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Linda Mayes’ journey to leading the Child Study Center

Yale Medicine Magazine, 2017 - Spring

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While training as a neonatologist at Vanderbilt University Medical Center in Nashville, Linda C. Mayes, M.D., FW ’85, cared for preterm infants born to rural families in her home state of Tennessee. Some babies weighed barely two pounds. “Seeing families come to grips with having to send their 800-gram baby many miles away taught me a lot about the complex systems of health care for seriously ill children and their families,” said Mayes, director of Yale’s Child Study Center.

Determined to better understand infant and child development, Mayes arrived at Yale in 1982 for a second fellowship in pediatric clinical research. She planned to return to Tennessee to care for preterm children and their families. Instead, she stayed in New Haven, where she was mentored by renowned psychologists and behavioral and developmental pediatricians.

Mayes, now the Arnold Gesell Professor of Child Psychiatry, Pediatrics, and Psychology, runs a behavioral neuroscience laboratory that has followed children and their families over 20 years. She has also developed interventions for at-risk families.

With colleagues across the pond, Mayes helped establish the Yale—University College London master’s program in developmental neuroscience and psychopathology. Since 2007, she’s served as special advisor to Dean Robert J. Alpern, M.D., Ensign Professor of Medicine. She continues to serve as principal or co-investigator on multiple clinical trials, including one on the neural circuitry of mothers who have abused cocaine. In 2016, she was named director of the 106-year-old Child Study Center.

Since her appointment, Mayes has met with researchers and physicians across the school to build interdepartmental collaborations among the center’s 25 disciplines with a focus on improved mental health care for children and families. “The most rewarding part of my job now is bringing people together and capturing their excitement around what we could do, where we could go—to try and imagine the Child Study Center 10 and 20 years from now.”

How has our understanding of child development and child mental health evolved? We now have a far better understanding of how life experience can affect genetic regulation. We know that early trauma and adversity shape the emerging brain and have lifelong implications not just for physical health but also for well-being, mental health, and overall life success. The old metaphors of nature versus nurture are completely outdated. We take a lifespan perspective and attempt to understand how childhood events carry into adulthood and potentially into the next generations as children become adults and raise their own children.

What are some of the center’s major achievements in research? The center began under founding director Arnold Gesell, Ph.D., M.D. 1915, whose innovative idea was that a child’s cognitive, social, and motor abilities unfold in a predictable and ordered way, as do physical growth and physiological capacities. The Child Study Center was at the forefront of these early developmental ideas and helped shape prominent ideas around children’s mental health in the 1960s and 1970s. By the 1980s, the center was leading the way in defining characteristics of childhood psychiatric disorders, including autism. In the 1990s, center researchers were conducting clinical trials on new pharmacological agents to treat childhood psychiatric disorders and beginning to investigate the genetic basis of these disorders. Today, we are at the forefront of understanding, for example, the neural basis of social development or how early childhood trauma can have a lifelong impact on key neural and immune systems.

How far along has the center’s clinical restructuring progressed? We have begun to change our infrastructure so our clinicians work in what we are calling a group practice. We will be able to have more collaboration across our specialty services and better cross-training for our fellows and our faculty. We are looking for one unified space to bring all of our services together, but even before we have that, we are designing our practice together and beginning to change the ways families are able to access our services.

The center has been a pioneer in developing community programs. How do these differ from other public programs? We distinguish ourselves by our range of our services—from providing specialty expertise around very specific childhood disorders such as autism, anxiety, Tourette’s syndrome, and post-traumatic stress disorder in children, to providing in-home services and serving parents and moms in the community. In our portfolio of services, we address concerns across generations. For example, we are opening a parenting center called the Parent and Early Family Development Program. When an adult becomes a parent, there’s an enormous amount of development going on at the psychological level and at the brain level. We’re interested in offering specific services to adults in their role as parents as these will positively impact their children.

These days it seems that kids are always staring into their mobile devices. Do we know whether these habits will affect development? At this point, we don’t really know. Never has the world of information been more accessible in such a rapid way to children. They will naturally gravitate toward and use technology. We do know that relationships are important for healthy brain development in children. Relationships open up and translate the world for children; for example, using the iPad to FaceTime with grandparents or uncle or aunt. Contextualizing the technology puts it inside relationships, which we know are absolutely essential for healthy development.

Watch a short interview with Linda Mayes here.

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