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Research Projects

Research is an important activity of the Department and has two important aims; firstly to learn more about the causes of childhood disability; and secondly, to improve treatment methods to ensure the best possible outcomes for children and their families. Our research program has focussed on cerebral palsy but we are broadening the agenda to investigate other conditions associated with developmental disability in childhood. A key feature of our program is our collaboration with other departments within the hospital, particularly orthopaedics, plastic surgery and allied health. But over the years, we have had joint projects with many others. In addition, we collaborate with community agencies including Yooralla and Scope.   

The current Research Team

Causes of childhood disability

Our research program in this area has focussed on cerebral palsy, the commonest cause of physical disability in childhood. 

Current projects are as follows:

• The Victorian Cerebral Palsy Register
• The Australian Cerebral Palsy Register
• Factor V Leiden mutation: a contributory factor for cerebral palsy?
• Intrauterine infection: role of the kynurenine pathway in causing perinatal brain damage and multi-organ failure
• Relationship between cerebral palsy and maternal blood groups, particularly rhesus factor
• Cerebral palsy and assisted reproductive technologies: a case control study
• Magnetic Resonance Imaging findings in a population-based cohort of children with cerebral palsy
• The prevalence of bowel disorders in autism
• Analysis of the relationship of DNA copy number variation to phenotypic variation in Down syndrome and development of a non-invasive prenatal diagnostic test based on paternal DNA copy number deletions

 

The Victorian Cerebral Palsy Register

Reid S., Lanigan A., Reddihough D.S.

The purpose of the Victorian Cerebral Palsy Register is to generate new information about the causes and prevalence of cerebral palsy in Victoria. The database created also forms a pool of names for many of the other projects within the Department. There are currently almost 4,000 names on the Register. The Victorian Register is in an unique position as it draws from a larger population than most other similar registers, enabling larger cohorts to be recruited for specific studies and increasing the potential for subgroup analysis in our epidemiological research.

A brochure about the Register can be obtained by clicking on the link below:

• Register Brochure    (PDF 155 KB)

Families or individuals with cerebral palsy may give their consent for their names to be included on the Register or to be contacted for research projects. The consent form is available below:

• Consent Form  (PDF 32 KB)

The Australian Cerebral Palsy Register

Reid S., Lanigan A., Reddihough D.S.

This was launched on 31 July, 2007. There were several national meetings prior to this. Data have yet to be combined to achieve a National Register and ascertainment in some states is still incomplete. The clearing house will be located with the New South Wales Register.

Factor V Leiden mutation: a contributory factor for cerebral palsy?

Reddihough D.S., Halliday J., Ekert H., Ditchfield M., Byron K.

Two mutations have been identified in recent years that predispose carriers to venous thrombosis (thromboembolism). One is a mutation localised to the factor V gene called the Factor V Leiden mutation. It is questioned whether the presence of this mutation may predispose children to cerebral palsy. This study was funded by NHMRC. One paper has been published and the second paper is in preparation.

Intrauterine infection: role of the kynurenine pathway in causing perinatal brain damage and multi-organ failure

Walker D., Manuelpillai U., Wallace E., Reid S., Reddihough D.S.

It has been suggested that a substance called quinolinic acid which is on the kynurenine pathway, may contribute to some cases of periventricular leukomalacia, which is the common MRI brain scan finding in premature children with cerebral palsy. An MCRI project grant was received for this study which is a joint project with the Department of Obstetrics and Gynaecology at the Monash Medical Centre.  

Relationship between cerebral palsy and maternal blood groups, particulary rhesus factor

Reid S., Westbury C., Savoia H., Reddihough D.S.

To determine if there are differences between Rhesus blood group status of children with cerebral palsy due to previous thromboembolic events, and their mothers. Blood groups (Rh, ABO) are being obtained from mothers and their children with cerebral pasly.

Cerebral palsy and assisted reproductive technologies: a case control study

Susanto C., Jaques A., Reid S., Reddihough D.S., Halliday J.

The relationship between assisted reproductive technologies and the outcome of cerebral palsy is being investigated in collaboration with Public Health Genetics (MCRI).

Magnetic Resonance Imaging Findings in a population-based cohort of children with cerebral palsy

Robinson M., Peake L., Reddihough D.S., Ditchfield M., Reid S., Lanigan A.

This is a comprehensive review of the MRI findings of 221 children with cerebral palsy, excluding postneonatal causes, born in Victoria in 2000 and 2001.

The prevalence of bowel disorders in autism.

Antolovich G., Marraffa C., McVeigh-Dowd A., Walstab J.

This is a study to determine the frequency of bowel problems and other related disorders in young children with autism spectrum disorders, who are being compared with age matched controls. This study is in progress.

Analysis of the relationship of DNA copy number variation to phenotypic variation in Down Syndrome and development of a non-invasive prenatal diagnostic test based on paternal DNA copy number deletions

Slater H., Reddihough D.S., Bruno D.

The aim of this project is to develop a safe test for Down syndrome which can be used by women in the early stage of pregnancy, utilising a routine pap smear sample.

Evaluation of outcomes to improve treatment methods

The other major focus of our research program is an evaluation of treatment strategies so that the best interventions can be put in place for children and their families.

Current projects are as follows:

• Improving the outcomes of premature infants: a randomised trial of preventative care at home
• Early childhood intervention: do more intensive services improve outcomes for children with developmental delay and their families?
• Evaluation of the "Mother Goose" Program
• The role of Botulinum toxin therapy for children with saliva control problems
• Development and validation of the drooling impact scale
• Development of a health-related quality of life instrument for children with cerebral palsy: self-report version (CP QOL-Child?)
• Development of a health-related quality of life instrument for adolescents with cerebral palsy: an extension of the cerebral palsy quality of life questionnaire for children (CP QOL-Child? )
• Exploring the quality of life of parents of children with cerebral palsy
• Think aloud: Parent proxy and child self reports of quality of life for children with cerebral palsy. Determining cognitive explanations for discordance
• A population-based study of health and quality of life in young adults with cerebral palsy
• Botulinum Toxin A therapy in the management of children with cerebral palsy (upper limb study)
• The use of an implantable pump to reduce spasticity and improve functional outcomes
• The Victorian Cerebral Palsy Surveillance Program
• Hip dysplasia in children with Rett Sydnrome
• The development of a database for children with Prader-Willi Syndrome
• Epilepsy in children with hemiplegic cerebral palsy

Improving the outcomes of premature infants: a randomised trial of preventative care at home

Doyle L., Inder T., Boyd R., Reddihough D.S.

This is an NHMRC study where extra intervention for premature infants at risk of cerebral palsy is being provided at home. There is a control group who will continue to receive regular community based services and the intervention group will receive an extra home based program.

Early childhood intervention: do more intensive services improve outcomes for children with developmental delay and their families?

Reddihough D.S., Rickards A., Walstab J. 

This project aims to determine whether a home based service, provided in addition to a centre-based service, leads to better outcomes for both children and families. The project is being undertaken at the Uncle Bobs Child Development Centre. Children with developmental delays or disabilities were recruited and randomised to receive either the conventional program, or the conventional program with an additional home based service provided for a 12 month period. Children were followed for a two year period to assess whether any beneficial effects are sustained. One paper has been accepted for publication and the second paper is in preparation.  

Evaluation of the "Mother Goose" program

Spreckley M., Rickards A., Walstab J., Simpson J., Tuck J.

This is a new model of service delivery aiming to increase language skills and social development in young children with developmental disabilities or who are disadvantaged. Evaluation is being undertaken in conjunction with the Australian Catholic University.

Saliva Control

The role of Botulinum toxin therapy for children with saliva control problems

Reid S., Johnstone B., Westbury C., Reddihough D.S.

This is a randomised trial whereby Botulinum toxin was injected into the salivary glands to reduce drooling. The paper resulting has been accepted for publication. We hope to do further work to document benefits and side effects more clearly.

Development and validation of the drooling impact scale

Reid S., Westbury C., Johnson H., Reddihough D.S.

This is a new measure that will be of use in evaluating the outcomes of treatment.

Quality of Life

Development of a health-related quality of life instrument for children with cerebral palsy: self-report version (CP QOL-Childﾩ)

Davis E., Waters E., Boyd R., Reid S., Reddihough D.S., Mackinnon A., Graham H.K.

Following the successful development of the CP-QOL-Child, this project will continue to gain data about the properties of this instrument for self report in children with cerebral palsy aged 9-12 years. 

Development of a health-related quality of life instrument for adolescents with cerebral palsy: an extension of the cerebral palsy quality of life questionnaire for children (CP QOL-Childﾩ )

Davis E., Waters E., Boyd R., Reid S., Reddihough D.S., Mackinnon A., Graham H.K.

Following the successful development of the CP-QOL-Child, this project will develop a measure of health related quality of life from the point of view of both the parents and the young people themselves. There is international collaboration in this project with centres in North America. 

Exploring the quality of life of parents of children with cerebral palsy

Davis E., Waters E., Reddihough D.S., Boyd R., Cook K., Shelly A., Reid S.

This project aims to explore the quality of life of parents/primary caregivers of children with cerebral palsy aged from 3-18 years. We want to examine how the quality of life of parents/primary caregivers varies depending on the child's age as well as understanding  the parental views on recommendations for support services.

Think aloud: Parent proxy and child self reports of quality of life for children with cerebral palsy. Determining cognitive explanations for discordance 

Davis E., Waters E., Boyd R., Reid S., Reddihough D.S., Mackinnon A., Graham H.K.

This study aims to determine why parents of children CP and the children themselves, report different levels of QOL. Interviews will be conducted with 20 parents and 20 children aged 9-12 years. This study will use the think-aloud technique. The "think aloud" approach is a qualitative technique for understanding the cognitive processes that individuals engage in when attempting to respond to questionnaire items. Parents and children will be given the CP-QOL - Child questionnaire to complete and instructed to talk to the inteviewer whilst considering their responses. Qualitive analysis will be conducted to assess the similar concordance in reasoning behind answers, the interpretation of key terms and the response styles of parents and children.

A population-based study of health and quality of life in young adults with cerebral palsy 

Jiang B., Davis E., Walstab J., Lanigan A., Reid S., Reddihough D.S.

This study aims to determine the health and quality of life of young adults aged 20-30 years with cerebral palsy. A postal questionnaire is being dispatched to several hundred young people.

Spasticity Management

Botulinum Toxin A therapy in the management of children with cerebral palsy (upper limb study)

Olesch C., Imms C., Reddihough D.S., Graham H.K.

This study aims to evaluate the functional outcomes following administration of Botulinum toxin A in young children (aged 18 months to five years) with hemiplegic cerebral palsy. This study is nearing completion.

The use of an implantable pump to reduce spasticity and improve functional outcomes

Olesch C., Antolovich G., Zdolsak H., Reddihough D.S.

Spasticity is a major problem for many individuals with cerebral palsy. The Departments of Developmental Medicine, Neurosurgery, Physiotherapy and Orthopaedics are working together to evaluate some of the treatments that have become available for the management of spasticity. One such treatment is the use of an implantable pump which delivers medication (baclofen) around the spinal cord. This type of device has application for a relatively small number of young people. It is important for us to define which children are likely to benefit and to document the potential problems with the use of such technology.

Hips

The Victorian Cerebral Palsy Surveillance Program

Reddihough D.S., Lanigan A., Reid S., Graham H.K.  

The main purpose is to improve the health and quality of life of young people with cerebral palsy. This will be achieved by instituting a state wide surveillance program in order to prevent the serious long term consequences of untreated problems, particularly hip displacement, hearing and visual difficulties and nutritional issues. The program is being linked with the Victorian Cerebral Palsy Register to ensure complete ascertainment and to expand knowledge about the Register both to parents and professional groups.

Hip dysplasia in children with Rett Syndrome

Baikie G., Graham H., Reddihough D.S., Graham H.K. 

This project aims to establish the rate of hip displacement in children with Rett Syndrome. The objective of the project was to determine how families perceive the role of the general practitioners and how well they believed that the Department of Developmental Medicine communicated with the GP. As a second part of the project, questionnaires were sent to general practitioners to establish their opinion about how well the specialist service communicated with them.

Prader-Willi Syndrome  

The development of a database for children with Prader-Willi Syndrome

Rowell M., Reid S. 

Prader-Willi Syndrome is a distressing condition. It is hoped to follow the children very carefully in efforts to prevent the considerable morbidity associated with uncontrolled obesity. It is planned to undertake a study to determine the quality of life of individuals with Prader-Willi Syndrome.

Other Projects

Epilepsy in children with hemiplegic cerebral palsy

Wanigasinghe J., Harvey S., Mackay M., Reddihough D.S., Reid S., Freeman J.

This study is about the type and nature of the seizure disorder in children with hemiplegic cerebral palsy. We hope around 65 children with cerebral palsy and their parents will take part in this project. Some of these children  will have epilepsy but others will not and we would like to study both groups.

Cognitive outcomes in children with cerebral palsy

Shewell S., Stargatt R., Wrennall J., Reid S., Reddihough D.S.

A cohort of 4-5 year old children with cerebral palsy will be seen for a cognitive assessment to determine more about the various learning difficulties in children with cerebral palsy.

Motor Imagery Ability of children with cerebral palsy

Williams J., Reddihough D.S., Anderson V., Reid S.

The aim is to determine whether children with mild spastic hemiplegia have a deficit in the ability to utilise motor imagery. A minimum of 42 children aged 8-12 years with mild spastic hemiplegia will be recruited from the Victorian Cerebral Palsy Register. 

Communication between families, general practitioners and the Royal Children's Hospital concerning children with developmental disabilities; how is it happening and how can it be improved?

Letlole F., Walstab J., Reddihough D.S.

The main objective of this research is to examine the perceptions of parents and general practitioners about the way communication occurs between them and the Department of Developmental Medicine. A further objective is to seek their views on how communication can be improved to facilitate the care of children with disabilities and their families.

Culture, coping and marital adjustment of parents of children with disability

Kothrakis H., Harvey D., Reddihough D.S.

Helen Kathrakis is a PhD student from Monash University. This study is in progress.

Communication in the Medical Consultation: Perceptions of paediatricians, children with cerebral palsy and their parents.

Garth B., Murphy G., Reddihough D.S. 

Work in this area is continuing with the completion of Belinda Garth's PhD in 2005.