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Paula J. Lockhart, MD is the Director of the Behavioral Teratology Clinic and The Fetal Alcohol Research Center at the Kennedy Krieger Institute. She is also an assistant professor of psychiatry at the Johns Hopkins School of Medicine. Dr. Lockhart is board certified in both general and child and adolescent psychiatry.
Biographical Sketch:
Dr. Lockhart received her medical degree from Georgetown University School of Medicine and completed her general psychiatry training at the Georgetown University Hospital. It was during her training in child psychiatry at Johns Hopkins Hospital and Kennedy Krieger Institute that Dr. Lockhart became interested in the extreme mental health problems of children with prenatal drug and alcohol exposure. After fulfilling her US Public Health Service obligation, Dr. Lockhart returned to Kennedy Krieger Institute and joined the faculty of the Johns Hopkins School of Medicine. She received additional didactic and experiential training as a Faculty Fellow in the Johns Hopkins Faculty Fellowship Program in Alcohol and Substance Abuse. Early work involved the development and implementation of a community outreach program-providing wrap around services to addicted mothers with other psychiatric co-morbidity.
Dr. Lockhart's primary clinical activities since joining the staff of Kennedy Krieger Institute involves her work with the patients and mental health professionals of the Behavioral Teratology Clinic. The Behavioral Teratology Clinic clinical team works to solve the complex psychosocial and special emotional/behavioral needs of children with developmental disabilities and prenatal alcohol exposure, through pharmacologic and or psychotherapeutic interventions. This team also works with community programs as often as possible to find the least restrictive means possible to help a family.
Dr. Lockhart’s primary research interests include understanding the neurobiological mechanisms underlying Attention problems in individuals with prenatal alcohol exposure, and determining the relationship, if any, between attention problems encountered in individuals with prenatal alcohol exposure, and the clinical disorder Attention Deficit Hyperactivity Disorder (ADHD). She is now engaged in a research project entitled The Neurobiology of Attention in Fetal Alcohol Syndrome, funded by the National Institute of Alcohol Abuse and Alcoholism.
Other research involves characterizing the neurobehavioral phenotype of FAS & nofas alcohol exposed individuals and determining the best pharmacological interventions.
Research Summary:
FAS, and other prenatal Alcohol-Related Disability are very serious conditions, accounting for up to 1 in 100 live births world-wide, arising directly or indirectly from prenatal alcohol exposure. Although, rates vary from region to region, prenatal alcohol exposure is found to be a widespread public health concern. The individuals affected can suffer from learning problems with and without mental retardation, social skills deficits, behavior problems and problems in independent living. Attention problems in particular are often considered the sine qua non of FAS. These abnormalities and many other features identified as the Fetal Alcohol Syndrome (FAS) phenotype can be catastrophic to the functioning of these individuals and represent what is considered the most severe end of the prenatal alcohol-related disability spectrum. Although the condition of FAS is now widely known, the special mental health problems of these individuals and of those without the classic features of FAS, are just now being elucidated in the mental health arena.
There is a large body of research documenting clinically defined attention problems in over-half of the individuals meeting criteria for FAS. Although all of the physical, cognitive, and behavioral anomalies that define this disorder are debilitating, problems of attention are found to greatly impact the daily lives of these individuals, and form the basis of many psychiatric referrals.
Prenatal alcohol exposure is found to disrupt the normal structure and function of the developing brain. Intermittent exposure of the developing fetus to a bolus of alcohol producing a high Blood Alcohol Concentration (BAC) is considered to be one of the most powerful determinants of the severity of developmental brain damage and possibly damage to areas involved in regulating attention.
One project that Dr. Lockhart is involved in is examining hypotheses that suggest that structures making up anterior and posterior networks of attention are damaged in children with FAS. The theoretical foundation of this argument is drawn from the vast neurobiological literature on Attention Deficit Hyperactivity Disorder and other attention disorders, which appears to overlap significantly with preliminary neuroanatomical findings in individuals with FAS. As yet there is little mention in the literature associating damage to these cortical and sub cortical areas in FAS and the high prevalence of attention problems in this population. Results of this and other projects evaluating attention from a cognitive neurology and psychiatric perspective will help to fine-tune the psychopharmacotherapy of attention in FAS and other prenatal alcohol related disability and improve the long-term prognosis of these individuals.
Recent Publications/Presentations:
Lockhart, Paula J. Fetal Alcohol Spectrum Disorders for Mental Health Professionals A Brief Review Current Opinions in Psychiatry 2001, 14:463-469.
Belcher, Harolyn ME, Lockhart, Paula J, Perkins-Parks S and McNally, MS; Using the PANDA (Preventing the Abuse of Narcotics, Drugs, and Alcohol) in Baltimore Head Start Setting, Journal of Black Psychology, Vol. 26 No. 4, November 2000 437-449.
Zimmerman,A., Jinnah,A., Lockhart, PJ. Behavioral Neuropharmacology, Mental Retardation and Development Disabilities Research Reviews 4:26-35, 1998
Mostofsky, SH., Reiss, AL., Denckla, MB. Lockhart, PJ. Evaluation of Cerebellar Size in Attention Deficit Hyperactivity Disorder Journal of Child Neurology, 13:434-439,1998
Lockhart, PJ. Infants of Substance Abusing Mothers Developmental Disabilities in Infancy and Childhood, Chapter 10, Editors Capute, A., Accardo, P., 1996
Lockhart, PJ,. "Long Term Treatment Follow-up of Psychopathology Associated with In-Utero Substance Exposure, 1st International Child and Adolescent Mental Health Conference, Chinese University, Hong Kong, China, 1998 (Abstract). |
