Children with comorbid mental health and neurodevelopmental disorders (NDDs) often require more intensive and coordinated care than those with mental health disorders alone. These two categories of disorders often present with comorbidity and engagement disparities in integrated behavioral health programs among this population remain poorly understood. This study examines differences in service utilization and attrition rates between these two populations using retrospective electronic health record (EHR) data from the SCCN study population (ages 6-18) across multiple primary care sites.
We will analyze visit frequency over a 6-12 month period to assess whether children with comorbid NDDs have higher service utilization. Additionally, early dropout rates will be examined using Kaplan-Meier survival analysis and Cox proportional hazards models to identify risk factors for attrition. Findings will provide critical insights into engagement patterns, informing strategies to enhance retention, reduce access disparities, and improve care coordination for children with complex behavioral needs. This study will contribute to investigating further integrated care model improvements in order to ensure more equitable and sustained mental health treatment for vulnerable pediatric populations.
Patient Population: Children
School-Based Paraeducator Education for Engagement at Recess (SPEER)
The purpose of this study is to compare two implementation strategies for a social engagement intervention that supports autistic children and their non-autistic peers during recess. Remaking Recess has been shown to improve peer engagement for autistic students when implemented by paraeducators during recess. However, without supports, paraeducators face barriers to implementing the intervention well. This study compares paraeducators’ use of Remaking Recess when they receive coaching alone and when they receive coaching along with consultation from school-based teams.
Testing the efficacy of the Helping Educational Leaders Mobilize Evidence (HELM) implementation strategy
This study will examine the efficacy of the Helping Educational Leaders Mobilize Evidence (HELM) implementation strategy for promoting building-level implementation leadership, implementation climate, and high-fidelity delivery of evidence-based practices. This study tests whether HELM improves outcomes when used in conjunction with Positive Behavioral Interventions and Supports (PBIS), an evidence-based practice. The researchers will compare the effects of PBIS implemented with usual supports and PBIS implemented with HELM. They will also explore what for whom, under what conditions, how equitably, and through which processes HELM works to improve student academic outcomes, as well as its cost-effectiveness.
Coach up the coaches: extending the reach of mental health professionals in sport settings
More than half of school-aged youth in the US play at least one organized sport, are similarly at-risk for mental health disorders as compared to their non-athlete peers, and face heightened barriers to seeking and sustaining mental health care. While coaches are not licensed mental healthcare providers, there is a robust evidence-base about laypeople (e.g., parents, teachers) effectively delivering brief interventions across population settings to help reduce psychological distress and increase the adoption of health behaviors. However, such brief interventions have not as-yet been adapted for the sport setting, or delivered by coaches.
The overarching goal of this project is to identify sport setting appropriate (very) brief interventions and adapt them for coach delivery in the sport setting. This will be accomplished by working in partnership with coaches, athletes, and licensed mental health care providers. We will use University of Washington’s First Approach Skills Training (FAST) training model (originally designed to train primary care clinicians in mental healthcare skills) to train a pilot cohort of coaches to deliver these interventions. This project is the starting point for a potentially transformative opportunity to extend the reach of mental healthcare professionals into the large and often underserved population of youth sport participants.
Adopting a lifespan approach for ADHD management
ADHD is common, heritable and impairing. As recognition of the negative functional impacts associated with ADHD in adulthood has grown and stigma around the diagnosis has diminished, demand for ADHD care across the lifespan has increased.
This project will begin foundational work to inform the development of a family-focused lifespan clinic at UW serving adults and children with ADHD. For such a program to be effective, equitable, and sustainable, we must clarify the true needs of individuals living with ADHD as well as the professionals caring for them. We will convene four groups of key community partners: (1) Adults with ADHD whose children have ADHD, (2) Adolescents with ADHD, (3) Mental health professionals representing the fields of psychiatry, psychology, psychiatry advanced practice nursing, school-based counseling, (4) Primary care providers. Results will guide program development and illuminate future research opportunities.
PHSKC School Based Health Services
Project includes the design and development of survey instruments for the provider-level skills and agency-level readiness needs assessment and analyzing the data.
PHSKC Planning and Evaluation
Project includes activities surrounding the provision of evaluation, training, and consultation services to PHSKC. These include developing, conducting and analyzing a needs assessment for mental health providers and agency leads to further refine a tier 2/3 model of care. Training and consultation supports will be provided.
State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center
The State Implementation and Scaling-up of Evidence-based Practices (SISEP) Center is a national technical assistance center funded by the U.S. Department of Education’s Office of Special Education Programs. Through this subcontract, the UW SMART Center has a subcontract to develop a micro-credentialing program on implementation science (IS) for educators, and to develop and convene a national community of practice of educators focused on application of IS.
Trigeminal nerve stimulation (TNS) for ADHD
TNS uses a device to send currents into the brain and stimulate the trigeminal nerve. This method has proven effective to treat depression and other psychiatric disorders. The research team is working to understand if this approach could help improve executive function and reduce symptoms of ADHD.
Previous studies have shown that this is effective for about half of people with ADHD. Our research team is working to better understand for whom this therapy might be most effective and if this could be a viable new treatment for ADHD.
Please contact us at tnsstudy@seattlechildrens.org.
Preparing teachers and paraprofessionals for the successful inclusion of children with ASD (ASD PREP)
The purpose of this IES study is to identify what EBPs teachers and paraeducators use to more meaningfully include and retain autistic in general education settings; and the malleable individual and organizational characteristics that increase EBP use.
