Abstract Details

Title Addressing Health Care Disparities Through a Neurodevelopmental Clinic for Early Exposures

Topic Practice, Policy, and Ethics

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 14-005

Objective To establish a Neurodevelopmental Clinic for Early Exposures aimed at providing comprehensive diagnostic and therapeutic services for children affected by prenatal exposures to substances and infections, with the goal of optimizing long-term neurodevelopmental outcomes.

Background The fetal brain is uniquely vulnerable to environmental insults during critical periods of neurodevelopment. Prenatal exposures, including maternal immune infection, stress, undernutrition, and substance use, have been implicated in a range of neurodevelopmental disorders (NDDs). These biological risks are often compounded by adverse childhood experiences, amplifying the likelihood of cognitive, behavioral, and psychiatric impairments. With increasing rates of exposures and substance use in pregnancy, there is an urgent need for coordinated early identification and intervention to mitigate the long-term neurological impact.

Design/Methods

As part of an AAN Health Care Equity Program project, the clinic was launched in April 2024 as a single-provider model within the Kennedy Krieger Institute, integrating referrals across multiple specialty programs. It focuses on children aged 3–10 years with known intrauterine exposures and emerging neurodevelopmental concerns, emphasizing early detection and intervention. The program takes a lifespan approach, facilitating transition from neonatal risk identification to comprehensive neurological and neuropsychological evaluation in school-age and beyond. Key collaborators include neuropsychology, behavioral psychology, speech and occupational therapy, and social work.

Results From April 2024-August 2025, 92 patients were referred to the clinic. Patients had a range of prenatal exposures including polysubstance use (26%), opioids (25%), alcohol (23%), infections such as CMV, syphilis, or Zika (7%), THC (5%), and cocaine (3%). All presented with developmental or behavioral concerns such as ADHD, autism spectrum disorder, learning difficulties, and emotional dysregulation.

Conclusions

The clinic provides a novel framework for early identification and intervention in children with prenatal exposures. Future directions involve expanding the clinic into an integrated, multidisciplinary neurodevelopmental program that serves as a centralized hub for comprehensive care.

Authors/Disclosures
Meghna Rajaprakash, MD (Kennedy Krieger Institute, Neurodevelopmental Disabilities/Child Neurology) PRESENTER	Dr. Rajaprakash has nothing to disclose.

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