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Adolescents with autism spectrum disorder (ASD) without an intellectual disability have daily living skills (DLS) impairments. An initial feasibility pilot of Surviving and Thriving in the Real World (STRW), a group intervention that targets DLS, demonstrated significant improvements. A pilot RCT of STRW was conducted to extend these findings. Twelve adolescents with ASD were randomized to the treatment or waitlist groups. The treatment group had significant DLS improvements on the Vineland Adaptive Behavior Scales, 3rd Edition and the DLS goal attainment scale. Four adolescents from the waitlist crossed over and completed STRW. Entire sample analyses with 10 participants demonstrated large DLS gains. Results provide further evidence of the efficacy of STRW for closing the gap between DLS and chronological age.

Children who are deaf and hard of hearing (DHH) often demonstrate pragmatic language difficulties which can impact academic and social outcomes. This randomized control trial for DHH children, ages 3-12 years, explored the Technology-Assisted Language Intervention (TALI), incorporating augmentative and alternative communication technology (AAC) into traditional speech/language therapy, compared to treatment-as-usual (TAU) to determine impact on pragmatics. Pragmatic outcome measures included parent reported Pragmatics Profile of the CELF-5 (for children age [greater than or equal to]5 years) and CELF-P Descriptive Pragmatics Profile (for children <5 years) in addition to parent reported Social and Communication domains of the Vineland Adaptive Behavior Scales, Third Edition (VABS). Over 24 weeks, children [greater than or equal to]5 years in the TALI made significantly more progress (increase in raw scores) on the Pragmatics Profile compared to children in TAU (12.7 points vs. -6.0 points; p = 0.04) and also showed significant gains on two of the three subscales. For children [greater than or equal to]5 years, no significant VABS changes were seen in either intervention group. For children <5 years, there were no statistically significant differences in growth on the CELF-P total pragmatics raw score or on any subdomain. However, children in TALI had significant increases in the mean VABS Communication (86.7-99.1) and Social domain standard scores (91.8-97.4; p = 0.01), while gains for children in TAU on the Communication and Social domain standard scores were not statistically significant. These promising results support the need for additional research exploring the effectiveness of AAC supported speech/language therapy to enhance DHH children's pragmatic language skills.

Aim While bradycardia in children with Down syndrome (DS) during inhalation induction of anesthesia is characteristic, its mechanism is not well understood. This study investigated sympathetic failure as a potential (and modifiable) mechanism of bradycardia. Materials and Methods Ninety-three children with DS and 102 typically developing (TD) children underwent inhalation induction of anesthesia. These children were monitored for sympathetic activity, exposed to sevoflurane anesthetic and were observed for the development of bradycardia. The primary outcome was sympathetic failure in the context of normoxic bradycardia within the first 300 seconds of induction. Secondary outcome measures included hypotension and parasympathetic excess. Results During the first 300 seconds of induction, 54 DS children became bradycardic (54/93, 58%) while 22 TD children became bradycardic (22/102, 22%). In the DS group, 23 experienced hypotension (23/80, 29%). Of those who experienced hypotension, 15 also experienced sympathetic failure (15/28, 54%). Conclusion More than half of children with DS undergoing inhalation anesthesia induction with sevoflurane experienced bradycardia. Bradycardia and hypotension were associated with sympathetic failure. Sympathetic activity therefore appears to be a modifiable target in the prevention of bradycardia in children with DS. Keywords:Down syndrome, pediatric anesthesia, autonomic nervous system diseases, sevoflurane: [ABSTRACT FROM AUTHOR]

In the last two decades, online learning has transformed the field of higher education. Also during this time, institutions of higher education have seen increases in their adult learner populations. The flexibility and accessibility of an online education model is often particularly appealing to adult learners, who bring unique needs, expectations, and learning styles to their educational experiences. Using Kolb's Learning Style Inventory and Knowles' andragogy model as theoretical frameworks, this study evaluates an online graduate course in epidemiology in terms of the demographics, learning styles, satisfaction, and achievement of students. Comparing the online course to the same, land-based course that was offered concurrently, we found no differences between students' learning styles, satisfaction, and overall achievement. However, students in the land-based class were more likely to be matriculated into a degree program (p<0.005), more likely to be full-time students (p<0.002). These findings provide evidence that student preferences for method of content delivery are correlated to lifestyle factors and not age, previous experiences, or learning styles. [Paper presented at the Special Interest Group on Online Teaching and Learning (SIG-OTL), American Educational Research Association (AERA) Centennial Annual Meeting (100th, Washington, D.C., April 8-12, 2016).]

Daily living skills deficits are strongly associated with poor adult outcomes for individuals with high-functioning autism spectrum disorder, and yet, there are no group interventions targeting daily living skills. Seven adolescents with autism spectrum disorder and their parents participated in a feasibility pilot of a 12-week manualized group treatment targeting specific daily living skills (i.e. morning routine, cooking, laundry, and money management). Outcomes included the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) age equivalence scores and four goal attainment scaling scores. Adolescents demonstrated significant improvement on two Vineland-II subdomains and on all goal attainment scaling scores at post-treatment and 6-month follow-up. The intervention has promise for improving critical daily living skills' deficits that affect independent living and employment. Limitations and implications for future studies are discussed.

Author(s): Katherine Bowers [sup.1] [sup.2] , Alonzo T. Folger [sup.1] [sup.2] , Nanhua Zhang [sup.1] [sup.2] , Ting Sa [sup.1] [sup.2] , Jennifer Ehrhardt [sup.2] [sup.3] , Jareen Meinzen-Derr [sup.1] [...], Objectives To determine whether participation in a home visiting program increases and expedites utilization of early intervention services for suspected developmental delays. Methods Children participating in Every Child Succeeds (ECS), a large home visiting (HV) program serving greater Cincinnati, between 2006 and 2012, were propensity score matched to a sample of children identified from birth records who did not receive services from ECS. Data were linked to early intervention (EI) data acquired from the Ohio Department of Health. Descriptive statistics were employed to evaluate success of the matching. Chi square and log-rank tests evaluated whether the proportion of children accessing EI and the time to EI services differed for families participating in HV compared to eligible children not participating. Logistic regression and Cox proportional hazards regression modeled the associations. Results Among 3574 HV and 3574 comparison participants, there was no difference in the time to EI service utilization; however a higher percentage of HV participants accessed services. Overall, 6% of the HV group and 4.3% of the comparison group accessed services (p = 0.001). Modeling revealed an odd ratio = 1.43 [95% confidence interval (CI) 1.16-1.78, p value = 0.001] and hazard ratio = 1.42 [95% CI 1.15-1.75, p value = 0.001]. Differences in utilization were greatest directly after birth and between approximately 2 and 3 years. Conclusions for Practise Participation in home visiting was associated with greater utilization of EI services during two important developmental time points, demonstrating that home visiting may serve as an important resource for facilitating access to early intervention services.

With a high rate of additional learning needs in children with permanent hearing loss, this study sought to understand their educational and support needs. School information on 62 children with varying degrees of hearing loss attending an urban public school during a 5-year period was analysed to understand types and amounts of services over time. Individualized Education Programs and Multifactored Evaluation Plans reported the number of minutes provided by various providers, the types of services provided, and the goals set for each student. Although all students had a documented hearing loss, the services and intensity of services varied widely based on primary educational label. This is characterized by changes in goals, services, and intensity (minutes provided) from one year to the next if a child experienced an educational label change. Implications are far reaching for educators and administrators regarding determination of educational label for students with comorbid conditions.

The number of children receiving cochlear implants (CIs) with significant disabilities in addition to their deafness has increased substantially. Unfortunately, children with additional disabilities receiving CIs have largely been excluded from studies on cochlear implant outcomes. Thus limited data exists on outcomes in this population to guide pre-implant counseling for anticipated benefits. The study objectives were: (1) evaluate differences in post-cochlear implant language skills between children with cochlear implants and developmental disabilities and age/cognitively matched controls; (2) quantify possible discrepancies between language level and cognitive level. Fifteen children with a developmental disability who received a CI were matched 1:1 on nonverbal cognitive ability and age to hearing controls. Language was evaluated using Preschool Language Scale-IV and reported as language quotients. Multivariable mixed models for matched pairs analyzed differences in language levels between groups. No significant differences were seen between CI and control groups regarding insurance, maternal education, or family income level. Results of the multivariable models indicated that compared to matched controls, the CI group had significantly lower mean receptive (24.6 points, p = 0.002) and mean expressive (21.9 points, p = 0.001) language quotients after controlling for confounders such as number of therapies and weekly hours in therapy. Significant discrepancies between language level and cognitive level were seen among CI participants only. Compared to age- and cognitively matched controls, children with CIs had significantly lower language levels with delays disproportionate to their cognitive potential. Mechanisms behind this performance-functional gap need to be understood to deliver appropriate intervention strategies for this special population. (Contains 4 figures and 3 tables.)

A multicenter study of 308 children with Autism Spectrum Disorder (ASD) was conducted through the Collaborative Programs of Excellence in Autism (CPEA), sponsored by the National Institute of Child Health and Human Development, to compare the family history of autoimmune disorders in children with ASD with and without a history of regression. A history of regression was determined from the results of the Autism Diagnostic Interview-Revised (ADI-R). Family history of autoimmune disorders was obtained by telephone interview. Regression was significantly associated with a family history of autoimmune disorders (adjusted OR=1.89; 95% CI: 1.17, 3.10). The only specific autoimmune disorder found to be associated with regression was autoimmune thyroid disease (adjusted OR=2.09; 95% CI: 1.28, 3.41).