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Hennessy A, Nichols ES, Al-Saoud S, Brossard-Racine M, Duerden EG. Identifying cognitive profiles in children with neurodevelopmental disorders using online cognitive testing. Clin Child Psychol Psychiatry 2024; 29:591-607. [PMID: 38282296 PMCID: PMC10945998 DOI: 10.1177/13591045241228889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Children with neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) tend to exhibit similar deficits in attention and memory ability. Early screening of cognitive deficits in children with NDDs, particularly in preschool children, is fundamental to improving cognitive and academic outcomes. In order to determine cognitive profiles in children with ASD and ADHD, we developed accessible audiovisual instructions for an online battery of 13 cognitive tests. Children ages 4-16 who were diagnosed with ADHD (n = 83), or ASD (n = 37), or who were typically developing children (TD) (n = 86) were recruited. Data were analyzed using a stepwise Discriminant Analysis to determine which cognitive tasks were the strongest discriminators between the diagnostic groups. Results revealed four tasks reflective of working memory, reasoning, and attentional processes, which correctly classified approximately 53-60% of each group. The ADHD group had lower scores on attentional tasks compared to TD, while ASD group had lower scores on reasoning tasks compared to the TD children, and made more attempts across all four tasks. The results from this study stress the need for cognitive screening assessments that include domain-specific items to improve the characterization of executive function deficits and promote academic achievement in all children with NDDs.
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Affiliation(s)
- Abagail Hennessy
- Applied Psychology, Faculty of Education, Western University, Canada
| | - Emily S Nichols
- Applied Psychology, Faculty of Education, Western University, Canada
- Western Institute for Neuroscience, Western University, Canada
| | - Sarah Al-Saoud
- Applied Psychology, Faculty of Education, Western University, Canada
| | | | - Emma G Duerden
- Applied Psychology, Faculty of Education, Western University, Canada
- Western Institute for Neuroscience, Western University, Canada
- Neuroscience, Schulich School of Medicine and Dentistry, Western University, Canada
- Psychiatry, Schulich School of Medicine and Dentistry, University of Western Ontario, Canada
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Davies J, Romualdez AM, Malyan D, Heasman B, Livesey A, Walker A, Pellicano E, Remington A. Autistic Adults' Priorities for Future Autism Employment Research: Perspectives from the United Kingdom. AUTISM IN ADULTHOOD 2024; 6:72-85. [PMID: 38435326 PMCID: PMC10902279 DOI: 10.1089/aut.2022.0087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background A growing body of research has sought to understand autistic people's research priorities. Several of these studies have identified employment as a key research priority. Yet, there have been a few attempts to identify specific, actionable priorities within this area. Methods Using an online survey, we asked 197 autistic people in the United Kingdom about their priorities for future autism-employment research. Results Participants spoke of their challenges in gaining and sustaining meaningful employment and called for researchers to conduct research that results in direct improvements to employment experiences. Regarding their research priorities, participants indicated a need for research covering all aspects of the employment lifecycle from accessing employment to transitioning out of employment. Importantly, participants also discussed how such research should be conducted: with autistic people as co-researchers and ensuring a diverse range of autistic people are listened to. Conclusion While much existing autism-employment research appears to align with the priorities outlined in this study, seemingly minimal attention has been paid to later stages of the work lifecycle (e.g., progressing into more senior job roles or transitioning out of work). By identifying disparities between autistic people's priorities and the research being conducted, we can support autistic people to drive the research agenda and ensure autism-employment research positively impacts the community it aims to serve.
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Affiliation(s)
- Jade Davies
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Anna Melissa Romualdez
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Danae Malyan
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Brett Heasman
- School of Education, Language and Psychology, York St John University, York, United Kingdom
| | - Adam Livesey
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
| | - Amy Walker
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
- Neurodiversity Works, London, United Kingdom
| | - Elizabeth Pellicano
- Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Anna Remington
- UCL Centre for Research in Autism and Education (CRAE), University College London, London, United Kingdom
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Zakirova-Engstrand R, Yakubova G. A scoping review of autism research conducted in Central Asia: Knowledge gaps and research priorities. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:342-354. [PMID: 37161788 PMCID: PMC10851649 DOI: 10.1177/13623613231170553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
LAY ABSTRACT Very little is known about the status of autism research in Central Asia. Through the library databases, we identified and reviewed 11 scientific studies conducted with autistic people and their families in five Central Asian countries-Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Of the 11 studies, 10 were conducted in Kazakhstan and 1 in Uzbekistan. Within these limited number of research studies, different topics such as diagnosis, risk factors of autism, biology, and various service and intervention areas were addressed. We identified several knowledge gaps and research priorities to address the needs of autistic people, their families, and professionals in Central Asia.
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Emerson E, Llewellyn G. The prevalence of significant cognitive delay among 3- to 4-year-old children growing up in low- and middle-income countries: results from 126 nationally representative surveys undertaken in 73 countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1200-1215. [PMID: 36109168 DOI: 10.1111/jir.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We sought to (1) update estimates of the prevalence of significant cognitive delay (SCD) among nationally representative samples of young children overall, and in upper-middle, lower-middle and low-income countries; (2) investigate whether variation in prevalence between countries was systematically associated with national wealth and other country characteristics; (3) investigate the stability of prevalence estimates over time; (4) examine the correlation between SCD and 2019 Global Burden of Disease estimates on the prevalence of the impairment of developmental intellectual disability under 5 years of age; and (5) investigate the extent to which risk of SCD within countries varies with child age and gender, maternal education and household wealth. METHODS Secondary analysis of data collected in 126 nationally representative Multiple Cluster Indicators Surveys (MICS) conducted under the supervision of UNICEF in 73 countries involving a total of 396 596 3- to 4-year-old children. RESULTS The overall prevalence of SCD was 9.7% (95% CI 8.6-10.9%). Between-country variation in prevalence was strongly related to national wealth, the Human Development Index, the Human Inequality-adjusted Development Index and the Multidimensional Poverty Index, but not income inequality. In the 46 countries in which more than one survey was available prevalence estimates were reasonably stable over time (r = 0.80, P < 0.001). There were strong independent associations between increased risk of cognitive delay and younger child age, lower levels of maternal education and lower levels of household wealth (but not male gender). There was only a weak association across countries between the estimated prevalence of SCD and Global Burden of Disease estimates of the under 5 prevalence of the impairment of developmental intellectual disability. CONCLUSIONS UNICEF's MICS data are readily (and freely) available to researchers and provide a cost-effective opportunity for researchers who are concerned about better understanding the situation of young children growing up in the world's LMICs with a marked loss of developmental potential in areas of cognition and learning.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - G Llewellyn
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Lopes LPN, Itria A, Lopes LC. Budget Impact Analysis of Risperidone Use and Adverse Event Monitoring in Autism Spectrum Disorder in Brazil: Assessment of Theoretical Versus Real Data. PHARMACOECONOMICS - OPEN 2023; 7:951-961. [PMID: 37707722 PMCID: PMC10721756 DOI: 10.1007/s41669-023-00436-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/20/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND AND AIMS Risperidone is used in autism spectrum disorder (ASD) to manage aggressive behavior. Budget impact analysis (BIA) assists managers in promoting more sustainable health systems; however, it is unclear whether BIAs underestimate or overestimate the estimates derived from real-world data. This study aimed to compare the estimated BIA values of risperidone use and the monitoring of adverse events in ASD using theoretical and real data. METHODS Analyses were conducted based on the clinical protocol and the Brazilian therapeutic guidelines for ASD. The perspective adopted was that of the Unified Health System (SUS), considering a time horizon of 5 years. Three possible scenarios were considered based on the maximum daily dose of risperidone. Expenses related to the acquisition of risperidone and the monitoring of adverse events were taken into account using health databases in Brazil. For the calculation based on theoretical data, the prevalence of ASD was estimated using information from the scientific literature and the Brazilian demographic census. The model calculated from real data was obtained by analyzing the linear trend of the number of users assisted in the SUS from 2017 to 2021. RESULTS The population estimated by the theoretical model compared with the model calculated from the real data was higher. Likewise, the 5-year budgetary impact of the theoretical model versus the model calculated from the real data was higher, with statistical significance in all scenarios (p < 0.001). In the real data model, the most economically advantageous scenarios were Scenario 1 for children (International dollars [I$] 7,630,040.73) and Scenario 3 for adults (I$60,329,288.17). Estimated expenditures for monitoring adverse events ranged from 17 to 74% in children and from 50% to 63% in adults. CONCLUSIONS The data revealed significant differences in population and cost estimation between theoretical data and real-world data. The expenses associated with monitoring adverse events represented a substantial expenditure estimate for the SUS.
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Affiliation(s)
- Luis Phillipe Nagem Lopes
- Graduate Course in Pharmaceutical Sciences, University of Sorocaba, UNISO, Rodovia Raposo Tavares, KM 92,5, Sorocaba, São Paulo, 18023-000, Brazil
| | - Alexander Itria
- Department of Gerontology, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Luciane Cruz Lopes
- Graduate Course in Pharmaceutical Sciences, University of Sorocaba, UNISO, Rodovia Raposo Tavares, KM 92,5, Sorocaba, São Paulo, 18023-000, Brazil.
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Onwujekwe O, Mbachu C, Okeibunor J, Ezema GU, Ejiofor N, Braka F, Thiam A, Koua EL, Chamla D, Gueye AS. What are the research priorities for strengthening public health emergency preparedness and response in Africa? Health Res Policy Syst 2023; 21:107. [PMID: 37872548 PMCID: PMC10594758 DOI: 10.1186/s12961-023-01059-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Research evidence is needed to strengthen capacities in emergency preparedness and response (EPR). However, the absence of a clear research agenda limits the optimal use of research evidence. This paper reports on the prioritization of research questions and topics that could contribute to evidence-informed strengthening of EPR capacities in the African region. METHODS The priority-setting consisted of desk review and stakeholder consultation workshop. Twenty-nine people participated in the workshop, including representatives from WHO regional office and EPR focal points in Africa, representatives of research institutions, and partners from Science for Africa Foundation, United Nations Children's Fund and Africa Center for Disease Control. Modified Delphi technique was used to systematically arrive at specific and cross-cutting research priorities in the three broad areas of the EPR, which are program Implementation, Clinical and Epidemiology. The research questions/topics were ranked on five-point Likert scale (1 = very low to 5 = very high) based on seven agreed-on criteria. Research priority score was calculated for each question as the mean of the criteria scores. RESULTS A total of 123 research questions comprising, 29 on Epidemiology, 22 on Clinical, 23 on program Implementation, and 49 on cross-cutting issues were ranked. The top ten research priorities were: knowledge and skills of healthcare workers in detecting and responding effectively to disease outbreaks; quality of data (accuracy, timeliness, completeness) for epidemic prone diseases; determinants of vaccine hesitancy; determinants of infection transmission among health care workers during PHE; effective measures for protecting health workers from highly infectious pathogens in PHE; strategies to improve the effectiveness of contact tracing for epidemic prone diseases; effectiveness of current case definitions as screening tools for epidemic and pandemic prone diseases; measures to strengthen national and sub-national laboratory capacity for timely disease confirmation within the Integrated Diseases Surveillance and Response framework; factors affecting prompt data sharing on epidemic-prone diseases; and effective strategies for appropriate community participation in EPR. CONCLUSIONS The collaborative multi-stakeholder workshop produced a starting list of priority research questions and topics for strengthening EPR capacities in Africa. Action needs to be taken to continuously update the research agenda and support member States to contextualize the research priorities and commission research for timely generation and uptake of evidence.
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Affiliation(s)
- Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
| | - Chinyere Mbachu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
| | - Joseph Okeibunor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Godwin Uchenna Ezema
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Enugu State Primary Healthcare Development Agency, Enugu, Nigeria
| | - Nonso Ejiofor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Fiona Braka
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Adama Thiam
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Etien Luc Koua
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Dick Chamla
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Abdou Salam Gueye
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
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Lestarevic S, Kalanj M, Milutinovic L, Grujicic R, Vasic J, Maslak J, Mitkovic-Voncina M, Ljubomirovic N, Pejovic-Milovancevic M. Internal Consistency of the Serbian Translation of the Stanford Social Dimensions Scale and Association to Strengths and Difficulties Questionnaire Scores in Male and Female Individuals on the Autism Spectrum and Non-autistic Individuals. J Autism Dev Disord 2023:10.1007/s10803-023-06061-z. [PMID: 37480441 DOI: 10.1007/s10803-023-06061-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 07/24/2023]
Abstract
We aimed to evaluate the internal consistency of Stanford Social Dimensions Scale (SSDS) translated to Serbian and to test it against the Strengths and Difficulties Questionnaire (SDQ). The sample consisted of 200 patients (32% ASD) of the Institute of Mental Health in Belgrade, Serbia (68 females, 132 males, Mage=9.61, SDage=4.06). Internal consistency coefficients were within good/acceptable range for Social Motivation, Affiliation, Recognition and Unusual Approach subscales and below acceptable for Expressive Social Communication subscale. The non-autistic group scored higher on all subscales compared to the ASD group. All SSDS subscales positively correlated with SDQ Prosocial Behaviors scale. The SSDS is a valuable instrument for accessing sociobehavioral phenotype in both individuals on the autism spectrum and non-autistic individuals.
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Affiliation(s)
| | | | | | | | | | | | - Marija Mitkovic-Voncina
- Institute of Mental Health, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Beograd, Serbia
| | - Natasa Ljubomirovic
- Institute of Mental Health, Belgrade, Serbia
- College of Social Work, Belgrade, Serbia
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Screening for Intellectual Disabilities and/or Autism Amongst Older Children and Young Adults: a Systematic Review of Tools for Use in Africa. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
There are many well-developed screening tools for both intellectual disabilities and autism, but they may not be culturally appropriate for use within Africa. Our specific aims were to complete a systematic review to (1) describe and critically appraise short screening tools for the detection of intellectual disabilities and autism for older children and young adults, (2) consider the psychometric properties of these tools, and (3) judge the cultural appropriateness of these tools for use within Africa. Six screening tools for intellectual disabilities and twelve for autism were identified and appraised using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. We identified two screening tools which appeared appropriate for validation for use within African nations.
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Davy G, Unwin KL, Barbaro J, Dissanayake C. Leisure, employment, community participation and quality of life in caregivers of autistic children: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1916-1930. [PMID: 35765798 DOI: 10.1177/13623613221105836] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT We searched a wide range of academic journals for published information on the participation levels of caregivers of autistic children in activities relating to leisure, social, community and employment contexts, and the impact that participation may have on caregiver quality of life. Overall, we found that the impact of parenting an autistic child is broad with caregivers often prioritising their child's needs over their own, particularly in occupational participation, which impacts their quality of life. Findings also highlighted a need for further research to investigate the experience of caregivers, and the relationship between participation and quality of life in caregivers of autistic children, as the results can inform the development of better supports for them.
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Global, regional and national burden of autism spectrum disorder from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiol Psychiatr Sci 2022; 31:e33. [PMID: 35535764 PMCID: PMC9121847 DOI: 10.1017/s2045796022000178] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIMS Autism spectrum disorder (ASD) is a neurodevelopmental condition, with symptoms appearing in the early developmental period. Little is known about its current burden at the global, regional and national levels. This systematic analysis aims to summarise the latest magnitudes and temporal trends of ASD burden, which is essential to facilitate more detailed development of prevention and intervention strategies. METHODS The data on ASD incidence, prevalence, disability-adjusted life years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardised rates (ASRs) of ASD burden by region, sex and age. RESULTS In 2019, there were an estimated 60.38 × 104 [95% uncertainty interval (UI) 50.17-72.01] incident cases of ASD, 283.25 × 105 (95% UI 235.01-338.11) prevalent cases and 43.07 × 105 (95% UI 28.22-62.32) DALYs globally. The ASR of incidence slightly increased by around 0.06% annually over the past three decades, while the ASRs of prevalence and DALYs both remained stable over the past three decades. In 2019, the highest burden of ASD was observed in high-income regions, especially in high-income North America, high-income Asia Pacific and Western Europe, where a significant growth in ASRs was also observed. The ASR of ASD burden in males was around three times that of females, but the gender difference was shrunk with the pronounced increase among females. Of note, among the population aged over 65 years, the burden of ASD presented increasing trends globally. CONCLUSIONS The global burden of ASD continues to increase and remains a major mental health concern. These substantial heterogeneities in ASD burden worldwide highlight the need for making suitable mental-related policies and providing special social and health services.
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Simpson K, Adams D, Manokara V, Malone S. Research and training priorities of staff supporting individuals with intellectual disabilities with or without autism. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2022. [DOI: 10.1111/jppi.12403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kate Simpson
- Autism Centre of Excellence, School of Education and Professional Studies Griffith University Brisbane Australia
- Griffith Institute of Educational Research Griffith University Brisbane Australia
| | - Dawn Adams
- Autism Centre of Excellence, School of Education and Professional Studies Griffith University Brisbane Australia
- Griffith Institute of Educational Research Griffith University Brisbane Australia
| | - Vimallan Manokara
- Movement for the Intellectually Disabled of Singapore (MINDS) Singapore
| | - Stephanie Malone
- Autism Centre of Excellence, School of Education and Professional Studies Griffith University Brisbane Australia
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Ceccarelli C, Bakolis I, Tekola B, Kinfe M, Borissov A, Girma F, Abdurahman R, Zerihun T, Hanlon C, Hoekstra RA. Validation of the Communication Profile-Adapted in Ethiopian children with neurodevelopmental disorders. Glob Ment Health (Camb) 2021; 8:e45. [PMID: 34966545 PMCID: PMC8679817 DOI: 10.1017/gmh.2021.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 10/21/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) are conditions affecting a child's cognitive, behavioural, and emotional development. Appropriate and validated outcome measures for use in children with NDDs in sub-Saharan Africa are scarce. The aim of this study was to validate the Communication Profile Adapted (CP-A), a measure developed in East Africa to assess caregivers' perception of communication among children with NDDs. METHODS We adapted the CP-A for use in Ethiopia, focusing on the communicative mode (CP-A-mode) and function (CP-A-function) scales. The CP-A was administered to a representative sample of caregivers of children with NDDs and clinical controls. We performed an exploratory factor analysis and determined the internal consistency, test-retest reliability, within-scale, known-group, and convergent validity of the identified factors. RESULTS Our analysis included N = 300 participants (N = 139 cases, N = 139 clinical controls, N = 22 who did not meet criteria for either cases or controls). Within the CP-A-mode, we identified two factors (i.e. verbal and physical communication); the CP-A-function scale was unidimensional. Combining both scales into one summary variable (the CP-A-total) resulted in a scale with excellent internal consistency and test-retest reliability (Cronbach's alpha = 0.97; Kappa = 0.60-0.95, p < 0.001; ICC = 0.97, p < 0.001). Testing known-group validity, the CP-A-total scores were significantly higher for controls than cases (Δ mean = 33.93, p < 0.001). Convergent validity assessment indicated that scores were negatively and moderately correlated with clinical severity (ρ = -0.25, p = 0.04). CONCLUSION The CP-A is a valid tool for the assessment of communication among children with NDDs in Ethiopia. It holds promise as a brief, quantitative, and culturally appropriate outcome measure for use in sub-Saharan Africa.
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Affiliation(s)
- Caterina Ceccarelli
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ioannis Bakolis
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bethlehem Tekola
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mersha Kinfe
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anton Borissov
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Fikirte Girma
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rehana Abdurahman
- Department of Psychiatry, Yekatit 12 Hospital and Medical College, Addis Ababa, Ethiopia
| | - Tigist Zerihun
- Department of Psychiatry, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Charlotte Hanlon
- Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Centre for Global Mental Health, Department of Health Services and Population Research and WHO Collaborating Centre for Mental Health Research and Capacity-Building, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
| | - Rosa A. Hoekstra
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Global Health Institute, King's College London, London, UK
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Oduyemi AY, Okafor IP, Eze UT, Akodu BA, Roberts AA. Internalization of stigma among parents of children with autism spectrum disorder in Nigeria: a mixed method study. BMC Psychol 2021; 9:182. [PMID: 34802470 PMCID: PMC8607563 DOI: 10.1186/s40359-021-00687-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 11/09/2021] [Indexed: 11/23/2022] Open
Abstract
Background Autism Spectrum disorder (ASD) has uniquely stigmatizing aspects because children with ASD have no physical markers of their condition. Parents are usually blamed and judgment from others is often internalized (felt stigma). Aim This study was conducted to determine knowledge about ASD, negative experiences (enacted stigma), internalization of stigma (felt or self stigma) and its correlates among parents of children with ASD in Lagos, Nigeria. Methods This was a cross-sectional study of 230 parents in Lagos, Nigeria employing mixed-method data collection methods. Quantitative data were collected using a structured interviewer-administered questionnaire and analyzed with Epi- Info™ version 7.0 statistical package. Data were summarized with proportions, mean and standard deviation. Chi square and Spearman’s correlation tests were done, and the level of significance was pre-determined at 5% (p < 0.05). In-depth interviews were also conducted among six parents to further explore the topic. The interviews were analyzed narratively. Results The proportion of mothers and fathers were 175 (76.1%) and 55 (23.9%) respectively. The mean age of respondents was 42 ± 8.5 years. Overall knowledge of ASD was very poor as only 3(1.3%) had good knowledge. Overall, 122(53%) usually had negative experience of parenting a child with ASD (enacted stigma), mothers (17.1%) more than fathers (9.1%). Majority 192(83.5%) internalized stigma. There was a low–moderate correlation between ‘enacted’ stigma and ‘internalized’ stigma (ρ- 0.400, p < 0.001). From in-depth interviews, many parents revealed that their child’s condition had negative effects on the family. Many also recounted negative experience of stigma.
Conclusion Overall, parents of children with ASD had poor knowledge of the condition. Majority internalized stigma and this increases with negative treatment from others. Parents should be properly educated about ASD. Community-based education to increase awareness about ASD in addition to encouraging people to show empathy and reduce stigmatizing behaviour towards parents of children with ASD are recommended.
Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00687-3.
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Affiliation(s)
- Aminat Y Oduyemi
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ifeoma P Okafor
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria.
| | - Ugochukwu T Eze
- Department of Community Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Babatunde A Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Alero A Roberts
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
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Children and adolescents with neurodevelopmental disorders show cognitive heterogeneity and require a person-centered approach. Sci Rep 2021; 11:18463. [PMID: 34531454 PMCID: PMC8445997 DOI: 10.1038/s41598-021-97551-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/09/2021] [Indexed: 11/15/2022] Open
Abstract
We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6–15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: “Lower Cognitive Profile” (LCP), “Lower Working Memory” (LWM), “Higher Working Memory” (HWM), “Higher Cognitive Profile” (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.
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15
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Hamdani SU, Huma ZE, Suleman N, Akhtar P, Nazir H, Masood A, Tariq M, Koukab A, Salomone E, Pacione L, Brown F, Shire S, Sikander S, Servili C, Wang D, Minhas FA, Rahman A. Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents' skills training intervention for children with developmental disorders in rural Pakistan: a cluster randomized controlled trial. Int J Ment Health Syst 2021; 15:53. [PMID: 34059074 PMCID: PMC8165981 DOI: 10.1186/s13033-021-00476-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally, there is a large documented gap between needs of families and children with developmental disorders and available services. We adapted the World Health Organization’s mental health Gap-Intervention Guidelines (mhGAP-IG) developmental disorders module into a tablet-based android application to train caregivers of children with developmental disorders. We aimed to evaluate the effectiveness of this technology-assisted, family volunteers delivered, parents’ skills training intervention to improve functioning in children with developmental disorders in a rural community of Rawalpindi, Pakistan. Methods In a single-blinded, cluster randomized controlled trial, 30 clusters were randomised (1:1 ratio) to intervention (n = 15) or enhanced treatment as usual (ETAU) arm (n = 15). After screening, 540 children (18 participants per cluster) aged 2–12 years, with developmental disorders and their primary caregivers were recruited into the trial. Primary outcome was child’s functioning, measured by Childhood Disability Assessment Schedule for Developmental Disorders (DD-CDAS) at 6-months post-intervention. Secondary outcomes were parents’ health related quality of life, caregiver-child joint engagement, socio-emotional well-being of children, family empowerment and stigmatizing experiences. Intention-to-treat analyses were done using mixed-models adjusted for covariates and clusters. Results At 6-months post-intervention, no statistically significant mean difference was observed on DD-CDAS between intervention and ETAU (mean [SD], 47.65 [26.94] vs. 48.72 [28.37], Adjusted Mean Difference (AMD), − 2.63; 95% CI − 6.50 to 1.24). However, parents in the intervention arm, compared to ETAU reported improved health related quality of life (mean [SD] 65.56 [23.25] vs. 62.17 [22.63], AMD 5.28; 95% CI 0.44 to 10.11). The results were non-significant for other secondary outcomes. Conclusions In the relatively short intervention period of 6 months, no improvement in child functioning was observed; but, there were significant improvements in caregivers’ health related quality of life. Further trials with a longer follow-up are recommended to evaluate the impact of intervention. Trial registration Clinicaltrials.gov, NCT02792894. Registered April 4, 2016, https://clinicaltrials.gov/ct2/show/NCT02792894
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Affiliation(s)
- Syed Usman Hamdani
- Institute of Psychiatry, Rawalpindi Medical University (RMU) and Benazir Bhutto Hospital, Rawalpindi, Pakistan. .,University of Liverpool, Liverpool, UK. .,Human Development Research Foundation, Islamabad, Pakistan.
| | - Zill-E- Huma
- University of Liverpool, Liverpool, UK.,Human Development Research Foundation, Islamabad, Pakistan
| | - Nadia Suleman
- Human Development Research Foundation, Islamabad, Pakistan
| | - Parveen Akhtar
- Human Development Research Foundation, Islamabad, Pakistan
| | - Huma Nazir
- Human Development Research Foundation, Islamabad, Pakistan
| | - Aqsa Masood
- Human Development Research Foundation, Islamabad, Pakistan
| | | | | | - Erica Salomone
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland.,Department of Psychology, University of Milan-Bicocca, Milan, Italy
| | - Laura Pacione
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland.,Department of Psychiatry, Division of Child and Youth Mental Health, University of Toronto, Toronto, ON, Canada
| | - Felicity Brown
- Research and Development Department, War Child Holland, Amsterdam, The Netherlands.,Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Stephanie Shire
- Special Education and Clinical Sciences, College of Education, University of Oregon, Eugene, OR, USA
| | | | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland
| | - Duolao Wang
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Fareed Aslam Minhas
- Institute of Psychiatry, Rawalpindi Medical University (RMU) and Benazir Bhutto Hospital, Rawalpindi, Pakistan
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16
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Sapiets SJ, Totsika V, Hastings RP. Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:695-711. [PMID: 33354863 PMCID: PMC8246771 DOI: 10.1111/jar.12852] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Early intervention (EI) can improve a range of outcomes for families of children with developmental disabilities. However, research indicates the level of access does not always match the level of need. To address disparities, it is essential to identify factors influencing access. METHOD We propose a framework where access to EI is conceptualised as a process that includes three main phases. A narrative review examined potential barriers, facilitators and modifiers of access for each phase. RESULTS The process of access to EI includes the following: 1) recognition of need, 2) identification or diagnosis and 3) EI provision or receipt. Several factors affecting access to EI for each phase were identified, related to the family, services, the intersection between family and services, and the context. CONCLUSION A broad range of factors appear to influence the process of access to EI for this population. Our framework can be used in future research investigating access. Broad implications for policy, practice and future research to improve access to EI are discussed.
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Affiliation(s)
- Suzi J. Sapiets
- Centre for Educational Development, Appraisal and Research (CEDAR)University of WarwickCoventryUK
| | - Vasiliki Totsika
- Centre for Educational Development, Appraisal and Research (CEDAR)University of WarwickCoventryUK
- Division of PsychiatryUniversity College LondonLondonUK
- Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClayton VIC 3800Australia
| | - Richard P. Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR)University of WarwickCoventryUK
- Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClayton VIC 3800Australia
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17
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Pett MA, Guo JW, Cardell B, Johnson EP, Guerra N, Clark L. Psychometric properties of a brief self-reported health-related quality of life measure (HRQoL-IDD) for persons with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:877-890. [PMID: 33522020 PMCID: PMC8247975 DOI: 10.1111/jar.12831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022]
Abstract
Background To encourage self‐determination and address health disparities among persons with intellectual and developmental disabilities, clinicians and researchers rely on self‐reported measures like health‐related quality of life (HRQoL). This study evaluated the psychometric properties of a theory‐driven self‐reported HRQoL measure for adults requiring mild to moderate support related to intellectual and developmental disabilities. Method 224 volunteers completed 42 quality of life items developed with extensive input from persons with intellectual and developmental disabilities, family members/caregivers, and providers. The 5‐point Likert scale format with visual images of fluid‐filled cups represented the range of responses. Results Exploratory and Unrestricted Factor Analyses yielded 16 HRQoL items with 4 subscales: Functional Well‐Being, Emotional Well‐Being, Social Well‐Being, and Healthy Decision‐making. The HRQoL‐IDD explained 62.8% of variance, had satisfactory internal consistency (0.73–0.83), stability of reponses, and reading level (2nd grade, ages 7‐8). Conclusions The HRQoL‐IDD is a promising measure of self‐reported HRQoL for use in community‐based settings for persons requiring mild to moderate support related to intellectual and developmental disabilities.
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Affiliation(s)
- Marjorie A Pett
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Jia-Wen Guo
- University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Beth Cardell
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, Salt Lake City, UT, USA
| | - Erin P Johnson
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Lauren Clark
- School of Nursing, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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18
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Lee JD, Meadan H. Children with Autism Spectrum Disorders in Low-Resource Settings: Reported Experiences and Needs of Parents in Mongolia. J Autism Dev Disord 2021; 51:3586-3599. [PMID: 33387240 DOI: 10.1007/s10803-020-04818-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/28/2022]
Abstract
Although it is well-documented that families of children with autism in developed nations report hardships, few researchers have focused on families who live in less-developed, low-resource settings. Using five focus groups with 30 parents of children with autism in Mongolia, a low- resource setting, the purpose of this study was to provide detailed accounts of their experiences, challenges, and needs. Participants reported severe challenges related to raising their children with autism in their country. Parents shared barriers related to the limited availability of services and support, exacerbated financial burdens, and a lack of enforcement of relevant laws. Parents also shared their perceived needs including more services for their children, more sustainable training and coaching programs for parents, and parents' collective advocacy.
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Affiliation(s)
- James D Lee
- Department of Special Education, University of Illinois at Urbana-Champaign, 1310 South 6th Street, Champaign, IL, 61820, USA.
| | - Hedda Meadan
- Department of Special Education, University of Illinois at Urbana-Champaign, 1310 South 6th Street, Champaign, IL, 61820, USA
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Susanty D, Noel P, Sabeh MS, Jahoda A. Benefits and cultural adaptations of psychosocial interventions for parents and their children with intellectual disabilities in low-and middle-income countries: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:421-445. [PMID: 33258302 DOI: 10.1111/jar.12820] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 08/24/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence and awareness of the importance of culturally adapting psychosocial interventions is growing. The aim of this paper is to systematically review studies on cultural adaptations of psychosocial interventions for parents and their children with intellectual disabilities, in low- and middle-income countries. METHODS Studies were identified through electronic databases and searching bibliographies. The quality and cultural adaptations of thirteen studies focusing on parental trainings were analysed using standardised tools and frameworks. RESULTS Findings suggest interventions reduce the risk of depression and stress and increase coping strategies and positive perceptions of family functioning. Parenting skills training may improve parent-child interactions and child development. However, these benefits should be interpreted cautiously due to methodological shortcomings. Most studies described efforts to make appropriate cultural adaptations to the interventions, but these adaptations were not comprehensive. CONCLUSION High-quality cultural adaptations are crucial to providing meaningful interventions in different parts of the world.
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Affiliation(s)
| | - Pia Noel
- PhD Candidate, Social and Political Science, University of Edinburgh, Edinburgh, UK
| | | | - Andrew Jahoda
- Professor of Learning Disabilities, Institute of Health and Wellbeing College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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20
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Mkabile S, Swartz L. 'I Waited for It until Forever': Community Barriers to Accessing Intellectual Disability Services for Children and Their Families in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8504. [PMID: 33212851 PMCID: PMC7698324 DOI: 10.3390/ijerph17228504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them. METHODS We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers' and parents' views. RESULTS Results revealed that caregivers and parents of children with intellectual disability did not use the intellectual disability service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes and self-stigmatisation. CONCLUSION Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.
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Affiliation(s)
- Siyabulela Mkabile
- Department of Psychology, Stellenbosch University, Stellenbosch 7602, South Africa;
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7735, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch 7602, South Africa;
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21
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Dada S, Bastable K, Halder S. The Role of Social Support in Participation Perspectives of Caregivers of Children with Intellectual Disabilities in India and South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6644. [PMID: 32933056 PMCID: PMC7558089 DOI: 10.3390/ijerph17186644] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022]
Abstract
Caregivers are an intrinsic component of the environment of children with intellectual disabilities. However, caregivers' capacity to support children's participation may be linked to the social support that they, as caregivers, receive. Social support may increase participation, educational, psychological, medical and financial opportunities. However, there is a lack of information on social support in middle-income countries. The current study described and compared the social support of caregivers of children with intellectual disabilities by using the Family Support Survey (FSS) in India and South Africa. The different types of social support were subsequently considered in relation to participation, using the Children's Assessment of Participation and Enjoyment (CAPE). One hundred caregiver-child dyads from India and 123 from South Africa participated in this study. The data were analysed using non-parametric measures. Indian caregivers reported greater availability of more helpful support than did the South African caregivers. Social support was associated with children's participation diversity (India) and intensity (South Africa). The child-/caregiver-reported participation data showed different associations with participation. Results from this study suggest that perceived social support of caregivers differs between countries and is associated with their child's participation. These factors need to be considered when generalising results from different countries.
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Affiliation(s)
- Shakila Dada
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Kirsty Bastable
- Centre for Augmentative and Alternative Communication, Humanities Faculty, University of Pretoria, Pretoria 0002, South Africa;
| | - Santoshi Halder
- Department of Education, University of Calcutta, Alipore Campus, 1 Reformatory St., Kolkata 700027, India;
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22
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Oner O, Kahilogullari AK, Acarlar B, Malaj A, Alatas E. Psychosocial and cultural needs of children with intellectual disability and their families among the Syrian refugee population in Turkey. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:644-656. [PMID: 32627246 DOI: 10.1111/jir.12760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Turkey is the country hosting the largest number of refugees from Syria, with currently 3 571 175 million persons. The general health needs of the refugees are being addressed; however, people with intellectual disabilities (IDs), particularly children, are relatively missed. The aim of this study was to identify medical, psychological and social needs of children with ID and their families, among the Syrian refugee population in Turkey, and to define psychosocial and cultural needs for planning of future services. METHODS One hundred forty-two children (67.6% men; mean age 90.5 months) diagnosed with intellectual disorders were included in the study. Family Needs Survey, with additional open-ended and close-ended questions, was used to evaluate family needs. Items from Developmental Disabilities Profile-2 were used to evaluate and screen cognitive, motor and language development as well as medical concerns and behavioural problems. Data on sociodemographic characteristics were also collected. RESULTS The highest needs were identified in information and financial needs domains. Other indicated needs were on child care and community services domains. The least indicated items were on family and social support and explaining to others domains. An average of 63.5% of the respondents definitely agreed with the Family Needs Survey items. The overall level of identification of need items was higher than that in some previous studies, indicating the level of unmet needs of the studied population. Family income, parents' employment and parents' education were not significantly associated with unmet family needs. Special education services were unreachable for most of the families in the study. CONCLUSIONS Families reported the highest needs in information and financial needs domains. The overall level of identification of needs was higher than that in some previous studies, indicating the level of unmet needs of the studied population. The majority of the parents reported that they had sufficient family and social support, which might be a protective factor for parental mental health. Parents' Turkish fluency was very significantly associated with every domain of unmet needs. Language barriers and translation problems had significant negative effects on families, as confirmed by the answers to open-ended questions. Another important factor identified was access to service professionals. Special education services, sorely needed for most of the families, could not always be reached. Although the progress of children who had received special education was not very encouraging, it was better than those who did not receive it. The first implication of the study is that increasing Turkish proficiency or providing high-quality and consistent translation services is vital for this category of children with ID. The second implication is that information and financial needs must be met with priority. Information must be tailored for each child's needs and developmental level. Special education and physical therapy must be more accessible and at higher quality.
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Affiliation(s)
- O Oner
- Child and Adolescent Psychiatry Department, Bahçeşehir University School of Medicine, Istanbul, Turkey
| | | | - B Acarlar
- Advanced Research Design and Analysis, Noema Scientific Consultancy, Istanbul, Turkey
| | - A Malaj
- WHO Country Office, Ankara, Turkey
| | - E Alatas
- Department of Mental Health, Ministry of Health, Ankara, Turkey
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Nuri RP, Ghahari S, Aldersey HM, Huque AS. Exploring access to government-led support for children with disabilities in Bangladesh. PLoS One 2020; 15:e0235439. [PMID: 32614867 PMCID: PMC7332059 DOI: 10.1371/journal.pone.0235439] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/15/2020] [Indexed: 12/20/2022] Open
Abstract
While access to support for individuals with disabilities has attracted international attention, children with disabilities and their families continue to face a range of barriers that limit their timely access to the needed support, including health service. This is even worse for children with disabilities living in resource poor settings like Bangladesh. The objective of this study was to determine the extent to which families of children with disabilities have knowledge about and access to government support for their children with disabilities in Bangladesh. We employed a cross-sectional study among 393 families of children with disabilities who sought services from the Centre for the Rehabilitation of the Paralysed for their children with disabilities in Bangladesh. We used chi-square test to measure the association between categorical variables and, Mann-Whitney U-test to compare mean across different sub-groups. Overall, family members of children with disabilities have limited knowledge about and access to government support. We found a significant association between knowledge and access to government support (p<0.001). Family members with children with disabilities aged younger than six years had less access to government support (p<0.001). We thus concluded with an urgent call on government agencies and service providers to provide relevant and timely information to families of children with disabilities to enable them to access the needed support.
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Affiliation(s)
- Reshma Parvin Nuri
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
- * E-mail:
| | - Setareh Ghahari
- School of Rehabilitation Therapy, Queen’s University, Kingston, Ontario, Canada
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Malapela RG, Thupayagale-Tshweneagae G, Mashalla Y. Transition of adolescents with intellectual disability from schools for learners with special educational needs: Parents views for the preparedness. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1440-1447. [PMID: 32539238 DOI: 10.1111/jar.12771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/17/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Studies on preparedness of parents of adolescents living with intellectual disabilities transitioning from school to adulthood are scarce in sub-Saharan Africa. This study explored views of parents on their preparedness to handle adolescents transitioning from special schools to adulthood. METHODS Descriptive qualitative method was used to collect views of parents of adolescents with intellectual disability on their preparedness to handle transition of their children from school into community life. Content analysis was used to analyse the data. FINDINGS Twelve female and two male participants expressed concerns on lack of transition plans, adolescent's future, culture and beliefs and inadequate community support. Views of parents of younger children and those of parents of older children were similar. CONCLUSION Parents were unprepared for transition of their children from school to community life. Multidisciplinary approach including family involvement and community support is necessary to enhance the transition of adolescents with intellectual disability.
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Affiliation(s)
| | | | - Yohana Mashalla
- Department of Health Studies, University of South Africa, Pretoria, South Africa.,Faculty of Medicine, University of Botswana, Gaborone, Botswana
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McConkey R, Taggart L, DuBois L, Shellard A. Creating Inclusive Health Systems for People With Intellectual Disabilities: An International Study. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mkabile S, Swartz L. Caregivers' and parents' explanatory models of intellectual disability in Khayelitsha, Cape Town, South Africa. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1026-1037. [PMID: 32232922 DOI: 10.1111/jar.12725] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 02/08/2020] [Accepted: 02/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Post-apartheid, understanding and management of intellectual disability remain poor in South Africa, complicated by various contextual and cultural explanations used to describe and conceptualize this condition. METHOD We conducted 20 semi-structured interviews with primary caregivers and parents of children with intellectual disability residing in Khayelitsha, a low-income setting in Cape Town, South Africa. We used Kleinman's Explanatory Models (EMs) of illness to explore terms used to describe and conceptualize this condition. RESULTS Carers' explanatory models included biomedical causes, injuries during pregnancy or birth, as well as spiritual causes. It was reported that there were significant difficulties in accessing services and support, and difficulties with coping in the context of extreme poverty and deprivation. CONCLUSIONS Current findings highlight a need for collaboration between the biomedical and alternative healthcare systems in educating carers and parents regarding intellectual disability.
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Affiliation(s)
- Siyabulela Mkabile
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.,Department of Psychiatry and Mental Health, Division of Intellectual Disabilities, University of Cape Town, Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
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Hopia H, Heikkilä J. Nursing research priorities based on CINAHL database: A scoping review. Nurs Open 2020; 7:483-494. [PMID: 32089844 PMCID: PMC7024619 DOI: 10.1002/nop2.428] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/18/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022] Open
Abstract
Aim To analyse nursing research based on the CINAHL database to identify research priorities for nursing. Design A scoping literature review was conducted. The CINAHL Plus (EBSCO) Full Text was searched between 2012-2018. Methods Out of 1522 original publications, 91 fulfilled the inclusion criteria. The Joanna Briggs Institute critical appraisal tools were applied. Data were analysed by a thematic analysis method. Results A strong emphasis should be put on development and evaluation of nursing theories and, in addition, randomized controlled trial studies, meta-synthesis, experimental and intervention studies are needed in nursing research. Development of competencies and skills in the nursing profession ought to be studied more extensively and research should be focused on variety fields of nursing practice.
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Affiliation(s)
- Hanna Hopia
- School of Health and Social StudiesJAMK University of Applied SciencesJyvaskylaFinland
| | - Johanna Heikkilä
- School of Health and Social StudiesJAMK University of Applied Sciences, Research and DevelopmentJyvaskylaFinland
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28
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Psychological treatment strategies for challenging behaviours in neurodevelopmental disorders: what lies beyond a purely behavioural approach? Curr Opin Psychiatry 2020; 33:92-109. [PMID: 31743125 DOI: 10.1097/yco.0000000000000571] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW Challenging behaviour shown by individuals with neurodevelopmental disorders (NDDs) has a major negative impact. There is robust evidence for the efficacy of treatments based on applied behaviour analysis. However, such approaches are limited in important ways - providing only part of the whole solution. We reviewed the literature to provide an overview of recent progress in psychological treatments for challenging behaviour and how these advance the field beyond a purely behavioural approach. RECENT FINDING We identified 1029 articles via a systematic search and screened for those implementing a psychological intervention with individuals with NDD (or caregivers) and measuring the potential impact on challenging behaviour. Of the 69 included studies published since 2018, more than 50% implemented a purely behavioural intervention. Other studies could generally be categorized as implementing parent training, meditation, skill training or technology-assisted interventions. SUMMARY Greater consideration of the interplay between behavioural and nonbehavioural intervention components; systematic approaches to personalization when going beyond the behavioural model; mental health and broad social communication needs; and models that include cognitive and emotional pathways to challenging behaviour; is needed to advance the field. Furthermore, technology should not be overlooked as an important potential facilitator of intervention efforts.
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Hasson F, Nicholson E, Muldrew D, Bamidele O, Payne S, McIlfatrick S. International palliative care research priorities: A systematic review. BMC Palliat Care 2020; 19:16. [PMID: 32013949 PMCID: PMC6998205 DOI: 10.1186/s12904-020-0520-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been increasing evidence and debate on palliative care research priorities and the international research agenda. To date, however, there is a lack of synthesis of this evidence, examining commonalities, differences, and gaps. To identify and synthesize literature on international palliative care research priorities originating from Western countries mapped to a quality assessment framework. METHODS A systematic review of several academic and grey databases were searched from January 2008-June 2019 for studies eliciting research priorities in palliative care in English. Two researchers independently reviewed, critically appraised, and conducted data extraction and synthesis. RESULTS The search yielded 10,235 articles (academic databases, n = 4108; grey literature, n = 6127), of which ten were included for appraisal and review. Priority areas were identified: service models; continuity of care; training and education; inequality; communication; living well and independently; and recognising family/carer needs and the importance of families. Methodological approaches and process of reporting varied. There was little representation of patient and caregiver driven agendas. The priorities were mapped to the Donabedian framework for assessing quality reflecting structure, process and outcomes and key priority areas. CONCLUSIONS Limited evidence exists pertaining to research priorities across palliative care. Whilst a broad range of topics were elicited, approaches and samples varied questioning the credibility of findings. The voice of the care provider dominated, calling for more inclusive means to capture the patient and family voice. The findings of this study may serve as a template to understand the commonalities of research, identify gaps, and extend the palliative care research agenda.
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Affiliation(s)
- Felicity Hasson
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland.
| | - Emma Nicholson
- UCD School of Nursing, Midwifery and Health Systems, UCD College of Health and Agricultural Sciences, University College Dublin, Belfield, Dublin 4, Ireland
| | - Deborah Muldrew
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland
| | - Olufikayo Bamidele
- Academcy of Primary Care, Hull York Medical School, Allam Medical Building, University of Hull, Hull, HU6 7RZ, England
| | - Sheila Payne
- International Observatory on End of Life Care, Lancaster University, LA14YX, Lancaster, UK
| | - Sonja McIlfatrick
- Institute of Nursing and Health Research, School of Nursing, Ulster University, Shore Road, Newtownabbey, BT37 0QB, Northern Ireland
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30
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Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, Jones EJH, Jones RM, Pickles A, State MW, Taylor JL, Veenstra-VanderWeele J. Autism spectrum disorder. Nat Rev Dis Primers 2020; 6:5. [PMID: 31949163 PMCID: PMC8900942 DOI: 10.1038/s41572-019-0138-4] [Citation(s) in RCA: 589] [Impact Index Per Article: 147.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 12/27/2022]
Abstract
Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication and repetitive behaviours, highly restricted interests and/or sensory behaviours beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries. Although gross brain pathology is not characteristic of autism, subtle anatomical and functional differences have been observed in post-mortem, neuroimaging and electrophysiological studies. Initially, it was hoped that accurate measurement of behavioural phenotypes would lead to specific genetic subtypes, but genetic findings have mainly applied to heterogeneous groups that are not specific to autism. Psychosocial interventions in children can improve specific behaviours, such as joint attention, language and social engagement, that may affect further development and could reduce symptom severity. However, further research is necessary to identify the long-term needs of people with autism, and treatments and the mechanisms behind them that could result in improved independence and quality of life over time. Families are often the major source of support for people with autism throughout much of life and need to be considered, along with the perspectives of autistic individuals, in both research and practice.
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Affiliation(s)
- Catherine Lord
- Departments of Psychiatry and School of Education, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Traolach S Brugha
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Guillaume Dumas
- Institut Pasteur, UMR3571 CNRS, Université de Paris, Paris, France
| | | | - Emily J H Jones
- Centre for Brain & Cognitive Development, University of London, London, UK
| | - Rebecca M Jones
- The Sackler Institute for Developmental Psychobiology, New York, NY, USA
- The Center for Autism and the Developing Brain, White Plains, NY, USA
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew W State
- Department of Psychiatry, Langley Porter Psychiatric Institute and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Julie Lounds Taylor
- Department of Pediatrics and Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
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Hyman SL, Levy SE, Myers SM. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics 2020; 145:peds.2019-3447. [PMID: 31843864 DOI: 10.1542/peds.2019-3447] [Citation(s) in RCA: 475] [Impact Index Per Article: 118.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with reported prevalence in the United States of 1 in 59 children (approximately 1.7%). Core deficits are identified in 2 domains: social communication/interaction and restrictive, repetitive patterns of behavior. Children and youth with ASD have service needs in behavioral, educational, health, leisure, family support, and other areas. Standardized screening for ASD at 18 and 24 months of age with ongoing developmental surveillance continues to be recommended in primary care (although it may be performed in other settings), because ASD is common, can be diagnosed as young as 18 months of age, and has evidenced-based interventions that may improve function. More accurate and culturally sensitive screening approaches are needed. Primary care providers should be familiar with the diagnostic criteria for ASD, appropriate etiologic evaluation, and co-occurring medical and behavioral conditions (such as disorders of sleep and feeding, gastrointestinal tract symptoms, obesity, seizures, attention-deficit/hyperactivity disorder, anxiety, and wandering) that affect the child's function and quality of life. There is an increasing evidence base to support behavioral and other interventions to address specific skills and symptoms. Shared decision making calls for collaboration with families in evaluation and choice of interventions. This single clinical report updates the 2007 American Academy of Pediatrics clinical reports on the evaluation and treatment of ASD in one publication with an online table of contents and section view available through the American Academy of Pediatrics Gateway to help the reader identify topic areas within the report.
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Affiliation(s)
- Susan L Hyman
- Golisano Children's Hospital, University of Rochester, Rochester, New York;
| | - Susan E Levy
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Scott M Myers
- Geisinger Autism & Developmental Medicine Institute, Danville, Pennsylvania
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32
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Tomlinson M, Darmstadt GL, Yousafzai AK, Daelmans B, Britto P, Gordon SL, Tablante E, Dua T. Global research priorities to accelerate programming to improve early childhood development in the sustainable development era: a CHNRI exercise. J Glob Health 2019; 9:020703. [PMID: 31673352 PMCID: PMC6815874 DOI: 10.7189/jogh.09.020703] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Approximately 250 million children under the age of five in low and middle-income countries (LMICs) will not achieve their developmental potential due to poverty and stunting alone. Investments in programming to improve early childhood development (ECD) have the potential to disrupt the cycle of poverty and therefore should be prioritised. Support for ECD has increased in recent years. Nevertheless, donors and policies continue to neglect ECD, in part from lack of evidence to guide policy makers and donors about where they should focus policies and programmes. Identification and investment in research is needed to overcome these constraints and in order to achieve high quality implementation of programmes to improve ECD. Methods The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities for improving ECD. A group of 348 global and local experts in ECD-related research were identified and invited to generate research questions. This resulted in 406 research questions which were categorised and refined by study investigators into 54 research questions across six thematic goals which were evaluated using five criteria: answerability, effectiveness, feasibility, impact, and effect on equity. Research options were ranked by their final research priority score multiplied by 100. Results The top three research priority options from the LMIC experts came from the third thematic goal of improving the impact of interventions, whereas the top three research priority options from high-income country experts came from different goals: improving the integration of interventions, increasing the understanding of health economics and social protection strategies, and improving the impact of interventions. Conclusion The results of this process highlight that priorities for future research should focus on the need for services and support to parents to provide nurturing care, and the training of health workers and non-specialists in implementation of interventions to improve ECD. Three of the six thematic goals of the present priority setting centred on interventions (ie, improving impact, implementation of interventions and improving the integration of interventions). In order to achieve higher coverage through sustainable interventions to improve ECD with equitable reach, interventions should be integrated and not be sector driven.
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Affiliation(s)
- Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
| | - Gary L Darmstadt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Aisha K Yousafzai
- Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts, USA
| | | | - Pia Britto
- Early Childhood Development Unit, UNICEF, New York, New York, USA
| | - Sarah L Gordon
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | - Tarun Dua
- World Health Organization, Geneva, Switzerland
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Hodes M, Vostanis P. Practitioner Review: Mental health problems of refugee children and adolescents and their management. J Child Psychol Psychiatry 2019; 60:716-731. [PMID: 30548855 DOI: 10.1111/jcpp.13002] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Since 2010, the numbers of refugees have increased and around half are under 18 years of age. It is known that experience of organised violence, displacement and resettlement increases the risk for psychiatric disorders and psychosocial impairment. This review integrates recent research into the risk and protective factors for psychopathology with service and treatment issues. METHODS We draw on and critically evaluate key systematic reviews in the selected areas, innovative robust studies and relevant government reports. RESULTS Many refugee children show resilience and function well, even in the face of substantial adversities. The most robust findings for psychopathology are that PTSD, and posttraumatic and depressive symptoms are found at higher prevalence in those who have been exposed to war experiences. Their severity may decrease over time with resettlement, but PTSD in the most exposed may show higher continuity. More severe psychiatric disorders including psychosis may also occur. Service delivery needs to take into account socioeconomic and cultural influences but, given the high level of unmet need even in high-income countries, stepped care delivery is required. The evaluation of psychological interventions, often delivered in group settings, suggests that they can be effective for many distressed children; however, for the more impaired, a greater range of disorder-specific therapies will be required. CONCLUSIONS Child and adolescent mental health clinicians and service providers need to be aware of the specific needs of this population and systems for service delivery. There are significant knowledge gaps in understanding risk and vulnerability, service delivery and treatment effectiveness.
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Affiliation(s)
- Matthew Hodes
- Centre for Psychiatry, Imperial College London, London, UK
| | - Panos Vostanis
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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34
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Hodes M. New developments in the mental health of refugee children and adolescents. EVIDENCE-BASED MENTAL HEALTH 2019; 22:72-76. [PMID: 30944095 PMCID: PMC10270370 DOI: 10.1136/ebmental-2018-300065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/31/2019] [Accepted: 02/13/2019] [Indexed: 12/22/2022]
Abstract
The increase in refugees globally since 2010 and the arrival of many into Europe since 2015, around 50% of whom are under 18 years, have been the stimulus to greater investigation and publications regarding their mental health. This clinical review summarises selected themes in the field as described in the published literature since 2016. The themes include refugee statistics, premigration and postmigration experiences, psychopathology focusing on parent-child relationships, unaccompanied refugee minors and associations between resettlement, acculturation and mental health. Some important reviews and studies are discussed that address service and treatment provision. While there has been a recent increase in research in this field, more is needed into the course of psychopathology, protective factors and the promotion of integration into resettlement countries, as well as models of service delivery and treatment effectiveness.
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Affiliation(s)
- Matthew Hodes
- Department of Medicine, Centre for Psychiatry, Imperial College London, London, UK
- Westminster Child and Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, UK
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Behavior Problems in Physically Ill Children in Rwanda. J Dev Behav Pediatr 2019; 40:642-650. [PMID: 31369465 PMCID: PMC6824509 DOI: 10.1097/dbp.0000000000000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Childhood behavior problems are underidentified in low- and middle-income countries. This study sought to systematically screen for behavior problems among children receiving medical care in Rwanda and investigate factors associated with behavior problems in this cohort. METHODS The Pediatric Symptom Checklist (PSC) was translated into Kinyarwanda, following best practices. Children aged 5.9 to 16 years admitted to the inpatient ward of a referral hospital or seen in the outpatient department (OPD) were screened using the PSC. All PSC-positive children and every third PSC-negative child were referred for definitive assessment by a child mental health specialist. RESULTS Among 300 eligible children, 235 were recruited; none refused. PSC scores were positive in 74 of 234 cases (32%, 95% confidence interval 26%-38%); a total of 28 of 74 (40%) PSC-positive children completed mental health assessments. Of these, 16 (57% of those assessed, and 7% of the 235 who were screened) required treatment or further assessment; none of the PSC-negative children did. Screening sensitivity was 100%, and specificity was 71%, with favorable receiver operating characteristics curve and internal consistency. In a multivariate analysis, higher PSC scores were associated with OPD care, central nervous system trauma or infection, and indices of malnutrition and with the use of traditional, complementary, and alternative medicine (TCAM). CONCLUSION Behavior problems are common among Rwanda children seen in a referral hospital, particularly in the OPD, and are associated with use of TCAM. The Kinyarwanda PSC showed favorable screening characteristics and resulted in some 7% of children accessing needed mental health care.
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36
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Odgers HL, Tong A, Lopez-Vargas P, Davidson A, Jaffe A, McKenzie A, Pinkerton R, Wake M, Richmond P, Crowe S, Caldwell PHY, Hill S, Couper J, Haddad S, Kassai B, Craig JC. Research priority setting in childhood chronic disease: a systematic review. Arch Dis Child 2018; 103:942-951. [PMID: 29643102 DOI: 10.1136/archdischild-2017-314631] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/07/2018] [Accepted: 03/12/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate research priority setting approaches in childhood chronic diseases and to describe the priorities of stakeholders including patients, caregivers/families and health professionals. DESIGN We conducted a systematic review of MEDLINE, Embase, PsycINFO and CINAHL from inception to 16 October 2016. Studies that elicited stakeholder priorities for paediatric chronic disease research were eligible for inclusion. Data on the prioritisation process were extracted using an appraisal checklist. Generated priorities were collated into common topic areas. RESULTS We identified 83 studies (n=15 722). Twenty (24%) studies involved parents/caregivers and four (5%) children. The top three health areas were cancer (11%), neurology (8%) and endocrine/metabolism (8%). Priority topic areas were treatment (78%), disease trajectory (48%), quality of life/psychosocial impact (48%), disease onset/prevention (43%), knowledge/self-management (33%), prevalence (30%), diagnostic methods (28%), access to healthcare (25%) and transition to adulthood (12%). The methods included workshops, Delphi techniques, surveys and focus groups/interviews. Specific methods for collecting and prioritising research topics were described in only 60% of studies. Most reviewed studies were conducted in high-income nations. CONCLUSIONS Research priority setting activities in paediatric chronic disease cover many discipline areas and have elicited a broad range of topics. However, child/caregiver involvement is uncommon, and the methods often lack clarity. A systematic and explicit process that involves patients and families in partnership may help to inform a more patient and family-relevant research agenda in paediatric chronic disease.
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Affiliation(s)
- Harrison Lindsay Odgers
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Pamela Lopez-Vargas
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Kid's Research Institute, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Andrew Davidson
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, France.,Department of Anaesthesiology, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Adam Jaffe
- Department of Respiratory Medicine, The Sydney Children's Hospital Network, Sydney, New South Wales, Australia.,Discipline of Paediatrics, The University of New South Wales, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Western Australian Health Translation Network, The University of Western Australia, Perth, Western Australia, Australia
| | - Ross Pinkerton
- Department of Oncology, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
| | - Melissa Wake
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, France.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Peter Richmond
- Division of Paediatrics, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.,Departments of General Paediatrics and Immunology, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
| | | | - Patrina Ha Yuen Caldwell
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Nephrology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Sophie Hill
- Center for Health Communication and Participation, La Trobe University, Melbourne, Victoria, Australia
| | - Jennifer Couper
- Department of Endocrinology and Diabetes, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Suzy Haddad
- Patient and Carer Representative, Sydney, New South Wales, Australia
| | - Behrouz Kassai
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Centre d'Investigation Clinique de Lyon, Lyon, France
| | - Jonathan C Craig
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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Significant cognitive delay among 3- to 4-year old children in low- and middle-income countries: prevalence estimates and potential impact of preventative interventions. Int J Epidemiol 2018; 47:1465-1474. [DOI: 10.1093/ije/dyy161] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 11/12/2022] Open
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Capri C, Abrahams L, McKenzie J, Coetzee O, Mkabile S, Saptouw M, Hooper A, Smith P, Adnams C, Swartz L. Intellectual disability rights and inclusive citizenship in South Africa: What can a scoping review tell us? Afr J Disabil 2018; 7:396. [PMID: 29850438 PMCID: PMC5968870 DOI: 10.4102/ajod.v7i0.396] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/05/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intellectual disability (ID) is the most prevalent disability in the world. People with intellectual disability (PWID) frequently experience extreme violations of numerous human rights. Despite greater prevalence in South Africa than in high-income countries, most ID research currently comes from the Global North. This leaves us with few contextually sensitive studies to draw from to advance inclusive citizenship. OBJECTIVES Our scoping review aims to investigate pertinent ID rights issues in South Africa, synthesise quantitative and qualitative studies, and provide a synopsis of available evidence on which to base future work. We aim to clarify key concepts, address gaps in the literature and identify opportunities for further research. METHOD We followed strict eligibility criteria. Medical subject heading terms were entered into seven databases. Seven reviewers worked independently, two per paper. Quantitative and qualitative data extraction forms were designed. We followed Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and registered a protocol. An inductive approach enabled a thematic analysis of selected studies. RESULTS By following PRISMA guidelines, 82 studies were assessed for eligibility of which 59 were included. Ten sub-themes were integrated into four main themes: the right not to be discriminated against, the right to psychological and bodily integrity, the right to accommodating services and challenges to rights implementation. CONCLUSION People with intellectual disability face compound difficulties when trying to assert their constitutionally entitled rights. This ongoing project requires serious commitment and action. Statutory obligations to nurture every South African's human rights naturally extend to PWID and their supporters who forge ahead in a disabling environment.
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Affiliation(s)
- Charlotte Capri
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
- Alexandra Hospital, Western Cape Government, South Africa
| | - Lameze Abrahams
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
- Lentegeur Psychiatric Hospital, Department of Health, South Africa
| | - Judith McKenzie
- Department of Health & Rehabilitation Sciences, University Of Cape Town, South Africa
| | - Ockert Coetzee
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
- Alexandra Hospital, Western Cape Government, South Africa
| | - Siyabulela Mkabile
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
- Lentegeur Psychiatric Hospital, Department of Health, South Africa
| | - Manuel Saptouw
- Lentegeur Psychiatric Hospital, Department of Health, South Africa
| | - Andrew Hooper
- Lentegeur Psychiatric Hospital, Department of Health, South Africa
| | - Peter Smith
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
- Lentegeur Psychiatric Hospital, Department of Health, South Africa
| | - Colleen Adnams
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, South Africa
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Welch C, Polatajko H, Rigby P, Fitch M. Autism inside out: lessons from the memoirs of three minimally verbal youths. Disabil Rehabil 2018; 41:2308-2316. [DOI: 10.1080/09638288.2018.1465133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Christie Welch
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Helene Polatajko
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Patty Rigby
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Margaret Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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40
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McDonald KE, Conroy NE, Olick RS. A quantitative study of attitudes toward the research participation of adults with intellectual disability: Do stakeholders agree? Disabil Health J 2017; 11:345-350. [PMID: 29292211 DOI: 10.1016/j.dhjo.2017.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 11/29/2017] [Accepted: 12/05/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Attitudes toward the research participation of adults with intellectual disability inform research policy and practice, impact interest in and support for research participation, and promote or discourage the generation of new knowledge to promote health among adults with intellectual disability. Yet we know little about these beliefs among the public and the scientific community. OBJECTIVE/HYPOTHESIS We quantitatively studied attitudes among adults with intellectual disability, family and friends, disability service providers, researchers, and Institutional Review Board (IRB) members. We predicted that adults with intellectual disability, and researchers would espouse views most consistent with disability rights, whereas IRB members, and to a lesser degree family, friends, and service providers, would espouse more protective views. METHODS We surveyed five hundred and twelve members of the five participant stakeholder groups on their attitudes toward the research participation of adults with intellectual disability. RESULTS We found broad support for research about people with intellectual disability, though slightly more tempered support for their direct participation therein. In general, IRB members and to some extent adults with intellectual disability endorsed direct participation less than others. We also found that adults with intellectual disability strongly believed in their consent capacity. CONCLUSIONS Resources should be directed toward health-related research with adults with intellectual disability, and interventions should be pursued to address ethical challenges and promote beliefs consistent with human rights.
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Affiliation(s)
- Katherine E McDonald
- Syracuse University, Public Health, Food Studies and Nutrition and the Burton Blatt Institute, 444 White Hall, Syracuse, NY 13244, USA.
| | - Nicole E Conroy
- The University of Vermont, Leadership & Developmental Sciences, Mann Hall 208A, Burlington, VT 05405, USA
| | - Robert S Olick
- SUNY Upstate Medical University, Center for Bioethics and Humanities, 618 Irving Avenue, Syracuse, NY 13210, USA
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Gordon S, Rotheram-Borus MJ, Skeen S, Parry C, Bryant K, Tomlinson M. Research Priorities for the Intersection of Alcohol and HIV/AIDS in Low and Middle Income Countries: A Priority Setting Exercise. AIDS Behav 2017; 21:262-273. [PMID: 28975440 PMCID: PMC5660137 DOI: 10.1007/s10461-017-1921-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The harmful use of alcohol is a component cause for more than 200 diseases. The association between alcohol consumption, risk taking behavior and a range of infectious diseases such as HIV/AIDS is well established. The prevalence of HIV/AIDS as well as harmful alcohol use in low and middle income countries is high. Alcohol has been identified as a modifiable risk factor in the prevention and treatment of HIV/AIDS. The objective of this paper is to define research priorities for the interaction of alcohol and HIV/AIDS in low and middle income countries. The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities of the interaction of alcohol and HIV/AIDS. A group of 171 global and local experts in the field of alcohol and or HIV/AIDS related research were identified and invited to generate research questions. This resulted in 205 research questions which have been categorized and refined by senior researchers into 48 research questions to be evaluated using five criteria: answerability, effectiveness, feasibility, applicability and impact, as well as equity. A total of 59 experts participated independently in the voluntary scoring exercise (a 34% response rate). There was substantial consensus among experts on priorities for research on alcohol and HIV. These tended to break down into two categories, those focusing on better understanding the nexus between alcohol and HIV and those directed towards informing practical interventions to reduce the impact of alcohol use on HIV treatment outcomes, which replicates what Bryant (Subst Use Misuse 41:1465–1507, 2006) and Parry et al. (Addiction 108:1–2, 2012) found. Responses from experts were stratified by location in order to determine any differences between groups. On average experts in the LMIC gave higher scores than the HIC experts. Recent research has shown the causal link between alcohol consumption and the incidence of HIV/AIDS including a better understanding of the pathways through which alcohol use affects ARV adherence (and other medications to treat opportunistic infections) and CD4 counts. The results of this process clearly indicated that the important priorities for future research related to the development and assessment of interventions focusing on addressing alcohol and HIV/AIDS, addressing and exploring the impact of HIV risk and comorbid alcohol use, as well as exploring the risk and protective factors in the field of alcohol and HIV/AIDS. The findings from this priority setting exercise could guide international research agenda and make research funding more effective in addressing the research on intersection of alcohol and HIV/AIDS
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Affiliation(s)
- Sarah Gordon
- The Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - Mary Jane Rotheram-Borus
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90024, USA.
- Global Center for Children and Families, Semel Institute and the Department of Psychiatry, University of California at Los Angeles, 10920 Wilshire Boulevard, Suite 350, Los Angeles, CA, 90024-6521, USA.
| | - Sarah Skeen
- The Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
| | - Charles Parry
- South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, South Africa
| | - Kendall Bryant
- National Institute of Alcohol Abuse and Alcoholism, 5635 Fishers Lane, Bethesda, MD, 20892-7003, USA
| | - Mark Tomlinson
- The Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa
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Foley KR, Pollack AJ, Britt HC, Lennox NG, Trollor JN. General practice encounters for young patients with autism spectrum disorder in Australia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:784-793. [DOI: 10.1177/1362361317702560] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study compared the patient demographics and reasons for encounter in general practice for patients <25 years with and without an autism spectrum disorder identified as a reason for encounter and/or problem managed. The Bettering the Evaluation and Care of Health programme collected information about clinical activities in Australian general practice. Each year, the programme recruited a random sample of 1000 general practitioners, each of whom collected data for 100 consecutive consultations (encounters). Encounters with patients <25 years, where at least one autism spectrum disorder was recorded as a reason for encounter and/or a problem managed (n = 579), were compared with all other encounters (n = 281,473) from April 2000 to March 2014 inclusive. Data were age–sex standardised. Patients at autism spectrum disorder encounters (compared to non-autism spectrum disorder encounters) were more likely to be younger and male. There was a dramatic rise in the number of general practitioner consultations at autism spectrum disorder encounters from 2000 to 2013. More reasons for encounter were recorded at autism spectrum disorder encounters than at non-autism spectrum disorder encounters (156.4 (95% confidence interval: 144.0–168.8) and 140.5 (95% confidence interval: 140.0–141.0), respectively). At autism spectrum disorder (vs non-autism spectrum disorder) encounters, there were more psychological, general and unspecified, and social reasons for encounter and fewer preventive and acute health reasons for encounter. People with an autism spectrum disorder have complex health care needs that require a skilled general practice workforce.
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Affiliation(s)
- Kitty-Rose Foley
- School of Psychiatry, University of New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Allan J Pollack
- School of Public Health, The University of Sydney, Australia
| | - Helena C Britt
- School of Public Health, The University of Sydney, Australia
| | - Nicholas G Lennox
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- School of Medicine, The University of Queensland, Australia
| | - Julian N Trollor
- School of Psychiatry, University of New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
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Abstract
PURPOSE OF REVIEW This review aims to summarize data published in the scientific literature and available on official websites on fetal alcohol spectrum disorder (FASD) in Africa. RECENT FINDINGS There is a paucity of published literature and evidence-based information on prenatal exposure to alcohol in the African continent and the majority of the continent's literature on FASD emanates from South Africa. A small number of scientific publications document FASD and drinking in pregnancy in other Sub-Saharan African countries and these findings provide evidence that FASD occurs across the continent. Further evidence shows that the world's highest reported rates of FASD occur in South Africa and that this confers a significant public health and neurodevelopmental disability burden on the region. There is an established body of epidemiological, diagnostic, neurobehavioral and neuroscientific knowledge from studies in South Africa. Universal and indicated case method preventions are effective in reducing maternal alcohol consumption in high-risk areas. Throughout Africa, a policy and service implementation gap exists that impedes translation of generated knowledge into effective prevention and intervention strategies. SUMMARY FASD is likely a widely occurring and largely unrecognized neurodevelopmental disability in Africa. A key future direction for global agencies and research partnerships is to collaboratively address evidence gaps and knowledge translation through scalable approaches and strategies that aim to ameliorate the burden of FASD in African and other countries.
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Savage A, Emerson E. Overweight and obesity among children at risk of intellectual disability in 20 low and middle income countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:1128-1135. [PMID: 27444252 DOI: 10.1111/jir.12309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 04/12/2016] [Accepted: 05/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Children with intellectual disability (ID) in high income countries are at significantly greater risk of obesity than their non-disabled peers. We aimed to estimate the prevalence of overweight and obesity in 3 to 4-year-old children who are/are not at risk of ID in low and middle income countries. METHOD Secondary analysis of Round 4 and 5 UNICEF Multiple Indicator Cluster Surveys (MICS) from 20 low and middle income countries that included a total of 83 597 3 to 4-year-old children. RESULTS Few differences in risk of overweight or obesity were apparent between 3 and 4-year-old children identified as being at risk/not at risk of ID in 20 low and middle income countries. In the two countries where statistically significant differences were observed, prevalence of overweight/obesity was lower among children at risk of ID. CONCLUSIONS These results stand in stark contrast to evidence from high income countries which suggest that children with ID are at significantly increased risk of obesity when compared to their non-intellectually disabled peers.
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Affiliation(s)
- A Savage
- Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia.
- Centre for Disability Research, Lancaster University, Lancaster, United Kingdom.
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Mikton CR, Tanaka M, Tomlinson M, Streiner DL, Tonmyr L, Lee BX, Fisher J, Hegadoren K, Pim JE, Wang SJS, MacMillan HL. Global research priorities for interpersonal violence prevention: a modified Delphi study. Bull World Health Organ 2016; 95:36-48. [PMID: 28053363 PMCID: PMC5180342 DOI: 10.2471/blt.16.172965] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 07/15/2016] [Accepted: 08/31/2016] [Indexed: 11/27/2022] Open
Abstract
Objective To establish global research priorities for interpersonal violence prevention using a systematic approach. Methods Research priorities were identified in a three-round process involving two surveys. In round 1, 95 global experts in violence prevention proposed research questions to be ranked in round 2. Questions were collated and organized according to the four-step public health approach to violence prevention. In round 2, 280 international experts ranked the importance of research in the four steps, and the various substeps, of the public health approach. In round 3, 131 international experts ranked the importance of detailed research questions on the public health step awarded the highest priority in round 2. Findings In round 2, “developing, implementing and evaluating interventions” was the step of the public health approach awarded the highest priority for four of the six types of violence considered (i.e. child maltreatment, intimate partner violence, armed violence and sexual violence) but not for youth violence or elder abuse. In contrast, “scaling up interventions and evaluating their cost–effectiveness” was ranked lowest for all types of violence. In round 3, research into “developing, implementing and evaluating interventions” that addressed parenting or laws to regulate the use of firearms was awarded the highest priority. The key limitations of the study were response and attrition rates among survey respondents. However, these rates were in line with similar priority-setting exercises. Conclusion These findings suggest it is premature to scale up violence prevention interventions. Developing and evaluating smaller-scale interventions should be the funding priority.
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Affiliation(s)
- Christopher R Mikton
- Department of Health and Social Sciences, University of the West of England, Bristol Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, England
| | | | | | | | - Lil Tonmyr
- Public Health Agency of Canada, Ottawa, Canada
| | - Bandy X Lee
- Yale University, New Haven, United States of America (USA)
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Eickmann SH, Emond AM, Lima M. Evaluation of child development: beyond the neuromotor aspect. J Pediatr (Rio J) 2016; 92:S71-83. [PMID: 27012923 DOI: 10.1016/j.jped.2016.01.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 01/12/2016] [Accepted: 01/14/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review the epidemiology and update the scientific knowledge on the problems of development and behavior in childhood, and the recommendations for the role of the pediatrician in identifying and managing delays and disturbances in child development and mental health. SOURCES A search for relevant literature was performed in the PubMed and Scopus databases and publications of the National Scientific Council on the Developing Child. SUMMARY OF THE FINDINGS With the decline in the incidence of communicable diseases in children, problems with development, behavior, and emotional regulation are increasingly becoming a part of the work of pediatricians, yet many are not trained and feel uncomfortable about this extension of their role. The available screening tools for child development and behavior are reviewed, and a 'school readiness' checklist is presented, together with recommendations on how the pediatrician can incorporate developmental surveillance into routine practice, aware of the need for children to acquire social, emotional, and cognitive skills so that they can develop their full potential. CONCLUSIONS The pediatrician's role in the future will include both physical and mental health, recognizing that social development, resilience, and emotional maturity are as important as physical growth and neuromotor skills in a child's life course.
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Affiliation(s)
- Sophie Helena Eickmann
- Post-graduation in Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil.
| | - Alan Martin Emond
- Centre for Child and Adolescent Health, University of Bristol, Bristol, United Kingdom
| | - Marilia Lima
- Post-graduation in Child and Adolescent Health, Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
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Eickmann SH, Emond AM, Lima M. Evaluation of child development: beyond the neuromotor aspect. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2016.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Parish-Morris J, Cieri C, Liberman M, Bateman L, Ferguson E, Schultz RT. Building Language Resources for Exploring Autism Spectrum Disorders. LREC ... INTERNATIONAL CONFERENCE ON LANGUAGE RESOURCES & EVALUATION : [PROCEEDINGS]. INTERNATIONAL CONFERENCE ON LANGUAGE RESOURCES & EVALUATION 2016; 2016:2100-2107. [PMID: 30167575 PMCID: PMC6112235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that would benefit from low-cost and reliable improvements to screening and diagnosis. Human language technologies (HLTs) provide one possible route to automating a series of subjective decisions that currently inform "Gold Standard" diagnosis based on clinical judgment. In this paper, we describe a new resource to support this goal, comprised of 100 20-minute semi-structured English language samples labeled with child age, sex, IQ, autism symptom severity, and diagnostic classification. We assess the feasibility of digitizing and processing sensitive clinical samples for data sharing, and identify areas of difficulty. Using the methods described here, we propose to join forces with researchers and clinicians throughout the world to establish an international repository of annotated language samples from individuals with ASD and related disorders. This project has the potential to improve the lives of individuals with ASD and their families by identifying linguistic features that could improve remote screening, inform personalized intervention, and promote advancements in clinically-oriented HLTs.
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Affiliation(s)
- Julia Parish-Morris
- Center for Autism Research. Children's Hospital of Philadelphia 3535 Market Street, Suite 860, Philadelphia, PA, 19104 USA
| | - Christopher Cieri
- Linguistic Data Consortium. University of Pennsylvania 3600 Market Street, Suite 810, Philadelphia, PA, 19104 USA
| | - Mark Liberman
- Linguistic Data Consortium. University of Pennsylvania 3600 Market Street, Suite 810, Philadelphia, PA, 19104 USA
| | - Leila Bateman
- Center for Autism Research. Children's Hospital of Philadelphia 3535 Market Street, Suite 860, Philadelphia, PA, 19104 USA
| | - Emily Ferguson
- Center for Autism Research. Children's Hospital of Philadelphia 3535 Market Street, Suite 860, Philadelphia, PA, 19104 USA
| | - Robert T Schultz
- Center for Autism Research. Children's Hospital of Philadelphia 3535 Market Street, Suite 860, Philadelphia, PA, 19104 USA
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Aldersey HM, Turnbull AP, Turnbull HR. Family Support in Kinshasa, Democratic Republic of the Congo. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12143] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sarrett JC, Rommelfanger KS. Commentary: Attention to Eyes Is Present but in Decline in 2-6-Month-Old Infants Later Diagnosed with Autism. Front Public Health 2015; 3:272. [PMID: 26697420 PMCID: PMC4672052 DOI: 10.3389/fpubh.2015.00272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/23/2015] [Indexed: 12/15/2022] Open
Affiliation(s)
- Jennifer C Sarrett
- Center for the Study of Human Health, Emory University Atlanta , Atlanta, GA , USA
| | - Karen S Rommelfanger
- Center for Ethics Neuroethics Program, Emory University Atlanta , Atlanta, GA , USA ; Department of Neurology, Emory University Atlanta , Atlanta, GA , USA ; Department of Psychiatry and Behavioral Sciences, Emory University Atlanta , Atlanta, GA , USA
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