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Paediatrics - Complex Autism and Neurodevelopment

Paediatrics - Complex Autism and Neurodevelopment

2023 team L-R: Cam Lee, Alex Tan, Marijke Mitchell, Alex Ure, Katrina Williams, Kirsten Furley, Natalie Mizzi, Siew-Lian Crossley, Vishnu Mohanakumar Sindhu, Beth Johnson, Wan Sim, Sally Fyfield, Mohammed Alshawsh, Amanda Brignell, Alma Giborski, Alice Garrick, Gauravi Gawade, Lauren Kalisch

The Complex Autism and Neurodevelopment Research Group sits within the Department of Paediatrics, Monash University, based at Monash Children’s Hospital. Our mission is to increase understanding of complex autism and neurodevelopment and work towards improved personalised care, services and supports for children and adolescents and their families.

We embed our research in clinical care and combine it with training, thereby providing children and families with access to the best evidence-based support and personalised services.

Research Leads

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Staff and students View

Research Fellows

Dr Alison Crichton
Dr Wan Sim

Clinician Research Coordinator

Cam Lee

Research Officers

Ava Nielsen
Wan Sim

Doctoral students

Henry Choi
Jennifer Fairthorne
Mandira Hiremath (PhD, Department of Paediatrics, Monash University)
Sewnet Kebede (PhD, Department of Paediatrics, Monash University)
Mia Moses (PhD, School of Psychological Sciences, Monash University)
Madeline Thorbecke (PhD, School of Psychological Sciences, Monash University)

Honours students

Theint Hay Thi (Biomedical Science Honours, Monash University)

Collaborators

We have extensive local, Victorian, national and international networks spanning clinical care, research, advocacy and service development. International collaborators Kings College London, Donders Institute for Brain Cognition and Behaviour (Netherlands), and Texas Children’s Hospital.

Funding

We are funded by Monash University, Monash Children’s Hospital, competitive grants, Monash Health Foundation and McNally Family Foundation.

Research streams

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Developmental Regression and Intellectual Disability View

Lead Investigator: Professor Katrina Williams

Other investigators and collaborators

Our team is leading projects to improve early identification of skill loss, to reduce preventable progressive skill loss and permanent disability. We are synthesising existing evidence, working towards global consensus for a definition and developing a cohort of children to better understand the causes and trajectories of skill loss, and improve assessment and intervention. We are also working with colleagues towards earlier diagnosis for children with genetic causes of intellectual disability. We work in partnership with lived and living experience communities to inform and enhance our work.

Current funded and postgraduate research

Defining and measuring developmental regression
Investigating developmental regression
Phenotyping a clinical cohort of children with developmental regression
Improving identification and assessment of children who experience skill loss
Earlier diagnosis for children with genetic causes of intellectual disability
Developing and evaluating an early, novel and accessible intervention for primary carers of children with developmental regression

There are opportunities for students to be involved in the projects.

Mental Health: Care, Support and Services View

Lead Investigator: Dr Alexandra Ure

We aim to improve supports and care for children diagnosed with autism or other developmental differences and their families. Our group includes individuals with lived experience and academic clinicians providing care to children and families in paediatric health services and schools across Melbourne. We partner with stakeholders, including individuals with specific lived experience and community organisations, to inform and enhance our work. Other collaborators include multidisciplinary clinicians, researchers, design and technology experts across Australia and internationally.

Our program of work includes the codesign and development, evaluation and implementation of new healthcare practices that improve mental health and well-being for children and families. We are passionate about inclusion, opportunity and optimising outcomes for families who experience disadvantage.

Current funded and postgraduate research includes:

Improving supports for neurodiverse children and their families who have experienced trauma and adversity
Codesigning and implementing innovative approaches into healthcare to better connect families of neurodiverse children with services
Using technology to enhance health care episodes for children and their families
A service evaluation of a children's health and wellbeing service and prospective work to develop and embed sustainable and strong quality and research capabilities.

Many opportunities for students are available, from short research placements to PhD candidates

Children who use minimal spoken language View

Lead Investigator: Dr Amanda Brignell

We aim to better understand why some children have minimal verbal language and to develop and assess interventions and supports so that we can best match interventions to each child’s skill profile. Our vision is to optimise all children’s ability to communicate as effectively as possible.

Children who use minimal verbal language may or may not have a diagnosis, such as autism, or an underlying genetic difference.

Current funded and postgraduate research includes:

Detailed speech and language assessment of children who use minimal verbal language, utilising new technologies and assessment methods.
Co-designing an intervention trial for children with minimal verbal language.
Synthesising evidence to improve care and outcomes

We collaborate with individuals with lived experience, researchers, academics and clinicians. We also collaborate internationally with colleagues in the US and UK.

Many opportunities for students are available, from short research placements to PhD candidates.

Simulation training and research View

Lead Investigator: Dr Marijke Mitchell

We utilise simulation training for health care professionals as an innovative solution to major health care problems. One such problem is behavioural emergencies, such as aggression and self-harm, which are increasing in frequency in acute health care settings. Behaviour is one way that children communicate fear and frustration, which can be magnified in the hospital setting. Children with complex neurodevelopmental needs, including autism, have increased health care needs and are at greater risk of behavioural emergencies in hospital. To improve outcomes for children, families and staff a confident, well-trained workforce is needed. We are currently delivering and evaluating the effectiveness of our innovative training has on staff confidence and performance in preventing and managing behavioural emergencies.

We work closely with Research staff including A/Prof Ram Nataraja, Ms Noor Chaudhry and Ms Iris Pilares at Monash Children’s Simulation.

Evidence synthesis to improve care View

Lead Investigator: Dr Mohammed Alshawsh

Our team is committed to synthesizing existing evidence-based studies and providing comprehensive information to enhance clinical decision-making and improve the well-being of children, and their families, with complex autism and neurodevelopmental trajectories, strengths and needs. Robust systematic reviews, meta-analyses and guidelines play a crucial role in advancing knowledge, refining healthcare practices, and guiding evidence-based clinical decisions. Our team has extensive experience in conducting systematic reviews and meta-analyses, and we are working as leaders in the Cochrane Collaboration and with colleagues with content expertise.

Current systematic reviews

Repetitive and restricted behaviours and anxiety in autism spectrum disorder
Prevalence of a diagnostic finding in children presenting with developmental regression
Association between adverse childhood experiences and neurodevelopmental difficulties
Interventions for parents of children with autism spectrum disorder
The relationship between IQ and sex differences in autism