I began my career in 1990 to help improve the functioning of children and adolescents with neurodevelopmental disorders. I’ve worked with several specific patient populations throughout my career, including individuals with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder, reading disorders and, more recently, children born prematurely. I focus on executive functioning and attention, reaction time variability, academic executive functions (including organization, planning, study skills, time management, working memory and task initiation), with a specific interest in developing and testing interventions to help youth with neurodevelopmental disorders.
My research career began at a nationally recognized child development center focused on ADHD at UC Irvine in California. Our team used several methods, including intervention development and testing, medication studies and neuroimaging like magnetic resonance imaging (MRI), functional MRI (fMRI) and near-infrared spectroscopy (NIRS). The center was one of the sites of the Multimodal Treatment Study (MTA), which included the largest cohort of children with ADHD and evaluated medication, behavioral therapy and their combination compared to treatment as usual in the community. Later, during postdoctoral studies at Stanford, I developed neuroimaging skills and increased our understanding of executive functioning in ADHD, fragile X syndrome and Turner syndrome.
After completing this work, I led a large-scale early intervention and prevention program to educate and train parents in behavioral management strategies in the local California communities. The program, which started with 32 families, grew quickly to include over 900 families each year, and served both Spanish- and English-speaking families. During this time, I also helped develop attention training and executive function interventions for preschoolers.
Later, I transitioned to the University of Texas Southwestern Medical Center to lead the Center for Advanced ADHD Research, Treatment and Education. I brought the parent training program and executive function training interventions for preschool-aged children from California to Dallas, TX. I also investigated “Pay Attention!” as an attention training program for school-aged children with ADHD.
Now, at Cincinnati Children’s, I work in the Center for ADHD with a variety of colleagues who explore many areas of neurodevelopmental research. I really enjoy working as part of the team, and I believe team science drives discovery. I’ve partnered with several other researchers on interesting studies, such as those exploring secondary ADHD following a head injury and using behavioral tools in a provider portal designed to improve pediatricians’ assessment and treatment of ADHD.
I also led a multisite study investigating how to treat ADHD and comorbid reading difficulties in children in second through fifth grade. This study was the first of its kind and discovered the best results came from treating reading problems and ADHD simultaneously using the latest evidence-based therapies for each disorder.
I also led a follow-up study to the Multimodal Treatment Study (MTA) where we completed brain imaging and substance use assessments at the 16-year follow-up to understand cannabis use in young adults with childhood ADHD compared to a local normative control group.
Currently, I work on multiple studies focused on various neurodevelopmental challenges, such as:
- Improving academic executive functions for middle school children, especially those with autism or ADHD.
- Identifying which prematurely born children are at the highest risk for executive dysfunction. Using brain imaging data collected soon after birth, we predict future cognitive and executive functions. We anticipate this information will help identify children who may need interventions in the future.
- Examining how reaction time variability, i.e., variable speed of responses on computerized tasks, is related to inattention. We hope to understand heterogeneity in ADHD and help tailor treatment for individual children.
My overarching goal is to help improve functioning in children with neurodevelopmental disorders. Additionally, I enjoy using brain imaging techniques to help understand the cause of neurodevelopmental disorders and related deficits.
ADHD; ADHD subtypes; non-medication interventions; early intervention and prevention; treatment outcomes; brain-behavior relationships; gene-environment interactions; motivation
Professor, UC Department of Pediatrics
Clinical Psychology, Attention Deficit Hyperactivity Disorder ADHD