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Center for Children with Special Needs

Research + Clinical Trials

Research, Funding, and Publications

The Center for Children with Special Needs (CCSN) at Floating Hospital for Children has earned national recognition for its research. The CCSN seeks to advance the prevention, identification, diagnosis and treatment of developmental-behavioral conditions in children. Our faculty have successfully obtained grant funding for many of the projects carried out within this division. Research findings have been nationally disseminated via professional conferences (e.g., The Society for Developmental and Behavioral Pediatrics (SDBP), Pediatric Academic Societies (PAS), National Association of School Psychologists (NASP), International Neuropsychological Society (INS), etc.) and national journals.

Current and past trainees are noted (*).

  • Resiliency in ADHD. This project aims to identify family and child factors associated with resiliency in a national sample of children identified as having ADHD. (Investigators: Pitterle*; Mulé; Sakai)
  • School-Based ADHD Monitoring System (under review). In collaboration with Northeastern University and local school districts, this project seeks to evaluate the feasibility and effectiveness of a school-based ADHD monitoring system applied to clinical management. (Investigators: Pitterle*; Mulé; Sakai)

  • Cultural Considerations in Diagnosis and Management of Autism Spectrum Disorders. Current work involves identification of barriers and facilitators to the diagnosis of Autism Spectrum Disorder across multiple cultural groups, inclusive of:
    • Latino families and Early Intervention perspectives. Funded by Academic Pediatric Association Young Investigator Award. (Investigators: Sakai*)
    • Chinese families and provider perspectives. Funded by Noonan Foundation Grant. (Investigators: Freund; LeClair; Leslie; Mulé; Sakai)
    • Arabic families (Investigators: Al Awami*; Sakai)
  • Evaluation of a Multi-Systemic Treatment Approach for Children with Autism. Using a multi-systemic approach between healthcare and educational systems, this project addresses a recognized area of need for families of children with autism and significant behavioral challenges at risk for residential placement. Funded by Attorney General of Massachusetts (2 years). (Investigators: Goepfert; Leslie; Mulé; Sargent; Sheldrick; von Hahn) 
  • Impact of Parental Health Literacy on Access to Services in Children with Autism. The study assesses parental health literacy and investigates the associations between parental health literacy and service utilization, satisfaction with care, and unmet need. (Investigators: Jacob*; Sakai)
  • Validation of the Parent's Observations of Social Interactions – A Brief Autism Screening Tool. In Press. (Investigators: Perrin, Salisbury, Sheldrick)

  • Screen Early and Accurately for Child Wellbeing (SESAW), an RO1 grant funded by the National Institute of Child Health and Human Development (NICHD). This is a comparative effectiveness study, investigating the accuracy of several developmental screening measures, including two used to detect autism in young children. (Investigators: Restrepo*; Perrin; Sheldrick; )
  • Developmental Disability Literacy Promotion Guide. Project goals are to create materials to help parents read to children with Autism Spectrum Disorder, ADHD, Cerebral Palsy, hearing loss, intellectual disabilities, speech and language problems, reading disabilities, and vision loss. Additionally develop and pilot a curriculum for primary care providers to encourage parents to read to children with developmental disabilities. Community Partners:  Reach out and Read National Center. Funded by NCR and Karen Kames (2017-18). (Investigator: Ultmann)
  • Developmental Screening in Resident Continuity Clinics. This study assessed the comfort level of pediatric and family medicine residents to engage in developmental screening and referral, and their continuity clinic practices. This study seeks to identify factors that might improve developmental screening practices in continuity clinics. (Investigators: Arvidson-Guzman*; Sakai) 
  • Bed Sharing Among Preschool Children and Its Association with Psychopathology. This is a project carried out in collaboration with the Duke University Center for Preschool Anxiety. The findings of a large community-based sample have been presented to a national meeting and are in preparation for publication. (Tufts MC Investigators: Restrepo*; Perrin; Sheldrick)
  • Colocated Mental Health/Developmental Care. Clinical Pediatrics (in press). (Investigators: Hill; Levy; Mattern; McKay; Perrin; Sheldrick)

  • Experiences of Children with Gay Fathers, a survey of gay fathers across the U.S. focusing on the understanding the decision to become fathers, their experience of fatherhood, the stigma they and their children have encountered, and their children‘s well-being. (Investigators: Perrin; Pinderhughes) 

  • Quality of Life Reported by Parents of 10 year Old Children Who Were Born Very Prematurely. Extremely Low Gestational Age Newborns (ELGANs) have a high prevalence of autism, ADHD, anxiety disorders, and other conditions. We are involved in an ongoing study of a cohort of these children, in which our role is to assess their quality of life, as reported by their parents. Funded by Subcontract, R01, 2011-2014. (Investigators: Perrin; Sakai)
  • Psychosocial Functioning in Adolescents Who Were Born Very Prematurely. This study is part of an ongoing study on a cohort of children born at extremely low gestational age. Our role is to assess adolescent mental health needs, cardiovascular outcomes, and quality of life. Funded by Subcontract, R01, NIH Environmental Influences on Child Health Outcomes. (Investigator: Sakai)
  • Promoting Attachment and Co-Regulation in Hospitalized infants with Neonatal Abstinence Syndrome (PATCH-NAS). This study seeks to improve caregiver infant attachment in the setting of neonatal withdrawal syndrome. The study will investigate whether attachment and bonding impact short-term and longer term infant/child outcomes. It investigates maternal infant factors that increase risk for poor boding. Finally, it aims to identify hospital factors that serve as barriers and facilitators to infant-caregiver attachment. (Investigators: Davis; Murzycki; Orinstein; Sakai)
  • Impact of the Newborn Behavioral Observation (NBO) on Residents’ Health Maintenance and Anticipatory Guidance in Newborns. It has long been recognized that the NBO is an effective tool to promote newborn observation and relationship building. This study seeks to investigate whether training residents on NBO will have an impact on their comfort level with providing anticipatory guidance to parents of newborns. (Investigators: Sukkarieh*; Capra; Sakai; Ultmann)

Christina M. Mulé, PhD

Christina M. Mulé, PhD is a Pediatric Psychologist at Floating Hospital for Children at Tufts Medical Center and an Assistant Professor at Tufts University School of Medicine. Dr. Mulé’s work focuses on comparative effectiveness research and health care services research within Developmental-Behavioral Pediatrics and Child and Adolescent Psychiatry. Her research has compared novel educational and behavioral interventions to current gold standard interventions for children with developmental disabilities. Dr. Mulé’s current research is focused on systemic interventions that help to reduce barriers to effective autism interventions and care coordination. She is an investigator of a Massachusetts Attorney General’s Office grant that seeks to evaluate the effectiveness of the innovative Autism Behavioral Consultation (ABC) program at Tufts Medical Center. Finally, through her work at the Clinical Translational Science Institute (CTSI) at Tufts Medical Center she has growing expertise in the area of stakeholder engagement and community-based participatory research.

Current Grant:

Grant Title: Oral Health 2020: Developing a Medical-Dental Collaborative Practice Model (Patterson & Nehring, Co-PIs)
Funding Agency: DentaQuest Foundation
Amount: $188,546
Period: 2016-2017
Role: Investigator

Grant Title: Pathways to Autism Diagnosis and Services in the Chinese Immigrant Community Population
Funding Agency: Deborah Munroe Noonan Memorial Research Fund
Amount: $100,000
Period: 2016-2017
Role: Investigator with Christina Sakai, MD of Tufts Medical Center

Previous Grants:

Grant Title: An Evaluation of a Multi-Systemic Treatment Approach for Children with Autism (Goepfert, PI)
Funding Agency: Attorney General of Massachusetts
Amount: $250,000
Period: 2014-2016
Role: Investigator with Laurel K. Leslie, MD, MPH, John Sargent, MD, R. Chris Sheldrick, PhD and Erik von Hahn, MD of Tufts Medical Center

Grant Title: Ruth L. Kirschstein National Research Service Award (NRSA) Institutional Research Training Grant (Parent T32)
Funding Agency: National Institutes of Health (NIH)
Period: 2014-2015
Role: Post-doctoral Fellow

View Dr. Mulé's publications

Ellen C. Perrin, MD 

Ellen C. Perrin, MD is a Developmental-Behavioral Pediatrician at Floating Hospital for Children at Tufts Medical Center and Professor of Pediatrics at Tufts University School of Medicine. Her clinical and research interests include children’s understanding of illness concepts, the management of developmental and behavioral issues and chronic health problems in primary care, and children in nontraditional families. She and Dr. Chris Sheldrick developed the Survey of Wellbeing of Young Children (SWYC) in response to the growing interest in comprehensive monitoring of children’s development in primary care and other settings.

Current Grants:

Grant Title: Comparative Effectiveness of Developmental-Behavioral Screening Instruments
Funding Agency: National Institute of Child Health and Development (NICHD)
Amount:$3,318,039
Period: 2013-2017

Grant Title: The Survey of Wellbeing of Young Children
Funding Agency: JPB Foundation
Amount: $41,000
Period: 2015-2017

View Dr. Perrin's publications.

Christina Sakai, MD

Christina Sakai, MD is a board-certified Developmental-Behavioral Pediatrician and a Pediatric Hospitalist at Floating Hospital for Children at Tufts Medical Center and an Assistant Professor of Pediatrics at Tufts University School of Medicine. Dr. Sakai’s work focuses on the social-cultural context within which complex medical illness and neurodevelopmental issues are understood and managed. Dr. Sakai’s current research is focused on addressing barriers to care for children with autism in various immigrant cultures.

Current Grants:

Grant Title: Extremely Low Gestational Age Newborns/Environmental Influences to Child Health Outcomes
Funding Agency: NIH
Amount: Subcontract
Period: 2016-2018
Role: Site Principal Investigator

Grant Title: Pathways to Autism Diagnosis and Services in the Chinese Immigrant Community Population
Funding Agency: Deborah Munroe Noonan Memorial Research Fund
Amount: $100,000
Period: 2016-2017
Role: Investigator with Christina Mulé, PhD of Tufts Medical Center

Previous Grant:

Grant Title: Cross Cultural Considerations in Autism Diagnosis and Management Young Investigators Award
Funding Agency: Academic Pediatric Association/Bright Futures
Period: 2013-2014
Role: Principal Investigator 

View Dr. Sakai's publications

Monica H. Ultmann, MD

Monica Ultmann, MD is a Developmental-Behavioral Pediatrician and Director of the CCSN at Floating Hospital for Children, Division Director of Developmental-Behavioral Pediatrics in the Department of Pediatrics, and Clinical Professor of Pediatrics at Tufts University School of Medicine. Dr. Ultmann’s advocacy and research interest is in literacy emergence in children with developmental disabilities. Working collaboratively with the Reach Out and Read (ROR) National Center, she wrote a training manual for Pediatric Primary Care Providers in 2010, “Developmental Disabilities Literacy Promotion Guide for Pediatric Healthcare Providers,” which is currently being updated and will include a training module for ROR providers, and will be piloted in practices nationwide.

Current Grant:

Grant Title: Developmental Disabilities Literacy Promotion Guide and Curriculum for Pediatric Healthcare Providers
Funding Agency: NCR and  Karen Kames
Period: 2017-2018
Community Partner: Reach Out and Read National Center

Previous Grant:

Grant Title: Developmental Disabilities Literacy Promotion Guide and Curriculum for Pediatric Healthcare Providers
Funding Agency: CVS Caremark Foundation
Period: 2011-2012
Community Partner: Reach Out and Read National Center

View Dr. Ultmann's publications

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