HEALthy Brain and Child Development Study (HBCD)

Research Spotlights

mother holding an infant on her shoulder

The HEALthy Brain and Child Development Study

A New Way to Look at the Infant Brain

Can Exposures Before Birth Predict Health Later in Life?

Overview

The Research Need

The first few years of life are a period of exponential growth and brain development. The long-term effects of perinatal exposure to opioids on infant and child development are unknown.

To address this knowledge gap, NIH is supporting research to better understand brain development, beginning in the perinatal period, and extending through early childhood, including variability in development and how it contributes to cognitive, behavioral, social, and emotional function. Knowledge of normative brain trajectories is critical to understanding how they may be affected by exposure to opioids and other substances (e.g., alcohol, tobacco, cannabis), stressors, trauma, and other significant environmental influences, including those that promote resilience.

About the Program

The HEALthy Brain and Child Development (HBCD) Study will recruit a large cohort of pregnant women from regions of the country significantly affected by the opioid crisis and follow them and their children through early childhood. The study will collect information beginning at birth and continuing through early childhood, including structural and functional brain imaging; anthropometrics; medical history; family history; biospecimens; and social, emotional, and cognitive development.

Knowledge gained from this research will be used to better understand and ultimately prevent or attenuate the harms of prenatal and postnatal exposure to drugs or other adverse environmental conditions, including risk for early substance use, mental disorders, and other behavioral and developmental problems. It will also identify resilience factors that may mitigate some of these adverse outcomes.

Program Details

Through the Helping to End Addiction Long-term^SM Initiative, or NIH HEAL Initiative^SM in collaboration with the National Institute on Drug Abuse and several NIH Institutes and Centers, NIH has funded 29 awards totaling $15.8 million in Phase I of the HEALthy Brain and Child Development (HBCD) Study, and 27 awards totaling $37.1 million for Phase II of the HBCD Study.

Phase I of the HBCD Study concluded an 18-month planning period during which awardees considered the experimental design and feasibility of approaches. Awardees conducted multisite pilot and feasibility studies addressing five key areas that are crucial for the Phase II study:

Recruitment and retention strategies
Ethical and legal challenges
Imaging technologies
Other assessment methodologies
Biospecimen collection and analysis

This planning phase was critical for ensuring a robust study design for the Phase II HBCD Study, which will launch in October 2021. In Phase II, a fully integrated, collaborative infrastructure will support the collection of data that will enable researchers to analyze brain and behavioral development in substance-exposed and non-drug-exposed infants and children across a variety of regions and from diverse demographic backgrounds.

Research Examples

Examples of HBCD Study activities include:

Multi-modal assessments of brain, cognitive and emotional development from birth through childhood to assess typical neurodevelopmental trajectories and determine how substance exposure and other environmental factors affect these developmental trajectories.
Creation of a large, diverse well-characterized cohort of caregivers, infants, and children whose anonymized data will be made available for analysis to the greater research community for years to come.
Evaluation of key developmental windows during which the impact of adverse environmental exposures (e.g., drugs, stress, COVID-19) or ameliorating factors (e.g., substance use disorder treatment; social/economic support) influence neurodevelopmental outcomes.
Identification of actionable items as results emerge pertinent to prevention, public policies, and innovative products.
Development, optimization, and validation of technologies for neuroimaging and neurophysiological assessments of infants, with standardized analysis pipelines.
Collaborative model with creation of community liaison boards comprising medical providers, patient advocates, ethicists, and representatives from state agencies to inform the study design and provide ongoing feedback throughout its lifetime.
Determination of the feasibility of mobile or wearable technology to track parent-child interactions and child physiology.