It’s the biennial conference of the World Association of Infant Mental Health this week, and 4 of the pPOD team from Imperial College are attending and presenting – Jane Iles, Christine O’Farrelly, Ellen Grimas and me. It’s based in Prague this year, and with the opening session starting at 4.30pm, it allowed for a quick tour of the city before heading to the conference venue. This isn’t a travelogue blog, it’s about the conference, but Prague is impressive, very impressive.
So, to the conference itself. The anticipation of a big international conference is always one of the best parts of the preparation – certainly more than the waiting at Gatwick airport and the final preparation of slides and posters. This year there were already a few talks I was particularly looking forward to hearing, and some of the titles of the symposia and individual talks were intriguing. In previous conferences I’ve found WAIMH attracts a very broad audience – all committed to improving health and wellbeing for infants, but from often different backgrounds and perspectives – clinicians, researchers, those running and designing services and policy makers. These groups don’t always meet at conferences, and so I’ve previously found the presentations to be a mix of inspiring science, some really fascinating clinical and service innovation, and the occasional quite baffling session as presenters use terms and language that don’t translate easily to people outside of their clinical field. This year may be the same, may be different.
So, now to describe the first couple of days. There’s been a lot going on, so I’m just going to pick out three sessions.
Day 1 - The first day proper got underway on Monday, and a session on the serotonin transporter gene and its possible role in moderating links between prenatal depression and child outcomes. The great thing about this session was that it bought together findings from three independent studies; Vanessa Babineau talked about the MAVAN cohort in Montreal, a second Canadian cohort study led by Tim Oberlander and a study led by Sherryl Goodman in Atlanta. They had overlapping findings, suggesting that the commonly described (and debated) moderating effect of this gene might be operating to moderate the association between prenatal depression and early child outcomes. It’s clearly complicated, and there are studies that don’t show moderation effects, but it was great to see this coordinated, collaborative effort to bring together studies. The extra step that this work took was also to consider the role of antidepressants in pregnancy (particularly the most commonly used drugs, SSRIs, which have an effect on the serotinergic system). The real bonus of this type of conference is to see this work from different groups brought together - and wonderful to see some top scientists presenting in person as well.
The second top session of day 1 was focussed on the Better Start programme. It’s a bit curious to come away to an international conference to have to chance to really hear about this UK-based programme, but it was fantastic to hear about it from the funders (Sarah Gibbs), the people running the programme (Merle Davies and Christ Cuthbert) and the people evaluating the programme (Jane Barlow), all in one place. This programme is attempting whole system change in 5 areas in the UK to improve the life chances for children. It looks like it has the potential to have a huge impact on the lives of children and families in the 5 areas where it runs. Hopefully the learning from it will mean that the benefits will run wider. It’s an inspiring approach and group of people, with a seriously big job to do in the next few years. If you want more detail look at the website higher in the paragraph – there are other websites for the evaluation and the other 4 sites in the UK.
Day 2- I’m only going to talk about one of the sessions from day 2, but in passing want to mention the presentation by Sheri Madigan from Calgary. She was awarded a prize by WAIMH for her work at the last congress, but this year she presented finding from her systematic review and meta-analysis of the links between maternal prenatal stress and child behavioural outcomes. She did a wonderful job of presenting a meta-analysis – which I think is a really tough thing to do in an interesting way, and certainly something I’ve failed to do on a number of occasions. At the moment she is winning the unofficial best presentation of the conference prize from the rest of the pPOD team. I’d suggest looking out for the findings when they’re published, as I think they are important – there does seem to be pretty good evidence for a consistent association between maternal stress and adverse child behavioural outcomes, with no moderating effect of any particular time in pregnancy seen.
And so to the final session of day 2 – a session of academic heavyweights, with Charles Zeanah presenting a summation of findings from the hugely influential Bucharest Early Intervention Project. The findings of this will be known to many people as numerous papers have been published, essentially showing that family based care (long-term fostering/adoption) leads to significantly better outcomes for children – and the earlier the better. It’s the first time that I have had the change to hear someone go so clearly through the findings – all in one place. This was followed by three brief discussant talks by Karlen Lyons-Ruth, Marinus van IJzendoorn and Neil Boris. All highlighted important aspects of the study, with Marinus in particular making a hard-hitting point about how a new generation of children may be becoming effectively institutionalised in Europe with the large numbers of refugees arriving. Given what we know about the detrimental effects of institutional living - for young children in particular, this is food for thought and action.
That’s it for today - 2 more days to go –and perhaps a shorter blog on those later in the week.
Author: Paul Ramchandani
So, to the conference itself. The anticipation of a big international conference is always one of the best parts of the preparation – certainly more than the waiting at Gatwick airport and the final preparation of slides and posters. This year there were already a few talks I was particularly looking forward to hearing, and some of the titles of the symposia and individual talks were intriguing. In previous conferences I’ve found WAIMH attracts a very broad audience – all committed to improving health and wellbeing for infants, but from often different backgrounds and perspectives – clinicians, researchers, those running and designing services and policy makers. These groups don’t always meet at conferences, and so I’ve previously found the presentations to be a mix of inspiring science, some really fascinating clinical and service innovation, and the occasional quite baffling session as presenters use terms and language that don’t translate easily to people outside of their clinical field. This year may be the same, may be different.
So, now to describe the first couple of days. There’s been a lot going on, so I’m just going to pick out three sessions.
Day 1 - The first day proper got underway on Monday, and a session on the serotonin transporter gene and its possible role in moderating links between prenatal depression and child outcomes. The great thing about this session was that it bought together findings from three independent studies; Vanessa Babineau talked about the MAVAN cohort in Montreal, a second Canadian cohort study led by Tim Oberlander and a study led by Sherryl Goodman in Atlanta. They had overlapping findings, suggesting that the commonly described (and debated) moderating effect of this gene might be operating to moderate the association between prenatal depression and early child outcomes. It’s clearly complicated, and there are studies that don’t show moderation effects, but it was great to see this coordinated, collaborative effort to bring together studies. The extra step that this work took was also to consider the role of antidepressants in pregnancy (particularly the most commonly used drugs, SSRIs, which have an effect on the serotinergic system). The real bonus of this type of conference is to see this work from different groups brought together - and wonderful to see some top scientists presenting in person as well.
The second top session of day 1 was focussed on the Better Start programme. It’s a bit curious to come away to an international conference to have to chance to really hear about this UK-based programme, but it was fantastic to hear about it from the funders (Sarah Gibbs), the people running the programme (Merle Davies and Christ Cuthbert) and the people evaluating the programme (Jane Barlow), all in one place. This programme is attempting whole system change in 5 areas in the UK to improve the life chances for children. It looks like it has the potential to have a huge impact on the lives of children and families in the 5 areas where it runs. Hopefully the learning from it will mean that the benefits will run wider. It’s an inspiring approach and group of people, with a seriously big job to do in the next few years. If you want more detail look at the website higher in the paragraph – there are other websites for the evaluation and the other 4 sites in the UK.
Day 2- I’m only going to talk about one of the sessions from day 2, but in passing want to mention the presentation by Sheri Madigan from Calgary. She was awarded a prize by WAIMH for her work at the last congress, but this year she presented finding from her systematic review and meta-analysis of the links between maternal prenatal stress and child behavioural outcomes. She did a wonderful job of presenting a meta-analysis – which I think is a really tough thing to do in an interesting way, and certainly something I’ve failed to do on a number of occasions. At the moment she is winning the unofficial best presentation of the conference prize from the rest of the pPOD team. I’d suggest looking out for the findings when they’re published, as I think they are important – there does seem to be pretty good evidence for a consistent association between maternal stress and adverse child behavioural outcomes, with no moderating effect of any particular time in pregnancy seen.
And so to the final session of day 2 – a session of academic heavyweights, with Charles Zeanah presenting a summation of findings from the hugely influential Bucharest Early Intervention Project. The findings of this will be known to many people as numerous papers have been published, essentially showing that family based care (long-term fostering/adoption) leads to significantly better outcomes for children – and the earlier the better. It’s the first time that I have had the change to hear someone go so clearly through the findings – all in one place. This was followed by three brief discussant talks by Karlen Lyons-Ruth, Marinus van IJzendoorn and Neil Boris. All highlighted important aspects of the study, with Marinus in particular making a hard-hitting point about how a new generation of children may be becoming effectively institutionalised in Europe with the large numbers of refugees arriving. Given what we know about the detrimental effects of institutional living - for young children in particular, this is food for thought and action.
That’s it for today - 2 more days to go –and perhaps a shorter blog on those later in the week.
Author: Paul Ramchandani
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