KL2 Program Fosters Collaborative Research on Hearing Loss, Behavioral Disorders in Appalachia

Dr. Matt Bush and Tina Studts, Ph.D., work with children from Appalachia in very different capacities – he's a pediatric ear surgeon, and she studies childhood behavioral disorders – but in both of their fields, timing is everything. 

For children with hearing loss or disruptive behavioral problems, early intervention is critical to prevent negative, lifelong effects on education, employment, and well-being."The impacts of hearing loss in children are immense, and they're lifelong," Bush said. "It's sort of a race against the clock to be able to identify hearing loss, if it's there, and to treat it appropriately to help a child develop oral communication." 

Childhood behavior problems, meanwhile, are associated with school dropout, drug use and involvement in the juvenile justice system. 

"It's clear that the earlier you can identify kids and the earlier you can intervene, even in a preventive way, you can offset all these really devastating, long term effects," Studts said. 

Bush and Studts, who met through the KL2 career development program for junior faculty, speculated that the connection between pediatric hearing loss and behavior disorders might extend beyond the shared importance of timely intervention. 

"This is something that those of us that are in practice that care for children with hearing loss know – that inherent difficulties in communication can cause problems with behavior," Bush said. 

When he saw a paper in his field that suggested behavioral disparities between children with and without hearing loss, the two researchers immediately recognized an opportunity for collaboration. With pilot funding support from the Center for Clinical and Translational Science, which also facilitates the KL2 program, Bush and Studts are working with families in Kentucky to investigate and compare rates of behavior problems in three groups of children: those without hearing loss, those with hearing loss who have a cochlear implant and those with hearing loss who have a hearing aid. 

Their project involves piloting a specific behavioral parent training program called the "Family Check-Up," which they plan to test as an annual aspect of care for children and families who are already receiving regular and frequent care related to pediatric hearing loss. The data and outcomes generated through this pilot research will be used to support applications for further grant funding. 

"We're interested in implementation. We're going to be pilot testing a lot of measures and then hopefully taking all this information and developing a larger grant application to do a wide-scale test," Studts said. 

She and Bush credit the KL2 program not only for fostering their collaborative project, but for accelerating their individual research careers as well. The program is designed to help junior investigators obtain independent investigator awards and provides funding, research training, conference travel support, and mentorship to that end. Both researchers have recently completed their two-year tenures as KL2 scholars. Studts received an R34 grant from the National Institute of Mental Health for a community-engaged project to adapt an evidence-based parenting intervention to be acceptable and accessible to parents in under-resourced Appalachian communities. Bush was awarded a K23 grant to develop and implement a novel intervention for promoting early diagnosis of congenital hearing loss through patient navigation. 

"It was professionally life-changing," Studts said, who benefited from participating in national conferences, workshops at other institutions and long-term planning of research goals. 

Bush also recognizes the specific benefits of the KL2 program for clinicians, whose clinical demands can leave little time for research. 

"Clinicians sometimes fall back on their default mode, which is to take good care of patients and to see patients on a daily basis. And even though they may be bright and have promise in the research realm, if they're not really connected with the right people, the right mentors,  and the right opportunities, then the research potential somewhat fizzles out," he said. 

Vickie King, Ph.D., career development director for the CCTS, describes Bush and Studts as an outstanding example of interdisciplinary team science, which is a national priority of the KL2 program. 

"Our focus is to help transform research at the University of Kentucky through providing career development support for junior faculty who want to engage in clinical and translational sciences," King said. "I feel extremely fortunate to work with scholars like Matt and Tina, who are really passionate about doing research, and to be able to provide them with the support that they need to start their research programs."