Lauren S. Wakschlag's research while affiliated with Telethon Kids Institute and other places

Publications (221)

Article
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In this editorial statement, we briefly delineated a series of observations, guidelines, and directions for future research focused on the most common outcome of multi-informant assessments of youth mental health. Discrepancies commonly occur between estimates of youth mental health and conclusions drawn from these estimates, depending on the infor...
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Objective Irritability is a dimensional trait manifest from early life and a robust transdiagnostic risk factor for psychopathology and impairment. We leveraged a large, national dataset to identify and broadly characterize trajectories from toddlerhood through adolescence, which is crucial for timely, targeted interventions. Method Data on irrita...
Article
Boys are more sensitive to environmental factors like parental behavior, an important predictor of executive function. This study examined whether the interaction between child sex and maternal behavior was associated with children's executive function in a manner consistent with the vulnerability or differential susceptibility model. Participants...
Article
Decreased consumption of nicotine and other drugs during pregnancy appears to be a cross‐species phenomenon from which mechanism(s) capable of interrupting addictive processes could be elucidated. Whether pregnancy influences smoking behaviour independent of women's knowledge of the pregnancy, however, has not been considered. Using repeated measur...
Article
Parental assistance with children's emotion regulation (ER) is a form of emotion socialization behavior that has recently been operationalized with the development of the Parent Assistance with Child Emotion Regulation (PACER) questionnaire. In line with Eisenberg et al.'s heuristic model of the socialization of emotion, this study sought to test t...
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The association between prenatal stress and children's socioemotional development is well established. The COVID‐19 pandemic has been a particularly stressful period, which may impact the gestational environment. However, most studies to‐date have examined prenatal stress at a single time point, potentially masking the natural variation in stress t...
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Background Preschool psychiatric symptoms significantly increase the risk for long-term negative outcomes. Transdiagnostic hierarchical approaches that capture general (‘p’) and specific psychopathology dimensions are promising for understanding risk and predicting outcomes, but their predictive utility in young children is not well established. We...
Article
The transdiagnostic importance of irritability in psychopathology has been demonstrated. However, the contribution of developmentally unfolding irritability patterns to specific clinical and neural outcomes remains an important and unanswered question. To address this gap in the literature, irritability patterns of 110 youth from a large, diverse c...
Article
Although concurrent associations between parent and child posttraumatic stress symptoms (PTSS) have been well-documented, few longitudinal studies have examined bidirectional influences by modeling the effects of both parent and child PTSS simultaneously over time. The current study examines patterns of PTSS in children and their mothers beginning...
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The period immediately after birth is a critical developmental window, capturing rapid maturation of brain structure and a child’s earliest experiences. Large-scale brain systems are present at delivery, but how these brain systems mature during this narrow window (i.e. first weeks of life) marked by heightened neuroplasticity remains uncharted. Us...
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Background Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy. Methods Participants were 154 pregnant women (M = 12.4 w...
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Objective: Assessing general ("global") health is important to clinicians caring for patients, researchers studying patient subgroups, and epidemiologists tracking population trends. The Patient-Reported Outcomes Measurement Information System® (PROMIS®) introduced an adult self-report Global Health measure (ages 18+) in 2009 and pediatric version...
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Objective: Create and validate developmentally sensitive parent-report measures of emotional distress for children ages 1-5 years that conceptually align with the Patient-Reported Outcome Measurement Information System (PROMIS®) pediatric measures. Methods: Initial items were generated based on expert and parent input regarding core components o...
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Objective: Expand the current Patient-Reported Outcome Measurement Information System (PROMIS®) well-being measures to early childhood (1-5 years) using best practices from PROMIS and developmental science. Methods: Qualitative methods included expert input, literature and measure review, and parent interviews to confirm measure frameworks, item...
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Objective: The early expression of lifespan health and disease states can often be detected in early childhood. Currently, the Patient-Reported Outcome Measurement Information System (PROMIS®) includes over 300 measures of health for individuals ages 5 years and older. We extended PROMIS to early childhood by creating developmentally appropriate,...
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Objective: Provide an overview of the Patient-Reported Outcomes Measurement Information System (PROMIS®) Early Childhood Parent Report measurement development project and describe its qualitative methods. Methods: The PROMIS Early Childhood (PROMIS EC) initiative used the PROMIS mixed-methods approach to patient-reported outcome development, wit...
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Although language samples are child-friendly and well-suited for obtaining global measures of language production, structured protocols have the potential to elicit many different exemplars of language structures in a shorter amount of time. We created a structured elicitation protocol, the Sentence Diversity Priming Task (SDPT), to efficiently ass...
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Translation of developmental science discoveries is impeded by numerous barriers at different stages of the research-to-practice pipeline. Actualization of the vast potential of the developmental sciences to improve children's health and development in the real world is imperative but has not yet been fully realized. In this commentary, we argue th...
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Pediatric irritability is the most robust indicator of transdiagnostic psychopathology risk. It is associated with altered neural reward processing, including neural networks related to cognitive control, and better cognitive control has been hypothesized to mitigate irritability. We evaluated the relationship of executive functioning (EF) with irr...
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Objective Apply the Patient-Reported Outcome Measurement Information System (PROMIS®) mixed-methods approach to develop and validate new parent-report measures of young children’s (1–5 years) family and peer relationships that conceptually align to those for 5–17 year olds. Methods Expert input, parent interviews, and reviews of theoretical and em...
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Despite increasing emphasis on emergent brain‐behavior patterns supporting language, cognitive, and socioemotional development in toddlerhood, methodologic challenges impede their characterization. Toddlers are notoriously difficult to engage in brain research, leaving a developmental window in which neural processes are understudied. Further, elec...
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Given inconsistent evidence on preconception or prenatal tobacco use and offspring autism spectrum disorder (ASD), this study assessed associations of maternal smoking with ASD and ASD‐related traits. Among 72 cohorts in the Environmental Influences on Child Health Outcomes consortium, 11 had ASD diagnosis and prenatal tobaccosmoking (n = 8648). an...
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Numerous conditions and circumstances place infants at risk for poor neuromotor health, yet many are unable to receive treatment until a definitive diagnosis is made, sometimes several years later. In this integrative perspective, we describe an extensive team science effort to develop a transdiagnostic approach to neuromotor health interventions d...
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The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral...
Article
Background/Objectives Older children with atopic dermatitis (AD) suffer from poor sleep and attention problems. However, until recently, the dearth of developmentally sensitive assessment tools impeded characterization in younger children. We aimed to characterize sleep and attention problems in young children with AD and identify modifiable factor...
Article
Sleep plays a critical role in neural neurodevelopment. Hallmarks of sleep reflected in the electroencephalogram during nonrapid eye movement (NREM) sleep are associated with learning processes, cognitive ability, memory, and motor functioning. Research in adults is well-established; however, the role of NREM sleep in childhood is less clear. Growi...
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Child genotype is an important biologically based individual difference conferring differential sensitivity to the effect of parental behavior. This study explored dopaminergic polygenic composite × parental behavior interactions in relation to young children’s executive function. Participants were 135 36-month-old children and their mothers drawn...
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The integration of neurodevelopmental perspectives into clinical science has identified irritability as an early dimensional marker of lifespan mental health risk. Elucidating the developmental patterning of irritable behavior is key to differentiating normative variation from risk markers. Accounting for dysregulation and contextual features of ir...
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Purpose: Childhood exposure to traumatic violence may shape how children respond to threatening faces and increase risk for psychopathology. Maltreated children may exhibit altered processing of threatening faces; however, the effects of witnessing intimate partner violence (IPV) on children's discrimination of facial expressions is under-studied....
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Significance Early detection of infant neuromotor pathologies is critical for timely therapeutic interventions that rely on early-life neuroplasticity. Traditional assessments rely on subjective expert evaluations or specialized medical facilities, making them challenging to scale in remote and/or resource-constrained settings. The results presente...
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Though electrophysiological measures (EEG and ERP) offer complementary information to MRI and a variety of advantages for studying infants and young children, these measures have not yet been included in large cohort studies of neurodevelopment. This review summarizes the types of EEG and ERP measures that could be used in the HEALthy Brain and Cog...
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Background A major challenge in prenatal drug exposure research concerns the balance of measurement quality with sample sizes necessary to address confounders. To inform the selection of optimal exposure measures for the HEALthy Brain and Child Development (HBCD) Study, we employed integrated analysis to determine how different methods used to char...
Preprint
BACKGROUND Cognitive behavioral therapy (CBT)-based interventions are effective in reducing prenatal stress, which can have severe adverse health effects on mother and newborn if unaddressed. Predicting next-day physiologic or perceived stress can help to inform and enable preemptive interventions for a likely physiologically and/or perceptibly str...
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Background: Cognitive behavioral therapy-based interventions are effective in reducing prenatal stress, which can have severe adverse health effects on mothers and newborns if unaddressed. Predicting next-day physiological or perceived stress can help to inform and enable pre-emptive interventions for a likely physiologically and perceptibly stres...
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While substantial research supports the role of parent–child interactions on the emergence of psychiatric symptoms, few studies have explored biological mechanisms for this association. The current study explored behavioral and neural parent–child synchronization during frustration and play as predictors of internalizing and externalizing behaviors...
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Neonates born to mothers taking opioids during pregnancy are at risk for neonatal opioid withdrawal syndrome (NOWS), for which there is no recognized standard approach to care. Nonpharmacologic treatment is typically used as a first-line approach for management, and pharmacologic treatment is added when clinical signs are not responding to nonpharm...
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There are large differences in expulsions and suspensions on the basis of race starting in preschool and divergent explanations for their cause. The current study explores how developmental methodology can shed light on this vexing issue. We leverage two measures: (1) childcare provider complaints about children's behavior and their recommended dis...
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Background Perinatal depression is a pervasive public health concern that disproportionately affects low-income women and can have negative impacts on parenting and child developmental outcomes. Few interventions focus on preventing perinatal depression. Previous studies suggest that Mothers and Babies is efficacious in preventing the worsening of...
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The National Institute of Mental Health Research Domain Criteria (RDoC) framework promotes the dimensional and transdiagnostic operationalization of psychopathology, but consideration of the neurodevelopmental foundations of mental health problems requires deeper examination. Irritability, the dispositional tendency to angry emotion that has both m...
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Introduction Self-regulation is a modifiable protective factor for lifespan mental and physical health outcomes. Early caregiver-mediated interventions to promote infant and child regulatory outcomes prevent long-term developmental, emotional and behavioural difficulties and improve outcomes such as school readiness, educational achievement and eco...
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The National Institute of Mental Health Research Domain Criteria’s (RDoC) has prompted a paradigm shift from categorical psychiatric disorders to considering multiple levels of vulnerability for probabilistic risk of disorder. However, the lack of neurodevelopmentally-based tools for clinical decision-making has limited RDoC’s real-world impact. In...
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Introduction: The importance of healthy family lifestyles and home environments (e.g. environments that support healthy choices for food, physical activity, and sleep) on health behaviors and obesity risks are well-recognized. Less is known about the association of family factors with cardiovascular health (CVH) in youth. We examined the cross-sect...
Article
Background: Cardiovascular health (CVH) declines with age starting in early childhood. Neurodevelopmental health (NDH) measures, such as executive function, in early childhood have been associated with subsequent behavioral and lifestyle outcomes; however, little is known about the association of NDH measures in early life with CVH during childhood...
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Introduction Maternal smoking is a well-known risk factor for youth smoking, yet whether this relationship is causal remains unresolved. This study utilizes propensity score methods for causal inference to robustly account for shared risk factors between maternal and offspring smoking. Methods An 8-year longitudinal cohort of 900 adolescents in th...
Article
Background Children of parents with posttraumatic stress (PTS) face heightened risk for developing emotional and behavioral problems, regardless of whether they experience a traumatic event themselves. The current study investigates whether child FKBP5, a stress relevant gene shown to interact with child trauma exposure to increase risk for PTS, al...
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Introduction Maternal smoking is a risk factor for offspring smoking. Lifetime maternal smoking vs. prenatal tobacco exposure (PTE) appear to act through different mechanisms. This study tested the hypothesis that maternal smoking measures’ effects on offspring smoking could be attributable to hereditary mechanisms: personality traits (novelty-seek...
Chapter
Maternal distress is common in the prenatal period, with well-established long-term effects on offspring neurodevelopmental vulnerability to mental health problems beginning early in life. The development and implementation of timely and effective preventive and treatment interventions for maternal distress therefore has considerable public health...
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Adverse childhood experiences (ACEs) profoundly impact neurocognitive development. Specifically, when these events occur during critical periods of brain plasticity, a time of significant synaptogenesis, neural pruning, and myelination, typical neurodevelopment can become derailed. Adverse childhood experiences promote morphological changes in neur...
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Cultural factors influence the development of all children. Yet, current knowledge of explicit cultural socialization processes in childhood remains limited, mainly by failing to incorporate the experiences of young children. To address this critical gap, the authors introduce the OMERS-Peds task, an observational measurement designed to systematic...
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Introduction: Short message service (SMS) is a widely accepted telecommunications approach used to support health informatics, including behavioral interventions, data collection, and patient-provider communication. However, SMS delivery platforms are not standardized and platforms are typically commercial "off-the-shelf" or developed "in-house."...
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Parent-child synchrony—parent-child interaction patterns characterized by contingent social responding, mutual responsivity, and co-regulation—has been robustly associated with adaptive child outcomes. Synchrony has been investigated in both behavioral and biological frameworks. While it has been demonstrated that adversity can influence behavioral...
Article
Objective To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). Study design A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published...
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Irritability is impairing and prevalent across pediatric psychiatric disorders and typical development, yet its neural mechanisms are largely unknown. This study evaluated the relation between adolescent irritability and reward‐related brain function as a candidate neural mechanism. Adolescents from intervention‐seeking families in the community (N...
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Prosocial behaviors are a key component of young children’s developing social competence. The current study examines the impact of two types of maternal socialization on young children’s prosocial behaviors: emotional expressiveness (defined as maternal displayed positive and negative affect) and direct coaching of prosocial responses and explores...
Article
We thank Benarous et al. for their recognition of the necessity of a developmental view on disruptive mood dysregulation disorder (DMDD) and for their thoughtful comments.¹ Indeed, a growing science base challenges the “old thinking” that developmental instability precludes earlier identification of DMDD syndromes. Notably, our paper was designed t...
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Disruptive mood dysregulation disorder (DMDD) is a novel diagnosis emerging from a continuing discourse on the best diagnostic home for children with severe, chronic irritability. DMDD emerged from a research diagnosis that was developed to test the hypothesis that severe, chronic irritability is a developmental phenotype of pediatric bipolar disor...
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The vast individual differences in the developmental origins of risk and resilience pathways combined with sophisticated capabilities of big data science increasingly point to the imperative of large, neurodevelopmental consortia to capture population heterogeneity and key variations in developmental trajectories. At the same time, such large-scale...
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Prenatal stress exposure increases vulnerability to virtually all forms of psychopathology. Based on this robust evidence base, we propose a “Mental Health, Earlier” paradigm shift for prenatal stress research, which moves from the documentation of stress‐related outcomes to their prevention, with a focus on infant neurodevelopmental indicators of...
Preprint
Full-text available
Background and Objectives Self-regulation is a modifiable protective factor for lifespan mental and physical health outcomes. Early caregiver-mediated interventions to promote infant and child regulatory outcomes prevent long-term developmental, emotional, and behavioural difficulties and improve outcomes such as school readiness, educational achie...
Article
Objective: Approximately 50% of children with autism exhibit severe tantrums, defiance, and/or aggression. We propose that the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS)-a standardized clinical observation modeled after, and complementary to, the Autism Diagnostic Observation Schedule (ADOS)-could enhance earlier identification of...
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Objective Precise phenotypic characterization of prenatal tobacco exposure (PTE)–related disruptive behavior (DB) that integrates nuanced measures of both exposures and outcomes is optimal for elucidating underlying mechanisms. Using this approach, our goals were to identify dimensions of DB most sensitive to PTE prior to school entry and assess co...
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The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and fun...
Article
Objective The DSM’s disruptive mood dysregulation disorder (DMDD), characterized by severe, chronic irritability, currently excludes children <6 years. However, capitalizing on a burgeoning developmental science base to differentiate clinically salient irritability in young children may enable earlier identification. Our objective was to advance an...
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Introduction Sleep and the development of language are prominent concerns of many parents and until recently, many have examined these concerns tangentially. Children with developmental delays/disabilities have shown to have impaired sleep and poor sleep quality, and impairments or changes in sleep quality may play a prominent role in the acquisiti...
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Purpose: To identify and evaluate methods for assessing pediatric patient-reported outcome (PRO) data quality at the individual level. Methods: We conducted a systematic literature review to identify methods for detecting invalid responses to PRO measures. Eight data quality indicators were applied to child-report data collected from 1780 childr...
Preprint
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Research has demonstrated the transdiagnostic importance of irritability in psychopathology pathways but the contribution of developmentally-unfolding patterns has only recently been explored. To address this question, irritability patterns of 110 youth from a large and diverse early childhood cohort were assessed at preschool age and at school age...
Article
Introduction: Shared genetics may explain some of the strong heritability of cardiovascular (CV) disease, however, excess risk is largely due to intergenerational transmission of poor lifestyles leading to the increased presence of cardiovascular risk factors. We examined the association between parental and child CV health (CVH), including behavio...
Preprint
Full-text available
Irritability is a transdiagnostic psychiatric symptom that spans the internalizing- externalizing divide and places children at greater risk for common mental health problems. There is evidence for disrupted affect-biased attention processing in children with high levels of irritability, but the underlying mechanisms supporting this dysfunction are...
Article
SYNOPSIS Objective. This study investigates maternal responsive parenting behaviors as a theorized buffer to the detrimental impact of maternal PTSD symptoms on young children’s depression and anxiety symptoms, disruptive behavior, and stress-related symptoms. Design. A multi-ethnic sample of 242 trauma-exposed mothers and their preschool-aged chil...
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Objective The objective of this study was to evaluate the relationship between ACEs and inflammatory profiles (i.e., pro- and anti-) in early childhood and to examine whether patterns differ for racial/ethnic subgroups. Study design Using longitudinal data from the Multidimensional Assessment of Preschoolers Study (MAPS) (N = 122), we examined the...
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Objective: To illustrate the integration of developmental considerations into person-reported outcome (PRO) measurement development for application in early childhood pediatric psychology. Methods: Combining the state-of-the-science Patient-Reported Outcome Measurement Information System (PROMIS®) mixed-methods instrument development approach wi...
Article
This study examined the frequent clinical observation that toddlers with less expressive language have more severe temper tantrums. A representative sample of 2001 mothers reported on their toddler’s expressive vocabulary and frequency of different temper tantrum behaviors, a prominent feature of irritability and an emergent marker of mental health...
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Background: Research to date has largely conceptualized irritability in terms of intraindividual differences. However, the role of interpersonal dyadic processes has received little consideration. Nevertheless, difficulties in how parent-child dyads synchronize during interactions may be an important correlate of irritably in early childhood. Inno...
Article
Facilitated attention toward angry stimuli (attention bias) may contribute to anger proneness and temper outbursts exhibited by children with high irritability. However, most studies linking attention bias and irritability rely on behavioral measures with limited precision and no studies have explored these associations in young children. The prese...
Article
Irritability is a substrate of more than one dozen clinical syndromes. Thus, identifying when it is atypical and interfering with functioning is crucial to the prevention of mental disorder in the earliest phase of the clinical sequence. Advances in developmentally based measurement of irritability have enabled differentiation of normative irritabl...
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Deliberate emotion regulation, the ability to willfully modulate emotional experiences, is shaped through interpersonal scaffolding and forecasts later functioning in multiple domains. However, nascent deliberate emotion regulation in early childhood is poorly understood due to a paucity of studies that simulate interpersonal scaffolding of this sk...
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Bridging advances in neurodevelopmental assessment and the established onset of common psychopathologies in early childhood with epidemiological data science and computational methods holds much promise for identifying risk for mental disorders as early as infancy. In particular, we propose the development of a mental health risk algorithm for the...
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Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology b...
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Standardized developmentally based assessment systems have transformed the capacity to identify transdiagnostic behavioral markers of mental disorder risk in early childhood, notably, clinically significant irritability and externalizing behaviors. However, behavior-based instruments that both differentiate risk for persistent psychopathology from...
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Individual differences in temperament have been theorized to be supported by differential recruitment of key neural regions, resulting in the distinct patterns of behavior observed throughout life. Although a compelling model, its rigorous and systematic testing is lacking, particularly within the heightened neuroplasticity of early childhood. The...
Chapter
The preschool age (3–6 years) is a unique period for development as both emotion regulation and foundational brain development are rapidly maturing. Emotions such as frustration are common during this age; however, there is extensive variability along the spectrum from typical to atypical. This juxtaposition of normative misbehaviors with stable ir...