As the ECHO Program moves into 2026, we continue to deepen our understanding of how environmental exposures during pregnancy and childhood influence health outcomes. By studying these early windows of development, ECHO helps identify opportunities for action that strengthen trajectories of health throughout kids’ lives.

On May 6, 2026, ECHO will host the 2nd annual ECHO Translating Science to Action Symposium, a hybrid event that this year focuses on plastics and air quality, highlighting how evidence on these widespread exposures can inform programs, policy, and practice. Feedback on our inaugural Symposium in 2025 was highly positive, and we’ll build on that momentum in this and coming years.

The symposium underscores ECHO’s role in both maximizing scientific insights and translating evidence into action. You can read more about the event in the latest issue of the Connector, and I hope you’ll register to attend.

I look forward to continuing to engage with you—our research community and partners—to enhance child health in 2026 and beyond.

Matthew Gillman, MD, SM
Director of the ECHO Program

As we close out the year, I express my deep gratitude to our many ECHO partners who share our commitment to enhancing child health. As we look toward ECHO’s 10th anniversary in 2026, I have been reflecting on how far our research has come and how essential your partnership has been in shaping its impact.

Despite some challenges, this year saw sustained momentum across ECHO’s two components. The ECHO Cohort, now well into its second 7-year cycle as the nation’s largest longitudinal child health study, continues to answer solution-oriented questions about how a broad range of early environmental exposures affect child health and development. The Cohort Consortium now also examines influences on child health that begin even before conception, including exploring the role of fathers during this foundational period. The ECHO Cohort continues to make its data accessible to the wider scientific community through the DASH platform and the ancillary studies program, which we began earlier this year.

The IDeA States Pediatric Clinical Trials Network entered a new multiyear phase with several pilot studies underway. I’m pleased that, early in 2026, the Network will begin recruiting participants for a full-scale, FDA-monitored clinical trial evaluating the extent to which phentermine can safely and effectively reduce body mass index (BMI) among rural and underserved adolescents with obesity—a group for whom lifestyle modification alone is often insufficient and accessible pharmacologic options are limited. Phentermine is a potentially safe and accessible option approved by the FDA in 1959 for individuals 16 years old or older.

We were proud to host ECHO’s first annual Translating Science to Action Symposium in September 2025. The event brought together more than 1,000 child health researchers, clinicians, policymakers, advocates, community leaders, and families to bridge the gap between cutting-edge child health science and actionable solutions that can be implemented in real-world settings. Learn more here and watch this space for news about our 2026 Symposium.

Thank you for your continued support and partnership. I wish you and your loved ones a restorative holiday season and a bright start to the year ahead.

Matthew Gillman, MD, SM
Director of the ECHO Program

I am happy to announce that ECHO has made 19 awards totaling over $13 million for FY 2026 for the ECHO Institutional Development Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN).

These awards support institutions located in 18 IDeA eligible states to serve as Clinical Sites and a Data Coordinating and Operations Center (DCOC) for the ISPCTN.

Each clinical site will:

• Develop, conduct, and disseminate findings from multicenter pediatric clinical trials that ensure the participation of children living in rural or underserved communities in IDeA states;
• Build pediatric clinical trial research capacity within these IDeA states;
• Engage communities, nonprofit organizations, and professional societies to enhance clinical trial impact, transferability, rigor, and feasibility.

The DCOC will serve as the central hub for the ISPCTN, providing essential leadership and infrastructure for the network.

ECHO funded these awards after a competitive peer review process. View a list of awardees.

Matthew Gillman, MD, SM
Director of the ECHO Program

Entering its 10th year, the ECHO Program is expanding its reach to enhance the health of children across the U.S. In this message, I highlight two ways ECHO is magnifying its impact: helping to translate ECHO research into tangible action via our upcoming Symposium, and broadening access to ECHO data and biospecimens to catalyze their widest use by the research community via ancillary studies.

First, I hope you will join us for the inaugural ECHO Symposium: Translating Science to Action on September 15, 2025, at the NIH campus in Bethesda, Maryland, and online. This free, one-day event will bring together scientists, clinicians, policymakers, advocates, community leaders, and more to explore how early-life environmental factors shape child health—and how we can collaboratively move research into action.

Second, I’m pleased to highlight the ECHO Cohort’s new ancillary studies process. Through this process, any eligible researcher, including those outside of ECHO, can access the rich data on the full ECHO Cohort Data Platform. They can also request biospecimens from the ECHO Cohort Biorepository. The rapidly growing biorepository contains a wide range of specimens from our pregnant and child participants, including blood, urine, stool, placenta, nasal swabs, shed teeth, and other samples. These data and specimen resources enable researchers to explore an almost limitless set of important research questions on the causes and prevention of preterm birth, asthma, obesity, autism, and ADHD, to name a few conditions, as well as how to preserve health as children grow and develop.

A wide range of analyses is possible with an ECHO Cohort ancillary study. Examples include:

• Detecting modifiable early developmental exposures that, if addressed by programs, policies, and practices, could enhance child health outcomes across the life course.
• Exploring pathways to child health outcomes that incorporate state-of-the-art analytical biochemical or statistical methods.
• Examining resilience or susceptibility factors that buffer or amplify the effects of adverse early exposures on child health outcomes.
• Identifying periods of development most sensitive to specific beneficial or detrimental exposures to inform new strategies to promote child health.
• Measuring the effects of natural experiments or new health innovations on child health outcomes.

Visit the ancillary studies page to get started.

Matthew Gillman, MD, SM
Director of the ECHO Program

I am delighted to announce the inaugural ECHO Symposium: Translating Science to Action on September 15, 2025, at the NIH campus in Bethesda, Maryland, and online.

Register today to join in person or online.

Please join me for this free-to-attend, one-day event that aims to translate child health research findings from ECHO and others into action by informing intervention programs, health policies, and clinical practice. Experts from multiple disciplines will explore factors that influence child health and address opportunities to prevent childhood disorders and enhance well-being. Join representatives of professional societies, advocacy groups, federal partners, Congress, state and local governments, research participants, and others.

Three sequential sessions will cover Chemical Exposures, Social and Neighborhood Factors, and Community Experiences. Each session will feature a chair, presenters, and a discussant to kick off a panel discussion that follows presentations. Both in-person and online attendees will have the chance to ask questions.

I look forward to seeing you there.

Matthew Gillman, MD, SM
Director of the ECHO Program

Now that the NIH ECHO Program is in its 9th year, it’s a good time to see how far we’ve come. ECHO continues to produce impactful research on the root causes of chronic childhood disease, including preterm birth, allergies and asthma, obesity, autism spectrum disorder, ADHD, and mental health challenges, among others. These causes may include what pregnant women and children eat, chemicals to which they are exposed, stress, and many other factors that ECHO researchers explore.

In its second 7-year cycle, the ECHO Cohort is enrolling pregnant women and their children in numbers even beyond what we projected. These new participants add to the potential impact of ECHO Cohort, already the largest longitudinal child health study in the U.S. The ECHO Cohort draws data from more than 130,000 participants, including more than 60,000 children, nationwide.

The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) has built the capacity to take on more and more complex issues, and its success is also reflected in the funding its sites have secured to address actionable research questions outside the Network’s own priority areas. The ECHO ISPCTN is the only NIH clinical trial network focused on children from rural or underserved communities, and some of its studies have already changed clinical practice in these areas.

I mention these accomplishments, in part, because they are aligned with the new administration’s “Make America Healthy Again” focus. ECHO plays a leading role in NIH research that “addresses the childhood chronic disease crisis.” In addition to pinpointing root causes, ECHO informs prevention of chronic conditions and promotes well-being among America’s children.

Thank you, as always, for helping us achieve ECHO’s mission to enhance the health of children for generations to come.

It has been a big year for the ECHO Program.

Among other successes, ECHO Cohort enrollment during pregnancy and during childhood has exceeded targets, and our pioneering work on preconception influences on child health is now off the ground. Our researchers continue to publish findings that inform programs, policy, and practice.

In the December issue of the ECHO Connector, we highlight research into birth outcomes of pregnant women living in historically redlined neighborhoods, and the association between exposure to flame-retardants during pregnancy and childhood obesity risk. Don’t miss our ECHO Cohort Year in Review (summarized below) on ECHOchildren.org.

In the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN), the first phase of the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Weaning trial*— which compares rapid with slow opioid weaning among newborns with NOWs who require medication treatment — is complete. Study teams are now following children through the age of 2 years to look at development and family functioning. Our investigators also published two new papers from the landmark ACT NOW Eat, Sleep, Console trial.

The Bronchiolitis Recovery and the Use of High Efficiency Particulate Air (HEPA) Filters (BREATHE) trial, which aims to determine the extent to which indoor air filtration improves respiratory symptoms in children under 12 months of age who have been hospitalized for bronchiolitis, is complete. The study staffs across the 17 sites not only recruited participants faster than we anticipated, but they also retained a very high number of them through 6 months of follow-up, thus enhancing validity of results. We await the primary findings of the Weaning and BREATHE trials.

Thank you for your continued support for the ECHO Program. Have a wondrous holiday season!

Matthew Gillman, MD, SM
Director of the ECHO Program

*ACT NOW clinical trials represent a collaboration between the ECHO Program and the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), funded through the NIH Helping to End Addiction Long-term® Initiative (HEAL).

The 9th annual Children’s Environmental Health (CEH) Day is Oct. 10, 2024.

First observed in 2018 by the Children’s Environmental Health Network, this observance serves as a platform for education and advocacy, emphasizing that children are particularly vulnerable to environmental hazards.

In the September issue of the ECHO Connector, we highlight a recent scoping review, by Emily Barrett, PhD, MA from Rutgers University and colleagues, which assessed the impact of chemical exposures on maternal and child health using ECHO Cohort data.

In addition, ECHO researchers have published 1,800+ journal articles investigating how a broad range of early environmental influences affects child health outcomes.

Our investigators are helping to advance understanding of how chemical exposures and other influences impact the health and well-being of children and families. Learn what we’re finding about chemical exposures at echochildren.org. You can find out more about CEH Day and learn how to get involved at cehday.org.

I also hope you’ll join ECHO on Oct. 9 at 12 pm ET on X for a social media chat hosted by the Children’s Environmental Health Network.

Thank you as always for your support.

Researchers across the ECHO Cohort Consortium and ECHO ISPCTN have now published more than 1,700 research articles. Recent research publications include associations of synthetic oxytocin, socioeconomic stress, and the infant gut microbiome with neurodevelopment and behavior outcomes in children, and another investigates the relationship between phthalate exposure and high blood pressure during pregnancy.

As we explored in our recent commentary in the American Journal of Epidemiology, ECHO breaks new ground not only by collecting data and samples for widespread use by the scientific community but also by building tools to investigate complex mixtures of environmental and social determinants of health.

Beyond our publications, ECHO continues to communicate through our live monthly ECHO Discovery webinars about research in progress, open to all. Our ECHO Research Spotlight (below) features work that ECHO researchers highlighted at one such recent webinar. We have also posted recordings of our May 2024 webinar on racism and maternal health disparities, our June webinar on fish consumption during pregnancy, and our July webinar on emerging trends in pediatric obesity. Our August webinar will focus on epigenetic regulators in human milk.

Whether you are a participant or researcher powering ECHO’s science, or a policymaker or advocate looking for better information to enhance child health, we hope you are benefitting from our work. Thank you.

—Matthew W. Gillman, M.D., S.M.

This month several observances shed light on crucial areas of ECHO research. From Clinical Trials Day to Air Quality Awareness Week, and from Asthma and Allergy Awareness Month to Children’s Mental Health Awareness Week, May presents an opportunity to highlight the breadth of research efforts the ECHO Program makes to achieve its mission to enhance child health for generations to come.

Clinical Trials Day, celebrated on May 20, allows us to highlight important advancements of ECHO’s intervention component, the ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN). In the network, researchers test carefully designed interventions, particularly among rural or underserved pediatric populations, to enhance children’s health in at least one of ECHO’s five health focus areas. I’m grateful to all our ECHO ISPCTN investigators, staff, and participants for their dedication to furthering the ECHO mission through clinical trials research.

One of these clinical trials is the BREATHE—Bronchiolitis Recovery and the Use of High Efficiency Particulate Air (HEPA) Filters—study. The goal of this ECHO ISPCTN research is to determine the extent to which indoor air filtration improves breathing symptoms among infants who have been hospitalized for bronchiolitis, a common respiratory disease in very young children. As we mark Air Quality Awareness Week and Asthma and Allergy Awareness Month, the BREATHE study reminds us of the influences that toxic environmental factors like indoor air pollution can have on children’s lungs.

In the May ECHO Connector’s News from the NIH section, please read about our current Request for Information (RFI) to inform ongoing strategic planning for the ECHO Program. I encourage you and your colleagues to participate by submitting your feedback and suggestions by May 31, 2024.