Kids and Teens: Developmental Milestones

Adolescent Depression

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

Tired of all those guides for idiots and dummies? This book will provide some welcome relief… The author provides a solid reference tool for anyone who works with adolescents. It is highly recommended for education professionals as well as public libraries.

(Diana Masla VOYA)

I heartily recommend this book to parents and relatives of adolescents who have or may have mood disorders. It is written clearly and simply… and with a style that helps parents to understand the complexities of the problem that is optimistic of the lihood of improvement with correct diagnosis and treatment.

(Marcia Slomowitz, M.D. Journal of Clinical Psychiatry)

As I prepared this brief review, I found myself advising families to obtain their own copy of Dr. Mondimore's well-written, clear, and valuable book.

(Nancy A. Durant, M.D. American Journal of Psychiatry)

Clear, medically precise terminology, drawings, and diagrams.

(Healing Magazine)

This is an intelligent and well-written work with a substantial amount of detail especially about medications and how they work.

(Metaphysiology Online Book Reviews)

This well-written book is both comprehensive and scientifically rigorous. Dr. Mondimore makes the complex concepts and terms involved in the diagnosis and treatment of adolescent depression enormously accessible to the layperson.

(Neal D. Ryan, M.D., Western Psychiatric Institute and Clinic, University of Pittsburgh)

Dr. Mondimore has clearly succeeded in his goal of providing parents with a sophisticated summary of everything that is currently known about adolescent mood disorders. His writing combines a keen clinical skill in the care of patients with a comprehensive and sensible review of the research literature.

In our clinic at Johns Hopkins Hospital, we spend a lot of time simply educating parents about these conditions, and we have badly needed a book to recommend to families. Dr. Mondimore's book more than satisfies this urgent need.

This is an outstanding work that surpasses anything else I have read for parents on clinical depression and bipolar disorder in teenagers.

(Anthony J. Drobnick, M.D., Director of the Adolescent Affective Disorders Consultation Clinic, Johns Hopkins Medical Institutions)

This is Dr. Mondimore's best book yet, thorough and comprehensive. He provides information that is vital for parents, pediatricians, and general practitioners trying to understand the behavioral symptoms of mood disorders in adolescents.

(Sallie P. Mink, Director of Education, Depression and Related Affective Disorders Association (DRADA))

Francis Mark Mondimore, M.D., is a psychiatrist and member of the clinical faculty of the Johns Hopkins University School of Medicine. His books include Depression: The Mood Disease and Bipolar Disorder: A Guide for Patients and Families, both available from Johns Hopkins.


Johns Hopkins Magazine

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

Janet Hardy “An ExtraordinaryRole Model”Born: January 14, 1916Education: BS, University of British Columbia (1937); MDCM from McGill University (1941). Decided on a career in medicine after her father, an internist, once told her, “No daughter of mine is ever going to be a physician.”Career Highlights: Served on the pediatric house staff at Johns Hopkins Hospital (1942-1945), where she was charged with developing the hospital's first neonatology ward; consultant to state of Maryland Health Department (1946-1950), where she helped develop a statewide transport system for premature and at-risk newborn infants; worked for Baltimore City Health Department (1951-1957), first as director of maternal and child health, ultimately as assistant commissioner of health for preventive medicine; director of Johns Hopkins Collaborative Perinatal Study (1957-1976); director of the Office of Continuing Medical Education at JHMI (1974-1981); director of Johns Hopkins Adolescent Pregnancy Programs (1975-1985); director of Johns Hopkins Children and Youth Programs (1982-1985); fifth woman to achieve rank of full professor on the Hopkins medical faculty.Family: Married to Johns Hopkins associate professor Paul H. Hardy for 66 years; has two children and three grandchildren. The couple reared their family on a 35-acre farm in Glen Arm, Maryland, where she raised horses, kept a garden, and canned her own jams and vegetables. Says Anne Duggan: “She's an extraordinary role model for how you can really have it all. She's an incredible researcher, wife, mother, grandmother, homemaker, gardener. And she has always made it look effortless.” 
Working with the late Theodore King, former chair of Hopkins' Department of Gynecology and Obstetrics, and other colleagues, Hardy put together the Johns Hopkins Adolescent Pregnancy and Parenting Programs in 1976. The project looked at teaching parenting skills to teens and teaching and evaluating pregnancy prevention methods. “It was a special clinical program that was very supportive and focused on health and parenting education,” Hardy recalls.

Several years later, Hardy became aware of new research by Laurie Schwab Zabin, a professor of population and family health sciences at the Bloomberg School of Public Health, that showed that pregnancy prevention efforts needed to reach teenagers earlier than previously thought.

The two worked with city children's advocate Rosalie Streett to develop the Hopkins Pregnancy Prevention Program. The innovative school-linked program was implemented at a Baltimore City high school and a junior high.

The program, which blended social support, education, and access to birth control for young men and women, succeeded in decreasing the pregnancy rate among participants by 30 percent while pregnancy rates at schools without the program grew 58 percent.

Zabin calls Hardy a dedicated, dogged researcher, someone who not only has curiosity but also has the ability to get the right people together for a project and find the funding to make it work.

“When she decided something was going to be done, she totally threw herself into it, picked very carefully who she was going to do it with, and did it,” Zabin says.

“She's always been a person who saw what the next step could be.”

Then there was the question of how the CPP participants, their children, and grandchildren were faring. After approximately 25 years since her last contact with CPP mothers and children, Hardy decided it was time for a follow-up.

In 1988, together with the late Sam Shapiro of the Bloomberg School's Department of Health Policy and Management, Hardy reconnected with a random sample of 2,694 CPP participants for the Pathways to Adulthood Study.

The goal: to see how their environment and health had influenced their development.

“Clearly the question was what had happened to the mothers and the children, and why did it happen,” Hardy says. Because of the fine relationship her CPP staff had with participants, Hardy had little trouble finding the children, who were now between the ages of 27 and 33.

There was the baby who, though tiny and brain damaged at birth, went on to lead an independent life and have a family. There was the girl with the high IQ who won a full scholarship to college. There were babies who grew up to be doctors, lawyers, and small business owners, and babies who grew up to continue the poverty cycle, live on welfare, and go to prison.

“It was amazing to see as the children developed and the families made their way in life,” Hardy says. “So many of them turned out to be successful.”

Hardy's follow-up study found that living with both parents, remaining free from poverty, and good behavior in and school were all predictors of successful adult lives among this inner-city population, which was largely African American.

She also found a strong link between a woman's age when she first gives birth and how her children do later on in life.

Those born to mothers in their late 20s were more ly to get high school diplomas, stay off public assistance, and avoid teenage pregnancies in their own lives than were the children of teenage mothers.

It was more than curiosity that brought Hardy back to the CPP data several years ago.

“We were beginning to hear of findings, particularly from a researcher named David Barker in England, that there was definitive evidence between perinatal factors and chronic diseases such as diabetes, heart disease, and hypertension, yet there were very few databases that included detailed prospective data from the mother's pregnancy through the children's development to adulthood,” Hardy says. The original CPP data, which included a collection of 60,000 frozen sera samples, could be a goldmine.

Now Hardy just needed Hopkins researchers who were interested in the next step — following the participants to middle age. Says Duggan: “[Janet] realized the incredible value [of continuing] to follow the cohort but [knew] it was never going to happen unless she took action to pass along to a next generation of researchers what she had done.”

William Eaton, chair of the Department of Mental Health at the Bloomberg School of Public Health, has been interested in life course studies for most of his career and immediately saw the value of continuing the CPP.

“We have studied thousands of generations of fruit flies . . . and hundreds of generations of rodents, but [there's not been] a single intensive study of even one generation of humans,” he says.

“Following up on the CPP is one of the first opportunities we have to do that.”


Pediatrician Lutherville, MD – Pavilion Pediatrics at Green Spring Station – Pediatrics for Family Health

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

At Pavilion Pediatrics we consider our patients to be our extended family. Our goal is for every parent to feel that we are caring for their child with the same compassion as we care for our own. We have been a part of the Baltimore community for over 45 years, originally founded by Dr.

Lawrence Pakula. We provide comprehensive, up-to-date medical care for infants, children, adolescents and young adults. We closely monitor your child's development, and provide extensive guidance to you as your child grows and matures.

We are affiliated with Johns Hopkins Hospital and Greater Baltimore Medical Center.

Our practice consists of six board certified pediatricians, along with our certified registered nurse practitioners who provide routine well exams and sick care for our patients.

We pride ourselves on providing compassionate, quality medical care for all of our patients.

Our physicians also enjoy their role as educators and participate in the education of medical students and pediatric residents who are completing their training at Johns Hopkins University School of Medicine.

Our Services

With our commitment to compassionate comprehensive care we offer:

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ICTR in the News: James Harris to Receive Catcher in the Rye Award from American Academy of Child and Adolescent Psychiatry

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

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  • ICTR in the News: James Harris to Receive Catcher in the Rye Award from American Academy of Child and Adolescent Psychiatry

Posted by: Crystal Williams on: October 18, 2017 | Print This Page

Congratulations to ICTR researcher James C. Harris, M.D. on receiving the Catcher in the Rye Award from the American Academy of Child and Adolescent Psychiatry.

James C. Harris, M.D.

Credit: Johns Hopkins Medicine

James C. Harris, M.D.

, founding director of the Developmental Neuropsychiatry Program at The Johns Hopkins University and the Kennedy Krieger Institute, and professor of psychiatry and behavioral sciences and pediatrics at The Johns Hopkins University, will be presented with the Catcher in the Rye Advocacy Award to an Individual on Oct. 24 at the annual meeting of the American Academy of Child and Adolescent Psychiatry (AACAP).

The award was established by the AACAP in 1996 to honor a child psychiatrist who has made significant contributions to society through the support of child and adolescent psychiatry.

The award takes its name from the J.D.

Salinger best-selling book The Catcher in the Rye, which includes a scene where the narrator imagines himself as a guardian responsible for saving the lives of children at risk of falling off a cliff.

The award citation for Harris credits him with being a “steadfast advocate” who has “worked tirelessly on behalf of children, adolescents, and their families.”

Harris is a past director of the Johns Hopkins Division of Child and Adolescent Psychiatry.

His nationally recognized, award-winning textbook Developmental Neuropsychiatry and his Intellectual Disability textbooks are standard works for child psychiatrists.

He says his advocacy for children with developmental disabilities was stimulated by his experiences dealing with ethical issues during his pediatric residency at Johns Hopkins.

As director of psychiatry at Kennedy Krieger, he initiated developmental neuropsychiatry specialty clinics (autism, developmental disabilities, infant psychiatry, traumatic brain injury, fetal alcohol spectrum disorders and Fragile X syndrome) and began National Institutes of Health-funded research on self-injury among patients with Lesch-Nyhan syndrome and studies of other neurodevelopmental disorders.

Harris also served as psychiatric adviser to Eunice Kennedy Shriver, who founded the Special Olympics, and he participated with her in the last White House Conference on Mental Health.

As lead author of the DSM-5 criteria for intellectual disability, he advises the American Psychological and American Psychiatric associations on amicus briefs for Supreme Court death penalty cases involving people with intellectual developmental disorders.

Upon learning he was to receive the Catcher in the Rye Award, Harris expressed his appreciation of the AACAP and lauded others.

“Thanks to the children with developmental disabilities and their families who taught me how much advocacy matters and what it can accomplish,” he said.

“Special thanks to my wife, Cathy DeAngelis, a past recipient of a Catcher in the Rye Humanitarian Award, R.E. Cooke, Hugo Moser, Leon Eisenberg and Eunice Shriver — all of whom inspired my advocacy.”


Child Psychiatry | Johns Hopkins Psychiatry Guide

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

— The first section of this topic is shown below —

  • Child psychiatry is centered on the assessment, treatment, and prevention of mental health problems in children and adolescents.
    • Unfortunately, children and adolescents can experience significant difficulties in emotion regulation, cognition, and behavior that cause marked impairments in functioning.
  • Interest in childhood development first emerged in the 18th century.
    • French philosopher Jean-Jacques Rousseau’s major novel, Émile, focused on the physical, emotional, and social development of children through education[1].
  • In the latter half of the 19th century, European psychiatrists including Emminghaus, Manheimer, and Moreau de Tours described childhood psychopathology based upon diagnostic classifications created for adults[2].
  • In 1930, the first academic child psychiatry department was founded by Dr. Leo Kanner, under the direction of Dr. Adolf Meyer, at the Johns Hopkins Hospital. Dr. Kanner wrote the first English-language textbook in the field titled Child Psychiatry in 1935 and was also a pioneer in describing the clinical syndrome of autism[3].
  • Child and adolescent psychiatry emerged as an established medical specialty in 1953 through the founding of the American Academy of Child Psychiatry[1].
    • The organization is now known as the American Academy of Child and Adolescent Psychiatry.

— To view the remaining sections of this topic, please sign in or purchase a subscription —

  • Child psychiatry is centered on the assessment, treatment, and prevention of mental health problems in children and adolescents.
    • Unfortunately, children and adolescents can experience significant difficulties in emotion regulation, cognition, and behavior that cause marked impairments in functioning.
  • Interest in childhood development first emerged in the 18th century.
    • French philosopher Jean-Jacques Rousseau’s major novel, Émile, focused on the physical, emotional, and social development of children through education[1].
  • In the latter half of the 19th century, European psychiatrists including Emminghaus, Manheimer, and Moreau de Tours described childhood psychopathology based upon diagnostic classifications created for adults[2].
  • In 1930, the first academic child psychiatry department was founded by Dr. Leo Kanner, under the direction of Dr. Adolf Meyer, at the Johns Hopkins Hospital. Dr. Kanner wrote the first English-language textbook in the field titled Child Psychiatry in 1935 and was also a pioneer in describing the clinical syndrome of autism[3].
  • Child and adolescent psychiatry emerged as an established medical specialty in 1953 through the founding of the American Academy of Child Psychiatry[1].
    • The organization is now known as the American Academy of Child and Adolescent Psychiatry.

There's more to see — the rest of this entry is available only to subscribers.

Chang, Shin-Bey, and Roma Vasa. “Child Psychiatry.” Johns Hopkins Psychiatry Guide, 2017. Johns Hopkins Guide, Chang S, Vasa R. Child Psychiatry. Johns Hopkins Psychiatry Guide. 2017. Accessed May 18, 2020.Chang, S., & Vasa, R. (2017). Child Psychiatry. In Johns Hopkins Psychiatry Guide Retrieved May 18, 2020, from S, Vasa R. Child Psychiatry [Internet]. In: Johns Hopkins Psychiatry Guide. ; 2017. [cited 2020 May 18]. Available from:* Article titles in AMA citation format should be in sentence-caseMLAAMAAPAVANCOUVERTY – ELECT1 – Child PsychiatryID – 787014A1 – Chang,Shin-Bey,M.D.AU – Vasa,Roma,M.D.Y1 – 2017/09/03/BT – Johns Hopkins Psychiatry GuideUR – – Johns Hopkins GuideDP – Unbound MedicineER –


The Growing Child: School-Age (6 to 12 Years)

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

Linkedin Pinterest Kids' and Teens' Health Kids and Teens: Developmental Milestones

Children progress at different rates.They have different interests, abilities, and personalities. But there are some commonmilestones many children reach from ages 6 to 12.

As your child grows, you’ll noticehim or her developing new and exciting abilities.

A child age 6 to 7:

  • Enjoys many activities and stays busy
  • s to paint and draw
  • Practices skills in order to become better
  • Jumps rope
  • Rides a bike

A child age 8 to 9:

  • Is more graceful with movements and abilities
  • Jumps, skips, and chases
  • Dresses and grooms self completely
  • Can use tools, such as a hammer or screwdriver

A child age 10 to 12:

As children enter into school age,their skills and understanding of concepts continue to grow.

A child age 6 to 7:

  • Understands the concept of numbers
  • Knows daytime and nighttime
  • Knows right and left hands
  • Can copy complex shapes, such as a diamond
  • Can tell time
  • Understands commands that have 3 separate instructions
  • Can explain objects and their use
  • Can repeat 3 numbers backward
  • Can read age-appropriate books

A child age 8 to 9:

  • Can count backward
  • Knows the date
  • Reads more and enjoys reading
  • Understands fractions
  • Understands the concept of space
  • Draws and paints
  • Can name the months and days of the week, in order
  • Enjoys collecting objects

A child age 10 to 12:

  • Writes stories
  • s to write letters
  • Reads well
  • Enjoys using the telephone

An important part of growing up islearning to interact and socialize with others. During the school-age years, you’ll seea change in your child.

He or she will move from playing alone to having multiplefriends and social groups. Friendships become more important. But your child is stillfond of you as parents, and s being part of a family.

Below are some of the commontraits that your child may show at these ages.

A child age 6 to 7:

  • Cooperates and shares
  • Can be jealous of others and siblings
  • s to copy adults
  • s to play alone, but friends are becoming important
  • Plays with friends of the same gender
  • May sometimes have temper tantrums
  • Is modest about his or her body
  • s to play board games

A child age 8 to 9:

  • s competition and games
  • Starts to mix friends and play with children of the opposite gender
  • Is modest about his or her body
  • Enjoys clubs and groups, such as Boy Scouts or Girl Scouts
  • Is becoming interested in boy-girl relationships, but doesn’t admit it

A child age 10 to 12:

  • Finds friends are very important and may have a best friend
  • Has increased interest in the opposite gender
  • s and respects parents
  • Enjoys talking to others

You can help boost your school-agedchild's social abilities by:

  • Setting limits, guidelines, and expectations and enforcing them with appropriate penalties
  • Modeling good behavior
  • Complimenting your child for being cooperative and for personal achievements
  • Helping your child choose activities that are suitable for his or her abilities
  • Encouraging your child to talk with you and be open with his or her feelings
  • Encouraging your child to read, and reading with your child
  • Encouraging your child to get involved with hobbies and other activities
  • Promoting physical activity
  • Encouraging self-discipline and expecting your child to follow rules that are set
  • Teaching your child to respect and listen to authority figures
  • Encouraging your child to talk about peer pressure and setting guidelines to deal with peer pressure
  • Spending uninterrupted time together and giving full attention to your child
  • Limiting screen time (TV, video, and computer) 


Children’s Medical Practice/Johns Hopkins Bayview Medical Center

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

Johns Hopkins Bayview Medical Center (JHBMC), located in southeast Baltimore City, MD, is a hospital and medical office center within the Johns Hopkins Health System.

The Medical Center offers a wide range of services, including a trauma center and neonatal intensive care unit that are part of the statewide system, and a nationally renowned geriatrics center.

Johns Hopkins Bayview is also home to the Johns Hopkins Burn Center.

Because of its growing immigrant population, diversity and inclusion is a top priority at JHBMC. According to Richard G. Bennett, M.D., President, “We have patients who come from all over the world from all sorts of backgrounds who need our care. Our goal in healthcare is to provide the safest care and best service to all.”

The Children’s Medical Practice (CMP) is the Medical Center’s outpatient pediatric clinic providing comprehensive primary care for children through age 21. The clinic’s majority patient population is Latino children with immigrant parents who have limited English proficiency (approximately 75% of annual clinic visits)
(DeCamp et al, 2015)

In an effort to create better health services to meet the needs of Latino families, the Latino Family Advisory Board (LFAB), El Consejo de Familias Latinas, was established in 2011 by two pediatricians at CMP, Dr. Lisa DeCamp and Dr. Sarah Polk.

The 19 active members of the LFAB are Latino immigrant families who have received care at CMP for an average of 8 years. (DeCamp et al, 2015) They come from countries throughout Central and South America. The LFAB meets monthly and all meetings are conducted in Spanish.

Childcare, dinner, and a small stipend are provided to LFAB members.

In August 2013, with a grant from the Aaron and Lillie Straus Foundation, JHBMC opened Centro SOL, the Johns Hopkins Center for Promoting Health/Salud and Opportunity for Latinos.

The primary goal of the center is learning about the health needs of the Latino community – and developing programs and services to meet them.

With the opening of Centro SOL, the LFAB had a sustainable source of funding and could work with the new center to develop and expand programming focused on improving the health of the local Latino community and the quality and safety of care provided to Spanish-speaking Latino families at Johns Hopkins.

During its years in existence, the Consejo has recommended and worked on a number of projects to improve Clinic services for Latino children and their families. In 2017 – 2018 alone, the Consejo was involved in the following initiatives:

  • Desirability and feasibility of group well child care.
  • Improved support for continuous Medicaid enrollment.
  • Development of grant proposals to support remote mental health services and community-based overweight management.
  • Child-centered vaccine administration via development and adaptation of an educational video in Spanish about how to manage childhood anxiety surrounding vaccine administration.
  • Feedback on Spanish language letter informing patients and families about a Long Term Reversible Contraceptive program.

The LFAB also participated in establishing a Youth Advisory Board component and in creating a space for teenage children of the clinic to provide direct input and feedback.

In a recent evaluation, Consejo members reported significant satisfaction with their involvement. Two members commented:

“This year has […] allowed us to express ourselves with confidence and contribute changes to improve our work as a group.”

“Our group is very interesting because it always gives really wonderful suggestions about our children and also about women’s health, which is what is most important.”

Latino Family Advisory Board, Yearly Report, 2016-2017

Dr. Lisa DeCamp, who directs the Consejo, describes its benefits: “As a result of the Consejo, we have been able to improve the care that we provide to immigrant Latino families.

Consejo members have helped us to prioritize changes, recognize the strengths and limitation of our programs, and gain a better understanding of the many factors that contribute to families’ ability to promote the health of their children.

Their tireless commitment to the work of the Consejo inspires us to continue working to improve our services and advocate for policies and system changes that reflect the needs of diverse populations.”

Read the LFAB's 2017-18 Yearly Report

To other clinics planning to create Patient/Family Advisory Councils for Latino or other immigrant populations, Dr. DeCamp offers the following advice:

  • Take time for partnership development and building trust. Consejo members have different opinions and we have worked hard to create a safe space for their views.
  • Supporting the practical needs of members to achieve sustained participation. For example, we know we must provide childcare to be successful and so that is part of the budget and staffing.

DeCamp et al (2015). A voice and a vote: The advisory board experiences of Spanish-speaking Latina mothers. Hispanic Health Care International, 13(4).


Elaine Tierney, MD

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine


Elaine Tierney is a research scientist at Kennedy Krieger Institute. She is also an associate professor of psychiatry at the Johns Hopkins University School of Medicine.


Tierney received her bachelor's of arts from the University of Florida and her medical degree at the University of South Florida in 1989.

After completing a transitional residency at Cook County Hospital in Chicago and a general psychiatry residency at Johns Hopkins Hospital, she accepted a child and adolescent psychiatry fellowship at Johns Hopkins Hospital.

She formerly served as the medical director of both Kennedy Krieger's Neurobehavioral Unit and its Center for Autism and Related Disorders, and as the director of the Department of Psychiatry. She continues to serve in the Neurobehavioral Unit. Dr.

Tierney is a pediatric and adult psychiatrist with a special interest in autism, genetic, metabolic and neurological disorders that cause behavioral disturbances. Dr. Tierney is a member of the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, the Maryland Psychiatric Society, and the Maryland Regional Council of Child and Adolescent Psychiatry.


Current statistics predict one every 68 children is destined to develop autism spectrum disorder (ASD). ASD is an incapacitating, lifelong developmental disability that typically appears within the first three years of life. It is the result of a neurological disorder that affects the functioning of the brain.

Individuals with ASD frequently exhibit developmental delays in physical, social and language skills, have abnormal responses to sensations, communicate unusually and have abnormal ways of relating to people, objects and events in the environment.

The condition is four times more ly in boys than girls, and sometimes occurs in association with other disorders.


Tierney works along with behavioral psychologists, neurologists, developmental pediatricians, nurses, communication specialists, educational specialists, social workers and occupational therapists to create treatments for individuals with ASD.

Previously, her research had included the Research Units on Pediatric Psychopharmacology (RUPP) Multisite Project in autism, funded by the National Institute of Mental Health.

The RUPP at Kennedy Krieger has completed double-blind, placebo-controlled studies of the use of risperidone and methylphenidate, and an open-blind study of the use of guanfacine in children and adolescents with ASD.


Tierney investigates the presentation of ASD in individuals which have metabolic disorders (conditions in which chemical pathways in the body are not working properly). These conditions include mitochondrial disorders, Smith-Lemli-Opitz syndrome (SLOS) and other sterol disorders.

In 2001, Dr. Tierney and colleagues identified that SLOS is associated with autism spectrum disorder. Since SLOS is known to be caused by a defect in the body's biosynthesis of cholesterol, SLOS may provide clues to the biochemistry of other autism spectrum disorders.

Because children with SLOS can be treated by dietary cholesterol supplementation, their work to determine the incidence of SLOS within individuals with autism and possible other cholesterol related autism spectrum disorders conditions may offer some new possibilities for treatment.


Tierney and colleagues published a paper in 2006 in the American Journal of Medical Genetics Part B (Neuropsychiatric Genetics) in which they describe the finding that a small subgroup of children with autism spectrum disorders have abnormally low cholesterol levels (hypocholesterolemia). The children's low cholesterol levels were apparently due to a limited ability to make cholesterol. This finding, in concert with their work with SLOS, has led them to believe that cholesterol may play a role in the cause of some cases of autism spectrum disorder.


Tierney and colleagues at Kennedy Krieger, in collaboration with the National Institutes of Health (NIH) and the Autism Genetic Resource Exchange have now begun analyzing the genes of the children with low cholesterol. These children's genes are being compared to their parents' to determine if there are common mutations affecting cholesterol metabolism being passed from parent to child.

This study is supported by funding from Cure Autism Now, Autism Speaks, and the Smith-Lemli-Opitz/RSH Foundation. 

Elsevier Fingerprint Engine Profile for Elaine Tierney

Research Publications

Scahill L, Bearss K, Sarhangian R, McDougle CJ, Arnold LE, Aman MG, McCracken JT, Tierney E, Gillespie S, Postorino V, Vitiello B (2017). Using a Patient-Centered Outcome Measure to Test Methylphenidate Versus Placebo in Children with Autism Spectrum Disorder. J Child Adolesc Psychopharmacol. 27(2), 125-131.

Wassif CA, Kratz L, Sparks SE, Wheeler C, Bianconi S, Gropman A, Calis KA, Kelley RI, Tierney E, Porter FD (2016). A placebo-controlled trial of simvastatin therapy in Smith-Lemli-Opitz syndrome. Genet Med. , .


Children who lose a parent to suicide more ly to die the same way, study finds

Kids and Teens: Developmental Milestones | Johns Hopkins Medicine

Losing a parent to suicide makes children more ly to die by suicide themselves and increases their risk of developing a range of major psychiatric disorders, according to a study led by Johns Hopkins Children's Center that is believed to be the largest one to date on the subject.

A report on the findings will appear in the May issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

How and when the parent died strongly influenced their child's risk, the researchers report. And because the findings show that parental suicide affects children and teens more profoundly than young adults, it is ly that environmental and developmental factors, as well as genetic ones, are at work in next-generation risk, the scientists say.

“Losing a parent to suicide at an early age emerges as a catalyst for suicide and psychiatric disorders,” says lead investigator Holly C. Wilcox, Ph.D., a psychiatric epidemiologist at Hopkins Children's. “However, it's ly that developmental, environmental and genetic factors all come together, most ly simultaneously, to increase risk.”

The good news, the researchers say, is that though children in this group are at increased risk, most do not die by suicide, and non-genetic risk factors can be modified. And there may be a critical window for intervention in the aftermath of a parent's suicide during which pediatricians could carefully monitor and refer children for psychiatric evaluation and, if needed, care.

Family support is also critical, the investigators say.

“Children are surprisingly resilient,” Wilcox says. “A loving, supporting environment and careful attention to any emerging psychiatric symptoms can offset even such major stressor as a parent's suicide.”

In the United States, each year, between 7,000 and 12,000 children lose a parent to suicide, the researchers estimate.

The current study looked at the entire Swedish population over 30 years, making it the largest one to date to analyze the effects of untimely and/or sudden parental death on childhood development.

U.S. and Swedish investigators compared suicides, psychiatric hospitalizations and violent crime convictions over 30 years in more than 500,000 Swedish children, teens and young adults (under the age of 25) who lost a parent to suicide, illness or an accident, on one hand, and in nearly four million children, teens and young adults with living parents, on the other.

Those who lost a parent to suicide as children or teens were three times more ly to commit suicide than children and teenagers with living parents. However there was no difference in suicide risk when the researchers compared those 18 years and older.

Young adults who lost a parent to suicide did not have a higher risk when compared to those with living parents. Children under the age of 13 whose parent died suddenly in an accident were twice as ly to die by suicide as those whose parents were alive but the difference disappeared in the older groups.

Children under 13 who lost a parent to illness did not have an increased risk for suicide when compared to same-age children with living parents.

In addition, those who lost parents to suicide were nearly twice as ly to be hospitalized for depression as those with living parents. And those who lost parents to accidents or illness had 30 and 40 percent higher risk, respectively, for hospitalization.

Losing a parent, regardless of cause, increased a child's risk of committing a violent crime, the researchers found.

The researchers did not count suspected suicides, nor did they include children with psychiatric or developmental disorders who were treated before the parent's death or as outpatients, meaning the effects of parental suicide may be even more profound than the study suggests.

Co-investigators on the study included S. Janet Kuramoto, M.H.S., of Hopkins; Paul Lichtenstein, Ph.D., Niklas Långström, M.D. Ph.D., and Bo Runeson, M.D. Ph.D, of the Karolinska Institutet in Sweden; and David Brent, M.D., of the University of Pittsburgh.

The research was funded by the National Alliance for Research on Schizophrenia and Depression (NARSAD), by the National Institute on Drug Abuse and by the Swedish Research Council.

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