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ALRuwaili BF, Alrashdi BAT, Mallick A, Alruwaili TAM, Alanazi MF, Alruwaili HFS, Alanazi WF, Alanazi WM, Altaymani AFM. Knowledge, Attitude, and Perception towards Autism Spectrum Disorders among Parents in Sakaka, Al-Jouf Region, Saudi Arabia: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:1596. [PMID: 39201155 PMCID: PMC11353907 DOI: 10.3390/healthcare12161596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/02/2024] Open
Abstract
Parents are an essential element of family intervention for all children, including those with autism spectrum disorders (ASDs). We can better understand and address parents' knowledge gaps about ASD through in-depth research and inquiry into parents' current level of understanding, attitude, and perception. We aimed to assess the knowledge, attitude, and perception of ASD and influencing factors towards ASD among a group of parents with and without a child diagnosed with ASD in Sakaka, Al-Jouf Region, Saudi Arabia. Using the cross-sectional study design, information from the parents was gathered using a pretested questionnaire that included validated scales for measuring knowledge, attitudes, and perceptions related to ASD. The required number of participants was selected using the convenience sampling method. We used Spearman's correlation test to determine the strength and direction of correlation between each domain. As a last step, we analyzed the influencing factors using binomial logistic regression. Among the 400 participants, 41.2% had high knowledge, 69.1% had a positive attitude, and 60.3% had a high perception of ASD. We found that knowledge was significantly higher among the parents with autistic individuals in the family (p = 038). The high and positive attitude was significantly greater among females (p = 0.010) and parents with high income (p = 0.007), and the perception was significantly associated with females (p = 0.037) and highly educated participants (p = 0.046). Furthermore, we found a positive correlation between knowledge, attitude, and perception. Overall, only less than half of the participants had a high knowledge of ASD. Hence, we recommend awareness-raising programs for the parents in this region. Furthermore, a prospective study involving parents from all provinces of Saudi Arabia is recommended.
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Affiliation(s)
- Bashayer Farhan ALRuwaili
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (B.A.T.A.); (A.M.)
| | - Bader Abdullah T. Alrashdi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (B.A.T.A.); (A.M.)
- Department of General Administration of Health Programs, Diabetes Control Program, Ministry of Health, Riyadh 12542, Saudi Arabia
| | - Ayesha Mallick
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia; (B.A.T.A.); (A.M.)
| | | | - Muhannad Faleh Alanazi
- Department of Internal Medicine, Division of Radiology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Hanan Farhan S. Alruwaili
- Department of Neonatal Intensive Care Unit, Maternity and Children Hospital, Arara 73241, Saudi Arabia;
| | - Wael Faleh Alanazi
- Department of Intensive Care Unit, Aljouf Health Cluster, Alquryyat Hospital, Alquryyat 77453, Saudi Arabia; (W.F.A.); (W.M.A.)
| | - Waad Mudhhi Alanazi
- Department of Intensive Care Unit, Aljouf Health Cluster, Alquryyat Hospital, Alquryyat 77453, Saudi Arabia; (W.F.A.); (W.M.A.)
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Li Y, Ragunathan S, Fuentes K, Hsu S, Lindsay S. Exploring the experiences of ableism among Asian children and youth with disabilities and their families: a systematic review of qualitative studies. Disabil Rehabil 2024; 46:3849-3868. [PMID: 37737152 DOI: 10.1080/09638288.2023.2258792] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Asian children and youth with disabilities often experience multiple barriers, stigmas and discrimination within and outside their families; yet less is understood about their lived experiences. This systematic review explored the experiences of ableism among Asian children and youth with disabilities and their families. METHODS We conducted a systematic review of qualitative studies and a qualitative meta-synthesis. We searched six databases including Ovid Medline, Embase, PsychInfo, Healthstar, Web of Science, and Scopus. RESULTS Forty-two articles met our inclusion criteria involving 17 countries and regions over a 22-year period. The findings were synthesized into four themes: (1) individual- and family-level ableism (i.e., stigma, fears, concerns, stress and anxieties, physical abuse, bullying, reduced engagement in community activities); (2) institutional-level ableism (i.e., barriers to accessing and navigating supports, ableist attitudes among service providers, unavailable services); (3) societal-level ableism (i.e., cultural and religious stigma, social rejection, discrimination, environmental and policy barriers); and (4) coping strategies (i.e., self-care activities, supports from family, friends and people with similar conditions, religious beliefs). CONCLUSIONS Our results highlight the ableist experiences that Asian children and youth with disabilities and their caregivers often encounter and the strong need for further supports to address ableism using culturally responsive strategies.
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Affiliation(s)
- Yiyan Li
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Sharmigaa Ragunathan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Faculty of Science, York University, Toronto, Canada
| | - Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
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Hauptman AJ, Salpekar JA, Cohen JS, Asato MR. Navigating Neurogenetics for Child and Adolescent Psychiatry Practice. J Am Acad Child Adolesc Psychiatry 2024; 63:666-669. [PMID: 38325519 DOI: 10.1016/j.jaac.2023.09.555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/29/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024]
Abstract
Neurodevelopmental disorders (NDDs) are a group of conditions characterized by impairments of brain processes that impact cognition, communication, motor abilities, and/or behavior during development. These conditions typically have significant effects across the life span and impact personal, social, academic, or occupational functioning. The US Centers for Disease Control and report that 1 in 6 children has a developmental disability, making it highly likely for child and adolescent psychiatrists to encounter children with NDDs in daily practice.1 While the etiologies of NDDs are broad, genetic syndromes are a common cause of NDDs. The diagnostic yield of thorough genetic testing for NDDs as a group is about 40% based on meta-analysis, including 30% to 50% yield in patients with global developmental delay (GDD) or intellectual disability (ID) and 15% to 20% yield in patients with in autism spectrum disorder.1-3 The findings are extremely heterogeneous, including chromosomal copy number variants (CNVs) and more than 2,000 known monogenic disorders associated with NDDs.3 Diagnostic yields will increase over time with advances in technology and disease gene discovery.3.
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Affiliation(s)
- Aaron J Hauptman
- Kennedy Krieger Institute, Baltimore, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Jay A Salpekar
- Kennedy Krieger Institute, Baltimore, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Julie S Cohen
- Kennedy Krieger Institute, Baltimore, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Miya R Asato
- Kennedy Krieger Institute, Baltimore, Maryland, and Johns Hopkins University School of Medicine, Baltimore, Maryland
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Castelin S, Okorodudu J, Smith T. Partnering With a Purpose: Promoting Equity and Justice for Black Children With Autism Spectrum Disorder. J Dev Behav Pediatr 2024; 45:e302-e308. [PMID: 39023854 PMCID: PMC11326990 DOI: 10.1097/dbp.0000000000001276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/12/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE Black children with autism and their families face disparities within clinical care and services, leading to inequitable health outcomes. However, there is limited research centering the voices of the Black autism community in understanding how to address these inequities. In this study, researchers explored the perspectives of caregivers of Black children with autism regarding barriers to equitable care and recommendations for improved services. METHODS Community leaders from an autism advocacy group and researchers from a large academic medical center partnered to conduct a Group Level Assessment with 31 Black families of children with autism. During a three-hour research event, participants discussed their experiences within community, school, and clinical services, collectively coded and interpreted the data, and generated action steps to improve services. RESULTS The findings revealed 6 areas of need regarding the services Black children with autism and their caregivers receive. Black caregivers recommended that systems of care improve access to culturally responsive care, integrate caregiver priorities within their care, and engage in collaborative decision-making with caregivers. Providers should also equip caregivers with an accessible roadmap for navigating their child's services and connect them to care management professionals and resources for mental health support. CONCLUSION The findings of this study address a critical gap in the literature by partnering with the Black autism community to identify solutions to address their needs; these recommendations can be used as a foundation for service providers to reduce disparities and improve outcomes for Black children with autism and their families.
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Affiliation(s)
| | | | - Teresa Smith
- Neurodevelopmental and Behavioral Psychology, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Baloyi O, Jarvis MA, Chironda G, Mbeje P, Ngcobo SJ, Gqaleni T, Mhlongo EM, Ngcobo WB, Brysiewicz P. Experiences of families with children diagnosed with Autism Spectrum Disorder in World Health Organization Afro-Regions: A scoping review. Nurs Health Sci 2024; 26:e13123. [PMID: 38692580 DOI: 10.1111/nhs.13123] [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: 02/13/2023] [Revised: 03/13/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024]
Abstract
A scoping review on Autism Spectrum Disorder (ASD) and its impact on the families of affected children was undertaken due to insufficient information available on the diverse experiences impacting their lives. Using the Joanna Briggs Institute methodology, eligibility criteria were guided by Population (families), Concept (family experiences), and Context (African region). English-language articles were sought from a variety of databases and search engines. The publication date of the identified articles ranged from 2003 to 2021 with most published in 2020 (n = 10), and the majority using qualitative methodologies (n = 51). Most family members involved were parents (n = 51) and their ages ranged from 18 to 75 years. The families experienced various challenges related to their child with regard to education, healthcare, and the broader community including lack of support. Family coping strategies included believing in God, attending counseling sessions, adapting, and accepting the situation. Healthcare professionals should be prepared and positioned to educate families and siblings on various aspects of ASD. There is a need for active, continued research on families within most countries of World Health Organization Afro-region.
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Affiliation(s)
- Olivia Baloyi
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mary Ann Jarvis
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Geldine Chironda
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Pretty Mbeje
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Silingene Joyce Ngcobo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Thusile Gqaleni
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Euphemia Mbali Mhlongo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Winnie Baphumelele Ngcobo
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Petra Brysiewicz
- Department of Nursing, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Girolamo T, Birmingham M, Patel K, Ghali S, Campos I, Greene-Pendelton K, Canale R, Larson C, Sterling A, Shogren KA. Self-determination in minoritized autistic adolescents and adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.02.24306799. [PMID: 38746405 PMCID: PMC11092698 DOI: 10.1101/2024.05.02.24306799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Self-determination plays an important role in outcomes in autism and shows intersectional disparities. Yet, little is known about the role of individual differences or social drivers of health in the development of self-determination. Understanding these factors is key for developing effective supports. This mixed-methods convergent study examined self-determination in racially and ethnically minoritized autistic individuals and caregivers. Participants ages 13 to 30 ( N = 73) varying widely in language and cognitive ability and caregivers ( n =52) completed the Self-Determination Inventory. Autism traits and sense of community predicted caregiver report of self-determination, and autism traits and language predicted self-report of self-determination, consistent with DisCrit and Diversity Science. Self-Determination Inventory interviews of a subset of participants ( n = 13) and caregivers ( n = 9) were analyzed using inductive thematic analysis. Themes pointed to the role of the intersection of race and disability in shaping self-determination. Altogether, findings point to the importance of these frameworks, environmental influences, and multi-informant perspectives in characterizing self-determination. Future work should focus on the impact of environmental factors in self-determination in minoritized autistic individuals during the transition to adulthood.
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Neece CL, Fenning RM, Morrell HER, Benjamin LR. Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:985-998. [PMID: 37555286 PMCID: PMC10853488 DOI: 10.1177/13623613231191558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
LAY ABSTRACT Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.
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Affiliation(s)
- Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Holly E. R. Morrell
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Laurel R. Benjamin
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
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Vela JC, Ramos N, Fielding C, Elizondo D. Exploring Latine Parent Leaders' and a Program Coordinator's Lived Experiences with a Culturally Adapted Parent-Directed Training Program. J Autism Dev Disord 2024:10.1007/s10803-024-06270-0. [PMID: 38443658 DOI: 10.1007/s10803-024-06270-0] [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: 01/28/2024] [Indexed: 03/07/2024]
Abstract
The purpose of the current study was to explore the lived experiences among parent leaders and a program coordinator who participated in a parent-directed training program to support other Latine parents of children with autism spectrum disorder. We used qualitative methods to explore 4 Latine parent leaders' and 1 program coordinator's experiences with a parent-directed training program to support other Latine parents who have children with autism spectrum disorder. We interviewed parent leaders and a program coordinator to learn about their lived experiences as leaders in a parent-directed training program. The following themes emerged from Interpretative Phenomenological Analysis data analysis: (a) personal growth, (b) leadership development, (c) sense of connection and community, (d) contributing to a larger and meaningful purpose, and (e) applying knowledge and skills to help other parents. A culturally adapted parent-directed training program has the potential to positively influence Latine parent leaders who are prepared to support parents of children with ASD. There were positive program impacts on parent leaders regarding personal growth, leadership development, connection and community, contribution to a larger purpose, and use of knowledge and skills to help other parents. We also discovered the importance of building a safe community for Latine parent leaders and other parents who have children with ASD in a parent-directed training program.
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Affiliation(s)
- Javier Cavazos Vela
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA.
| | - Noe Ramos
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Cheryl Fielding
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
| | - Denisse Elizondo
- University of Texas Rio Grande Valley, 1201 W. University Drive, EDUC 3.102H, Edinburg, TX, 78539, USA
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Lee J, Barger B. Factors Predicting Poor Mental and Physical Health in Parents of Children with Autism Spectrum Disorder: Results from 2016 to 2019 National Survey of Children's Health. J Autism Dev Disord 2024; 54:915-930. [PMID: 36562931 DOI: 10.1007/s10803-022-05870-y] [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] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Although poor health has been reported in parents of children with autism spectrum disorder (ASD), most studies excluded fathers and focused on mental health. We combined 2016-2019 data from the National Surveys of Children's Health to determine child and parent characteristics that predict poor mental and physical health in fathers (n = 818) and mothers (n = 2111) of children with ASD. For fathers of children with ASD, higher parenting stress was significantly associated with greater odds of poor physical health, whereas racial and ethnic minorities and living at 400% above the federal poverty were significantly associated with lower odds of poor mental health. For mothers of children with ASD, greater child sleep problems were significantly associated with greater odds of poor physical health, and two-parent household living 400% above the poverty line was significantly associated with reported lower odds of poor mental health. Continued efforts to reduce parenting stress and improve child sleep problems, along with expanding existing services and coverages of ASD services, especially for low-income families, may help reduce the burden on these families, preventing adverse future health outcomes in this population.
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Affiliation(s)
- Jiwon Lee
- School of Nursing, Byrdine F. Lewis School of Nursing and Health Professions, Georgia State University, 140 Decatur Street, Urban Life Building Suite 911, Atlanta, GA, 30303, USA.
| | - Brian Barger
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
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Weitlauf AS, Miceli A, Vehorn A, Dada Y, Pinnock T, Harris JW, Hine J, Warren Z. Screening, Diagnosis, and Intervention for Autism: Experiences of Black and Multiracial Families Seeking Care. J Autism Dev Disord 2024; 54:931-942. [PMID: 36626007 PMCID: PMC10330934 DOI: 10.1007/s10803-022-05861-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE Despite advances in screening and awareness, Black and multiracial families continue to experience challenges when seeking an autism diagnosis for their children. METHODS We surveyed 400 Black and multiracial families of young children with autism from an existing research database in the United States about their retrospective diagnostic experiences. We gathered quantitative and qualitative data and engaged in iterative coding to understand timing and content of first concerns, families' experiences of care providers and systems, and the impact of race and culture on accessing care. RESULTS Families provided examples of early developmental concern and described provider, systemic, and cultural barriers and facilitators to care. Families also provided insight into the influence of culture and made recommendations on how the medical system could better care for Black and multiracial families of children with autism. CONCLUSIONS Results add to a growing body of literature supporting the need for culturally sensitive and accessible care related to developmental monitoring, diagnosis, and follow-up care for Black and multiracial children.
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Affiliation(s)
- Amy S Weitlauf
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Alexandra Miceli
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Alison Vehorn
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Yewande Dada
- Department of Pediatrics, Meharry Medical College, Nashville, TN, USA
| | - Theodora Pinnock
- Department of Pediatrics, Meharry Medical College, Nashville, TN, USA
| | - Joyce W Harris
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeffrey Hine
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
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Kendeou P, Johnson V. The nature of misinformation in education. Curr Opin Psychol 2024; 55:101734. [PMID: 38029642 DOI: 10.1016/j.copsyc.2023.101734] [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: 09/01/2023] [Revised: 10/31/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
In this opinion piece, we review and characterize the nature of misinformation in education and discuss the implications for corrective efforts. In education, misinformation manifests at three different levels: the individual, the community, and the system. At the individual level, misinformation manifests as naive beliefs or misconceptions students hold before they receive instruction or because of instruction. At the community level, misinformation manifests as shared flawed views or misconceptions about certain topics often around risk factors and treatments of learning disabilities. At the system level, misinformation manifests as state or district educational policies and practices that have no scientific evidence. Thus, corrective efforts in education must be implemented at all three levels and follow best practices.
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Troxel M, Kraper C, Verbalis A, Safer-Lichtenstein J, Seese S, Ratto A, Myrick Y, Armour AC, Pugliese CE, Strang JF, Ba C, Martucci J, Biel MG, Jackson V, Hardy KK, Mandell D, Goode TD, Anthony BJ, Kenworthy L, Anthony LG. Reaching "The Other Half": Teacher Referral Increases Inclusivity in Intervention Research for Neurodivergent School-Age Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-14. [PMID: 38270579 DOI: 10.1080/15374416.2024.2303723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVE Researchers employed two recruitment strategies in a school-based comparative effectiveness trial for students with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) or autism. This study assessed the: 1) effectiveness of school-based referrals for identifying students meeting diagnostic criteria and 2) impact of eliminating requirements for existing diagnoses on recruitment, sample characteristics, and intervention response. METHOD Autistic students and students with ADHD in schools serving underresourced communities were recruited for an executive functioning (EF) intervention trial over 2 years. In Year 1, school staff nominated students with previous diagnoses. In Year 2, school staff nominated students demonstrating EF challenges associated with ADHD or autism; previous diagnosis was not required. Study staff then confirmed diagnoses. RESULTS More students were included in Year 2 (N = 106) than Year 1 (N = 37). In Year 2, 96% of students referred by school staff met diagnostic criteria for ADHD or autism, 53% of whom were not previously diagnosed. Newly identified students were less likely than previously diagnosed students to be receiving services and, for those with ADHD, were more likely to speak primarily Spanish at home. Previously diagnosed and newly identified students did not differ on other demographic variables or intervention response. Caregivers of previously diagnosed students reported more symptoms than caregivers of newly identified students for both diagnostic groups. Previously diagnosed students with ADHD had more researcher-rated symptoms than newly identified students. CONCLUSIONS Recruitment for an intervention study using behavior-based referrals from school staff enhanced enrollment without compromising the sample's diagnostic integrity and engaged children who otherwise would have been excluded.
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Affiliation(s)
- Mary Troxel
- Department of Psychiatry, University of Colorado School of Medicine, and Pediatric Mental Health Institute, Children's Hospital of Colorado
| | - Catherine Kraper
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Alyssa Verbalis
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Jonathan Safer-Lichtenstein
- Department of Psychiatry, University of Colorado School of Medicine, and Pediatric Mental Health Institute, Children's Hospital of Colorado
| | - Sydney Seese
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Allison Ratto
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Yetta Myrick
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - A Chelsea Armour
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Cara E Pugliese
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - John F Strang
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Caroline Ba
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Jillian Martucci
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Matthew G Biel
- Department of Psychiatry, Georgetown University Medical Center
| | - Vivian Jackson
- Center for Child and Human Development, Georgetown University
| | - Kristina K Hardy
- Center for Autism Spectrum Disorders, Children's National Hospital
- Center for Child and Human Development, Georgetown University
| | - David Mandell
- Center for Mental Health, Department of Psychiatry, University of Pennsylvania, School of Medicine
| | - Tawara D Goode
- Center for Child and Human Development, Georgetown University
- National Center for Cultural Competence, Department of Pediatrics, Georgetown University Medical Center
| | - Bruno J Anthony
- Department of Psychiatry, University of Colorado School of Medicine, and Pediatric Mental Health Institute, Children's Hospital of Colorado
- Department of Psychiatry, Georgetown University Medical Center
- Center for Child and Human Development, Georgetown University
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children's National Hospital
| | - Laura Gutermuth Anthony
- Department of Psychiatry, University of Colorado School of Medicine, and Pediatric Mental Health Institute, Children's Hospital of Colorado
- Center for Autism Spectrum Disorders, Children's National Hospital
- National Center for Cultural Competence, Department of Pediatrics, Georgetown University Medical Center
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Grosvenor LP, Cohen RJ, Gordon NP, Massolo ML, Cerros HJ, Yoshida CK, Ames JL, Croen LA. Barriers to Healthcare for Latinx Autistic Children and Adolescents. J Autism Dev Disord 2024:10.1007/s10803-023-06229-7. [PMID: 38231382 DOI: 10.1007/s10803-023-06229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE To understand the ways in which autistic Latinx children experience disparities in diagnosis, healthcare, and receipt of specialty services. METHODS 417 individuals who identified as Latinx caregivers of autistic children who were members of the same integrated healthcare system in Northern California were surveyed. Responses were analyzed using the child's insurance coverage (Government or Commercial) and caregiver's primary language (Spanish or English). RESULTS Compared to the commercially-insured, government-insured participants accessed several services at a higher rate and were less likely to cite the high cost of co-pays as a barrier. CONCLUSION There were no significant differences in service access by language status, but Spanish speakers were more likely to cite health literacy as a barrier to receiving care.
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Affiliation(s)
- Luke P Grosvenor
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ryan J Cohen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Columbia Medical School, New York, NY, USA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Maria L Massolo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Hilda J Cerros
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Cathleen K Yoshida
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jennifer L Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
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Coulter KL, Moreno P, Barton M, Dumont-Mathieu T, Robins DL, Fein DA. Validity of the Toddler Autism Symptom Inventory in Non-Hispanic White and Black Toddlers. J Autism Dev Disord 2024; 54:339-352. [PMID: 36316523 PMCID: PMC10148924 DOI: 10.1007/s10803-022-05756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 05/01/2023]
Abstract
Racial disparities exist in autism diagnosis, and yet, the development of most diagnostic tools has not explicitly examined measurement equity between racial and ethnic groups. We examined the validity of the Toddler Autism Symptom Inventory (TASI), a semi-structured interview developed for diagnosis of toddlers, in non-Hispanic Black/African American and non-Hispanic White children. After controlling for group differences in socio-economic status, no differences in diagnosis, age at diagnosis, mean developmental level, or autism severity were found. TASI ROC curves for both groups, in the overall sample, and in samples stratified by SES, showed high AUC values. Validity of two cutoff scores was acceptable. Lack of significant differences in TASI score or responses to individual items suggests similar symptomatology. These results provide early support for the use of the TASI in diagnostic evaluations of Black and White children.
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Affiliation(s)
- Kirsty L Coulter
- University of Connecticut, 406 Unit 1020, Babbidge Rd, 06269, Storrs, CT, USA.
| | - Paula Moreno
- University of Connecticut, 406 Unit 1020, Babbidge Rd, 06269, Storrs, CT, USA
| | - Marianne Barton
- University of Connecticut, 406 Unit 1020, Babbidge Rd, 06269, Storrs, CT, USA
| | - Thyde Dumont-Mathieu
- University of Connecticut School of Medicine, Connecticut Children's Medical Center, Farmington, CT, USA
| | | | - Deborah A Fein
- University of Connecticut, 406 Unit 1020, Babbidge Rd, 06269, Storrs, CT, USA
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15
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Onovbiona H, Quetsch L, Bradley R. Racial and Practical Barriers to Diagnostic and Treatment Services for Black Families of Autistic Youth: A Mixed-Method Exploration. J Autism Dev Disord 2023:10.1007/s10803-023-06166-5. [PMID: 38038872 DOI: 10.1007/s10803-023-06166-5] [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: 10/20/2023] [Indexed: 12/02/2023]
Abstract
The present study explored the role race-related barriers and practical barriers to treatment participation play in treatment effectiveness and satisfaction among Black families with autistic youth using a mixed-method approach. In a sample of Black caregivers with autistic youth (N = 101), multiple regressions were conducted to examine the impact of reported racial and practical barriers on parental stress, treatment effectiveness, and treatment satisfaction. Caregivers provided further narratives on their experience navigating diagnostic and treatment services in qualitative interviews. The study demonstrated that Black caregivers of autistic youth are still encountering several racial and logistical barriers when seeking treatment and diagnostic services for their children. These barriers negatively impact caregiver stress and caregiver perceived treatment quality. Contrary to the barriers and stress experienced by Black caregivers, caregivers are generally satisfied with the treatments they are utilizing and find them helpful. The narratives told by caregivers further elucidate the tumultuous experiences of Black caregivers as they seek diagnostic and treatment services for their children. An experience that may be worsened by family, professional, and systemic barriers, and can be improved by advocacy, acceptance, peer and community support, and increased knowledge. Black families of autistic youth call for increased compassion, support, training, and humility among professionals who serve autistic youth.
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Girolamo T, Shen L, Gulick AM, Rice ML, Eigsti IM. Studies pertaining to language impairment in school-age autistic individuals underreport participant socio-demographics: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2218-2240. [PMID: 37157821 PMCID: PMC10592656 DOI: 10.1177/13623613231166749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
LAY ABSTRACT Although exclusion of racially and ethnically minoritized autistic individuals from research is a long-standing issue, we have yet to determine how exclusion impacts areas of autism research important for identifying language impairment. Diagnosis depends on the quality of the evidence (i.e. research) and is often the pathway to gaining access to services. As a first step, we examined how research studies related to language impairment in school-age autistic individuals report participant socio-demographics. We analyzed reports using age-referenced assessments in English (n = 60), which are commonly used by both practitioners and researchers to diagnose or identify language impairment. Findings showed only 28% of studies reported any information on race and ethnicity; in these studies, most (at least 77%) of the participants were white. In addition, only 56% of studies reported gender or sex and specified what they were reporting (gender, sex, or gender identity). Just 17% reported socio-economic status using multiple indicators. Altogether, findings indicate broad issues with underreporting and exclusion of racially and ethnically minoritized individuals, which might overlay with other aspects of identity including socio-economic status. It is impossible to determine the extent and precise nature of exclusion without intersectional reporting. To ensure that language in autism research is representative of the autistic population, future research must implement reporting guidelines and broaden inclusion of who participates in research studies.
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Affiliation(s)
- Teresa Girolamo
- Department of Psychological Sciences, University of Connecticut
- Connecticut Institute for Brain and Cognitive Sciences
| | - Lue Shen
- Speech, Language, and Hearing Sciences, Boston University
| | | | - Mabel L. Rice
- Child Language Doctoral Program, University of Kansas
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut
- Connecticut Institute for Brain and Cognitive Sciences
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17
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Larson C, Kaplan D, Girolamo T, Kover ST, Inge-Marie E. A Bayesian statistics tutorial for clinical research: Prior distributions and meaningful results for small clinical samples. J Clin Psychol 2023; 79:2602-2624. [PMID: 37477577 PMCID: PMC10591806 DOI: 10.1002/jclp.23570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/13/2023] [Accepted: 07/03/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES Bayesian statistics provides an effective, reliable approach for research with small clinical samples and yields clinically meaningful results that can bridge research and practice. This tutorial demonstrates how Bayesian statistics can be effectively and reliably implemented with a small, heterogeneous participant sample to promote reproducible and clinically relevant research. METHODS/RESULTS We tested example research questions pertaining to language and clinical features in autism spectrum disorder (ASD; n = 20), a condition characterized by significant heterogeneity. We provide step-by-step instructions and visualizations detailing how to (1) identify and develop prior distributions from the literature base, (2) evaluate model convergence and reliability, and (3) compare models with different prior distributions to select the best performing model. Moreover, in step three, we demonstrate how to determine whether a sample size is sufficient for reliably interpreting model results. We also provide instructions detailing how to examine results with varied bounds of clinical interest, such as the probability that an effect will reflect at least one standard deviation change in scores on a standardized assessment. This information facilitates generalization and application of Bayesian results to a variety of clinical research questions and settings. CONCLUSION The tutorial concludes with suggestions for future clinical research, ensuring the utility of our step-by-step instructions for a broad clinical audience.
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Affiliation(s)
- Caroline Larson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Connecticut Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
| | - David Kaplan
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Teresa Girolamo
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, USA
| | - Sara T. Kover
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Eigsti Inge-Marie
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- Connecticut Institute for the Brain and Cognitive Sciences, Storrs, CT, USA
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Girolamo T, Castro N, Hendricks AE, Ghali S, Eigsti IM. Implementation of Open Science Practices in Communication Sciences and Disorders Research With Black, Indigenous, and People of Color. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:2010-2017. [PMID: 36409964 PMCID: PMC10465151 DOI: 10.1044/2022_jslhr-22-00272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 08/22/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Open science that is truly accessible and transparent to all will enhance reproducibility. However, there are ethical and practical concerns in implementing open science practices, especially when working with populations who are systematically excluded from and marginalized in communication sciences and disorders (CSD) research, such as Black, Indigenous, and People of Color (BIPOC) from clinical populations. The purpose of this article was to discuss these concerns and present actionable steps to support open science in CSD research with BIPOC. CONCLUSIONS In the movement toward open and reproducible science, the discipline of CSD must prioritize accessibility and transparency, in addition to the implementation of individual scientific practices. Such a focus requires building trust with BIPOC not only as research participants but also as valued leaders of the scientific community.
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Affiliation(s)
- Teresa Girolamo
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Nichol Castro
- Department of Communicative Disorders and Sciences, University at Buffalo, NY
| | | | - Samantha Ghali
- Child Language Doctoral Program, The University of Kansas, Lawrence
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs
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Girolamo T, Ghali S, Eigsti IM. A Community-Based Approach to Longitudinal Language Research With Racially and Ethnically Minoritized Autistic Young Adults: Lessons Learned and New Directions. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:977-988. [PMID: 36927069 PMCID: PMC10473368 DOI: 10.1044/2023_ajslp-22-00341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/12/2023] [Accepted: 01/14/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE Language and autism research each typically excludes racially and ethnically minoritized (REM) autistic individuals. In addition, in the case of autistic individuals with language impairment, investigators often approach caregivers to discuss research participation, rather than autistic individuals themselves. This gap limits the ecological validity of language research in autism. To address this gap, this clinical focus article describes strategies for engaging REM autistic young adults with language impairment using lessons learned from 5 years of longitudinal research with this population. This approach involved an ongoing community partnership, as well as participatory partnerships with REM autistic individuals and community stakeholders, consistent with a "slow science" approach. CONCLUSIONS The approach yielded excellent retention of participants over 5 years and led to co-development of research projects aimed at priorities described by REM autistic individuals and their families, including understanding self-determination, social determinants of health, and language variability in autistic REM individuals with language impairment. Findings support the utility of community-based methods with autistic REM young adults with language impairment, with key takeaways for diversifying research while replicating, extending, and building theory.
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Affiliation(s)
- Teresa Girolamo
- Department of Psychological Sciences, University of Connecticut, Storrs
- Connecticut Institute of the Brain and Cognitive Sciences, Storrs
| | - Samantha Ghali
- Child Language Doctoral Program, The University of Kansas, Lawrence
| | - Inge-Marie Eigsti
- Department of Psychological Sciences, University of Connecticut, Storrs
- Connecticut Institute of the Brain and Cognitive Sciences, Storrs
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20
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An Intersectional Examination of Disability and Race Models in Behavior-Analytic Practice. BEHAVIOR AND SOCIAL ISSUES 2022. [DOI: 10.1007/s42822-022-00116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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