I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.

From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes how I write, how I testify, and how I remember.

In Ohio, I reclaimed rural developmental clinics that had been neglected by my predecessor. These clinics brought care to children long ignored by institutional medicine. We integrated speech, OT, psychology, and pediatrics into a single operational model. No one handed us a blueprint. We built it ourselves.

Over five years, we expanded from occasional visits to 4 sites into a network that included 25 developmental clinic sessions across 8 counties, plus 10 behavioral clinic sessions in 2 more. Children from 20 neighboring counties came for evaluations. That work earned the Academic Pediatric Association’s 2003 Health Care Delivery Award, but more importantly, it gave families access to care they had never had before.

Later, I became the chief pediatrician, alongside a former fellow, in the NIH-funded RUPP Autism Network, shaping landmark studies on psychopharmacology and autism spectrum disorders. Our work focused on disruptive behavior in children with ASD, exploring the efficacy and safety of medications like risperidone, methylphenidate, and atomoxetine. I co-designed protocols, performed DSM-IV evaluations, analyzed data, and prepared manuscripts. But my most pivotal role came during the final editorial review of our risperidone discontinuation study, published in the New England Journal of Medicine.

The Data Safety Monitoring Board had halted the study two-thirds through the sample. The findings were clear, but the manuscript was a patchwork: multiple authors, multiple voices, no coherent message. I was asked to edit the final draft. I stripped out every passive sentence. I clarified the clinical implications. I made sure the paper spoke plainly and powerfully, just as our patients deserved.

That paper became a touchstone. It validated what many of us had seen in practice: That risperidone could be effective, but discontinuation required careful monitoring. It also showed that pediatric voices, when trusted, could sharpen the impact of psychiatric research.

I authored or co-authored eight additional peer-reviewed articles within the RUPP consortium. My side studies added depth to the pharmacologic findings, including nutritional intake and weight normalization after medication withdrawal. These were not academic exercises. They were real-world tools for families navigating complex care.

I collaborated closely with Mike Aman, PhD, and the late Gene Arnold, MD, two giants in the field. Gene, a psychiatrist, chaired the Multimodal Treatment of ADHD (MTA) Study, which proved that combination treatment was superior to medication or behavioral therapy alone. Mike brought statistical rigor and clinical insight to every project. I brought a practical pediatric lens to the RUPP. Together, we shaped national discourse on autism treatment and pediatric mental health.

Later, as Director of a federally funded Leadership Education in Neurodevelopmental Disabilities (LEND) program, I secured a $2 million grant to train interdisciplinary leaders in neurodevelopmental disabilities. We built a curriculum that integrated clinical care, policy, and family systems. We trained future pediatricians, psychologists, and therapists not just to treat, but to lead. That program became a model for replication, proof that systems reform could be taught, scaled, and sustained.

But even as our data gained traction, replication lagged. Institutions hesitated. Systems stalled. The findings were published, validated, and cited, but rarely implemented at scale. The gap between research and practice remained stubbornly wide.

That is why I believe pediatric voices matter, not just in the clinic, but in the research room. We bring a different lens. We see the child behind the diagnosis, the family behind the data point. We ask different questions. We edit differently. We write differently. And when given the chance, we clarify the message. We can educate Congress and the Cabinet Room about the need to eliminate health disparities in all pediatric care, not just for children with developmental disabilities.

A call to elevate pediatric voices

We need more pediatricians in national research, not as token contributors, but as full voices. We need editors who understand both the science and the stakes. We need clinicians who can translate data into care.

I was not waiting for permission. I was building clarity in a system that often preferred confusion. And I believe that is still our task: to speak plainly, act precisely, and never forget who the research is for.

Ronald L. Lindsay is a pediatrician.