Developmental Epidemiology

My initial attraction to developmental epidemiology was its ability to separately model both risk to an individual and risk to a community. For example, a rare risk factor may have a large effect upon individuals, but, because few experience it, have a small effect upon rates of a disorder in a community. Alternatively, a common risk factor may have a small effect upon individuals, yet, because many people experience it, have a large effect upon rates of a disorder in a community. This pattern is seen in the impact of maternal education and very low birthweight upon cognitive impairment in children. Children born very low birthweight are at a significantly elevated risk of experiencing a mild cognitive impairment; however, because few children are born very low birthweight, the impact upon the overall rates of cognitive impairments in the population is relatively small. In contrast, having a mother who did not complete high school is associated with a relatively smaller increase in risk, but because the number of women not completing high school is much greater than the number of infants born very low birthweight, the impact on overall rates of cognitive impairments in the population is larger.

My personal area of focus in developmental epidemiology has been on early hearing detection and intervention (EHDI) for newborns with hearing loss, including strategies for improving rates of early diagnosis and intervention, as well as understanding and documenting the long-term developmental outcomes for children. In connection with this work, I have a long-term partnership with the Early Hearing Detection and Intervention Program at the Centers for Disease Control and Prevention in Atlanta (CDC-EHDI). I also collaborate with a University of Colorado-Boulder team led by Christie Yoshinaga-Itano, as well as partner with multiple colleagues in other states.

In addition to newborn hearing, I have also been involved in developmental epidemiological work on birth defects and various developmental disabilities, with an interest in identifying factors that may facilitate or limit a child's development. However, I am also interested in epidemiological modeling of behavioral/conduct problems and in applying epidemiological measures of effect to developmental analytic techniques. Given the focus on electronically linked population-level data sets, my research in developmental epidemiology is closely linked (no pun intended) to my work in biobehavioral informatics.