Ashley Fournier-Goodnight, PhD

Cancer can present at any time and any age. When it presents at a very young age, in infancy or throughout the toddler years (ages 0-3), the effects of cancer and its treatment can appear differently than in older patients. This is especially true in regard to the impact of cancer and treatment on a young child’s developing cognition, observed in slight changes to skills like memory, attention, language and problem-solving abilities, among others. Because these disease- and treatment-related cognitive changes are slight or may appear later in life, my clinical research aims to develop and implement cognitive assessments that improve the prognostication and direction of care for our youngest patients. 

The rapidly developing brain of a young child is an ever-changing landscape that makes the assessment of cancer- and treatment-related neurocognitive changes challenging but essential. To meet this need, my work concentrates on the following clinical research areas in an effort to expand our understanding of the neurocognitive impacts of cancer and its treatment on infants and young children.

The results of SJYC07 gave the field of neuro-oncology a wealth of information regarding risk-based treatment approaches for infants and young children with high grade gliomas. But, for those patients who experienced seizures, we know less about how the experience of these seizures impacts outcomes. To assess this impact, I am retrospectively analyzing data from the SJYC07 trial to examine how the presence or absence of seizures impacted outcomes in this patient population. I am also seeking to understand how often cortical reorganization happens in pediatric patients with brain tumors and what these profiles look like when we actively examine whether cortical reorganization happened as a result of cancer or treatment.  

For pediatric patients with brain tumors who receive CAR T–cell therapy as part of the Loc3CAR study, I am actively working to characterize what neurotoxicity of treatment looks like for them. As an active member of the trial, I perform bedside examinations of patients using pediatric neurocognitive assessments both before and after infusion of modified CAR-T cells to establish the progression of neurotoxicity-related symptoms. This work is vital to inform the progression of CAR T–cell therapy as a safe and effective treatment for pediatric brain tumors.

Due to the rapid brain development that occurs through ages 0-3 years, cognitive changes that may present because of disease or treatment can be difficult to detect if not assessed with sensitive neurocognitive assessments. This need is further complicated when children are diagnosed with ultra-rare neurological diseases as many of these conditions do not have established neuropsychological profiles. Part of my work with the St. Jude Center for Experimental Neurotherapeutics (CENT), is to develop neurocognitive assessments that are sensitive enough to detect changes in the cognitive skillsets of pediatric patients who may not possess typical neurobehavioral skillsets and for whom changes may be minor.

My desire to work collaboratively with investigators and clinicians to proactively assess neurocognitive changes in our youngest and most vulnerable patient population guides all aspects of my research as we collectively seek to provide care and treatment that gives patients and families adequate information to prepare for life during and after treatment.

Ashley Fournier-Goodnight, PhD, is a licensed psychologist and a board-certified clinical neuropsychologist with expertise in pediatric patients with acute neurological injury. She completed her PhD in School Psychology at Texas Woman’s University followed by a postdoctoral fellowship at St. Jude in pediatric neuropsychology. As a faculty member at St. Jude with a clinical research focus, Fournier-Goodnight focuses on childhood neuropsychology and the impacts of pediatric acute neurological injury. In her clinical work, she assesses patients in the Early Childhood Clinic along with infants and toddlers through the Acute Neurologic Injury program while also working to implement a new evidence-based neuropsychological consultation and assessment model. Her research is a collaborative effort to advance the utilization of neurobehavioral assessments of infants and toddlers to progress prognostic and care efforts in this population.