Research
Current Studies
Youth Conversation Simulator and Performance Evaluator: A TMU and Kids Help Phone Partnership
From TorontoMet Today
Volunteer crisis responders at Kids Help Phone (KHP) will soon benefit from enhanced training thanks to a groundbreaking AI-powered tool developed through a collaboration between an interdisciplinary team of TMU researchers and KHP team members including researchers and clinical staff. The project is supported by a $3.2 million grant from Wellcome, a U.K.-based charitable foundation.
This is the first major joint project TMU and KHP are undertaking as part of a new, five-year research partnership focused on advancing solutions in child and youth mental health through technology-enabled innovation. Read more
Supporting Transition Age Youth with Intellectual and Developmental Disabilities and those who Care for Them
Youth with intellectual and developmental disabilities (IDD) often face significant barriers to accessing healthcare and other supports, particularly as they transition from pediatric to adult services. Navigating complex systems, long waitlists, limited specialized care, and services that do not address the whole person can contribute to poorer health and well-being for youth and their families.
These challenges may be even greater for youth who experience structural barriers and discrimination related to factors such as race, gender, age, national origin, and disability. However, little research has examined how these intersecting inequities shape the experiences of youth with IDD during the transition to adulthood.
This research aims to better understand the experiences of diverse youth with IDD and their caregivers, identify barriers and gaps in existing systems of care, and work alongside community organizations to inform more equitable, accessible, and responsive services and policies.
Past Studies
WISE Caregivers
Parenting Stress in Mothers with Problematic Substance use: What does problem-solving have to do with it?
Talk to any parent and they will tell you that “on the fly problem-solving”, multi-tasking, stopping what you are doing and shifting focus on a dime, and keeping lists of things in mind while navigating your day, is par for the course when it comes to parenting.
These parenting behaviours draw on executive functions, higher order cognitive abilities that support effective problem-solving and goal-direction action. While many studies have examined executive functions and their association with children’s mental health, parents executive functions have only recently been studied. Further, most studies that have looked at parents have not examined clinical samples who may be navigating greater challenges related to mental health, executive functions, and social and structural barriers to well-being, such as mothers with problematic substance use.
We completed a study with 74 mothers of children (0-3 years) who were attending outpatient substance use treatment in Ontario, Canada. They completed performance-based tasks assessing the three primary EF processes (inhibition, flexibility and working memory), along with self-report questionnaires assessing relational parenting stress, household chaos, socioeconomic stress, depressive symptoms, and substance use severity.
We found that maternal depressive symptoms and socioeconomic stress were the strongest predictors of relational parenting stress and household chaos. For relational parenting stress, weaker inhibition and working memory predicted parenting stress. Conversely, stronger set-shifting significantly and positively predicted household chaos. Self-reported substance use severity was not significant.
Thank you to the parents who participated in these studies, the ECD programs in Ontario that opened their doors to support data collection, and the many graduate and undergraduate students who supported data collection and analysis, including the lead author of this study Victoria Ingram, MA thesis). Thank you to the TMU Health Research Award for generous funding that supported completion of this study.
WISE Implementation of Parenting Interventions within Integrated Substance Use Programs
Mothers experiencing problematic substance use often face complex challenges, including mental health concerns, trauma, socioeconomic stress, and involvement with child protection services. Integrated treatment programs address many of these concerns, but evidence-based parenting interventions are not consistently available within these programs.
This study examines the implementation of Attachment and Behavioural Catch-up for Infants (ABC-I), an evidence-based parenting intervention, within two integrated treatment programs in Ontario. Using a mixed-methods approach, the research explored the experiences of service providers and mothers to understand what helps (and hinders) the deliver an evidence-based parenting program in real-world community settings.
Findings highlighted several strengths of ABC-I, including on positive parent-child interactions and strength-based feedback. At the same time, challenges related to client engagement and scheduling, intensive provider training, program costs, and the need to balance intervention fidelity with flexibility and individualized care afected its feasibility and sustainability.
Neurodiversity and Youth Mental Health Intervention
Integra Mindfulness Martial Arts (R), commonly known as Integra MMA or MMA is a 20-week transdiagnostic group treatment for adolescents with learning disabilities (LD) and mental health problems (MH) developed by the Integra Program at the Child Development Institute.
Adolescents with a broad range of mental health disorders (e.g., ADHD, anxiety, depression, oppositional defiant disorder) and learning profiles are treated together, based on the assumption that to improve problem-solving skills and social and emotional well-being, youth need to become aware of their distress and remain present with it rather than engaging in behaviours that facilitate avoidance. combines mindfulness, cognitive therapy, and behavioural activation strategies to achieve this. A unique aspect of Integra MMA is that these therapeutic components are embedded in martial arts training. Martial arts plays two key roles. First, it promotes engagement in therapy for youth who would not normally engage or stay in treatment (Milligan, Badali, & Spiroiu, 2013). Since 2002, over 450 youth have participated in Integra MMA, with impressive treatment completion rates exceeding 95%. Second, martial art is an experiential vehicle that provides opportunities for youth to practice attentional control, self-monitoring, and staying present with challenging tasks rather than engaging in impulsive patterns of fight or flight when faced with stress.
We are interested in the attention, cognitive processing and mental health outcomes associated with this treatment and how best to support the implementation of this program in community settings, such as schools.
Our research on Integra MMA supports the following promising outcomes:
-reduced externalizing behaviour (e.g., aggression) in youth with ADHD+LD compared to a waitlist control (Haydicky, Weiner, Badali, Ducharme, & Milligan, 2012)
-decreased self-reported anxiety in youth with LD + anxiety compared to a waitlist control (Haydicky, Weiner, Badali, Ducharme, & Milligan, 2012)
-significant gains on EEG indices of attention compared to a waitlist control (Sibalis et al., in press; Milligan et al., submitted), and
-significant gains in secondary control and realistic thinking compared to a waitlist control (Milligan et al., 2017).
Funding: Scottish Rite Foundation
Videos about Integra’s MMA™ program:
Dr. Milligan presenting on Integra’s MMA™ program to the Scottish Rite Charitable Foundation.