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Translating research to change the way ​America ​​cares for ​​children and​ ​families.

We are internationally recognized as a leader in clinical and research programs focusing on childhood deafness, developmental language disorder, and related communication disorders. In 2013, we began a new frontier in neurobehavioral research using brain imaging techniques to better help diagnose and treat troubled children with severe behavioral and mental health problems.

Areas of ​Research

 

 

Balance ResearchDoctor doing Vestibular Reseach https://www.boystownhospital.org/research/balanceBalance Research
Center for Perception and Communication in Children (COBRE Grant)Cobre Areahttps://www.boystownhospital.org/research/cobreCenter for Perception and Communication in Children (COBRE Grant)
Hearing and Speech Perception ResearchAudiologist tools on a medical charthttps://www.boystownhospital.org/research/hearing-speech-perceptionHearing and Speech Perception Research
Neurobehavioral Research3T MRI machinehttps://www.boystownhospital.org/research/neurobehavioralNeurobehavioral Research
Sensory Neuroscience ResearchDNA Strand - Researchhttps://www.boystownhospital.org/research/sensory-neuroscienceSensory Neuroscience Research
Speech and Language ResearchSpeech language research https://www.boystownhospital.org/research/speech-languageSpeech and Language Research

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News

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Social Problem-Solving Skills are Protective for Youth Exposed to Traumahttps://www.boystownhospital.org/news/social-problem-solving-skills-youth-traumaSocial Problem-Solving Skills are Protective for Youth Exposed to Trauma2020-03-31T05:00:00Z<p>​​​​Childhood trauma changes the way that children’s brains function, and many traumatized kids end up with post-traumatic stress disorder (PTSD). Researching and developing methods ​to ​provide the best care for these kids is the role of the Child and Family Translational Research Center at Boys Town. The research that we do directly informs our staff, and other organizations, who are responsible for caring for kids who have experienced trauma.</p><p>​A major challenge to providing effective therapies is that the type and th​e severity of trauma experienced affect young brains differently [1]. Boys Town has developed a screening instrument to identify possible symptoms youth may have related to past trauma [2] and uses a <a href="https://www.boystownhospital.org/news/trauma-informed-care-critical-for-youth">trauma-informed care model</a> to avoid further traumatization. Boys Town care providers use the questionnaire to determine the suppo​rts and services youth need to help children heal. However, more research is always needed to support existing practices and to help us to continually improve how we take care of at-risk kids.</p><p>In a recent publication, Patrick Tyler, Ph.D., Director of Research Translation, and his colleagues evaluated outcomes for 667 youth, ages 10–18 years old, who received social skills training as part of our trauma informed care model. For this study, the researchers were also focused on kids with more severe trauma and PTSD. The social training was broken down into 3 focus categories: self-advocacy, emotional regulation, and problem solving. The youth in this study were receiving group home services in the Boys Town Family Home Program, which involves direct-care staff residing with them in a family-type setting [3]. The social skills training is also an integral part of their treatment to help them manage their emotions and develop skills for healthy interactions in the home and after they leave. Duration of treatment was a significant factor, with kids who were in treatment longer showing more improvement that those with shorter stays.</p><p>Social skills training for the children was conducted by following established practices at Boys Town. The specific social skills training varied for each child based on the assessment of their needs by their care providers. The researchers were looking for improvements in behavioral incidents, self-injury, conduct, and emotional problems. </p><p>From the 3 categories of social skills t​raining that were examined, the authors noted that all types helped to some degree with behavioral problems. However, problem-solving training had the biggest effect on both behavioral incidents and emotional problems, such as anxiety and depression. This suggests that prioritizing problem-solving skills is an approach that could help a large proportion of traumatized kids. It also offers a narrowed set of skills that can be supp​orted by educators or other caregivers who could receive focused training in this area. Having this support to maintain these skills after a child leaves clinical or residential care may be the best way to help these kids stay healthy.</p><p>You can read more about this study, currently in press, in the journal, <i>Psychological Trauma: Theory, Research, Practice and Policy</i> [3].</p><h2>References</h2><ol><li>Blair K.S., Aloi J., Crum K., et. al. (2019) Association of Different Types of Childhood Maltreatment With Emotional Responding and Response Control Among Youths. 2(5). JAMA Netw Open.</li><li>Tyler, P.M., Mason, W.A., Chmelka, M.B., et. al. (2019) Psychometrics of a Brief Trauma Symptom Screen for Youth in residential care Journal of Traumatic Stress. doi: 10.1002/jts.22442.</li><li>Tyler, P.M., Aitken, A.A., Ringle, J.L., et. al. (2020) Evaluating Social Skills Training for Youth with Trauma Symptoms in Residential Programs. (In Press). Psychological Trauma: Theory, Research, Practice and Policy.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://care.boystownhospital.org/research-newsletter/" target="_blank">Newsletter Sign-Up</a></div>
School Success as an Adult is Influenced by Childhood Traumahttps://www.boystownhospital.org/news/childhood-trauma-influences-later-school-successSchool Success as an Adult is Influenced by Childhood Trauma2020-03-11T05:00:00Z<p>​Success as an adult is associated with educational achievement. Unfortunately, kids who experience childhood trauma and maltreatment are more likely to struggle academically and later in life. There are many ways that kids experience maltreatment, including neglect, emotional, physical, and sexual abuse. These events affect many aspects of development. Furthermore, different types of trauma can be associated with different outcomes that need to be understood in order to correctly focus resources and therapies.</p><p>In a recent paper Jay Ringle, M.A., at the Boys Town Child and Family Translational Research Center, and his colleagues tested a developmental cascades model for potential direct and indirect effects of childhood maltreatment on adult educational achievement [1]. The developmental cascades model essentially means that a traumatic event or series of events can alter or disrupt a child’s developmental transitions, thus creating a cascading effect of maladaptation. One result of this can be lower adult academic achievement [2]. For this study, the researchers used longitudinal data on a sample of children and their families assessed 4 times over 30 years, starting in the 1970s [3, 4]. The data were a mix of self-report measures and agency-reported case information.</p><p>Finding direct impacts of any event over a long period of time is difficult, largely due to the number and variety of events that individuals experience. With that in mind, this study only found a direct effect of agency-reported cases of maltreatment — which are likely to be made up of more severe cases than just self-reported cases — and adult educational achievement. Further, the researchers did find several indirect impacts. For example, neglect predicted adolescent engagement academic engagement, which in turn predicted adult educational achievement. Adolescent school discipline reports were also predictive of adult educational achievement.</p><p>With regards to the different categories of abuse, the stud​y found that physical, emotional, and sexual abuse predicted early school-age attention problems that then predicted discipline issues. On the other hand, neglect indirectly impacted adult education achievement through lower ​school engagement in adolescence.</p><p>Perhaps the most important thing to take away from this study is that a case-specific educational approach will more benefi​cial to kids exposed to childhood trauma than a one-size-fits-all approach. This study provides some perspective on different types of childhood maltreatment and how it effects adult educational achievement through different pathways (e.g., attention problems, poor school engagement) The findings also provide a starting point for creating appropriate interventions. For example, positive school-based interventions for kids who have experienced maltreatment are likely to be a more effective approach than punishment. Additionally, developing alternative approaches to get kids who have suffered neglect to engage in school has the potential to make a difference in where they end up.</p><p>Boys Town has been taking care of at-risk kids for more than 100 years. Scientists at Boys Town National Research Hospital also conduct influential research on youth care programs so we can provide the best care possible here and help other schools and youth-care organizations to do the same. The findings from this study are published in Childhood Maltreatment [1]. Find more about our youth care and related research by visiting <a href="https://www.boystown.org/research/Pages/Translastion-Research-Center.aspx" target="_blank">Child and Family Translational Research Center</a>.</p><h2>References</h2><ol><li>Jay L Ringle, J.L., Mason, W.A., Todd I Herrenkohl H.I., et. al. (2020) Prospective Associations of Child Maltreatment Subtypes With Adult Educational Attainment: Tests of Mediating Mechanisms Through School-Related Outcomes. Child Maltreat. EPUB ahead of print.</li><li>Masten, A. S., Roisman, G. I., Long, J. D., et. al. (2005). Developmental cascades: Linking academic achievement and externalizing and internalizing symptoms over 20 years. Dev Psychol, 41(5), 733–746.</li><li>Herrenkohl, R. C., Herrenkohl, E. C., Egolf, B. P., et. al. (1991) The developmental consequences of child abuse: The Lehigh Longitudinal Study. In R. H. J. Starr & D. A. Wolfe (Eds.), The effects of child abuse and neglect: Issues and research (pp. 57–81). Guilford Press.</li><li>Herrenkohl, R. C., and Herrenkohl, T. I. (2009) Assessing a child’s experience of multiple maltreatment types: Some unfinished business. J. Fam Violence, 24(7), 485–496.</li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://care.boystownhospital.org/research-newsletter/" target="_blank">Newsletter Sign-Up</a></div>
Boys Town National Research Hospital Researchers Investigate Hearing and Speech Perception in Down Syndromehttps://www.boystownhospital.org/news/hearing-speech-perception-in-down-syndromeBoys Town National Research Hospital Researchers Investigate Hearing and Speech Perception in Down Syndrome2020-03-03T06:00:00Z<p>It takes years of consistent, high-quality auditory information to develop the ability to effectively “hear out" one person talking (for example, a teacher) when other people are talking in the background (for example, classmates).  Children with Down syndrome may be at risk for disruptions in this developmental process because of the high prevalence of middle ear infections and hearing loss that occur in this population. Despite these risk factors, very few research studies have looked at how well children with Down syndrome understand speech in noisy environments, such as the classroom.</p><p>Lori Leibold, Ph.D. and Heather Porter, Ph.D., along with their colleagues at the Center for Hearing Research at Boys Town National Research Hospital, are working to identify factors that improve listening-in-noise difficulties so we can increase the likelihood of success for children with Down syndrome. Dr. Porter explains that, “In general, kids have a harder time than adults when listening to speech if other people speaking. This is partly because we develop the ability to tune out background noise through experience. Problems with hearing get in the way of the brain learning to filter out distracting sounds. Therefore, we expect to see that this developmental process is impacted in kids with Down syndrome, and that it will be influenced differently for individuals by their varying sensory, language, and cognitive characteristics." </p><div class="is-clearfix"><div class="inline-image is-size-7"> <img src="https://assets.boystown.org/hosp_peds_images/Computer-Screen.png" alt="computer screen children see when listening to speech-in-noise task" class="inline-image__image" style="max-width:100%;" /> <p>Figure 1. Example of the computer screen children see when listening to the speech-in-noise task.</p></div><p style="margin-bottom:1rem;">The team of researchers at Boys Town National Research Hospital has established Project INCLUDE to learn more about the communication abilities of children with Down Syndrome. Children who participate in this study complete a series of measures that assess hearing, language, and problem-solving abilities. Hearing assessments are completed using developmentally-appropriate, game-like tasks and children have the ability to demonstrate their listening skills using a touchscreen computer application (see Figure 1). The research team has decades of experience working with children with developmental delays, which they use to ensure participants and their families are also welcomed to a friendly and engaging environment. </p></div><p>Families of children with Down syndrome ages 5 to 17 years old are invited to participate in this study.  The study includes up to three visits that last 1–2 hours each. In addition, children receive hearing and language assessments by licensed professionals with expertise working with children with developmental delays. Information from this study will help us to determine influences on the developmental timeline for listening-in-noise in children with Down syndrome and serve as the basis for future funding applications to support work in this area. Compensation for this study is $15 per hour.</p><p>Boys Town National Research Hospital is dedicated to improving care for children and families around the world. This research is important because Down syndrome is a common condition, affecting about 1 in 1000 people in the US, and gaps in our knowledge could have a negative impact on the care and services people receive. As we increase our understanding, we anticipate that we will be able to improve the services children with Down syndrome receive both locally and nationally.</p><p>This study is funded by the National Institutes of Health INCLUDE (INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE) Project, launched in June 2018 in support of a Congressional initiative to investigate critical health and quality-of-life needs for individuals with Down syndrome [1]. The results from Project INCLUDE at Boys Town National Research Hospital will contribute to national INCLUDE goals by identifying factors associated with successful speech understanding in less-than-optimal listening environments and result in opportunities for improved communication outcomes for individuals with Down syndrome.</p><h2>References:</h2><ol><li> <a href="https://www.nih.gov/include-project">https://www.nih.gov/include-project</a></li></ol><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://care.boystownhospital.org/research-newsletter/" target="_blank">Newsletter Sign-Up</a></div>
Remarkable New Sound Research Facility added at Boys Town National Research Hospitalhttps://www.boystownhospital.org/news/anechoic-chamber-sound-research-facilityRemarkable New Sound Research Facility added at Boys Town National Research Hospital2020-01-20T06:00:00Z<p>​​The first thing you notice when entering the new anechoic chamber at Boys Town National Research Hospital is how big the chamber is. The large white cube stands over 18 feet high and occupies roughly 400 square feet of floor space. The anechoic chamber is the newest addition to our sound research facilities and is also the most advanced facility of its kind in the region.</p><p>The chamber is isolated from outside noise and vibrations by thick walls and sound-deadening insulation. The walls, floor, and ceiling inside the chamber are also completely covered by triangular shaped structures called anechoic wedges that are 19 inches tall. The shape, size and arrangement of the wedges are designed to control all but the lowest frequency​ sound reflections inside the booth. (Figure 1). Finally, a floating, mesh floor suspends occupants above the same wedges in the floor of the structure. These features make the inside of the chamber very quiet with virtually none of the reflected environmental sounds that we hear without thinking about every day. It’s an interesting location to talk to G. Christopher (Chris) Stecker, PhD, the director of the Spatial Hearing Lab, about the new facility.</p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/IDAwSz8YT_g" frameborder="0"></iframe> </div>​ <p>Inside, the chamber is configured with a 96-channel speaker system to enable a range of sound simulations and experiments. Dr. Stecker explains that “the array is used for research on hearing and localization of sounds in 3-dimensional spaces. For example, the system can simulate classroom sound environments that helps researchers understand how children develop the ability to focus on one person who is speaking without being confused or distracted by other speakers or noises. This research is relevant for things like refining hearing aid and cochlear implant technology so that they convey the best possible spatial and voice information. Interestingly, the same equipment can also be used to demonstrate for others how a noisy world sounds through a hearing aid or cochlear im​plant."</p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="https://assets.boystown.org/hosp_peds_images/anechoic-chamber-wedges.png" alt="anechoic chamber wedges installation details" class="inline-image__image" /> <h2 class="is-size-5">Figure 1.</h2><p>Anechoic wedges, 19 inches measured from base to apex of the triangle, cover the walls floor and ceiling to eliminate all but the lowest frequency sound reflections inside the chamber.</p></div>​ <p>In another type of experiment, tiny microphones can be placed on the ear to measure the influence of head position and ear anatomy on our perception of sound location with assistance from the large speaker array. One use of this capability according to Dr. Stecker is testing by companies developing virtual reality applications. “In order to create convincing virtual environments, it is necessary to know how sound coming from different locations is affected by the ear anatomy so sound cues can be simulated by headphones placed physically on the ear.”</p><p>The described experiments are only some examples of what is possible in the anechoic chamber. We expect that othe​r labs and other research institutions will want to answer a wide range of sound related questions in this space. Support services for the anechoic chamber will also be available through our technology core services. Those interested in conducting research using the anechoic chamber can contact Dr. Chris Stecker in the Spatial Hearing Lab at Boys Town Hospital.</p><p>We are grateful to the National Institutes of Health (NIH), and the Great Plains Institutional Development Award for Clinical and Trans​lational Research (IDeA-CTR) for the financial support that helped make the chamber a reality. The Great Plains IDeA-CTR is an NIH-funded program to increase training, collaboration, development of core facilities, and resources for clinical and translational research at in our region. </p><h2>Research Newsletter</h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://care.boystownhospital.org/research-newsletter/" target="_blank">Newsletter Sign-Up</a></div></div>
Checking Speech Audibility is Important When Assessing Kids with Mild Bilateral Hearing Losshttps://www.boystownhospital.org/news/checking-speech-audibility-importance-when-assessing-hearing-lossChecking Speech Audibility is Important When Assessing Kids with Mild Bilateral Hearing Loss2020-01-19T06:00:00Z<p>​​​​​​​​The ability to hear is directly connected with children’s development of the written and spoken language skills that are essential for many aspects of life. However, there is some confusion and disagreement regarding whether children with mild, bilateral hearing loss should receive hearing aids. Compared to young children with moderate or severe hearing loss, children with mild hearing loss may be able to hear some speech sounds without the use of hearing aids. The impact of mild hearing loss on early speech and language development can be subtle and easy to miss by parents and doctors alike, but without intervention these children may still be at risk for later language delays. Therefore, providing better assessment of the impact of hearing aids for children with mild hearing loss would be a great benefit to families and audiologists who are working to help them.</p><p> <a href="https://www.boystownhospital.org/research/faculty/ryan-mccreery">Ryan McCreery, Ph.D., Director of Research at Boys Town National Research Hospital</a>, and his team have been looking at how amplification, language, and cognition support speech perception in children who are hard of hearing in order to improve outcomes. In a recent paper, Dr. McCreery and colleagues specifically examined the use of a standardized Speech Intelligibility Index (SII) score <sup>[1]</sup>, measured without hearing amplification, as a new tool for assessing hearing aid candidacy for children with mild hearing loss<sup>[2]</sup>. Their goal was to develop an evidence-based criterion for when children with mild hearing loss would benefit from hearing aids.</p><p>The SII uses audiological measurements and takes into account individual ear acoustics to predict a child’s access to speech sounds <sup>[1]</sup>. Children with scores less than 80 on the unaided SII should be consid​ered candidates for amplification because of risks for language problems. This score would correspond to pure tone averages of 20 to 30 dB of hearing loss but is more informative than just measuring dB of hearing loss from the audiogram <sup>[2]</sup>.</p>​ <p>Another goal of the study was to determine how much hearing loss poses a risk to language development. Dr. McCreery and his team found that children who were able to hear 80% of speech sounds, or less, without hearing aids were at risk of delays in language and vocabulary development, emphasizing the need for more meaningful testing <sup>[2]</sup>.</p><p>Based on the results from the study, Dr. McCreery and colleagues recommend that clinical audiologists include speech audibility as part of a standard for hearing aid fitting instead of the hearing test. Specifically, the authors found th​at hearing aids could support language development for children with mild hearing loss who hear 80% or less of regular speech sounds. In addition to providing a clear criteria for fitting hearing aids, discussing hearing loss in terms of speech audibility can help families of children with mild hearing loss better understand the benefits of consistent hearing aid use on language development.</p><p>The authors’ complete findings can be found in the journal, <em>Language, Speech, and Hearing Services in Schools</em>.</p><div class="embed-container"> <iframe width="560" height="315" src="https://www.youtube.com/embed/ZR6ZJ-Wxbb0" frameborder="0"></iframe> </div><h3>References</h3><ol><li>American National Standards Institute. (1997). <em>American National Standard: Methods for calculation of the speech intelligibility index</em>. Acoustical Society of America.</li><li>McCreery R.W., Walker E.A., Stiles D.J., Spratford M., et. al. (2020) <em>Audibility-based hearing aid fitting criteria for children with mild bilateral hearing loss</em>. Lang Speech Hear Serv Sch. 51(1): 55–67.<br></li></ol><h2>Research Newsletter<br></h2><p>Please sign up to receive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://care.boystownhospital.org/research-newsletter/" target="_blank">Newsletter Sign-Up</a></div>​<br>
Boys Town Researchers Find that Cannabis Changes how the Brain Responds to Threatshttps://www.boystownhospital.org/news/cannabis-changes-threat-responseBoys Town Researchers Find that Cannabis Changes how the Brain Responds to Threats2019-11-08T06:00:00Z<p>​​​​Cannabis use is becoming increasingly acceptable in the United States with several states legalizing cannabis for medical uses, and some states moving to decriminalization of recreational usage. However, increased access to cannabis is also creating potential harms, especially for adolescents whose brains are still developing.</p><p>James Blair, Ph.D., Susan and George Haddix Endowed Chair in Neurobehavioral Research, and his research team at Boys Town National Research Hospital are interested in how cannabis and alcohol use affects neurodevelopment. They recently published a study where they measured brain activity in 43 male and 44 female adolescents, ages 14–18, who volunteered for the study.​<br></p><p>The researchers specifically looked at how the brain responds to threatening stimuli in young people with different levels of alcohol use disorder (AUD) or cannabis use disorder (CUD) symptoms [1]. The teens saw threatening (angry faces, predatory animals) or neutral images. These appeared to loom towards (or recede from) the adolescents who were lying in a magnetic resonance imaging (MRI) scanner. This scanner detects brain activity through localized changes in blood flow.<br></p><p>Dr. Blair’s team found that more severe CUD, but not AUD, symptoms were related to less responding to looming threats within brain structures such as the rostral frontal cortex and the amygdala. These are brain regions critically involved in emotional processing.<br></p><p>The ability to respond to threats is important for guiding people away from dangerous or risky choices. In other work conducted previously by Dr. Blair’s team, reduced responding to threat on the same task has been related to an increased risk for aggression and antisocial behavior. The link between increased CUD and reduced threat processing may underpin some of the recent findings linking cannabis abuse to aggression. There remains a lot that we don’t know how cannabis and alcohol affect developing brains, and what changes may become long-term changes. For a more detailed review of these findings see the paper Threat Responsiveness as a Function of Cannabis and Alcohol Use Disorder Severity [1].</p><h2>References</h2><ol><li>​Blair R.J.R., White S.F., Tyler P.M., Johnson K., et. al., (2019) <em>Threat Responsiveness as a Function of Cannabis and Alcohol Use Disorder Severity</em>. J Child Adolesc Psychopharmacol. 29(7):526–534.</li><li>Coker-Appiah D.S., White S.F., Clanton R., Yang J., Martin A., Blair R.J. (2013) <em>Looming animate and inanimate threats: The response of the amygdala and periaqueductal gray</em>. Soc Neurosci 8:621–630.<br></li></ol><h2>About Boys Town National Research Hospital</h2><p>Boys Town National Research Hospital offers a broad range of hospital and clinic services, backed by 40 years of life-changing research to provide the latest, most innovative care to our patients. The Hospital is internationally recognized as a leader in hearing research and clinical care and is leading research efforts in language and neuroscience to improve the lives of children and families across America.</p>​<br>

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