather than 10%? Here are our estimates for what a “herd immunity" experience in the US would look like:</p><ul><li>197 million cases</li><li>3.6 million people hospitalized</li><li>1.2 million deaths</li></ul><p>This is not a solution. The loss of life would be many times more devastating than what we see now. The economic impact would be ruinous for our state and country. If you see statements that claim otherwise, keep in mind there has not been a single scientifically verified study anywhere in the world that shows unchecked herd immunity as a solution. </p><p>What is the solution? As scientists around the world work tirelessly toward a vaccine, we must follow what we know works to stop the spread. We agree with state leaders who encourage you to avoid the three Cs:</p><ul><li> <strong>Crowded places:</strong> Avoid gathering in groups where you cannot maintain a minimum of 6 feet of distance from others</li><li> <strong>Close contact:</strong> Wear a mask whenever you are within 6 feet of people from outside your household. Masks work – scientific data from around the world continues to show this. In areas with mask mandates, the primary driver of COVID cases is people who spent significant time without their masks on in places like bars and restaurants</li><li> <strong>Confined spaces:</strong> Avoid enclosed spaces with poor ventilation. We know how the virus spreads. When people are physically separated from others by 6 feet or more in well-ventilated areas, they are much less likely to become infected.</li></ul><p>We do not have to choose between the total shutdown of society and letting the virus run unchecked through the population. We can instead rely on science and a spirit of helping each other by protecting each other and getting through this together. </p><p style="text-align:center;"> <img src="" alt="healthcare logos" class="ms-rtePosition-4" style="margin:5px;" /> <br> </p>