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Behavior White Paper (PDF - 172KB)

Created on April 14, 2011



17 Submitted Comments on Behavior
Thank you for honoring me with the opportunity to participate in this important NICHD Vision Workshop and process. I found the conference stimulating and quite forward thinking. I have a few suggestions, particularly regarding scientific opportunities that were not included in the White Paper but merit attention and were discussed during the Workshop: 1) The importance of community-based participatory research (CBPR). Because CBPR is a community-based, partnership approach which addresses social, structural, and physical environmental inequities in health and healthcare through active involvement of community members, organizational representatives, and researchers in all aspects of research process, it offers great promise for providing innovative solutions to many of the major issues discussed during the Workshop. 2) Resiliency was only briefly touched upon in the White Paper, but is another exciting area for future work. A better understanding, for example, of why it is that certain children in poverty overcome all obstacles and disadvantages to become healthy and successful may lead to some of the most innovative and effective interventions for all children. 3) Racial/ethnic disparities. The Census 2010 data indicate that minority children will likely outnumber white children by the 2020 Census, and a large body of literature documents that racial/ethnic disparities in children?s health and healthcare are extensive, pervasive, persistent, and impact the spectrum of health and healthcare. The White Paper only mentions racial/ethnic disparities in terms of understanding the social context, but much more could be said about both the current major issues and gaps and future directions for research.

Submitted by Glenn Flores on April 25, 2011 at 10:07 AM
Is someone concerned about increased uncontrolled reproduction in the mentally-ill, drug addiction group of people with 0-2 in the intellectual, educated high-achieving group of people? Is that upsetting the genetic pool?

Submitted by Anonymous Guest on May 8, 2011 at 1:22 PM
I concur that we need to address regulatory restrictions that serve to impeded low risk behavioral research. Too often, a bio-medical regulatory approach is inappropriately applied to behavioral research, thereby impeding the collection of important data. The NICHD is well-positioned to develop guidelines for researchers and IRBs on ethical procedures in behavioral research. I suggest that particular attention be given to the ethics of conducting research on children and sexual violence. How should parental consent be handled (when that adult may be a perpetrator of the violence)? Should the children be a minimal age for participation in such a study? Are there issues of recall bias around sexual abuse that should be taken into account when defining the sample? How might one balance the risks and benefits of gathering such information?

Submitted by Anonymous Guest on May 17, 2011 at 1:26 PM
I first want to thank the workshop for their hard work and the compelling document that has been disseminated. This should have a significant impact on NICHD's scientific vision. I appreciate the focus on life-span issues, but I think that it would be particularly beneficial to examine preschool predictors of later functioning at the brain-behavior level. Currently, we have a very rudimentary understanding of how brain networks sub-serving important behavioral processes are dynamically related to subsequent development in this period. I also appreciate the focus on the development of statistical approaches to characterize development across multiple levels. However, I also think that it is important to support the development of computational/mathematical modeling within some levels. In particular, the development of models to examine the relationship between brain structure, function and behavior it critically needed. These computational/mathematical models would provide needed explanatory power to characterize the underlying mechanisms involved in behavior. Finally, I also appreciate the focus on large-scale investigations across multiple levels (i.e. gene-brain-behavior-environment). However, I think that it is equally important to conduct large-scale investigations within a level or levels. For example, the field would benefit from systematic investigations of brain-behavior across multiple domains (e.g. executive function, memory, language, spatial and literacy) and populations (e.g. those with different skill levels, disorders).

Submitted by Anonymous Guest on June 1, 2011 at 3:42 PM
basic aspects of hormone biosynthesis and long-term outcomes of children with related disorders (such as congenital adrenal hyperplasia) are understudied and in need of more investigation

Submitted by Anonymous Guest on June 2, 2011 at 9:58 AM
Congratulations on an excellent document on complex issues. I have a couple of comments: page 1, section 1 - outdated statement "effects of early life conditions on adults are not solely genetic in origin ...." This sentence should be re-written to express the dynamic nature of interactions, including alterations of gene expression depending on the early environment (crucial research of Meaney, Szyf, Champagne and many others).
page 5, section 4 - "environmentally at risk segments of society include: ... dual language children ..." This is a very narrow view of dual language - i.e. plenty of evidence that dual language in an appropriate environment enhances brain development and executive functions. It is the context of dual language that matters.

Submitted by Ruth Grunau on June 7, 2011 at 10:57 AM
Congratulations on a strong vision paper that proposes to position the study of behavior in the context of both developmental trajectories and influences ranging from the genetic to the macro-environmental. The vision is ambitious but correct: behavior is the result of a complex web of interacting processes and when science moves to focus in on particular pieces of the web, it must do so in a way that is well-informed by knowledge of what is being left out.
The vision is ambitious even when focused on a specific behavior. For example, take the problem of understanding contraceptive risk-taking. Aspects of this problem include executive function, social competence, knowledge, and motivational/emotional/cognitive orientations to having a baby. The potential determinants range from genetic and epigenetic characteristics to partnership, social, cultural, and policy environments. No one study can address all these aspects, but an integrated body of knowledge can be created through the strategic intersection of studies across levels of analysis and developmental stages. NICHD can pursue the vision in the white paper by creating networks of interdisciplinary studies, each of which explores specific cross-level and/or cross-stage antecedents of behavior, and encouraging active interaction and exchange among participants in the network to inform and improve knowledge of the system as a whole.
The focus of the behavior workshop centered on children's development and behavior, but adult behaviors are equally critical to the NICHD mission: not only those influencing pregnancy and childbearing, but also those affecting healthy development in childhood through adulthood: a partial list would include the choices people make about how far to go in school, where to live, when to have children, and what foods to buy for their families. The demographic and behavioral portfolio of the NICHD has been strong precisely because so many scientists recognize the importance of these behaviors and NICHD is the natural home for research on them. Keeping this body of behavioral research strong and encouraging innovation through the kinds of interdisciplinary research described above will be critical to addressing the Institute's mission. It will also maintain an essential information base for informing the development of policies to improve health and well-being. NICHD has received repeated recognition from Congress for its contributions to this ongoing need.

Submitted by Christine Bachrach on June 9, 2011 at 2:32 PM
The Society for Women's Health Research appreciates the opportunity to provide comments to NICHD's Vision process and appreciates the group's excellent work in laying out an agenda towards understanding behavior. SWHR strongly encourage the Workgroup on Behavior, when exploring areas target for investigation in the area of development trajectories, to ensure that biological sex is documented and examined as a factor -much like race, ethnicity, cultural background, immigration status, and socioeconomic status.

In addition, biological sex can also be influenced by genetic and environmental factors and should be examined in any new studies that look at the genetic and environmental factors that impact behavioral development at the genetic, brain, environmental level.

There are clear sex differences already noted in the incidence, diagnoses, treatment and outcomes relating to attention deficit hyperactivity disorder (ADHD), obesity, and learning disabilities as well as other behavioral disorders. Also, there is abundant literature on the role of sex differences in behaviors, especially in children (Zakrisi, et all 2005) (Sobin, et all 2009). Recent studies have revealed gender differences in regards to behavioral trajectories of aggressive and disruptive behavior problems were associated with negative life outcomes in young adults (Bradshaw, et all 2009). Additionally, women are two to three times more likely to suffer from a major depressive or anxiety disorder and. The sex difference begins in adolescence and the incident of depression peaks at age 44 for women, while it continues to rise later in life for men (Savvy Woman Patient, 2006). NIMH recently held a workshop (Feb-March 2011) discussing the influence of sex differences on behaviors in mental disorders. NIH, ORWH and the FDA Office of Women's Health are now offering a course on Sex and Gender Differences in Health and Behavior.

As the thought leaders in research on sex differences, it is SWHR's hope that NICHD will be cognizant of sex as a variable when studying the biology of behaviors and will encourage the analysis and reporting of sex-specific differences.

Submitted by Leslie Stevens on June 9, 2011 at 5:03 PM
The Scientific Vision Workshop on Behavior emphasizes "Integrating understanding of behavioral and biological factors and their interplay in development" during critical transitions. Important critical transitions in brain development and behavior take place during the first year of life when the optimal nutritional modality for the infant is breastfeeding, an activity that involves intense maternal-infant interactions. In this document there is no specific mention of the potential effects of nutritional interventions such as formula feeding on the critical transitions in neural, cognitive, behavioral and social development taking place in the first year of life. Animal data, in rodents and non-human primates provide extensive documentation of the effects of deprivation of maternal interactions on aggressive and other behaviors (review, AH Veenema, Front Neuroendocrinol). That these behavioral constructs carry over into the non-breastfed infant is suggested by new data from the Millenium Cohort Study in Britain (K Heikkija, Arch.Dis Child, May 9, 2011) showing a 30% increase in behavior problems in formula-fed compared to breastfed infants. While it is not clear whether this finding relates to components of breast milk that foster brain development or to more optimal mother-infant interaction during breastfeeding, it does suggest that feeding modality during the first year of life can be an important determinant of long term behavior. In addition, there is evidence that these behavioral effects carry across generations (AS Fleming, Pharmacology, Biochemistry and Behavior). In this context the specific application of research tools outlined in the white paper to breastfeeding is particularly important. The definition of critical behavioral, environmental, and social constructs within which breast-feeding alters behavioral outcomes will allow more specific answers to the question of under what circumstances does the intervention of formula feeding have detrimental effects on short and long term behavior. It is critical to catalog the duration and exclusivity of breast-feeding in populations under study as well as data on the nature of alternative feeding. In sum, what is important here is that the modality through which infants are nourished in the first year of life be fully integrated into well designed longitudinal and multidimensional studies evaluating biological and behavioral outcomes.

Submitted by Margaret Neville on June 9, 2011 at 10:43 PM
The Behavior White Paper emphasizes the broad contexts of development and a broadening of integrative approaches to study development. These emphases strike me as reasonable. This emphasis extends to interventions and a call for translational research on a large scale. However, it is important to realize that large scale clinical trial type studies are very expensive and the failure rate (not finding a predicted effect of an intervention) has been high in the area of educational interventions. It is important for NICHD to support small scale interventions that are based on sound theory and empirical results. Such small scale interventions can have in-vivo features that are closer to the real world than laboratory studies. The results of such interventions are important for increasing the success of the larger and more expensive trials. I would urge that NICHD value these kinds of studies.

The paper's emphasis on executive functions is appropriate. However, it is important not to push this to the exclusion of other development. Some of the research on executive function is detached from the tasks and contexts in which they function. The search for a wholly generalized system of executive functioning divorced from tasks that force their development is likely to be a failure.

Submitted by Charles Guest on June 10, 2011 at 8:11 AM
The American Occupational Therapy Association (AOTA) represents over 140,000 occupational therapy practitioners and students whose goal is to maximize independence and function for people across the lifespan.

AOTA commends the participants of the behavior workshop for recognizing the importance of environmental factors on behavioral development. We recommend considering the impact of sensory factors on behavioral development. Sensory processing of environmental stimuli as well as internal stimuli (from one's own body) can influence the ability to achieve self-regulation (Miller, 2005; Porges, 1996) and provide a foundation for successful environmental interactions across multiple domains for learning and adaptive behaviors. Systematic reviews suggest that sensory integration intervention positively effects behavioral outcomes and that these gains are sustained at follow-up (American Occupational Therapy Association [AOTA], 2009). However, it is unclear whether sensory integration intervention is more effective than other interventions.

The emphasis of early health conditions on behavioral development is particularly needed in populations of children and adolescents with intellectual and developmental disabilities as they transition from one system of care to another (i.e., early intervention, school system, etc.).

We agree with the idea of conceptualizing child behaviors using a dimensional approach. We also need more research examining the moderators and mediators of behavior, particularly in young children with disabilities (0-5 years). For issue #7, it may be helpful to examine behavior and executive function separately. For example, what antecedent skills or body and structure functions are necessary for self-regulation of behavior? The same question could be asked for executive function.

AOTA has also been interested in studying environmental influences on behavioral expression across a severity continuum, in the context of what enables functional performance. Questions like "How can environmental supports influence the expression of independent and adaptive behavior, coping, and self-regulation" could spark research using universal design principles and assistive technology interventions.

AOTA appreciates this opportunity to submit comments to guide NICHD's vision for future research. For additional information, please call 301-652-6611.

Submitted by Susan Lin on June 10, 2011 at 8:12 AM
The Behavior vision white paper identifies several key issues that will occupy many researchers in coming years. Notably both Biomedical Scientists and Social Scientists recognize the need to (in the words of the paper) "integrate mechanisms derived across domains involving the genes, brain, and environment." The white paper appropriately identifies several compelling areas for investigation and investment. The recognition that environmental influences operate at multiple levels or scales is important to moving research forward in a productive fashion. The white paper rightly points out the need to invest in data and tools for carrying such multi-scale integrated research to completion.

Submitted by Michael White on June 10, 2011 at 9:00 AM
Compelling Scientific Opportunities and Research Questions: We believe that NICHD should focus on the dimensions in which individual difference may occur as opposed to whether or not persons fulfill diagnostic criteria. Within this approach it may be useful to expand this approach though by examining interfamilial differences in addition to looking at individual differences. Thus for example, research on ADHD can be expanded via using approaches that use the family as the mode of measurement and thus the pool data across siblings and generations to capture intergenerational patterns. It is anticipated that within the next 10 years we will have the capacity to analyze interfamilial patterns as a result of efforts to promote the use of Electronic Health Records in health settings.

Compelling Scientific Opportunities and Research Questions: Environmental influences on behavior- we are in sync with the vision of the members of the Committee of the Scientific Vision Workshop on Behavior in their emphasis on the measurement of resilience factors, gene-environment interplay, the role of environment on health disparities and the role of the environment at sensitive stages of development. We also understand that research which advances the measurement of the influence of the environment on behavior factors may be occurring at institutions both within and outside of the U.S. As such, we hope that NICHD continues to use its international partnerships to bring to the table cutting edge perspectives on how to measure these relationships.


Compelling Scientific Opportunities and Research Questions: Critical Periods of Development and Transition- We think that it would be useful for NICHD to support research which is reflective of the use of developmental markers that are culturally grounded, as there are many sub cultures within each society that communicate social expectations regarding transitions in development.

Compelling Scientific Opportunities and Research Questions: Promoting Healthy Development: Interventions-The comments regarding intervention research on families overlaps with our comments as we expect that some of the data which examines families will come from longitudinal interventions, while other data will come from patient encounter health data.
Submitted by Dr. Llewellyn Cornelius -Society for Social Work and Research

Submitted by Llewelyn Cornelius on June 10, 2011 at 1:09 PM
On behalf of the Population Association of America, I am pleased to comment on the Behavior white paper.

One of the paper's four research opportunities, "Environmental Influences on Behavior," encompasses a wide range of demographic research interests as long as it relates directly to children's well being. The paper suggests moving "beyond the family to schools, neighborhoods, and structural factors." It recommends refining traditional concepts such as SES, disadvantage, stress, and social network support-the population research community agrees with these recommendations.

The document urges that research cut across levels, such as by incorporating genetic influences into studies of environmental effects. Many major demographic surveys supported by NICHD (Add Health, Fragile Families) are collecting genetic information and other biomarkers. We agree that this is an exciting direction for research. Using this information productively will be one of the great future research opportunities.

There are fields of demographic research that the paper doesn't emphasize. For example, the report focuses almost exclusively on child-development, overlooking human development more broadly. As an illustration, future studies are needed to understand the emerging field of early adulthood (the life stage between adolescence and full adulthood) as well as the impact of family formation. Also, the paper does not discuss basic population dynamics. Part of the mission of the NICHD Demographic and Behavioral Sciences Branch is to "add[ing] to knowledge about human population dynamics and their causes and consequences." These include the growth and movement of populations. Demographic studies of fertility do not seem to have a place in this vision statement. NICHD has historically been concerned about high births rates in the U.S. and elsewhere and supported studies of birth rates, contraceptive usage, etc. Growing concerns about an increasingly older age structure - in other words, about not having enough children - justify the need for broader studies of fertility dynamics being on the list of behavioral studies priorities. Child health and human development may be threatened by a postponement and decline of births among the population today, and studies of fertility could contribute to our knowledge of how the United States can avoid an age structure tilted toward the elderly and away from the young in the years and decades ahead.

Submitted by David Lam on June 10, 2011 at 1:56 PM
The Behavior workshop white paper addresses critical points for our understanding of development. My congratulations to the workshop participants for tackling wide-ranging topics in such a compelling and integrative manner. The focus on normal developmental trajectories and the various mechanisms underlying behavioral development is essential as a foundation for any work on atypical development or intervention. Even more, it is important to the scientific community to see that NICHD devoted a workshop to the topic of "behavior." There is a tremendous amount of excitement and focus on genetics and neuroscience research, but we must not lose our excitement about behavioral science research.

Submitted by Martha Ann Bell on June 10, 2011 at 4:00 PM
The panel has done an excellent job in identifying research themes and critical questions in the area of behavior. The fact that behavior was identified as one of the white paper topics is itself a significant accomplishment from this process, and an endorsement of the need for further research on typical and atypical behavior patterns. It remains true that behavior is the "rubber meets the road" point for so many contemporary problems and concerns, including health and development, violence and safety, and performance and well-being. Relatively little was said in this white paper about the importance of animal models of behavior, and thus I wanted to underscore the need for a research program on behavior to be inclusive, embracing behavior as it is manifest across species. Not only can these animal models provide important links to neuroscientific data, as was mentioned in the white paper, but they provide essential and foundational information about the psychology and development that underlie various behavioral manifestations and problems. I hope that NICHD will continue to support comparative research as part of its suite of research resources for advancing knowledge about the causes and consequences of behavior.

Submitted by David Washburn on June 10, 2011 at 4:20 PM
The longitudinal studies that the White Paper proposes to assess social, environmental, and other features impacting our psychic, social, and behavioral development are certainly worthwhile. We would offer the following suggestions in terms of these studies:
* If this were truly to be a population study, then it would be necessary to narrow the number of variables to be followed. In this case, many of the more subtle influences on personality and behavior could not be included.
* If this were to be a study involving a greatly reduced number of subjects, then it may be possible to apply the very labor intensive methods needed to address (in at least a modestly comprehensive manner) the wide range of influences discussed.
Some of the areas listed might be viewed as belonging to a second tier study that could then follow upon the collection of such a wide range of information. For instance, item 7, "Self-Regulation..." is almost within the domain of a therapeutic intervention and relationship. That kind of work could (potentially) be funded as part of such a longitudinal study, but it would be greatly complicated. Also, item 8, "Promoting a Healthy Development" seems to be suited to an analysis phase rather than to the initial study.
In examining how all these component pieces might fit together, we are inclined to think that some portions of the proposals might be better served if taken as correlations based on the data rather than as projects intended to work out basic mechanisms residing in genetic, neurological, or other deeply somatic attributes. It seems impossible to house within the scope of a single project all these diverse mechanistic and behavioral aspects; however, the document does describe many worthwhile and valuable areas of study.
Again, we appreciate the opportunity you have provided us to comment on the document. We hope our input has been helpful. Like NICHD, we believe that research in reproductive science and medicine are fundamental underpinnings to the goals of ensuring that every child reaches their full potential.

Submitted by Michael on June 10, 2011 at 4:58 PM
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Last Updated Date: 05/31/2012