Tim is a developmental pediatrician studying how early social experience (prenatal maternal mental illness and psychotropic medication exposure) influences the developmental origins of stress and self-regulation and its impact on thinking, learning and behaviour during childhood.
Tim's research extends from studies of child behaviour at the individual to population levels that seeks to understand how in utero exposure to maternal mood and selective serotonin reuptake inhibitor (SSRI) antidepressants sets pathways for both developmental risk and resiliency during early childhood. His work provides strong evidence that both influences have an impact on stress regulation and mood in childhood, possibly reflecting early changes in central serotonin (5HT) levels.
Increasingly Tim's work is showing that the developing brain has a remarkable capacity for change, such that even in the face of adversity, some children do very well. The goal of his work is to figure out how and why this happens, and use these findings to identify opportunities for interventions that reduce risk. Emerging findings are beginning to point to ways that could possibly assist clinicians and families in understanding critical issues that influence a child’s emotional well-being and academic success later in school. As Project Lead for CFRI’s 3T MR Imaging facility he has the opportunity to advance studies of early brain development using advance imaging technology.
Main areas of research:
Developmental effects of prenatal psychotropic medication exposure – fetal, neonatal, infant and childhood outcomes: This research focuses on studies of the developmental impact of prenatal exposure to psychotropic medications (i.e. selective serotonin reuptake inhibitor [SSRI] antidepressants) and depressed maternal mood that extends from fetal periods to early adolescence. Biobehavioural, pharmacologic and genetic factors that moderate fetal exposure are studied. Outcomes of particular interest are pain/stress reactivity (neuroendocrine, heart variability), cognitive function (executive functions), attention threat bias, and measures of arousal and emotional regulation. This work also includes examination of the role of key genetic (i.e. SLC6A4) variations and epigenetic (i.e. methylation) factors that may also contribute to altered early serotonin levels.
Pharmacoepidemiology and Child Development: Since 2004 researchers have used population level health data linking antenatal maternal prescription records with birth/neonatal health records to distinguish the impact of maternal mood from in utero SSRI exposure. Researchers have reported novel findings indicting that the effects of gestational maternal SSRI use differ from those of maternal mental illness and that neonatal outcomes vary with the timing and duration of prenatal SSRI exposure. Recently, researchers have started examining developmental and behavioural outcomes (learning, mood and autism spectrum disorder risk, ASD) related to in utero SSRI exposure, socioeconomic conditions and maternal mental health.
Pain and children with developmental disabilities: This research seeks to understand pain in children with developmental disabilities. The current focus of this work is to improve pain assessment management among this population of children.