New Directions in Child Psychiatry: Shaping Neurodevelopmental Trajectories

Historically, the field of child psychiatry has lagged behind the field of general psychiatry in terms of research innovations and the availability of empirically supported treatment modalities. However, over the last two decades there has been increasing interest in and research focused on the developmental origins of mental disorders examining both neurobiological and psychosocial etiologies.1 This has catalyzed the field leading to advances in understanding the developmental psychopathology of mental disorders and the generation of novel early interventions that have shown significant promise.2-4 Further, catalyzing this effort is new data demonstrating the powerful impact of psychosocial forces on neurodevelopment. New methodologies and discoveries in the basic areas of early childhood developmental psychology have led to a greater appreciation for the emotional and cognitive sophistication of children in the first three years of life. Advances in methods to understand preverbal children's emotional and attentional responses (through measures of eye gaze and suck for example) as well as observational methods to glean a variety of mental health relevant behaviors early in life (e.g. behavioral inhibition, pro-social behaviors and social motivation) have further elucidated and validated these capacities. In addition, measures of neural function using electroencephalogram and evoked response potentials (EEG/ERP) and functional magnetic resonance imaging (fMRI) as early as the neonatal period, with many analysis methods developed at WUSTL, have further informed this domain providing new insight into early brain and behavioral relationships as well as how intervention impact brain function.5-7.