NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT SPECIAL EMPHASIS
AREAS FOR USE IN DISCRETIONARY FUNDING

Release Date:  May 14, 1998

P.T.

National Institute of Child Health and Human Development

PURPOSE

The purpose of this notice is to highlight the special emphasis areas that the
National Institute of Child Health and Human Development (NICHD) will consider
in Fiscal Years 1999 and 2000 when making discretionary funding decisions. 
This notice is a revision of the previous notice concerning the NICHD's
discretionary funding, or select-pay, process published in the NIH Guide for
Grants and Contracts, Vol. 24, No. 31, August 25, 1995.

BACKGROUND

The NICHD has primary responsibility for supporting basic, clinical and
applied research and research training in maternal and child health and human
development; reproductive biology and fertility regulation; population
dynamics; developmental biology and teratology; clinical nutrition; perinatal
and infant morbidity and mortality; human learning and behavior; mental
retardation and developmental disabilities; pediatric, adolescent and maternal
AIDS; and medical rehabilitation.  While the NICHD will continue to fund those
projects that are deemed to be scientifically excellent and innovative within
the full scope of its mission, this notice highlights scientific areas to be
considered by the NICHD when making discretionary funding decisions.

Formally establishing and publishing these special emphasis areas (SEAs) to be
considered for discretionary funding will allow the NICHD to encourage
submission of applications on topics that address areas of public health
importance, that represent timely scientific opportunities, and/or that are
currently underfunded areas in need of increased emphasis.  When used together
with a discretionary funding or select-pay process, the SEAs will help the
NICHD meet program needs and take advantage of scientific opportunities, while
still ensuring that high quality applications are funded.

Complementing the scientific criteria, the NICHD will give special
consideration to applications in the SEAs that are submitted by "new
investigators" to the field.  These include established investigators changing
fields and targeting areas that meet NICHD program needs, and/or investigators
who have not previously received NIH funding.  With the termination of the
First Independent Research Support and Transition (FIRST) (R29) Award by the
NIH, the criterion allows the NICHD to continue to focus attention on this
important group of investigators.

PROCESS

The process described here represents a change from that which has been in
place since 1995 (see the "PURPOSE" section above for complete reference to
the previous notice).  Under this revised NICHD discretionary funding process,
all traditional research grant applications (R01s) that are rated highly by
peer review will continue to be paid, ordinarily, in percentile rank order. 
This ordered funding will continue up to the point where approximately 20
percent of available funds remain.  All R01 applications which are being
reviewed by the National Advisory Child Health and Human Development (NACHHD)
Council in a particular round and that are not paid to that point may then be
considered for discretionary funding.  With the advice of the NACHHD Council,
program staff may recommend funding any of the remaining applications that
address the SEAs.  The SEAs listed below will be used as the first criteria
guiding decisions to pay grants through the discretionary funding or select-
pay process.  These areas will be used as scientific criteria for the next two
years (FY 1999 and 2000).  If researchers are deemed to be new investigators,
as defined above, this will further support their applications for
consideration.

NICHD SPECIAL EMPHASIS AREAS FOR DISCRETIONARY FUNDING

The following areas are organized in alphabetical order.

Alleviation of Reproductive Disorders.  Research is sought to investigate:  a)
potential avenues for the treatment of the sequelae of benign gynecologic or
andrologic diseases or disorders, especially those affecting the reproductive
tract; b) the mechanisms by which these conditions affect male and female
fertility; and/or c) approaches leading to the preservation or restoration of
fertility potential by improved diagnosis and management options.

Behavioral Studies and Interventions to Prevent Injuries and Diseases of
Adults with Origin in Childhood.  Emphasis will be placed on identifying
behavioral, environmental, social, familial, and educational factors that
influence certain life-style and risk-taking behaviors which may lead to
childhood injuries, or to diseases among adults that have their origins in
childhood.  Critical to this topic are studies that address interactions among
subject variables, types of risk behaviors, stages of development,
sociocultural variables, and environmental and educational programs and
interventions that produce resilience, behavioral change and behavioral
compliance, over time and across settings.

Central Nervous System Development:  Normal and Abnormal.  Research is
encouraged on central nervous system (CNS) development and function, including
influences by genetic or exogenous factors, such as infectious agents, trauma,
toxic agents and environmental pollutants, that lead to mental retardation or
other developmental disorders, such as Down syndrome, phenylketonuria, autism,
fetal alcohol syndrome, learning disabilities, neural tube defects, and
cognitive and behavioral problems.  Studies using animal models (vertebrate
and invertebrate) and human subjects, basic studies on processes underlying
CNS development, and the application of structural and functional neuroimaging
techniques are emphasized.

Childhood Antecedents of Adult Disease.  There is an increasing amount of
epidemiologic evidence which indicates that the pathophysiologic origins of
several severe adult diseases may begin early in life.  Studies are,
therefore, encouraged on fetal and childhood antecedents of chronic diseases
which occur later in life, including obesity, insulin resistance, glucose
intolerance, Type I and Type II diabetes, dyslipidemia, atherosclerosis,
hypertension, and osteoporosis.  Studies are also encouraged on developing
genetic and biochemical markers to identify infants and children at high risk
for these diseases later in life.

Contraceptive Development.  Basic, applied, and clinical research is sought to
develop and test new contraceptive drugs, devices and surgical procedures for
either men or women.  Studies may involve molecular, cellular, and
immunological approaches to regulating gamete production, maturation, and/or
fertilization by hormonal or other pharmacological means.  Research on
physical or chemical barrier methods that can prevent both pregnancy and
reduce transmission of sexually transmitted diseases is also encouraged.

Environmental Factors and Behavioral Adaptation in Persons with Chronic
Disability.  Basic or clinical research regarding relationships between
environmental factors and the behavioral adaptation to chronically disabling
physical conditions is a priority.  Areas of interest include: a) basic
studies examining intrapersonal (e.g., perceptual-motor, cognitive, emotional,
or psychophysiological) changes that occur while people with physical
disabilities perform particular tasks in specific environments; b) studies
delineating environmental factors (physical, familial, social, or cultural)
that influence behavioral adaptation; and c) the development and validation of
interventions that utilize any of these factors to promote adaptation.

Etiology and Prevention of Low Birth Weight and Prematurity.  Birth of infants
either too soon (premature) and/or too small (intrauterine growth restriction
or IUGR), and the resultant short- and long-term morbidities, continue to be
unresolved problems.  Research on mechanisms responsible for preterm birth and
IUGR and on their prevention and treatment is sought.

Interrelationships of Health with Demographic and Social Processes. 
Demographic studies of health are encouraged, including studies that link
demographic processes and infant, child and adult health and well-being;
development of relevant, innovative and cost-effective research designs and
measurement tools; studies of health over the life course and across
generations; and studies of health that take into account the physical and
social environment; biologic and genetic factors, socioeconomic and
demographic characteristics such as age, education, gender, race and
ethnicity, income, wealth; and measures of social and economic inequality, and
disability status.

Population Movement and Its Interrelationship with Social, Economic, Health,
and Environmental Factors.  Research is encouraged on the determinants and
consequences of population movement, including international migration,
internal migration, and residential mobility.  Topics of interest include
research on the forces that shape these demographic processes; their impact on
individual health and well-being, families, communities, and society;
processes through which migrants adapt; intergenerational transfers and
generational differences; selectivity of migrants; measurement of population
movement; modeling of selection effects in studies of contextual effects on
demographic behaviors; and research on the interrelationship between the
physical environment and population movement.

Processes of Normal and Abnormal Development, with Emphasis on Germ Cell
Biology and Birth Defects.  Development is a continuum, and NICHD's interests
cover all facets of pre-, peri-, and postimplantation development (as well as
parallel stages in vertebrate and invertebrate models) including gametogenesis
and other aspects of germ cell biology, fertilization, embryogenesis and
organogenesis.  Basic and clinical research is encouraged that seeks to
explain the processes underlying both normal and abnormal development,
including biological and genetic studies of development and reproduction, as
well as the causes and prevention of birth defects.

Rational Strategies for the Development of Drugs for Pregnant and Lactating
Women, Children, and Persons with Disabilities.  The development and testing
of new therapeutic agents for infants, children, persons with disabilities,
pregnant women, lactating women, and other women of childbearing age has
lagged behind new drug development for other populations for a variety of
reasons, including safety concerns, dearth of robust outcome measures,
reluctance to do studies in these populations and lack of appropriate
formulations.  Therefore, research to develop rational strategies for drug
development and novel therapeutic interventions is needed.

Reproductive Endocrinology.  Studies are sought that address the biosynthesis
and secretion of reproductive hormones; structure-function analysis of
reproductive hormone-receptor interactions; evaluation of the signal
transduction pathways mediating the mechanism(s) of reproductive hormone
action; and the neuroendocrinology-mediating processes that regulate
reproduction.

Reproductive Epidemiology.  Research sought includes:  a) epidemiologic
studies to determine the efficacy and adverse effects of contraceptive and
reproductive drugs, devices and surgical procedures as well as to elucidate
the etiology of disorders affecting reproductive health; and b) epidemiologic
studies of factors/conditions that affect fertility (in females or males) or
cause chronic pelvic pain, including endometriosis and leiomyomata (uterine
fibroids), and their treatments.

Secondary Complications of Disabling Conditions.  Preclinical and clinical
studies are encouraged on the pathophysiology and development of conditions
that occur secondary to a primary disabling condition.  Secondary conditions
include, but are not restricted to, pain; spasticity; autonomic dysreflexia;
bowel, bladder, or sexual dysfunction; syringomyelia; pressure ulcers and
other soft-tissue problems; joint dysfunction; infection; deconditioning;
cognitive and memory dysfunction; behavioral dysfunction; and depression.

APPLICATION PROCEDURES

When submitting an application that appears to be responsive to the SEAs as
described above, the investigator should type the title of this notice ("NICHD
SEAs for Use in Discretionary Funding") on line 2 of the face page of PHS Form
398, and mark the "YES" box.  Applications will be assigned according to the
PHS Referral Guidelines and formal determination of the emphasis areas will be
made by NICHD staff.

INQUIRIES

Inquiries regarding this notice are encouraged.  The NICHD welcomes the
opportunity to clarify any issues or questions from potential applicants. 
Inquiries regarding the SEAs or the discretionary funding process may be
directed to:

Sumner Yaffe, M.D.
Center for Research for Mothers and Children
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 4B05, MSC 7510
Bethesda, MD  20892-7510
Telephone:  (301) 496-5097
FAX:  (301) 402-2085
Email:  yaffes@exchange.nih.gov

Florence P. Haseltine, M.D.
Center for Population Research
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8B07, MSC 7510
Bethesda, MD  20892-7510
Telephone:  (301) 496-1101
FAX:  (301) 496-0962
Email:  haseltif@exchange.nih.gov

Marcus Fuhrer, Ph.D.
National Center for Medical Rehabilitation Research
6100 Executive Boulevard, Room 2A03, MSC 7510
Bethesda, MD  20892-7510
Telephone:  (301) 402-2242
FAX:  (301) 402-0832
Email:  fuhrerm@exchange.nih.gov

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