Lauren Wakschlag

Professor and Vice Chair for Scientific and Faculty Development, Department of Medical Social Sciences, Feinberg School of Medicine | IPR Fellow


Clinical and developmental psychologist Lauren Wakschlag directs the developmental mechanism program in Feinberg’s Department of Medical Social Sciences (MSS). The major thrust of her work is on developing tools and identifying mechanisms that will enable earlier detection of poor neurodevelopmental health by specifying "when to worry." Based on her novel developmental specification theory, her program has generated the only assessment tools specifically designed to differentiate the normative misbehavior of early childhood from emergent mental health risk, the Multidimensional Assessment Profile of Disruptive Behavior (MAP-DB) and the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). These tools are increasingly being used in conjunction with developmentally-sensitive neuroimaging tools to detect early brain:behavior atypicalities that underlie emergence and persistence of mental health problems.

Via cross-campus collaborations, this “when to worry” framework is also being extended to identification of emergent language risk (via partnerships with SOC scientists Elizabeth Norton and Megan Roberts), and emergent cardiovascular risk (funded by a recent American Heart Association Center grant to pediatric investigator Bradley Marino).  These tools are also the foundation for studies designed to discover and modify how adverse prenatal exposures (such as prenatal stress and smoking) contribute to early neurodevelopmental risk. 

At Northwestern, Wakschlag also directs the Institute for Innovations in Developmental Sciences (DevSci), whose mission is to promote a healthier, earlier population beginning even before birth, via integration of biomedical and social science approaches. She specifically promotes collaboration between the medical school and IPR through her work with IPR’s Cells to Society (C2S): The Center for Social Disparities and Health

Current Research

Continuities and Discontinuities in Preschool Mental Health Problems. One key question for early childhood identification research is which children will persist in having adaptational problems. To address this question in terms of long term prediction, Wakschlag and colleagues are investigating individual differences in risk and resilience pathways via a longitudinal follow-up of the MAPS Study preschoolers through pre-adolescence (ages 9–10). The results of the preschool phase of MAPS included validation of the MAP-DB survey, contributing to better differentiation of normative variation from emergent disruptive behavior. The MAPS Follow-Up Study (MAPS-FUS) examines which disruptive preschoolers show persistent problems in adaptation and functioning over time. The study includes examination of disruptions in neural function via FmRI at pre-adolescence (n=120). Via a health disparities supplement, Wakschlag, IPR associate and MSS faculty Frank Penedo, and colleagues are also investigating inflammatory mechanisms of racial/ethnic and SES disparities in impairment, as well as observed cultural socialization as a protective mechanism in these pathways. Wakschlag has been eager to use the rich data generated by the MAPS Study (including population level data and intensive longitudinal data) as a platform for collaborations with IPR faculty that can generate important information for translation to early childhood policy. For example, employing MAPS data, IPR education economist David Figlio is leading examination of gender and SES disparities in behavioral and academic outcomes, and developmental psychologist and IPR associate Terri Sabol is examining mechanisms of disparities in preschool explusion. Both the MAP-DB and companion observational DB-DOS tool are also being used cross-nationally and in collaborative neuroscientific studies to advance mechanistic discovery and applications across varied populations.

Generating an Earlier Science of When to Worry. Another key question for early identification of poor neurodevelopmental health is how early these atypical pathways are detectable. The NIMH-funded When to Worry (W2W) Study extends the program’s work earlier in development via investigation utilizing longitudinal and neural approaches for differentiating the onset of atypical irritability pathways beginning in infancy. Co-led by clinical psychologist and IPR associate Amelie Petitclerc, this study focuses on irritability as the most robust developmental indicator of lifespan mental health risk across both problems—both internalizing and externalizing domains). Three hundred and fifty 12-month-old infants recruited from pediatric clinics and community advertisements are being followed until the age of 36 months. Intensive longitudinal assessment of irritability will be conducted bimonthly, including an infant-toddler version of the MAP-DB and LENA real-time recordings for ecologically valid assessment of infant crying patterns. An extreme group sub-sample (n=100) will participate in a sub-study to pinpoint how behavioral atypicalities map onto abnormalities in rate and pattern of brain growth (assessed via natural sleep MRI) across the early childhood period.

Moving the Dial on Developmental Origins of Disease. Experimental studies are also being conducted to test the modifiability of the early disease susceptibility pathway. The Promoting Healthy Brain Project (PHBP) is a strategic research initiative within the Perinatal Origins of Disease: Research at the Maternal:Fetal Interface Center funded by the Ann & Robert H. Lurie Children’s Hospital.  This cross-campus collaboration includes scientists from MSS, Pediatrics, Ob/Gyn, School of Communication, Computer Science, and Bioengineering, to test a novel prenatal stress intervention using health sensing technology and real-time messaging to tailor intervention delivery. The study will test the efficacy of this intervention for altering adverse neurodevelopmental trajectories of infants prenatally exposed to stress via randomized controlled trial of 200 pregnant women and their infants.

Selected Publications

Journal Articles and Chapters

Wakschlag, L., S. Perlman, J. Blair, E. Leibenluft, M. Briggs-Gowan, and D. Pine, D. In press. Specifying the neurodevelopmental basis of early childhood disruptive behavior: Irritable and callous phenotypes as exemplars. American Journal of Psychiatry.

Grabell, A., Y. Li, J. Barker, L. Wakschlag, J. Huppert, and S. Perlman. Epub ahead of print. Evidence of non-linear associations between frustration-related prefrontal cortex activation and the normal:abnormal spectrum of irritability in young children. Journal of Abnormal Child Psychology.

Mittal, V., and L. Wakschlag. 2017. Research domain criteria (RDoC) grows up: Strengthening neurodevelopment investigation within the RDoC frameworkJournal of Affective Disorders 216:30–35.

Massey, S., A. Hatcher, D. Pine, E. Cook, D. Goldman, K. Espy, and L. Wakschlag. 2017. Does MAOA increase susceptibility to prenatal stress in young children? Neurotoxicology & Teratology 61:82–91. 

Clark, C., S. Wiebe, K. Espy, and L. Wakschlag. 2016. Developmental pathways from prenatal tobacco and stress exposure to behavioral disinhibitionNeurotoxicology & Teratology 53:64–74.

Demir, O., J. Voss, J. O’Neill, M. Briggs-Gowan, L. Wakschlag, and J. Booth. 2016. Early life stress exposure alters prefrontal resting-state fMRI local connectivity in young childrenDevelopmental Cognitive Neuroscience 19:107–14.

White, S., M. Briggs-Gowan, J. Voss, A. Petitclerc, R. Blair, and L. Wakschlag. 2016. Can the fear recognition deficits associated with callous-unemotional traits be identified in early childhood? Journal of Clinical and Experimental Psychology 38(6): 672–84

Estabrook, R., S. Massey, S. Clark, J. Burns, T. O’Brien, K. Espy, and L. Wakschlag. 2015. Separating family-level and direct exposure effects of smoking during pregnancy: Bridging the behavior genetic and behavior teratologic divide. Behavior Genetics 46(3): 389–402.