Search

Introduction: The aim of this systematic review was to synthesize the literature on the correlates and risk factors of anxiety among adults with ID. Methods: Following the PRISMA guidelines, a systematic search of peer-reviewed literature was conducted across six major electronic databases. From an initial screening of 844 records, 13 studies were included for full-text review. Factors associated with anxiety were categorized utilizing the biopsychosocial model. Methodological quality was evaluated. Results: Correlates of anxiety were identified at all levels of the biopsychosocial model, including psychological or psychiatric diagnoses, level of ID, gender, chronic health conditions, stressful life events, and social interactions. Modifiable correlates were discussed as potential targets for designing anxiety interventions for adults with ID. Conclusion: Despite the increased recognition of the mental health needs of individuals with ID in recent years, this review highlighted a dearth of research investigating the risk factors of anxiety among this population.

A reliable autism spectrum disorder (ASD) diagnosis can occur as early as 18 months; however, the average age at diagnosis in the United States is over 2 years later. While there are numerous well-known barriers to seeking an ASD diagnosis, no research has examined if separation between a child's biological parents affects timing of ASD diagnosis for their child. Data for this study were obtained from 561 children (M age = 5.4 years, SD = 3.9 years) referred to an urban, outpatient ASD specialty clinic for their first ASD evaluation. Biological parents self-reported their relationship status during the evaluation, which was then categorized as either "together" (married or living together but not married) or "not together" (separated, divorced, or never married). An inverse-probability of exposure weighted linear regression model, which adjusted for 16 different child, family, and sociodemographic variables, was utilized to assess differences in child age of ASD diagnosis between groups. At the time of diagnosis, most children's biological parents were together (69%) versus not together (31%). In the fully adjusted model, children of parents who were together were diagnosed 1.4 years earlier than those who were not together (p < 0.001). Strategies for supporting these families and reducing age disparities are indicated.

Social networks of persons with intellectual disabilities (ID) have been characterized as smaller and less diverse than those of typical peers. Advocates have focused on strengthening those social networks by expanding circles of social support, protection, and friendship. As young adults with ID experience increasing levels of community integration and move into new postsecondary education environments, the nature and potential functions of their social networks may shift. We describe the development and use of a social network instrument that is intended to capture an expanded view of social networks as structures influencing career opportunities. Using data from participants in our college program for students with ID, we then describe and illustrate how social network analyses can be used to examine individuals' social networks. Finally, we discuss lessons learned from our development process and implications for social network assessment and analysis with persons who have ID in postsecondary education.

Internal validity and measurement invariance of the Counseling Center Assessment of Psychological Symptoms-62 item (CCAPS-62) was examined via confirmatory factor analytic models among autistic (n = 1,268) and non-autistic (n = 3,776) college students. Findings reviewed the CCAPS-62 had a strong model fit and was invariant across groups. [ABSTRACT FROM AUTHOR]

Despite speculation about an 80% divorce rate among parents of children with an Autism Spectrum Disorder (ASD), very little empirical and no epidemiological research has addressed the issue of separation and divorce among this population. Data for this study was taken from the 2007 National Survey of Children's Health, a population-based, cross-sectional survey. A total of 77,911 parent interviews were completed on children aged 3-17 years, of which 913 reported an ASD diagnosis. After controlling for relevant covariates, results from multivariate analyses revealed no evidence to suggest that children with ASD are at an increased risk for living in a household not comprised of their two biological or adoptive parents compared to children without ASD in the United States.

The current study describes the development and psychometric properties of a new measure targeting sensitivity to change of core autism spectrum disorder (ASD) symptoms, the Autism Impact Measure (AIM). The AIM uses a 2-week recall period with items rated on two corresponding 5-point scales (frequency and impact). Psychometric properties were examined using a large sample (n = 440) of children with ASD enrolled in the Autism Treatment Network. The exploratory factor analysis indicated four factors and resulted in a 25-item questionnaire with excellent overall model fit. Test-retest reliability, cross-informant reliability, and convergent validity with other measures of ASD symptoms and overall functioning were strong. The AIM is a reliable and valid measure of frequency and impact of core ASD symptoms. Keywords Autism spectrum disorder * Outcome * Treatment * Symptoms * Impairment, Introduction Recent increases in ASD prevalence (Centers for Disease Control 2012; Fombonne 2005) have underscored the immediate and critical need for effective ASD treatments. A number of promising treatments are [...]

The study aimed to collect data from families of children and youth with Autism Spectrum Disorder (ASD) in the state of Delaware, USA to understand their ongoing needs and challenges in accessing child healthcare and family support services. We analyzed responses from 263 caregivers of children and youth with ASD from 3 to 24 years using a statewide needs assessment survey. Over 50% caregivers indicated having unmet needs relative to both child/youth healthcare services and family support services. Between 24 and 38% caregivers expressed unmet needs for healthcare services such as social skills training, speech‐language therapy, behavioral intervention, and occupational therapy for their child and 20–24% expressed needs for family support services such as respite care, parent/sibling support groups, counseling, and babysitting support. Additionally, number of prior early interventions received, limitations in accessing healthcare services, and unmet needs for family support services significantly predicted child/youth unmet healthcare needs. Greater ASD severity and difficulties accessing child/youth healthcare services predicted participant's functional dependence on caregivers for activities of daily living. Together, these findings call for designing holistic, family‐centered interventions that address needs of both children and youth with ASD and their families. Lay summary A statewide needs assessment survey of caregivers of children and youth with ASD revealed that 50% responders had unmet needs relative to both child/youth healthcare services and family support services. Number of prior services received, limitations in accessing healthcare, and unmet needs for family support are linked to child/youth unmet healthcare needs. Severity of autism and difficulties accessing child/youth healthcare are associated with participant's functional dependence. Together, these findings call for placing the family at the heart of the service system in ASD. [ABSTRACT FROM AUTHOR]

As part of a larger storytelling project with college students belonging to minoritized social groups, nine young adults from an inclusive college program for students with intellectual disability (ID) participated in narrative interviews. All were invited to tell stories about campus incidents of microaggression and microaffirmation related to their disability. They also were invited to tell stories about other social identities they claimed. Stories were analyzed thematically and for correspondence with findings from previous studies involving other social identity groups. Students told a variety of stories about interpersonal incidents on campus that made them feel respected or disrespected. They also shared stories of institutional encounters that influenced their sense of acceptance at the university. Although they told more stories about microaffirmations, they were not immune to microaggressions. However, many of the students' microaffirmation stories placed importance on not being perceived as different rather than a clear affirmation of disability identity. Students' stories have implications for fostering a campus climate where students with ID are respected and included and where ableism is addressed in substantial ways. [ABSTRACT FROM AUTHOR]

Current methods of introducing creativity techniques in industrial training courses can be modified to increase the amount of personalized learning, according to the authors. They offer a framework for a new approach to creativity training in short courses and workshops, with both in-house and business school examples. (MF)

Caregivers of children with autism spectrum disorder (ASD) may find it difficult to feel a sense of control and to cope with the overall physical and emotional demands of caring for their child. While caregivers are able to successfully cope with a high level of stress, there are limits to their resources and abilities to cope over time. Genetic counselors working with affected families may be able to help parents more effectively manage stress related to the disorder. Few short-term interventions have been reported in genetic counseling yet implementation of evidence-based examples may be achievable. This study aimed to assess the feasibility of a coping effectiveness training (CET) intervention designed to enhance coping self-efficacy (CSE) among caregivers of children with ASD, with the eventual goal of translating this intervention into genetic counseling practice. A randomized treatment-control design was used to investigate the feasibility of an intervention using CET among caregivers of children with ASD. The primary outcome was the feasibility of the intervention; the secondary outcome was improvements in CSE in the intervention group as compared to the control group. Caregivers were recruited and randomized into the treatment (n=15) or control (n=13) groups. Of these, 22 completed the study (retention: 78.6%). The intervention was highly feasible; most caregivers found the CET helpful, practical, useful, and relatively easy to attend. The treatment group demonstrated significantly increased CSE from pre-intervention to post-intervention (p=0.02). Between group differences were not significant when comparing the pre-post changes. We provide preliminary evidence that CET may be beneficial to caregivers of children with ASD. The results of this feasibility study support development of a phase II study of this intervention in a larger cohort, aimed to be implemented into a genetic counseling setting. [ABSTRACT FROM AUTHOR]

Objective: The authors compared the health care experiences of families raising a child with autism spectrum disorder (ASD), an intellectual disability disorder (IDD), or attention-deficit hyperactivity disorder (ADHD). Methods: Children with a current diagnosis of ASD (N=3,005),ADHD (N=9,662), or IDD (N=949) were identified in the 2009-2010 National Survey of Children With Special Health Care Needs. Weighted structural equation modeling was used to determine the association between family satisfaction with medical care, timeliness of care, and medical insurance coverage and the impact of the child's condition on the family's financial situation. Results: Families of children diagnosed as having ASD comorbid with either ADHD or IDD or comorbid with both conditions reported the highest levels of dissatisfaction across all health care quality variables and experienced the greatest impact on the family's financial situation. Conclusions: The findings underscore the need for comprehensive and accessible health care services for children with ASD, particularly those with comorbid conditions. [ABSTRACT FROM AUTHOR]

The recent discovery of the peritrichous, swarm-competent bacterium Enterobacter sp. SM3 has offered a new opportunity to investigate the connection between bacterial swimming and swarming. Here, we report the run-and-tumble behavior of SM3 as planktonic swimming cells and as swarming cells diluted in liquid medium, drawing comparison between the two states. Swimming cells of SM3 run for an average of 0.77 s with a speed of approximately 30µm/s before tumbling. Tumbles last for a duration of 0.12 s on average and cause changes in direction averaging 69^{∘}. Swimming cells exposed to the common chemoattractant serine in bulk solution suppress the frequency of tumbles in the steady state, lengthening the average run duration and decreasing the average tumble angle. When exposed to aspartate, cells do not demonstrate a notable change in run-and-tumble parameters in the steady state. For swarming cells of SM3, the frequency of tumbles is reduced, with the average run duration being 50% longer on average than that of swimming cells in the same liquid medium. Additionally, the average tumble angle of swarming cells is smaller by 35%. These findings reveal that the newly identified species, SM3, performs run-and-tumble motility similar to other species of peritrichous bacteria such as E. coli, both in the swimming and swarming states. We present a simple mechanical model, which provides a physical understanding of the run-and-tumble behavior of peritrichous bacteria.

The study aimed to collect data from families of children and youth with Autism Spectrum Disorder (ASD) in the state of Delaware, USA to understand their ongoing needs and challenges in accessing child healthcare and family support services. We analyzed responses from 263 caregivers of children and youth with ASD from 3 to 24 years using a statewide needs assessment survey. Over 50% caregivers indicated having unmet needs relative to both child/youth healthcare services and family support services. Between 24 and 38% caregivers expressed unmet needs for healthcare services such as social skills training, speech-language therapy, behavioral intervention, and occupational therapy for their child and 20-24% expressed needs for family support services such as respite care, parent/sibling support groups, counseling, and babysitting support. Additionally, number of prior early interventions received, limitations in accessing healthcare services, and unmet needs for family support services significantly predicted child/youth unmet healthcare needs. Greater ASD severity and difficulties accessing child/youth healthcare services predicted participant's functional dependence on caregivers for activities of daily living. Together, these findings call for designing holistic, family-centered interventions that address needs of both children and youth with ASD and their families. LAY SUMMARY: A statewide needs assessment survey of caregivers of children and youth with ASD revealed that 50% responders had unmet needs relative to both child/youth healthcare services and family support services. Number of prior services received, limitations in accessing healthcare, and unmet needs for family support are linked to child/youth unmet healthcare needs. Severity of autism and difficulties accessing child/youth healthcare are associated with participant's functional dependence. Together, these findings call for placing the family at the heart of the service system in ASD., (© 2021 International Society for Autism Research and Wiley Periodicals LLC.)

Objectives: This research project aims to build capacity for social skills interventions for ASD for adolescents in community mental health settings in Delaware, using The Program for the Education and Enrichment of Relational Skills (PEERS), a social skills group program developed at UCLA., Methods: Aim 1: A two-day education on PEERS was provided to community clinicians (n=15), and clinicians completed a survey assessing their perception of implementing a social skills group intervention for families at three time points. Aim 2: Five PEERS groups were held at three community mental health locations. Caregivers (n=14) completed rating scales assessing family quality of life, social skills, or parenting stress., Results: Clinicians reported increased confidence in their ability to deliver social skills intervention following two-day education on PEERS. Furthermore, the clinicians who facilitated a PEERS group (n=9) reported a clinically significant increase in confidence. Fourteen families completed PEERS; no difference was reported regarding family quality of life, social skills, or parenting stress., Conclusions: This study shows the feasibility of expanding social skills interventions for children and families affected by ASD into community mental health settings, as 15 clinicians received additional education regarding social skills interventions and five more group opportunities using the PEERS program were made available in the community.

Objective: This study aimed to examine the prevalence and characteristics of psychiatry-related emergency department (ED) visits among children with an autism spectrum disorder (ASD), including the specific reason for visit, as well as the influence of insurance type., Methods: Data used for this cross-sectional, observational study were obtained from the 2008 National Emergency Department Sample, the largest all-payer ED database in the United States. Psychiatry-related visits to the ED among children with ASD were identified using International Classification of Diseases, Ninth Revision, billing codes. A total of 3,974,332 visits (unweighted) were present for youth 3-17 years, of which 13,191 involved a child with ASD., Results: Thirteen percent of visits among children with ASD were due to a psychiatric problem, as compared with 2% of all visits by youths without ASD. Results from the multivariate analyses revealed that the likelihood for a psychiatric ED visit was increased 9-fold (odds ratio [OR], 9.13; 95% confidence interval [CI], 8.61-9.70) among pediatric ASD visits, compared with non-ASD visits. Children with ASD who were covered by private insurance, compared with those with medical assistance, were at even greater risk for a psychiatric ED visit (OR, 1.58; 95% CI, 1.53-1.63). Visits among children with ASD were more likely to be due to externalizing (OR, 1.62; 95% CI, 1.44-1.83) and psychotic (OR, 1.93; 95% CI, 1.58-2.35) disorders compared with visits among non-ASD children., Conclusions: This study highlights the need for improving community-based psychiatric systems of care for youths with ASD to divert psychiatry-related ED visits, particularly for those children with private insurance.

Objective: Two widely discussed yet highly understudied factors that obstruct timely diagnosis and intervention among children with an autism spectrum disorder (ASD) are missed scheduled appointments and wait time for outpatient services. Research surrounding outpatient appointment no-show and cancellation rates as well as predictors of such would shed light on the barriers to community-based clinical care., Methods: In this study, data from 8049 children and adolescents (mean = 6.97 years, SD = 4.81) with scheduled appointments at a multidisciplinary pediatric outpatient autism center were examined. A total of 43,504 appointments, scheduled between June 2003 and April 2012, were analyzed. Random and fixed effects multinomial logistic regression models were employed to explore the child-, clinician-, and appointment-related determinants of no-show and cancellation for initial and follow-up appointments., Results: A no-show rate of 9% and 15%, and a cancellation rate of 11% and 10% was observed for initial (n = 8049) and follow-up (n = 35,455) appointments, respectively. Different predictors were found for both no-show and cancellation at the initial and follow-up appointments. In the multivariate analyses, the most consistent and robust predictors of no-show were African-American child race, medical assistance, provider type and appointment type, and evening appointments. For cancellation, these included increased wait time and provider type. Importantly, cancellation and no-show at the initial evaluation increased the risk for these same outcomes at follow-up., Conclusion: As ASD prevalence figures continue to increase in the United States, findings surrounding wait time, appointment absenteeism, and clinical models of care are important to improving public health.