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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

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

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Childhood Sexual Trauma Alters Emotional Regulation and Brain Developmenthttps://www.boystownhospital.org/news/childhood-sexual-trauma-alters-emotional-regulation-brain-developmentChildhood Sexual Trauma Alters Emotional Regulation and Brain Development2020-06-25T05:00:00Z<p>​Traumatic experiences during childhood have the ability to disrupt long-term brain development and function. Advances in imaging technology have shown us that not all traumatic experiences do this in the same way. Sexual trauma, in particular, severely alters how the brain responds to perceived threats as the child learns to deal with the terrible experience.</p><p> <a href="https://www.boystownhospital.org/research/faculty/karina-blair">Karina Blair, Ph.D​</a>. is a behavioral neuroscientist at Boys Town National Research Hospital, and an e​xpert in the area of how trauma affects brain development. She has been using functional brain imaging (fMRI) to investigate the areas of the brain that are involved in trauma, and especially looking for changes that persist long after specific events and relative to different types of trauma.</p><p>Much of the literature on post-traumatic stress is focused on the amygdala, a small, almond-shaped region in the brain that is associated with emotional responding and fear. In a recent paper, Dr. Blair was interested in how other regions that may also be involved might also be altered.</p><p>For this study, Dr. Blair worked with 23 adolescents who had reported sexual trauma, and 24 adolescents who had not experienced significant trauma as comparisons. Participants were placed in an fMRI scanner that allowed her to measure increases or decreases in brain function in specific anatomical regions while they were shown either threatening or neutral images.</p><p>Dr. Blair and her team identified several areas of increased activation during threatening stimuli. These areas of the brain were in the frontal lobe that we know are involved in emotional responding and regulation that are also necessary for understanding social situations. The data appears to suggest that past sexual abuse may cause exaggerated responses when these kids are exposed to stimuli that are perceived as threatening, or potentially threatening.</p><p>Dr. Blair's work helps clinicians at Boys Town Hospital, and elsewhere understand what has happened to the brains of children after trauma. It's a useful tool for selecting and developing appropriate treatment plans. Unfortunately, these kids also end up in trouble more frequently. Understanding that, unless they get the right help, their brains have been altered for the long-term, if not permanently. This shows the critical need to help children get the right help and not punish them for things beyond their control. </p><p>For over 100 years Boys Town has been treating and advocating for children under these and other terribl​e circumstances. Our research team is critical to our efforts to provide the best care possible for these youth.​</p><p>Read more about the <a href="https://www.boystownhospital.org/research/neurobehavioral">Center for Neurobehavioral Research</a> at Boys Town.</p><h2>References</h2><ol><li>Blair, K. S., Bashford-Largo, J., Shah, N., et. al. (2020) <i>Sexual Abuse in Adolescents Is Associated With Atypically Increased Responsiveness Within Regions Implicated in Self-Referential and Emotional Processing to Approaching Animate Threats</i>. Front. Psychiatry; <a href="https://doi.org/10.3389/fpsyt.2020.00345" target="_blank">https://doi.org/10.3389/fpsyt.2020.00345</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>
Research During the COVID-19 Pandemichttps://www.boystownhospital.org/news/research-during-covid-19-pandemicResearch During the COVID-19 Pandemic2020-06-03T05:00:00Z<p>​​Life-changing research doesn't stop during a pandemic. For more than 40 years, Boys Town National Research Hospital has been conducting research to improve lives. Our mission is to change the way America cares for children and families. Below are some of the ways we are continuing our mission during these unprecedented times.</p><h2>Continuing to Train and Innovate</h2><p>Each year, Boys Town Hospital selects audiology student investigators to participate in a summer research traineeship. This program is designed to give formal research experience through a mix of clinical and research audiology experiences, presentations, and scientific group discussions. This summer we will still host our students, and they will be challenged to find new ways to answer questions about hearing and speech recognition through virtual tools.</p><h2>Research Forging Ahead</h2><p>With the current pause in inviting research volunteers to come to our laboratories to participate in studies, our researchers have moved to online interviews, questionnaires and mobile applications for testing. Some studies are even collecting hair or other biological samples, which can be done with simple instructions through the mail, for needed data.</p><h2>Researching Health Outcomes of the Pandemic</h2><p>Our behavioral health scientists regularly investigate brain development as well as asking how traumatic experiences such as abuse and neglect affect neural, cognitive​, and social development. Unfortunately, this COVID-19 pandemic has presented a societal trauma on a very large scale, including impacts on our youth who have experienced weeks of disruption to their school, daily routines and social lives. </p><p>Additionally, new precautions for wearing masks and social distancing may have an even greater impact on children with hearing and communications difficulties. These kids rely more than others on facial expressions to get the full meaning of speech. Our hearing and language experts are looking at how this new reality is affecting them and way we might be able to help.</p><p>Our researchers are working with our youth care programs to monitor how these large-scale disruptions in daily life, and the accompanying stress, are affecting treatment progress and outcomes. The research team is uniquely positioned to examine the effects of these changes on children and adolescents through our community relationships with families and care providers. Over the coming months, these researchers will be helping the nation understand how the isolation, change in routines, and the stress of the pandemic have affected our youth.​</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://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>​<br>
Residential Care for At-Risk Youth has Long-Term Economic Benefits for Governments and Societyhttps://www.boystownhospital.org/news/economic-benefits-helping-at-risk-youthResidential Care for At-Risk Youth has Long-Term Economic Benefits for Governments and Society2020-04-27T05:00:00Z<p>​Residential care for youth with severe emotional or behavioral issues involves intensive treatment and around-the-clock care. This makes the cost of care high and policy makers often want to know if there are other ways to provide this care or to reduce the amount of services in order to reduce costs. However, young people typically end up in these programs only after multiple other forms of care have been tried and failed, making group residential care programs very important. Therefore, it is vital to show the value of these services and to advocate for continued support.</p><p>Researchers at Boys Town and elsewhere have been looking at ways to place the context of residential care in relationship to the costs of not providing these services. In a recent study, Jonathan C. Huefner and his colleagues adapted a previously developed Return on Investment Tool (ROI tool) for use with Boys Town’s Family Home Program data [1]. The ROI tool relates the cost of care to projected government fiscal and societal impacts, including increased economic contributions after treatment, tax revenue increases from employment gains, and costs associated with criminal recidivism and dependency on safety-net programs like unemployment [2].</p><p>The study looked at 141 individuals who had been treated for less than 6 months (median stay of 3.7 months) and 1031 who had been in treatment for longer than 6 months (median stay of 18.4 months). Outcomes were assessed by a 35-question assessment that was given 24 months after treatment. To compare the 2 groups, the authors normalized the data for the smaller group to the cost of similarly treating 1031 youth. Costs can only be compared for shorter treatment vs. longer treatment because it would be unethical to have a comparison group of young people needing treatment that do not receive it.</p><p>When it comes to cost, one thing that policy makers are often concerned about is whether there is really a need for longer, more costly stays; represented here as stays longer than 6 months. They reasonably want to know if a shorter stay could produce similar results while saving expense. In this study, the authors report that there was a definite benefit for kids who were in treatment for longer than 6 months, with higher educational achievement, better employment outcomes, and​ reduced recidivism. Here is a brief summary of the findings in this paper [1]:</p><ul><li>The estimated cost to care for 1031 kids for 6 months or less was approximately $29 million, whereas the estimated cost for the same number of youth in treatment for more than 6 months was $153 million.</li><li>The net benefit to government is estimated at $44 million through increased revenue and decreased expenditures in the future. However, with the increased cost of care for longer treatment amounts to an $80 million additional cost to the government.</li><li>The societal savings through increased productivity, better employment, and other contributions over a 40-year adult lifetime increased for the more-than-6-month group by $325 million.</li><li>For the group that received more than 6 months of care, the authors calculate that for every $1 spent the societal lifetime return is $3.61.</li></ul><p>A short-term perspective which focuses only on governmental expenditure might conclude that the cost of care is greater than the fiscal returns. This perspective ignores the real human impacts of not taking care of these kids, which most people would not advocate. However, adult lifetime societal savings that are realized by giving kids who need it more care, training and education makes it clear that complete treatment has financial benefits that exceed any arbitrary cutoff. Such improvements (e.g., increased productivity and wages) have a direct impact on the community through spending and investment by these individuals over time. These outcomes should be of concern to policy makers who we need to support these programs.</p><h2>References</h2><ol><li>Huefner J.C., Jay L. Ringle J.L., Thompson R.W., and Wilson F.A., (2018) Economic evaluation of residential length of stay and long-term outcomes. Residential Treatment for Children & Youth, 35(3), 192–208.</li><li>Wilson F.A., Araz O.M., Thompson R.W., Ringle J.L., et. al. (2016) A decision support tool​ to determine cost-to-benefit of a family-centered in-home program for at-risk adolescents. Eval Program Plann, 56, 43–49.</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://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>
Awareness of Developmental Language Disorder is Improved by Using Clear Terminologyhttps://www.boystownhospital.org/news/developmental-language-disorder-terminology-awarenessAwareness of Developmental Language Disorder is Improved by Using Clear Terminology2020-04-10T05:00:00Z<p>​Millions of people in the United States struggle to learn language because of an underlying difference in how their brain develops. Despite the large numbers of people affected, many people are not aware of this because of a confusing array of diagnostic terms and inconsistent criterion for diagnosis. Additionally, better awareness and clear terminology will make it easier to get resources for treatment and new research into causes and therapies.</p><p>Boys Town National Research Hospital is a leader in hearing and communications related research. Our research team, led by <a href="https://www.boystownhospital.org/research/faculty/karla-mcgregor">Karla McGregor, Ph.D.</a> and others are working to raise awareness of Developmental Language Disorder (DLD), as well as developing tools to help clinicians, families, and educators to deal with associated challenges.</p><p>In a recently published paper, Dr. McGregor and her colleagues define DLD, describe the difference between DLD and specific language impairment (SLI), and discuss advantages of for using DLD over other terms, including SLI. They define DLD as ‘a language problem that endures into middle childhood and beyond and that has a significant impact on social or educational function DLD is a spectrum disorder where some individuals have relatively exclusive language deficits and normal non-verbal IQ scores, while others have co-occurring deficits or low-normal-range IQs” [1].</p><div class="is-clearfix"><div class="inline-image is-size-7">​​​​​​​​<img src="https://assets.boystown.org/hosp_peds_images/DLD-infographic.png" alt="What is Developmental Language Disorder infographic" class="inline-image__image" /> <h2 class="is-size-5">What is Developmental Language Disorder?</h2><p>Source: <a href="https://www.dldandme.org/" target="_blank">DLDandMe.org</a></p></div>​ <p>One of the major benefits of using DLD as the diagnostic term is that it includes and emphasizes the social and educational influences of language problems. These are the most challenging problems individuals face with language disorders and will be the reason many will seek help. These functional consequences of DLD can also lead to kids acting out or become depressed and isolated. Unlike a more simplistic approach of using cutoff scores from language or intelligence testing, including functional aspects into the definition improves overall understanding and, hopefully, will open the door to greater availability of resources for affected individuals. The recommendation from the authors of this paper is to emphasize the severity of the impact of DLD on social interactions and academic success over scores when diagnosing DLD [1].</p><p>A key aspect of this paper is to improve awareness of the DLD terminology. With a myriad of terms used to describe developmental language conditions, it is hard for people outside of speech-language pathologists and researchers to understand the scale of the problem. The authors emphasize the use DLD as a unifying term that is widely used and understood, to create an international platform for information, education, advocacy, and resources. Indeed, the authors and their colleagues at Raising Awareness of Developmental La​nguage Disorder (<a href="https://radld.org/" target="_blank">RADLD</a>) and <a href="https://www.dldandme.org/" target="_blank">DLDandMe.org</a> have already made quite a bit of progress to increase awareness and provide resources to those who need it. Check out the full, open-access article in Perspectives of the ASHA Special Interest Groups, at ASHA.org [1].</p><h2>References</h2><ol><li>1. Karla K. McGregor, K. K., Goffman, L., Van Horne, A. O., et. al. (2020) <i> <a href="https://pubs.asha.org/doi/10.1044/2019_PERSP-19-00083">Developmental Language Disorder: Applications for Advocacy, Research, and Clinical Service</a></i>. Perspectives of the ASHA Special Interest Groups; 5(1) 38–46.</li></ol><h2>Research Newsletter</h2><p>Please sign up to r​eceive occasional research news and events emails from Boys Town National Research Hospital.</p><div align="center"> <a class="button is-primary" href="https://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div></div>
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) Psycho​metrics 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://www.boystownhospital.org/research/newsletter">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 Longit​udinal 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://www.boystownhospital.org/research/newsletter">Newsletter Sign-Up</a></div>

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