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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, ​visual ​impairment 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

Read the latest news about life-changing research at Boys Town National Research Hospital.​

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The Vocal Development Landmarks Interview Helps Clinicians and Families Track Vocal Developmental Milestoneshttps://www.boystownhospital.org/news/vocal-development-landmarks-interviewThe Vocal Development Landmarks Interview Helps Clinicians and Families Track Vocal Developmental Milestones2019-09-18T05:00:00Z<div class="embed-container">​​​ <iframe src="https://www.youtube.com/embed/AckEv3CcXtI" width="560" height="330" frameborder="0"></iframe> </div> ​ <p>Monitoring how babies progress through the early stages of vocal development is important for professionals and families, especially when infants have developmental challenges, such as cerebral palsy, hearing loss, down syndrome, cleft palate, or other special needs. It is essential that children who are at risk for speech and language delays are identified as early as possible so interventions can be tailored to minimize developmental risk. Drs. Mary Pat Moller and Sophie Ambrose at Boys Town National Research Hospital, along with Dr. Anne Thomas of the University of Nebraska-Lincoln, developed the Vocal Development Landmarks Interview (VDLI) for this purpose. </p><p>They recognized that the best way for professionals to monitor an infants' vocal development is to ask the parents about the child's vocal productions. However, they also realized that a better tool was needed to allow professionals to do that. The VDLI is a parent-report instrument for infants and young children who are not developmentally ready to cooperate with more structured testing [1]. It incorporates what has been learned from years of laboratory-based observations about the orderly stages of vocal development that babies go through and involves parents as the best resource for understanding if their child is meeting these vocal milestones. </p><p>The VDLI design uses a series of digital slides with audio files containing authentic infant vocalizations to ensure parents know exactly what vocal behavior the professional is asking them to report on. The vocal behaviors are also arranged in developmental order, beginning with those typically observed by 6 months of age and ending with those typically observed by 21 months of age.</p><p>According to Dr. Ambrose, “The feedback we've gotten is that the tool really helps both parents and clinicians learn about behaviors to watch for and which behaviors to encourage the development of next in early intervention." She also indicated that clinicians reported wanting a tool that was easy to use with families in homes, which led the team to collaborate with the Technology Core at Boys Town National Research Hospital to create the VDLI as an iOS App that allows for maximum accessibility and portability. For more information on the VDLI, watch the included video in this article or access their recent publication cited below. For help with downloading the app and its related resources, you can contact Dr. Ambrose at sophie.ambrose@boystown.org. </p><h1>References</h1><ol><li>Moeller, M. P., Thomas, A. E., Oleson, J., & Ambrose, S. E. (2019). Validation of a parent report tool for monitoring early vocal stages in infants. <em>Journal of Speech, Language, and Hearing Research, 62</em>(7), 2245–​2257. <a href="https://linkprotect.cudasvc.com/url?a=https://doi.org/10.1044/2019_JSLHR-S-18-0485&c=E%2c1%2cTyO9MT8ZeqKqTirqyM4xKxHff156PQsvhkojUIsEvKRTjCOZGYRCZtCYAtis0fB9fSOCsaPzhZ99XRXf3PmhDNSRbXQqOfmSbvP7fua6hmyPH2ofJQ%2c%2c&typo=1">https://doi.org/10.1044/2019_JSLHR-S-18-0485</a>​<br></li></ol>​​​​ <br>
Trauma-Informed Care is Critical for Youth Needing Residential Serviceshttps://www.boystownhospital.org/news/trauma-informed-care-critical-for-youthTrauma-Informed Care is Critical for Youth Needing Residential Services2019-08-26T05:00:00Z<p>​​​​​​​​Repeated exposure to trauma is extremely common for youth that end up in residential programs. Exposure to trauma changes these kids, <a href="https://www.boystownhospital.org/news/abuse-maltreatment-affect-brain-development"> even altering their brain development [1], </a>in ways that affect their responses to many aspects of their environment, including how they will respond to those people who are attempting to help them. In some cases, this means that attempts to treat kids unintentionally ends up traumatizing them further.</p><p>Boys Town, however, uses a trauma-informed car​e model that takes past trauma exposure into account in order to prevent the treatment from causing additional trauma. Additionally, Boys Town developed a screening instrument to identify possible symptoms youth may have related to past trauma [2]. Boys Town clinicians use this information to determine the supports and services youth need to help them heal. While this approach is widely accepted as the recommended approach for improving care in residential programs, research is also needed to support existing practices and to help us further improve how we take care of at-risk kids.</p><p>To help understand the benefits of our trauma-informed model, researchers at Boys Town, led by Patrick Tyler, Ph.D., recently conducted a study examining records for 1,096 youth from 9 to 18 years old who received Boys Town services. Their goals were to assess how trauma was associated with behavioral incidents, as well as the effects of trauma on psychological health at intake and when youth discharged from our program. [3]</p><p>Among the discoveries from their study, the researchers found that trauma symptoms were the best predictor of emotional problems and self-injury. Additionally, girls had higher rates of self-injurious behaviors than boys, whereas boys had higher rates of conduct problems at intake than girls in this study. Younger children also had higher rates of disruptive behavior compared to older children.</p><p>This study also showed that boys and girls who were grouped into either high or low trauma categories responded favorably to the trauma-informed program. Overall decreases were observed in disruptive and self-injurious incidents while in care, as well as conduct and emotional problems from intake to discharge for all of the groups. However, youth whom clinicians identified as having lower levels of trauma did have greater decreases in emotional problems.</p><p>A primary goal of Dr. Tyler’s team for this study was to determine how well the trauma-informed model has been working for youth that receive Boys Town services. Future studies will build on this by looking at best practices for incorporating trauma screening and assessment into the admission process in order to plan and provide the most effective care for our youth. Research is currently ongoing to identify strategies that can help youth with higher levels of trauma make even greater improvement.</p><h2>References<br></h2><ol><li>Blair K.S., Aloi J., Crum K., et. al. (2019) <em>Association of Different Types of Childhood Maltreatment With Emotional Responding and Response Control Among Youths</em> 2019 <strong>2</strong>(5). JAMA Netw Open.</li><li>Tyler, P.M., Mason, W.A., Chmelka, M.B., et. al. (2019) <em>Psychometrics of a Brief Trauma Symptom Screen for Youth in residential care</em> Journal of Traumatic Stress. doi: 10.1002/jts.22442. </li><li>Tyler P.M., Patwardan I., Ringle J.L., et. al., (2019) <em> <a href="https://assets.boystown.org/hosp_peds_docs/Trauma-Informed_Group_Homes_Tyler_et_al._2019.pdf"> Youth Needs at Intake into Trauma-Informed Group Homes ​and Response to Services: An Examination of Trauma Exposure, Symptoms, and Clinical Impression​</a>.</em> doi: 10.1002/ajcp.12364. Am J Community Psychol</li><ol></ol></ol>
Functional Brain Imaging Shows How Maltreatment Affects Brain Developmenthttps://www.boystownhospital.org/news/abuse-maltreatment-affect-brain-developmentFunctional Brain Imaging Shows How Maltreatment Affects Brain Development2019-06-20T05:00:00Z<p>Boys Town is recognized as a world leader in caring for kids in trouble, many of whom have been subjected to childhood trauma. Boys Town National Research Hospital is also home to research investigating the impacts of maltreatment on developing brains. Karina Blair, Ph.D. and her team at Boys Town Hospital recently published a paper titled, <em>Association of Different Types of Childhood Maltreatment</em><em> </em> <em>With</em><em> Emotional Responding and Response Control Among Youths</em> [1] that examines some of these issues. </p><p style="text-align:left;">Specifically, the authors looked at measures of brain function and behavior for 116 young people from 10–18 years of age who reported and rated their personal experiences with different types of abuse and neglect. The children and adolescents were either enrolled in Boys Town programs or from the surrounding community, and their families gave consent to the study with the option to withdraw at any time. The kids' brain activity was monitored while they performed a number counting task in the presence of distracting emotional images. This allowed Dr. Blair to determine the association of different forms of maltreatment on brain systems critical for task performance as well as emotional responding.  </p><p style="text-align:left;">The main findings of this study were the association of abuse, rather than neglect—at least, within this group of participants—with both difficulties with response control and heightened emotional responding.  Moreover, physical abuse was particularly associated with heightened threat responding. Sexual abuse was associated with a cascade of difficulties that were present even after the influence of other forms of maltreatment was statistically accounted for (Figure 1). </p> <img src="https://assets.boystown.org/hosp_peds_images/brainMRI.png" alt="Brain MRI" /> <p> <strong>Figure 1. The anterior cingulate region of the brain is importantly involved in emotional processing and shows overly increased responding in kids who have suffered sexual abuse. </strong>The colored areas in this image show the regions showing greater responding in kids who have suffered sexual abuse relative to those who have not.  The “hotter" the color, the more overly responding the region. </p><p style="text-align:left;"> </p><p style="text-align:left;">These findings are important because we know these kids need help. They may find themselves in dangerous situations and sometimes legal trouble.  We need to understand exactly what problems they face. Understanding their brain level-difficulties are part of the picture.  Moreover, the findings of this work suggest that maltreatment may have different impacts according to the form of maltreatment.  Indeed, sexual abuse may be associated with particularly severe brain-level difficulties.  Potential findings such as these may become the basis for assessing treatment success at the level of the individual. For a much more detailed description of their findings <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2734074" target="_blank"> <span style="text-decoration:underline;">see the article in JAMA Network Open</span></a> [1]. </p> <p>References </p><ol><li>Blair KS1, Aloi J2, Crum K3, Meffert, et. al. (2019) <em>Association of Different Types of Childhood Maltreatment </em> <em>With</em><em> Emotional Responding</em><em> </em> <em>and Response Control Among Youths</em>, 2019 <strong>2</strong>(5). JAMA Netw Open.  </li></ol>
Discussing the Neuroscience of Kids Facing Adult Justice Systemhttps://www.boystownhospital.org/news/discussing-the-neuroscience-of-kids-facing-adult-justice-systemDiscussing the Neuroscience of Kids Facing Adult Justice System2019-06-12T05:00:00Z<p>The adult criminal justice system is often charged with determining the appropriate response to young children who have done bad things. However, these young child offenders are often also victims of abuse, pre-natal drug exposure and neglect. Trauma may change the brain's response to stressful situations and alter the child's ability to control unwanted behaviors. Courts must weigh these circumstances when considering whether the child should be charged as an adult.</p><p>Boys Town researchers are working to understand typical brain development as well as how this may be altered by stress using behavioral assessment tools and functional neuroimaging. In addition, for more than 100 years, Boys Town has been helping at risk youth and their families to change outcomes for the better. This combined experience puts us in an ideal position to provide judges with information relevant to their decisions about what to do with kids who end up in their courtrooms.</p><p>In partnership with the National Courts and Science Institute, Boys Town recently hosted a Neuroscience and the Law Workshop. Led by James Blair, Ph.D., Susan and George Haddix Endowed Chair for Neurobehavioral Research at Boys Town National Research Hospital, the judges were given an overview of current science on brain development and childhood trauma. In addition, judges and Boys Town staff held round table discussions covering case examples and how current knowledge may be applicable to judicial decision making. The judges were given a tour of facilities and technologies they may hear about in cases, and what those technologies can and cannot tell us about developing brains and mental health.</p><p>Advocating for youth, including those who end up in the criminal justice system but might be better served by therapy and intervention, is part of Boys Town's mission to help at risk youth. We appreciate the participation of the judges and hope that this meeting will be a model for future workshops as new discoveries are made.</p><div class="embed-container"> <iframe src="https://www.youtube.com/embed/5sXkqRfThlk?rel=0" width="560" height="315" frameborder="0"></iframe> </div>​
Findings on Safe Vestibular Evoked Myogenic Potential Testing in Children https://www.boystownhospital.org/news/findings-on-safe-vestibular-evoked-myogenic-potential-testing-in-childrenFindings on Safe Vestibular Evoked Myogenic Potential Testing in Children 2019-06-11T05:00:00Z<p>The vestibular evoked myogenic potential (VEMP) test is something you may encounter if you or a family member are experiencing issues with balance or dizziness. The VEMP is a non-invasive test that uses short, intense sound stimuli to produce a muscle reflex in the eye or neck muscles. The muscle reflex is recorded with surface electrodes that attach to the skin over the muscle. The test specifically informs clinicians about the health of vestibular components of the balance system—the utricle and saccule organs of the inner ear (Figure 1).<br></p><p style="text-align:center;"> <img class="ms-rtePosition-4" alt="inner-ear-v2.jpg" src="https://assets.boystown.org/hosp_peds_images/inner-ear-v2.jpg" style="margin:auto;width:340px;height:268px;" />  </p> <strong style="font-size:0.87em;">Figure 1. Diagram of the inner ear. </strong> <span style="font-size:0.87em;">The inner ear in humans contains the auditory and balance systems. The utricle, saccule and semi-circular canals are central components of the balance system and process information about the head's position and movement in space. The cochlea is a central component of the auditory system.</span> <div> <span style="font-size:12.25px;"><br></span><span style="font-size:0.87em;"></span> <p>In children, VEMP responses are correlated with development of standing, walking, and posture control [1, 2]. Children with impaired vestibular function are more likely to achieve these milestones at a later age [3], and can benefit from rehabilitation.</p><p>While the VEMP test is used with children, most of what we know about the test is from research and clinical experience with adults. It is not uncommon for doctors to need to rely information from adults for pediatric procedures but, because children are physically different, this can come with risks. For the VEMP test, there is some risk that the intensity of sound stimuli used for testing in adults is too loud in children and can damage the specialized cells in the ear that are crucial for hearing in children. It's also possible that children will respond better to different frequencies of sound than adults.</p><p>Understanding how the balance system works and develops is the focus of Kristen Janky, Ph.D, in her Vestibular and Balance Laboratory at Boys Town National Research Hospital. In a recent paper, Janky and Amanda Rodriguez explored optimum conditions for completing VEMP testing in children and young adults. They found that young children, ages 4–9, required significantly lower sound levels to elicit normal VEMP responses compared to adolescents or young adults. However, they found that there were no differences in response to the standard 500 Hz and 750 Hz frequencies that are used in testing [4].</p><p> <strong>TABLE 1. Mean (SD) VEMP thresholds at 500 Hz and 750 Hz for adults, adolescents, and children.</strong></p><table class="ms-rteTable-default" width="100%" cellspacing="0"><tbody><tr><td class="ms-rteTable-default" style="width:20%;"> <strong> </strong></td><td class="ms-rteTable-default" style="width:20%;"> <span style="text-decoration:underline;"><strong>500 Hz</strong></span></td><td class="ms-rteTable-default" style="width:20%;">​</td><td class="ms-rteTable-default" style="width:20%;"> <span style="text-decoration:underline;"><strong>750 Hz</strong></span></td><td class="ms-rteTable-default" style="width:20%;">​</td></tr><tr><td class="ms-rteTable-default"> </td><td class="ms-rteTable-default">Mean <br>(dB SPL)</td><td class="ms-rteTable-default">Standard Deviation<br> (dB SPL)</td><td class="ms-rteTable-default">Mean <br>(dB SPL)</td><td class="ms-rteTable-default">Standard Deviation<br> (dB SPL)</td></tr><tr><td class="ms-rteTable-default">Cervical VEMP Threshold<br> Response (dB SPL)</td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td></tr><tr><td class="ms-rteTable-default">Adults</td><td class="ms-rteTable-default"> <strong>111.5</strong></td><td class="ms-rteTable-default"> <strong>3.25</strong></td><td class="ms-rteTable-default"> <strong>112</strong></td><td class="ms-rteTable-default"> <strong>2.61</strong></td></tr><tr><td class="ms-rteTable-default">Adolescents</td><td class="ms-rteTable-default">107.5</td><td class="ms-rteTable-default">4.85</td><td class="ms-rteTable-default">109.5</td><td class="ms-rteTable-default">3.68</td></tr><tr><td class="ms-rteTable-default">Children</td><td class="ms-rteTable-default"> <strong>106</strong></td><td class="ms-rteTable-default"> <strong>4.63</strong></td><td class="ms-rteTable-default"> <strong>106</strong></td><td class="ms-rteTable-default"> <strong>3.91</strong></td></tr><tr><td class="ms-rteTable-default">Ocular VEMP Threshold Response (dB SPL)</td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td><td class="ms-rteTable-default"> <strong> </strong></td></tr><tr><td class="ms-rteTable-default">Adults</td><td class="ms-rteTable-default"> <strong>116</strong></td><td class="ms-rteTable-default"> <strong>3.94</strong></td><td class="ms-rteTable-default"> <strong>117</strong></td><td class="ms-rteTable-default"> <strong>3.49</strong></td></tr><tr><td class="ms-rteTable-default">Adolescents</td><td class="ms-rteTable-default">112.5</td><td class="ms-rteTable-default">4.81</td><td class="ms-rteTable-default">114.5</td><td class="ms-rteTable-default">2.83</td></tr><tr><td class="ms-rteTable-default">Children</td><td class="ms-rteTable-default"> <strong>111.1</strong></td><td class="ms-rteTable-default"> <strong>4.10</strong></td><td class="ms-rteTable-default"> <strong>112.2</strong></td><td class="ms-rteTable-default"> <strong>4.17</strong></td></tr></tbody></table><p> <em>Bold values represent significant differences. Children showed lower cervical and ocular VEMP thresholds compared to adults.</em></p><p>This research will help children by providing guidelines for safe VEMP testing in children, and keeping children's ears safe from possible injury. Experienced audiologists will already be careful with the ears of their young patients, but this knowledge will give them a better testing range, and information about what is normal responsiveness. For additional experiments, details and the authors' conclusions check out their paper, <em>Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children, Adolescents, and Young Adults: Thresholds, Frequency Tuning, and Effects of Sound Exposure</em>.</p><p>Thanks to the research volunteers for this study. Our volunteers included 10 children, ages 4–9, 10 adolescents, ages 10–19, and 10 young adults, ages 20–29.</p><h2>References<br></h2><ol><li>Wiener-Vacher, S.R., F. Toupet, and P. Narcy, <em>Canal and otolith vestibulo-ocular reflexes to vertical and off vertical axis rotations in children learning to walk.</em> Acta Otolaryngol, 1996. <strong>116</strong>(5): p. 657-65.</li><li>Wang, S.J., W.S. Hsieh, and Y.H. Young, <em>Development of ocular vestibular-evoked myogenic potentials in small children.</em> Laryngoscope, 2013. <strong>123</strong>(2): p. 512-7.</li><li>Inoue, A., et al., <em>Effect of vestibular dysfunction on the development of gross motor function in children with profound hearing loss.</em> Audiol Neurootol, 2013. <strong>18</strong>(3): p. 143-51.</li><li>Rodriguez, A.I., M.L.A. Thomas, and K.L. Janky, <em>Air-Conducted Vestibular Evoked Myogenic Potential Testing in Children, Adolescents, and Young Adults: Thresholds, Frequency Tuning, and Effects of Sound Exposure.</em> Ear Hear, 2019. <strong>40</strong>(1): p. 192-203.</li></ol></div>
NIH awards $11 Million Grant to Boys Town National Research Hospital to Study Communication and Perception in Childrenhttps://www.boystownhospital.org/news/nih-grant-awarded-communication-researchNIH awards $11 Million Grant to Boys Town National Research Hospital to Study Communication and Perception in Children2019-04-16T05:00:00Z<p>Boys Town National Research Hospital has received an $11 million grant from the National Institute of General Medical Sciences (NIGMS), part of the National Institutes of Health (NIH). </p><p>The five-year Centers of Biomedical Research Excellence (COBRE) grant is set to expand the range of existing, highly successful research programs at the Boys Town National Research Hospital and tackle more complex issues that directly address the problems encountered by children with hearing loss.</p><p>Core research programs covered by the grant will investigate issues related to: </p><ul><li>Speech understanding for young listeners with cochlear implants</li><li>Diagnosis and outcomes for children with otitis media, an inflammatory condition of the inner ear</li><li>Strategies used by children to overcome working memory limitations</li></ul><p>Related projects that will receive funding cover multiple labs and include, examining the impact of hearing loss in real-world environments like classrooms, the contributions of bottom-up and top-down processing in children learning English as a second language, how visual and auditory information work together in speech and language learning, and the consequences for visual processing of vestibular deficits associated with hearing loss.</p><p>Lori Leibold, Ph.D., is the primary investigator on the grant and Director of the Center for Hearing Research. Dr. Leibold notes that, "Our goal is to become the national leader for research on speech, language, hearing, and cognitive development in ​children with communication disorders. We believe we are close to achieving this goal, in large part due to this NIH award that has allowed us to grow our research program and provide the resources these young investigators need to be successful."</p><p>This is the second round of COBRE grant funding for Boys Town Hospital. The first $11.3 million grant was awarded in 2014 and has contributed to Boys Town Hospital recruiting several world-class senior scientists, hosting more than 60 experts from around the country for research talks, sparking many new collaborations. The 2014 grant also established a state-of-the-art Auditory-Visual Core facility that supports research using techniques such as augmented and virtual reality.</p><p>"Scientists and other professionals supported by this grant are the next generation in the 40-year legacy of Boys Town Research," states Director of Research, Ryan McCreery, Ph.D., who also notes that "this additional five years of support from the National Institute of General Medical Sciences (NIGMS) is recognition for the high-impact translational research that our scientists do every day. Their research has the potential to improve the lives of people with hearing and communication problems."</p><p>The new COBRE grant award will have lasting impacts on research in Nebraska and the surrounding region by providing mentoring and resources for the young investigators needed to sustain a thriving research community. The grant also includes a strategic sustainability and development plan for core facilities that expand the technical capabilities of individual labs at Boys Town National Research Hospital and collaborating institutions. The benefits of this grant will be far reaching for Boys Town and for Nebraska, supporting our scientific community and high-skill jobs in Omaha and beyond.​</p>

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