Carrie E. Bearden, Ph.D.*, Maria Jalbrzikowski, Jennifer Ho, Carolyn Chow, and Chelsea Anderson

Departments of Psychiatry and Biobehavioral Sciences and Psychology

Semel Institute for Neuroscience and Human Behavior University of California, Los Angeles

cbearden@mednet.ucla.edu Phone: 310-206-2983

18th International Scientific Meeting of the VCFS Educational Foundation

Newark, NJ July 15-17 2011

Intervention for Social Skills Deficits in Children with 22q11.2 Deletion Syndrome

(VCFS)

Presentation Outline

Characterization of social deficits in children nad adolescents with 22qDS Treatment approaches for social deficits

Exercise-induced brain plasticity Neuroplasticity as a pre-requisite for treatment response?

Development of a possible intervention

ADHD

Autism

22q11.2

microdeletion

OCD

Anxiety Disorders

Psychosis

ADHD

Autism

22q11.2

microdeletion

OCD

Anxiety Disorders

Psychosis

Neural Features

-Anomalous myelination

- Dopamine Neurotransmission

Social Problems

Psychosocial Profile of Children with 22q11DS: Child Behavior Checklist

At-

risk

Norm

al

Range Philadelphia

(CHOP)

UCLA

Characteristic Social Deficits

Autistic Spectrum

Poor regulation of social interaction through eye contact, facial expression, gesture, posture, intonation

Failure to develop age-appropriate peer relationships

Limited social-emotional reciprocity

Preoccupations/ restricted interests

Theory of mind/perspective-taking

Schizotypal Spectrum

Social anhedonia

Poor recognition of emotional expression

Excessive social anxiety

Cycle of bullying/teasing

Bearden et al. Cer Cortex 2009 Gray Matter Thinning in : -anterior cingulate and medial frontal cortex (social cognition network) -occipito-parietal cortex (visuospatial navigation)

Publications on Brain Imaging, Genetics and Cognition in VCFS

We need more/better psychosocial treatments for children and teens

with VCFS!!

Interventions for Social Deficits in ASD Using Peer Group

-Peer-mediated practice to improve social interactions for children with autism during recess activities -Peers are taught Pivotal Response Training (PRT) strategies: gaining attention, varying activities, narrating play, reinforcing attempts, and turn-taking

Number of independent appropriate attempts for social initiations/ gaining attention directed at peers

-Link between hippocampal neurogenesis, stress-induced behavioral changes, and beneficial effects of enriched environment. -Social stress in mice can cause behavior resembling human depression -Behaviors can be ameliorated if mice are in an environment that promotes exercise and exploration. -Beneficial effect of activity depended on the growth of new neurons in the adult brain.

Treatment Rationale: Restorative Power of Exercise

Additive effects of exercise and environmental enrichment on adult

neurogenesis

Exercise also increases hippocampal volume in patients with schizophrenia

Pajonk et al Arch Gen Psych 2010

Social Exercise Remediation Program

Exercise may provide the optimal platform in which remediation effects can occur

New treatment will integrate social activities with physical exercise program

While physical exercise can boost brain development, social element may differentially improve social function and self-esteem

Summary and Implications

Children with 22qDS are at increased risk for a variety of psychiatric symptoms, and social deficits are a component of many disorders

Poor social function very common in 22qDS- developmental trajectory not clear

Early intervention can help!

Importance of Early Intervention

Screening of at risk groups for early signs of illness E.g., mammography, liver function tests, EKG

Invasiveness of intervention scales with stage of illness

Longitudinal Study at UCLA : Cognition and Brain Structure in

22q11.2DS

Acknowledgements

NIH/NICHD grant # P50-HD-055784 (CART Pilot Project Grant to CEB), Consortium for Neuropsychiatric Phenomics (RB), ARRA Award 1R01HD065280-01 (SB), RO1 MH085953 (CEB)

Department of Psychology Theo van Erp

Katie Karlsgodt

Ty Cannon

Laboratory of NeuroImaging

Rebecca Dutton

Christina Boyle

Paul Thompson

Arthur Toga

Angela Matevoysan

Pegeen Cronin

Dan Geschwind

Mirella Dapretto

Susan Bookheimer

Lab Members: Laurie Brenner

Maria Jarlbrkowski

Peter Bachman

Danielle Schlosser

Shauna Mc Manus

Sarah Jacobson

Jennifer Ho

Carolyn Chow

Jessica Hopkins

Nicole Enrique

Ivana Poste

Neurobehavioral

Genetics Nelson Freimer

Giovanni Coppola

And most importantly.. THANK YOU!!

and HAPPY BIRTHDAY BOB!!