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Dr. Graham J. Reid greid@uwo.ca Westminster Hall 319 East 519-661-2111 ext. 84677
Research Activities
Research areas in the Reid Lab:
About 1 in every 5 children, adolescents, and adults has a clinically significant psychosocial problem (i.e., problems in the areas of cognitive/academic, behavioural, emotional, psychological, or social functioning). However, over 80% of children with psychosocial problems do not receive treatment. Without treatment, about ½ of children continue to have problems years later. We are looking at issues related to how families access care for children with psychosocial problems and new methods of treating and preventing children's psychosocial problems. ( Click here for selected publications by topic. )
1) RESEARCH ON ACCESSING AND USING HEALTH AND MENTAL HEALTH SERVICES
a) Access to care.
This program of research focus primarily on how families access and use mental health services for children or adolescents who have mental health problems. We have studied the process of how parents attempt to access mental health services for children (Shanley, Reid, & Evans, 2008; Reid et al., 2011). In one study of families looking for mental health services for their children, we sought to a) identify where and why families were looking for help, and b) describe the treatment services parents were both offered and accepted. Kyleigh Schraeder (M.Sc. in progress) is currently studying how being placed on a waitlist at a children's mental health agency alters the probability that families will contact another agency for help. The role of family physicians in helping parents of children with psychosocial problems is also a focus in this line of studies (Reid et. al., 2011). Another project includes how individuals of all ages access care from family physicians (Reid, Freeman et al., 2009).
b) Measurement development
As part of our work in both access to care and in other pediatric research, we have developed a number of questionnaires. We have investigated methodological issues, such as how best to ask parents about their help-seeking contacts within the mental health system ( Reid, Tobon, & Shanley, 2008). Dianne Shanley (Ph.D., 2008) developed a parent-report measure that helps us understand parent-perceptions of their child's mental health problems. Mor Barzel (Ph.D., 2008) examined the validity of the Coparenting Questionnaire (Margolin, 2001) and developed a diabetes-specific measure of coparenting [ Barzel, M. & Reid, G.J. (2011); Barzel, M. & Reid, G.J. (in press)] . Aimee Coloumbe (Ph.D., 2011) developed three measures related to night-waking among preschool-age children that measure: a) what parents think they should do when 2- to 5-year-olds wake at night (Night-waking Vignettes Scale), b) what parents report that they do when their own child wakes at night (Night-waking Strategies Scale), and c) what parents think and feel when their child wakes at night (Parental Cognitions about Night-waking Questionnaire).
Juliana Tobon (Ph.D. in progress) is developing a measure of the Continuity of Care Scale for Children's Mental Health that will assess continuity of care within the mental health sector as well as continuity between the children's mental health and the education and the medical/health sectors.
c) Patterns of Services Use.
Virtually nothing is known about patterns of service use over extended periods of time in children's mental health. In one of our recently completed studies, close to one-fifth of parents reported their child or adolescent had been receiving mental health services more than one year before they were interviewed, yet they were seeking additional services. This pattern of service is differs from our current acute-illness model of psychological care in which services are provided only in times of extreme need, and children/families usually receive treatment for a brief period (e.g., about 6 months). This could be contrasted with an ongoing care or "chronic illness" model (e.g., attending regular clinic appointments for diabetes). There is no evidence base for this approach to the treatment of mental health disorders among children, yet certain mental health problems can be considered chronic. We are embarking on a series of studies designed to move us toward the development and testing of new models of chronic care for children within the mental health service system. As a first step we are examining patterns of service utilization over an extended period of time (4-5 years) within agencies providing mental health services for children in Ontario.
2) PEDIATRIC SLEEP PROBLEMS
a) Parenting Children with Sleep Problems
We have developed and tested a program called: Parenting Matters: Helping parents with young children . The target population is parents of young children (age 2-5 years) seen by family physicians who have concerns about their children's sleeping and bedtime behaviours, or discipline. Treatment consists of brief self-help booklets and support from a telephone coach. A variety of issues and questions will be examined in this line of research including the effects of early intervention for children with mild levels of behaviour problems, identifying factors that predict who will benefit from brief parenting interventions, primary care models for psychology, and ways of collaborating with family physicians. In a series of randomized clinical trial, over 550 parents were enrolled.
We have recently been awarded a CIHR Sleep and Circadian Rhythms Team grant, entitled " Better Nights/Better Days: Improving Psychosocial Health Outcomes in Children with Behavioural Insomnia" . This 5-year project will develop, implement and evaluate web-based sleep interventions for children ages 1-10 years. Three randomized clinical trials will be conducted to test the effectiveness of programs for toddlers (1-2 years), preschoolers (3-5 years) and school-aged children (6-10 years). The PI is Dr. Penny Corkum at Dalhousie University, and the London site will be responsible for recruitment, assessment, and treatment for families in Ontario and Manitoba. This research brings together an outstanding team of sleep researchers along with a number of important partners. The project will provide opportunities for students to learn about delivering evidence-based treatments for pediatric sleep problems, distance-based treatments, and randomized clinical trial design.
The Parenting at Midnight research program, led by Aimee Coulombe (Ph.D., 2011), is testing a model of the multiple factors contributing to night-waking among young children. Night-waking is one of the most prevalent behaviourally-based sleep problems in 2-5-year old children. Over 30% of preschool aged children wake at least once per night and require parental intervention; 5% wake twice or more per night and 20% of wakings last 15 minutes or longer. This disrupted sleep has negative effects on children and parents, which includes fatigue and impairment in affective, cognitive, and behavioural functioning. A series of questionnaires are under development that will measure how parents respond to night waking, what they believe are ideal strategies for dealing with night waking and how their cognitions related to their children's sleep and other sleep-related factors (e.g., parent's own fatigue) relate to night-waking strategy preference and use.
b) Outcomes of sleep problems
Sleep problems have been related to psychopathology among children and adolescents. We examined the relation between sleep and psychopathology in a number of studies. Our Parenting Matters program examined how improvements in the sleep of preschool-age children impacted their behavior. In studies using large community-based samples, we examined the contribution of sleep problems to psychopathology in relation to known correlates of psychopathology such as parenting, family stress, and temperament (Reid, Hong, & Wade, 2009; Coulombe, Reid, Boyle, & Racine, 2010 & 2011).
Kathryn Turnbull (Ph.D. in progress) is taking the lead on a new study that is examining the effects of brief sleep restriction and sleep fragmentation (analogous to night waking) on attention and working memory among preschool-age children. This experimental study of healthy children without sleep problems should help us better understand if sleep directly influences preschool children's cognitive abilities and may help inform the definition of a clinically significant sleep problems in this age group.
INFORMATION FOR PROSPECTIVE STUDENTS
Students applying for graduate school and wanting to join my lab should be interested in a research topic related to one of the above research programs. Students may also be interested in the looking at the Centre for Studies in Family Medicine website that describes the work of the core researchers in the Department of Family Medicine.
Students conducting research related to primary care may apply to TUTOR - PHC - our CIHR funding training program in primary care research.
McGrath, P.J. (co-PI), Cunningham, C.E. (co-PI), Bagnell,A.L., Boyle,M.H., Brannen,C., Corkum,P.V., Dooley,M.D., Lipman,E.L., Reid, G.J. , Stewart,H.S., Shannon,S.H. (2008-2012). Delivering treatment for Oppositional Defiant Disorder at a distance: a randomized trial. (4 years) Canadian Institutes of Health Research Randomized Clinical Trials Grant.
M. Stewart (PI), L. Bainbridge, MD Beaulieu, JB Brown, F. Burge, L. Dolovich, D. Dozois, J. Goudreau, J. Haggerty, S. Harris, A. Kothari, L. Lalonde, R. Martin-Misener, C. McWilliam, V. Ramsden, G. Reid , A. Thind, R. Thomas-MacLean, E.Vingilis, S. Watt, S. Wong. (04/2009 - 03/2015) Transdisciplinary Understanding and Training on Research - Primary Health Care (TUTOR-PHC) . Canadian Institutes of Health Research (CIHR) Strategic Training Initiative in Health Research (STIHR) Program.
Reid, G.J. , Turnbull, K. A., &amp; Morton, J. B. (01/2010-12/2012) Brief sleep restriction and neurobehavioural outcomes in preschool children . (2 years) Lawson Health Research Institute Internal Research Funding Competition.
Reid, G.J. , Tobon, J., Stewart, S.L.., Evans, B., Brown, J.B., Goffin, R. (04-2010 - 03-2012). Continuity of Care in Children's Mental Health: Development of a Measure (2 years). Grant from the Canadian Institutes of Health Research; Advancing Theoretical and Methodological Innovations in Health Research (CIHR #213130).
Reid, G.J. (Co-PI),Stewart,S.L.(Co-PI), Barwick,M., Carter,J., Evans, B., Leschied,A., Neufeld, R., St. Pierre,J. Tobon,J., Vingilis, E., &amp; Zaric,G. (10/2010-09/2014). Predicting and understanding patterns of service utilization within children's mental health agencies (3 years). Canadian Institutes of Health Research (CIHR #220153).
Corkum, P. Andreou, P., Barwick, M., Chambers, C., Godbout, R., Gruber, R., Hall, W., McGrath, P., Reid, G.J. , Rusak, B., Stremler, R., Wade, T., Watters, C., Weiss, S., &amp; Witmans, M. (10-2010 to 09-2015) Better Nights/Better Days: Improving Psychosocial Health Outcomes in Children with Behavioural Insomnia Canadian Institutes of Health Research TEAM Grants program (Sleep and Circadian Rhythms).
Reid, G. J. , Turnbull, K. A. &amp; Morton, J. B. (06/2011-05/2013). Brief sleep restriction and neurobehavioural outcomes in preschool children: Exploring between and within subject effects . Children's Health Research Institute Internal Research Grant Fund.