Applied behavior and psychosocial 

Behavioral/social/emotional aspects of chronic disabilities; longitudinal study design; enhancing compliance and health-promoting activities; ecological validity; transfer of clinical therapies to community settings; support of telemedicine; health services research.  

The Children’s National Medical Center site is involved in a number of health services and health disparity research projects related to rehabilitation medicine in pediatric populations.  These include studies of bone health, exercise, and obesity.  The CNMC site can assist with incorporation of SNP genotyping into community-based interventions, writing of IRB and consent forms including genomics technologies and endpoints, and database design/implementation for multi-site data acquisition.

NCRRN offers a number of resources in this area, including:

• Systems for efficient recruitment of research subjects: NCRRN operates a consent-based research registry of individuals with stroke and traumatic brain injury who are interested in participating in cognitive rehabilitation research (Myrna Schwartz, PhD, Principal Investigator). These individuals are recruited from a variety of inpatient and outpatient programs in the Philadelphia area. This consent-based registry protects potential subjects' privacy within the standards of HIPAA, while facilitating access to researchers who have appropriate approvals in place. The registry includes demographic information, information about brain lesions, and gross information about the types of cognitive deficits displayed by enrolled individuals. Investigators who enroll participants from the registry provide updated information about cognitive function that helps to maintain the registry's accuracy. The operation of the registry has been described (Schwartz MF, Brecher AR, Whyte J, Klein MG: A patient registry for cognitive rehabilitation research: A strategy for balancing patients' privacy rights with researchers' need for access. Archives of Physical Medicine and Rehabilitation 86:1807-1814, 2005; Phipps E, Harris D, Brown N, Harralson T, Brecher A, Polansky M, Whyte J: Investigation of ethnic differences in willingness to enroll in a rehabilitation research registry: a study of the Northeast Cognitive Rehabilitation Research Network. American Journal of Physical Medicine and Rehabilitation, 83;(12):875-883, 2004). Registry staff are able to provide guidance regarding establishing such registries elsewhere. In addition, for individuals who are approved to engage in collaborative research with NCRRN investigators, the registry is available as a source of local research participants.
• Expertise in cognitive theory and cognitive assessment: NCRRN investigators study a range of cognitive topics that span normal cognitive processing, the nature of neuro-cognitive impairments, and the impact of treatments designed to enhance cognitive functioning. This range of expertise ensures that theories of cognitive impairment are developed in light of the current state of knowledge regarding normal cognitive processes, and that treatments under investigation have a logical theoretical basis, given what is known about the cognitive process and its disordered functioning. NCRRN investigators are able to provide guidance about relevant cognitive theories and about ways to measure specific cognitive processes, particularly in the areas of auditory processing (Stefanatos), language (Coslett, Fink, Schwartz, Stefanatos), spatial attention (Buxbaum, Coslett), temporal attention (Hart, Kim, Whyte) executive function (Hart, Kim, Kimberg, Osman, Schwartz, Whyte), skilled hand use (Buxbaum), and control of multi-step naturalistic actions (Buxbaum, Schwartz).
• Expertise in the naturalistic assessment of cognitive impairments: Treatment of cognitive impairments of necessity requires attention to two levels of assessment. How are the fundamental cognitive processes being targeted for treatment altered by the intervention? and What is the impact of treatment on complex naturalistic tasks that depend on the cognitive processes of interest? NCRRN investigators, including Drs. Whyte, Schwartz, Buxbaum, and Hart, have particular expertise in assessing the relationship between underlying cognitive processes and real world behavior, using innovative naturalistic assessment tools.
• Expertise in applications of technology and virtual reality techniques to cognitive assessment and as cognitive orthoses (Buxbaum, Coslett, Fink, Hart, Schwartz, Stefanatos).
• Expertise in treatment experimental design: Cognitive rehabilitation treatment research encounters many complex challenges ranging from the selection of appropriate treatment candidates, to the definition of the active ingredients of treatment, to the appropriate outcome measures to detect treatment effects. NCRRN investigators offer specific expertise in experimental design for studies related to an enhanced understanding of cognitive impairments and their response to treatment.