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.   

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    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. 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:

    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:

    The Australian Cerebral Palsy Register

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

    This was launched on 31 July, 2007. Data is combined at the age of 5 years to achieve a National Register and the first report has been published. The clearing house is located at the Cerebral Palsy Research Institute in New South Wales.

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

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

    The aim of this project is 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) have been obtained from mothers and their children with cerebral palsy.

    Magnetic resonance imaging findings in a population-based cohort of children with cerebral palsy

    Reid S, Dagia C, Ditchfield M, Reddihough D.

    The aim of this project is to examine, describe and classify patterns of cerebral abnormalities found on magnetic resonance imaging (MRI) in a large population-based cohort of children with cerebral palsy (800 children) born in Victoria between 1999 and 2006. These MRI findings will be correlated with data available in the Victorian Cerebral Palsy Register. 

    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:

    • FAB Trial - Multi-site randomised controlled trial of Fluoxetine in children and adolescents with autism Clinical features and MRI findings in children with cerebral palsy and periventricular white matter injury
    • Evaluation of the "Mother Goose" Program
    • The role of Botulinum toxin therapy for children with saliva control problems
    • The prevalence of drooling in children with cerebral palsy living in Victoria
    • 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)
    • Quality of life within multiple birth families with children with special needs
    • A population-based study of health and quality of life in young adults with cerebral palsy
    • The development of a database for children with Prader-Willi Syndrome

    FAB Trial - Multi-site Randomised Controlled Trial of Fluoxetine in Children and Adolescents with Autism

    Reddihough D, Marraffa C, Kohn M, Hazell P, Wray J, Lee K, Silove N, Dossetor D, Whitehouse A, Kloprogge S, Paramala S, Reid S.

    This NHMRC funded multisite study aims to determine the efficacy and safety of fluoxetine for treating repetitive behaviours in children and adolescents with autism spectrum disorders. The study is recruiting children aged between 8 and less than 18 years of age with troublesome, restricted, repetitive and stereotyped behaviours,

    Clinical features and MRI findings in children with cerebral palsy and periventricular white matter injury

    Reddihough D, Imms C, Ditchfield M, Beare R, Eldridge B, Rodda J, Lee K, Reid S, Harvey A, Randall M, Dagia C.

    The aim of this study is to determine the clinical outcomes of children (for example, gross motor and upper limb function) with the particular MRI finding of periventricular white matter injury on their brain scans. Children with cerebral palsy born between 1999 and 2006 inclusive will be recruited.  We are particularly interested to understand whether those born prematurely differ in their clinical outcomes to those born at term. 

    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 has been undertaken in conjunction with the AustralianCatholicUniversity.

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

    Reid S, Johnstone B, Chong D, Westbury C., Walstab J, Reddihough D.

    After completing a randomised study of the outcomes of using Botulinum toxin for saliva control problems, we are now doing further work to document the benefits and side effects of this intervention more clearly.

    The prevalence of drooling in children with cerebral palsy living in Victoria

    McCutcheon J, Johnson H, Reid S, Westbury C, Lionti T, Reddihough D.

    The primary aim of the study was to investigate the prevalence of drooling in children with Cerebral Palsy (CP) living in Victoria who were born between January 1, 1996 and December 31, 2001. The prevalence of drooling was also examined across subgroups of children with CP, according to the functional severity, type and topographical distribution of the movement disorder, and presence of various comorbid factors.

    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)

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

    Following the successful development of the CP-QOL-Child, this project has now developed a measure of health related quality of life of adolescents 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

    Quality of life within multiple birth families with children with special needs

    Bolch C, Umstad M, Fisher J, Davis P, Reddihough D.

    This project is exploring the quality of life within families of multiple birth children (twins, triplets etc) with disabilities. Analysis of data will allow estimation of the prevalence of disability amongst multiples and the identification of family and individual characteristics rendering members of a family particularly vulnerable to experiencing poor quality of life. Determining which of those characteristics might be amenable to change has important implications for providers of care to multiple birth families with children with disabilities.

    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.

    This study aimed to determine the health and quality of life of young adults aged 20-30 years with cerebral palsy. A postal questionnaire was dispatched to several hundred young people.Papers are in preparation.

    Prader-Willi Syndrome

    The Victorian Prader-Willi Syndrome Register

    Lionti T, Rowell M., Reid S. 

    Prader-Willi syndrome is a neurogenetic characterised by severe infantile hypotonia and failure to thrive at birth, delayed motor milestones, learning disabilities, abnormal growth patterns and development of hyperphagia in early childhood. The hyperphagia continues throughout adulthood, creating a substantial risk for life-threatening conditions including obesity. We have developed a Register to determine the outcomes of this condition with the hope of reducing the considerable morbidity associated with it. 

      

    Other Projects

    Potential for cord blood stem cells to treat cerebral palsy

    Stem cells have the potential to treat a number of diseases, and there is research being conducted worldwide to find out more about their uses. At present only a few of the potential uses for stem cells have been shown to be effective; for example, to treat blood and bone marrow disorders, metabolic disorders and graft-versus-host disease following an organ transplant.

    Stem cells from umbilical cord blood are the simplest and safest to use because they are plentiful, freely available, have low risk of being rejected from the body and they have been used safely in children to treat blood-based diseases for many years. Over the past few years, the possibility of using cord blood stem cells to treat neurological disorders such as cerebral palsy (CP) has been raised. Early studies in CP show mixed results but they show that the treatment is safe, which has led to a small number of clinical trials starting internationally.

    We have looked at a range of options for testing cord blood stem cells as a therapy for CP. Now, together with researchers at other sites in Melbourne, Sydney and Brisbane, we are planning a small clinical trial for children with CP who have either their own or a sibling’s cord blood in storage. The aims of this study will be to look at whether a cord blood cell injection is safe; whether it works when combined with intensive therapy; and if it works, how it might work. This study will gather information to guide future research; it will not tell us any definite answers as to the value of injecting stem cells into children with CP. The final aim for this study is to find out whether a large Australian trial of this use of stem cells is feasible.

    Current status: Planning stage

     

     

    Hearing impairment in cerebral palsy

    Modak M, Reid S, Berkowitz R, Reddihough D.

    Hearing impairment is reported to occur in approximately 12% of children with cerebral palsy. Early assessment and identification of hearing impairment lies in its potential impact on a child's speech-language, cognitive, and psychosocial development. This project aims firstly to determine current data on the frequency of hearing problems in children with cerebral palsy to make international comparisons and to gauge the extent of the problem for service providers. Secondly we hope to gather up to date information about the possible causes of hearing impairment in a recent cohort of children with cerebral palsy, to increase knowledge of the area and to determine whether there are any ways of preventing this added comorbidity. 

    Speech and language development in cerebral palsy

    Mei C, Morgan A, Reilly S, Mensah F, Reddihough D

    This study will use a population-based cohort to determine the frequency and range of speech and language impairments in children with cerebral palsy. The features of speech and language impairment in these children will also be determined.The proposed study will provide clinicians with a greater understanding of speech and language development in children with cerebral palsy which will contribute to early detection and intervention for these children and their families. 

    Cognitive outcomes in children with cerebral palsy

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

    A cohort of 4-5 year old children with cerebral palsy have been seen for a cognitive assessment to determine more about the various learning difficulties in children with cerebral palsy. The results are currently being analysed.

    Motor Imagery Ability of children with cerebral palsy

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

    The aim of this work is to determine whether children with mild spastic hemiplegia have a deficit in the ability to utilise motor imagery. A project has been completed and more work is underway in this area. 

    Obesity in children with disabilities

    Lionti T, Sabin M, Reddihough D.

    The aim of this project is to compare the degree of hyperphagia present in three groups of children; those those with lifestyle-related obesity, those with Prader-Willi Syndrome and a group of overweight or obese children with intellectual disability. We also hope to determine if there is a difference in physical activity levels and dietary quality between the same three groups. It is hoped that the outcomes of this study will assist clinicians in managing weight problems in children with obesity and disabilities.

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

    Kothrakis H, Harvey D, Reddihough D.

    Helen Kathrakis is a PhD student from MonashUniversity. This study is nearing completion.