Developmental Medicine

Leadership

William O. Walker, MD
Professor
Robert A. Aldrich Endowed Professor in Pediatrics
Division Chief
Director, Neurodevelopmental/Birth Defects Clinic

Overview

The Division of Developmental Medicine is committed to providing an outstanding level of patient care, education and research.

Clinical Programs

The Developmental Medicine division evaluates and cares for children with conditions related to the development of the nervous system, including the brain. We specialize in the care of children with special needs, and tailor our services to the individual child and family.

We see children with many conditions, including: autism spectrum disorders, brain and nervous system problems, cerebral palsy (CP), developmental delays in language skills and in controlling muscle movement (motor skills), Hydrocephalus, Premature Birth, the evaluation and management of spasticity, Spina bifida and other neural tube defects, Tourette Syndrome (TS). We also provide prenatal consultation to mothers identified to have a fetus with central nervous system abnormalities in conjunction with the Prenatal Center.

For appointments, please call: Neurodevelopmental/Birth Defects Clinic: (206) 987-2210

Research Programs

William O. Walker, MD
Professor and Division Chief
Director, Neurodevelopmental/Birth Defects Clinic

Dr. Walker has research projects underway on the issue of bowel and bladder continence management in spina bifida as part of a collaborative agreement between the Association of University Centers on Disability and the National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. He has participated in  research projects evaluating the role of assistive devices in promoting health and reducing the onset, severity and impact of secondary conditions in patients with spina bifida. Dr. Walker and the University of Washington are one of eight sites participating in a national Spina Bifida Registry project.

Kristie F. Bjornson, PhD, PT, PCS
Assistant Professor
Research Affiliate, Center on Human Development and Disability
Coordinator, Research Emphasis Area on Neurodegenerative Disorders
Dr. Bjornson's research is concerned with evidence-based clinical interventions to improve the activity and social participation of persons with cerebral palsy. A related interest is to develop a methodology to enable rigorous testing of the effectiveness of various current and emerging treatments (e.g., orthotics, physical activity/exercise, and physical therapy timing and frequency) on relevant outcomes (e.g., ambulatory and physical activity, participation in daily life).
Dr. Bjornson's current research focuses on ambulatory children with cerebral palsy, ages 2-9 years. A primary goal is to understand the relationship between aspects of the International Classification of Functioning system and children's participation in daily life activities.

Charles Cowan, MD
Clinical Professor
Dr. Cowan has recently completed research related to variation and utilization patterns in bronchiolitis and is a co-author on a paper with Dr. Dimitri Christakis entitled "Variation in Inpatient Diagnostic Testing and Management of Bronchiolitis." He has additional clinical research in progress looking at bladder augmentation in spina bifida and plans studies using computers to aid in the diagnosis of autism.

Daniel A. Doherty, MD, PhD
Associate Professor
Research Affiliate, Center on Human Development and Disability

Dr. Doherty’s research interests focus on hindbrain malformations as a way to understand human brain development and common disorders such as intellectual disability, autism, ataxic cerebral palsy and even mental health disorders such as schizophrenia. The hindbrain regulates basic functions (level of consciousness, heart rate, respiratory rate), coordinates balance, limb and eye movements, as well as having possible roles in cognition and emotional regulation. His group uses a variety of genetic techniques (SNP mapping, array CGH, and high throughput sequencing) to identify the genes responsible for hindbrain malformation disorders such as Joubert syndrome. Identifying the genes responsible for a disorder immediately translates into molecular diagnostic testing, and detailed work on genotype-phenotype correlations improves diagnostic, prognostic and medical management information for patients. In addition, Dr. Doherty’s group and his collaborators use the disease genes to dissect the molecular mechanisms of normal and abnormal brain development in vitro and in animal models. The human hindbrain is a fascinating system in which to study the role of basic developmental processes (spatially restricted gene expression to define positional information, organizing centers, morphogenetic movements, cell-cell and long-range signaling, cell migration and axon guidance) in human disease.

John McLaughlin, MD
CHDD Director, Professor
Director, Spasticity Management Clinic

Dr. McLaughlin's research program is aimed at developing better treatments for persons with cerebral palsy and other disabilities. This includes studies of the long-term effects of selective dorsal rhizotomy and continuous intrathecal baclofen using an implantable pump. Dr. McLaughlin is involved in studies of the incidence of pain and fatigue in persons with cerebral palsy and in developing outcome measures for quality of life.

John P. Welsh, PhD
Professor of Pediatrics
Dr. Welsh’s research focuses on the role of brain rhythms in cognitive and motor function.  He and his colleagues are studying the role of high frequency thalamocortical rhythms in tests of auditory function that can be diagnostic of language insufficiency in autism.  For this work, Welsh’s group uses behavioral tests in normal and genetically-altered rats and combines them with multiple microelectrode neurophysiology of neocortical function to examine the circuitry mechanisms that underlie the expression of high-frequency brain rhythms.  The goal of this research is to better understand the reasons why children with autism are unable to generate high-frequency brain rhythms in the cerebral cortex, leading to an inability to rapidly process sound sequences and learn language during a critical period of brain development.

Welsh’s other research projects address brain activity dysfunction during recovery from ischemic stroke and in the motor disorder of dystonia.  Global hypoxic-ischemic injury to the brain during birth is a significant cause of neurological disability affecting the cerebellum and hippocampus, causing long-term disability in motor and memory function.  Pediatric dystonia of genetic or acquired origin causes inadvertent movements to be involuntarily expressed in the middle of otherwise normal voluntary movement.  Current projects are to use animal models of hypoxic injury and dystonia in order to elucidate the circuitry mechanisms underlying pathological brain activity states in these disorders.

Samuel Zinner, MD
Associate Professor
Dr. Zinner pursues clinical and research interests with a strong focus on psychosocial and behavioral aspects of neurodevelopment. Within the subspecialty field of Developmental and Behavioral Pediatrics (DBP), Dr. Zinner has a particular interest in Tourette syndrome and its associated conditions, including Attention Deficit Disorders, learning disabilities and anxiety disorders among others in the context of family and other social influences. Dr. Zinner provides outpatient care services with the Birth Defects Clinic at Seattle Children's; the Child Development Clinic at the Center on Human Development and Disability (CHDD); and the Autism Center, also at the CHDD.  He is the coordinator for the pediatric DBP resident rotation. Current research activities will explore behavioral intervention for youth with Tourette syndrome; and barriers & successful strategies in effective pediatric residency training in DBP. Dr. Zinner is a member of the medical advisory board for the national Tourette Syndrome Association, Inc.

Training Programs

Established in 1975, the Developmental Behavioral Fellowship program has a long history of successfully producing leaders in developmental disabilities care, research and education. This 3 year program is fully accredited and approved by the ACGME. Our faculty members have a wide variety of interests and serve a diverse group of patients. Opportunities for collaboration with other internal and external fellowship programs allow our fellows to cross departmental and institutional lines to tailor a fellowship experience that best fits their interests.

For more information, please visit the Developmental Behavioral Pediatrics Fellowship page.

Fellowship contacts

Chris Wong
Fellowship Coordinator, Developmental/Behavioral Pediatrics
chris.wong@seattlechildrens.org, (206) 987-3664

William Walker
Fellowship Director, Developmental/Behavioral Pediatrics
william.walker@seattlechildrens.org, (206) 987-2210

John McLaughlin
Project Director, Leadership Education in Neurodevelopmental Disabilities (LEND) Training Program, Clinical Training Unit
jfmcl@u.washington.edu, (206) 685-1350
http://depts.washington.edu/lend

Sam Zinner
Developmental/Behavioral Pediatrics Rotation
szinner@u.washington.edu, (206) 685-1290
http://depts.washington.edu/dbpeds/