Preventive Intervention

Over the past two decades, a vast amount of knowledge has accrued regarding the prevalence and consequences of adverse life events in childhood.  The toll of these consequences has been confirmed in well-controlled, genetically-informative studies. Child maltreatment is the single preventable cause with the highest associated disease burden, approaching 20% or more of the population-attributable risk for all psychiatric conditions of childhood.

For this reason, a major focus of our laboratory has been to advance understanding of the prevention of child maltreatment and its consequences. We have adopted a targeted preventive intervention strategy in which children at highest risk for child maltreatment and its consequences are identified as early in life as possible, and supportive family-based interventions proven to offset risk for child abuse and neglect are implemented, tested, and refined. These include home visitation, evidence-based parenting education, and two-generation psychiatric intervention.

Our SDS laboratory has clarified risk predictors that can be utilized prenatally or in the newborn period to identify families who will benefit from intervention most.  We maintain active collaborations with the faculty of the world renowned Brown School of Social Work in the evaluation of promising new approaches to preventive intervention.  Outreach to stressed, disadvantaged families in our community has been a continuous hallmark of our program, and our work has been funded by the Department of Justice, the Centers for Disease Control, the Health Resources and Services Administration, and the U.S. Administration for Children and Families.

Current Studies

Early Head Start University Partnership Grants: Buffering Children from Toxic Stress examines whether a parenting intervention, an adaptation of the Incredible Years Toddler program, can buffer high-risk children in Early Head Start (EHS) from toxic stress and its consequences by fostering supportive and responsive care giving. Specifically, the study is determining  the efficacy of the proposed intervention, how a range of variables relate to the occurrence of toxic levels of stress within the EHS population, and whether the intervention buffers children from toxic stress and/or its consequences.  If the intervention is effective in reducing toxic stress, broader implementation of this supplemental intervention would represent a new opportunity for supporting emotional and cognitive development among at-risk children.

Intervention Programs

The SYNCHRONY Project: A Comprehensive Approach to Unmet Mental Health Needs of Infants and Preschool Children in Foster Care utilizes the Incredible Years curriculum, is a collaboration of the Family Court of Saint Louis County, the Children’s Division of the Missouri Department of Social Services, and the Division of Child Psychiatry at the Washington University School of Medicine.  It is designed to promote positive relationships between parents and their children, and to teach parents how to support their child’s earliest emotional development in the areas of bonding and attachment, communication, self-regulation, discipline, cooperation, and the formation of lasting relationships.