Possibilities and Realities With Early Intervention to Prevent Neurodevelopmental Disorders: Shafali Jeste, MD


The chief of neurology and co-director of the Neurological Institute at the Children’s Hospital Los Angeles discussed the hesitancy to enroll children with neurodevelopmental issues in early intervention trials without proven products or markers. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"One way to accelerate this is to directly integrate research into the effectiveness of interventions into the clinic. My dream is that any baby who’s seen in a pediatricians office where there’s ref flags is immediately enrolled into some sort of interventional arm. It might be closer surveillance, parent-mediated training and intervention, or even a medication, if there’s a trial that’s appropriate."

Diagnosing and treating neurodevelopmental disorders in children can be complex due to the diverse range of symptoms and their overlap with other conditions. Examples of these disorders in this age group include attention-deficit/hyperactivity disorder, autism, learning disabilities, intellectual disability, conduct disorders, cerebral palsy, and impairments in vision and hearing. Approaching each of these disorders with a tailored and effective treatment approach has been difficult, with some studies questioning whether common parent programs or neurodevelopmental therapy truly work.

The Kids with Neurogenetic and Developmental Disabilities (KiNDD) lab, a section of Children’s Hospital Los Angeles (CHLA), has worked towards diagnosing, evaluating, and treating children with various intellectual disabilities and neurodevelopmental disorders. Led by Shafali S. Jeste, MD, the lab specifically aims to identify different subgroups of children with these disorders to better understand how atypical development occurs, and to develop and implement targeted interventions personalized to the individual child. The lab also studies several genetic syndromes including tuberous sclerosis complex, Dup15q syndrome, and Angelman syndrome, as children with these disorders are at high risk for developing autism spectrum disorders.

In a recent interview with NeurologyLive®, Jeste, who also serves as the chief of neurology and co-director of the Neurological Institute at CHLA, discussed the current barriers in clinical trials that assess interventions for developmental disorders. She talked specifically about the lack of data to try new approaches and the hesitancy that comes with it. In addition, she provided comment on why children with these disorders should be enrolled in some sort of intervention study in clinics immediately after receiving diagnosis, and the benefits that early intervention may bring. Furthermore, she stressed why integrating children into these studies will help those in underserved communities and of non-English speaking backgrounds.

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