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February 21, 2023; 100 (8) Research Article

The ALIGN Framework

A Parent-Informed Approach to Prognostic Communication for Infants With Neurologic Conditions

Monica E. Lemmon, Mary C. Barks, Simran Bansal, Sarah Bernstein, Erica C. Kaye, Hannah C. Glass, Peter A. Ubel, Debra Brandon, Kathryn I. Pollak
First published December 1, 2022, DOI: https://doi.org/10.1212/WNL.0000000000201600
Monica E. Lemmon
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Mary C. Barks
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Simran Bansal
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Sarah Bernstein
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Erica C. Kaye
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Hannah C. Glass
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Peter A. Ubel
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Debra Brandon
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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Kathryn I. Pollak
From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
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The ALIGN Framework
A Parent-Informed Approach to Prognostic Communication for Infants With Neurologic Conditions
Monica E. Lemmon, Mary C. Barks, Simran Bansal, Sarah Bernstein, Erica C. Kaye, Hannah C. Glass, Peter A. Ubel, Debra Brandon, Kathryn I. Pollak
Neurology Feb 2023, 100 (8) e800-e807; DOI: 10.1212/WNL.0000000000201600

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Article Information

vol. 100 no. 8 e800-e807
DOI: 
https://doi.org/10.1212/WNL.0000000000201600
PubMed: 
36456199

Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received June 16, 2022
  • Accepted in final form October 7, 2022
  • First Published December 1, 2022.

Article Versions

  • Previous version (December 1, 2022 - 12:45).
  • You are viewing the most recent version of this article.
Copyright & Usage: 
© 2022 American Academy of Neurology

Author Disclosures

    1. Monica E. Lemmon, MD,
    2. Mary C. Barks, MA,
    3. Simran Bansal,
    4. Sarah Bernstein, MD, MHA,
    5. Erica C. Kaye, MD, MPH,
    6. Hannah C. Glass, MD,
    7. Peter A. Ubel, MD,
    8. Debra Brandon, PhD and
    9. Kathryn I. Pollak, PhD
  1. Monica E. Lemmon, MD,
  2. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. (1) National Institute of Neurological Disorders and Stroke of the National Institutes of Health, K12NS098482, PI, 2018-2020 (2) Patient Centered Outcomes Research Institute, Site PI, 2016-2020(3) National Institute of Neurological Disorders and Stroke of the National Institutes of Health, K23K23NS116453, PI, 2020-2021(4) National Institute of Neurological Disorders and Stroke of the National Institutes of Health, R01NS111166, ProjectSite PI, 2020 - 2025(5) National Institute of Neurological Disorders and Stroke of the National Institutes of Health, R01NS124051, Site PI, 2022 - 2027

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. BAND FoundationDoris Duke Charitable FoundationDerfner FoundationNational Palliative Care Research Center

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  3. Mary C. Barks, MA,
  4. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  5. Simran Bansal,
  6. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  7. Sarah Bernstein, MD, MHA,
  8. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  9. Erica C. Kaye, MD, MPH,
  10. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. Career Development Award from the National Palliative Care Research Center (2019-2022)

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  11. Hannah C. Glass, MD,
  12. Scientific Advisory Boards:
    1. (1) Non profit entity (NIH)

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. Pediatric NeurologyEditorial board2013-present

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. PCORI CER-1507-31187 mPI 2017-2020NIH/NINDS R01NS104322 PI 2018-2022NIH/NINDS R01NS111166 mPI 2020-2024NIH/NINDS R01NS124051 mPI 2022-2027

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. Cerebral Palsy AllianceThe Marcus Program in Precision Medicine Innovation (MPPMI)

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. Consultant for various legal firms

  13. Peter A. Ubel, MD,
  14. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. NONE

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  15. Debra Brandon, PhD and
  16. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. Advances in Neonatal Care, Co-Editor in Chief, 2012 to present

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  17. Kathryn I. Pollak, PhD
  18. Scientific Advisory Boards:
    1. None

    Gifts:
    1. NONE

    Funding for Travel or Speaker Honoraria:
    1. None

    Editorial Boards:
    1. Nicotine Tobacco Research, Associate Editor 2017-present

    Patents:
    1. NONE

    Publishing Royalties:
    1. NONE

    Employment, Commercial Entity:
    1. NONE

    Consultancies:
    1. NONE

    Speakers' Bureaus:
    1. NONE

    Other Activities:
    1. NONE

    Clinical Procedures or Imaging Studies:
    1. NONE

    Research Support, Commercial Entities:
    1. NONE

    Research Support, Government Entities:
    1. NONE

    Research Support, Academic Entities:
    1. NONE

    Research Support, Foundations and Societies:
    1. None

    Stock/Stock Options/Board of Directors Compensation:
    1. NONE

    License Fee Payments, Technology or Inventions:
    1. NONE

    Royalty Payments, Technology or Inventions:
    1. NONE

    Stock/Stock Options, Research Sponsor:
    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:
    1. NONE

    Legal Proceedings:
    1. NONE

  1. From the Departments of Pediatrics (M.E.L., M.C.B., S. Bansal, S. Bernstein), Population Health Sciences (M.E.L., K.I.P.), Duke University School of Medicine, Durham, NC; University of Utah School of Medicine (S. Bernstein), Salt Lack City; Department of Oncology (E.C.K.), St. Jude Children's Research Hospital, Memphis, TN; Departments of Neurology and Pediatrics (E.C.K.), UCSF Benioff Children's Hospital and Department of Epidemiology & Biostatistics (H.C.G.), University of California, San Francisco; Fuqua School of Business and Sanford School of Public Policy (P.A.U.), Duke University, Durham; and Duke University School of Nursing (D.B.), Durham; Cancer Prevention and Control (KIP), Duke Cancer Institute, Durham, NC.
  1. Correspondence
    Dr. Lemmon monica.lemmon{at}duke.edu
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Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

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