“Nowhere is the importance of investing in health more
apparent than in our care of the developing child: the
earlier the investment the greater the return on investment.”
In early 2015, Three to Be was approached by Dr. Steven Miller (head of neurology at Sick Kids Hospital) to participate in a Canada-wide network of key stakeholders for the evaluation of care, treatment and long-term well-being of children with brain-based developmental disabilities and their families.
The goal of this national environmental scan was to identify priorities for a pan-Canadian, inter-disciplinary, multi-centred research initiative aimed at creating brighter futures for children with neurological disorders. Taking a non-categorical approach (i.e. not disease/disorder specific) based on the hypothesis that while individual disabilities have specific clinical characteristics, they all share common care needs, allows for extended reach and expanded opportunities for a larger segment of Canadian children.
Just over 900 Canadian families responded, representing children with autism, global delay, fetal alcohol syndrome and cerebral palsy. They strongly endorsed all of the proposed projects/priorities, placing the greatest importance on strategies that share knowledge and provide supports, testing approaches for pain, anxiety, aggression and attention problems, as well as the development of integrated and coordinated care services. These results confirmed the need for a broad study, crossing through all of the most critical elements of childhood brain disorders.
The CHILD-BRIGHT Network focuses on the “whole” child and family unit by exploring brain repair, early interventions, improved outcomes for children with neurological disorders and long-term solutions for well-being and quality of life outcomes. This initiative is a new outlook on how research is conducted and introduces a level of innovation that will advance our knowledge and awareness surrounding childhood neurological disorders.
Three to Be is honoured to be collaborating with renowned institutions across Canada such as, The Canadian Institutes of Health and Research (CIHR) under Canada’s Strategy for Patient-Oriented Research (SPOR), BC Children’s Hospital, Hospital for Sick Children, Holland Bloorview Kids Rehabilitation Hospital and Montreal Children’s Hospital Foundation.
Three to Be is exceptionally proud to be a Platinum Partner of the CHILD-BRIGHT Network as we further our vision for infinite possibilities for children with neurological disorders.
Early intervention is key in minimizing developmental problems that children may face. Over the past decade, experimental studies have identified fetal, neonatal, and early childhood rehabilitation practices that optimize brain and developmental outcomes. CHILD-BRIGHT’s five research projects under the BRIGHT Beginnings theme will focus on bringing these experimental advances to human clinical studies to minimize brain injury and restore brain function. Knowing how these therapies influence brain development will allow our team to implement best practices that will promote resilience, and directly improve the child’s physical and mental health, and overall well-being.
The BRIGHT Supports theme will transform outcomes by integrating mental health support into the care of children and youth with brain-based developmental disabilities who experience behavioural difficulties. Novel information technologies as well as medical interventions will be evaluated in children with a wide range of developmental disabilities. Health promotion strategies that foster fitness and social participation will also be developed. The four BRIGHT Supports projects will also fill a critical gap by offering family-centred ‘help-giving’ practices to support parents in their role as caregiver.
Under the BRIGHT Futures theme, we will redesign key parts of the healthcare system to be more responsive to the needs of families as the child develops. We will focus on key transition periods: discharge from the neonatal intensive care unit, the transition from preschool to school, and the transition into the adult healthcare system. Our intent is to produce policy-relevant, cost-effective innovations that will transform real-world service delivery to patients and families throughout their growth trajectories. This transformation will both improve children’s physical and mental health, and empower their families.
Support from Three to Be to stem cell research in the laboratory at the Peter Gilgan Centre for Research and Learning worked to unravel the mysteries of childhood neurological disorders. The goal was to develop new therapies that will improve the future for many children.
Three to Be provided support to the research efforts of Dr. Jing Wang, an Assistant Professor in the Stem Cell Institute at the University of Ottawa and a Postdoctoral Fellow. Her research was focused on the CBP gene; a gene we now know tells neural stem cells to produce two key brain cell types. Concurrently, other laboratory results showed that the commonly-used type II diabetes drug, metformin, turned on the same CBP pathways in liver cells. This finding led to Dr.Wang’s discovery that metformin, which is used chronically and safely in humans, turns on the CBP pathway in neural stem cells, thereby telling them to create new, functionally important brain cell types.
Dr.Wang’s identification that Metformin can be a potential drug to regenerate brain injury was published in the prestigious scientific journals Developmental Cell and Cell System Cell in 2010 and 2012. This discovery inspired the work of the clinical trial to test whether metformin can enhance cognition or promote brain repair following radiation-induced brain injury.
Metformin and Medulloblastoma Trial
With funding from Three to Be, Dr. Don Mabbott was able to lead the “Metformin and Brain Repair in Children with Acquired Brain Injury: Placebo Controlled Double Blind Crossover Clinical Trial”. This trial focused on 30 children treated with radiation for medulloblastoma – the most common malignant brain tumour.
By focusing on brain repair, the goal is to reduce devastating neurological morbidity and bring new hope to families dealing with the effects of brain injury in children.
Research and Pilot Clinical Trial for Children with Acquired Brain Injury (ABI)
Three to Be funded research in the laboratories of Dr. Freda Miller at SickKids and Dr. Cindi Morshead at the University of Toronto.
Three to Be provided initial funds for neuro-oncologist Dr. Eric Bouffet, and neuropsychologist Dr. Donald Mabbott to conduct a pilot clinical trial on a highly select group of children with ABI who have received whole brain irradiation to treat their brain tumours.
Dr. Mabbott performed a clinical trial questioning if exercise can enhance brain growth and cognitive improvement in children who have had brain tumours removed, but as a direct result, suffer lasting cognitive deficit. Compelling results of this trial led to Three to Be’s funding for Dr. Mabbott’s clinical trial combining exercise and metformin. The potential significance of this work was also recognized by the Canadian Stem Cell Network, who provided partnered funds to move the science forward. Brain Canada, together with the W. Garfield Weston Foundation, funded a $1.5 million-dollar team grant focused on this innovative work.
The Interaction Between Genes and the Environment:
Regulating Development of Autism Spectrum Disorder
While many children may be genetically predisposed to develop syndromes like Autism Spectrum Disorder (ASD), the environment plays a key role in whether and/or how these disorders manifest themselves.
Initial funding from Three to Be assisted the Miller laboratory in the research conducted by two postdoctoral fellow, Drs. Denis Gallagher and Hideaki Tomita, on how ASD regulates neural stem development, and how maternal infection, which has been implicated in a number of childhood cognitive disorders including cerebral palsy, might interact with ASD genes.
The gift of communication to children with physical
and neurological disabilities
In 2012, Three to Be welcomed the opportunity to invest in research that led to the development of devices that fundamentally changed the way children with neurological disorders communicate. In Holland Bloorview’s Infinity Centre for Access Innovations, Dr. Tom Chau focused studies on children who can’t speak or move to discover how other signals from the body and the brain can be harnessed to make communication possible.
Three to Be’s commitment tripled the number of children involved in the research and being outfitted with technology or a custom device to help them communicate with the world. Our commitment addressed the immediate and urgent needs of children and families by creating new opportunities to learn, grow and connect with family, friends and their community.
In addition to helping these kids immediately, Three to Be’s support aided the development of the engineering scientists in the lab and training more scientists. Additionally, this accelerated the amount of data available, the numbers of solutions and potentially, shortening the time between research, product development, commercialization and service delivery.