Over the past 30 years, Dr. Msall has been involved with understanding the complexity of child, adolescent and young adult outcomes after new neonatal technologies, whether genetic, pulmonary, ophthalmological or neuroprotective. With interdisciplinary colleagues, he developed a pediatric functional independence measure (WeeFIMTM) that was used for 3-7 year outcomes in three NIH Multicenter Studies: Cryosurgery for Retinopathy of Prematurity, Fetal Surgery for Myelomeningocele (Danzer et al Fetal myelomeningocele surgery: preschool functional status using the Functional Independence Measure for children (WeeFIM). Childs Nerv Syst. 2011 Jul; 27(7): 1083-8. (PMID: 21327591), and the Cool Cap trial of head cooling for neonatal encephalopathy (Guillet et al Pediatr Res. 2012 Feb; 71(2): 205-9 PMID: 22258133).
In the follow-up at age 5 years of children enrolled in surfactant comparison trials and in inhaled nitric oxide studies for preterm respiratory distress syndrome (NCT00152542), he demonstrated that the multidimensional concept of school functioning at kindergarten entry could provide important information about the impact of children’s health and developmental status on educational success and community functioning.
In the multicenter cryosurgery after retinopathy of prematurity RCT, Dr. Msall and his colleagues demonstrated that explicitly measuring motor, communicative and self-care functioning in daily activities at age 5.5 years could improve understanding of pathways underlying severe multiple neurodevelopmental disabilities and that among 8-10 year old children with favorable visual outcomes there were dramatic reductions of developmental disabilities, special education services and below-grade-level academic performance.
Most recently he has completed with colleagues in the Extremely Low Gestational Age Newborn Observational Study(K Kuban PI) how retinopathy of prematurity and visual fixation are linked to adverse neurodevelopmental outcomes at age 2. In the 10-year follow-up of the ELGAN cohort, biomarkers of inflammation are being linked to protocolized neuroimaging, cognitive, executive function and educational assessments. Currently he is involved in three multicenter neuroprotective trials Neonatal Erythropoietin And Therapeutic Hypothermia Outcomes in Newborn Brain Injury (NEAT O) NCT01913340 (Y Wu PI):Trial of Erythropoietin Neuroprotection in Extremely Preterm Infants (PENUT) (NCT01378273) (S Juul PI) and PAEAN – Erythropoietin for Hypoxic Ischaemic Encephalopathy in Newborns (H Liley PI). In each of these trials he has trained interdisciplinary professionals to implement neurodevelopmental observations and protocolized assessments to understand children’s health, functioning, and family well-being.
Since 1997, Dr. Msall has collaborated with Sullivan and colleagues in a longitudinal observational study of preterm infants with diverse medical risks and prospectively recruited term controls in applying indicators of whole child, adolescent, and adult measures of physical and behavioral health, cognitive outcomes, and educational/community functioning. They are currently proposing a 30 year outcome study that examines how cumulative risk and protective factors across neonatal, preschool, middle childhood, and adolescent development impact on the life-course health outcomes and the role of neuroendocrine, inflammatory, and metabolic biomarkers on these outcomes. In current studies, he is examining the role of medical and social risk and protective factors on functioning, resiliency, quality of life and economic impact among children with critical illness, genetic disorders, or developmental disabilities.