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Samuel D, O'Malley F, Brink FW, Crichton KG, Duffy B, Letson MM, Michaels NL. Characterizing child maltreatment fatalities among child victims with disabilities in the United States, 2010-2019. CHILD ABUSE & NEGLECT 2023; 144:106354. [PMID: 37517210 DOI: 10.1016/j.chiabu.2023.106354] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/07/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND There has been little research on child maltreatment-related fatalities among children with disabilities. Despite being a minority of children in the United States, children with disabilities experience higher rates of victimization. OBJECTIVE To characterize fatalities due to child maltreatment among children with disabilities in the United States. METHODS Data from the National Violent Death Reporting System from 2010 to 2019 were analyzed to describe child maltreatment-related deaths among children with disabilities aged birth to 17 years. RESULTS There were 106 fatalities meeting the study criteria. The average age of the victims was 5.9 years old and 74.6 % were male. The most frequent suspected perpetrators of maltreatment-related fatalities were biological mothers (35.2 %), and most perpetrators were White (55.7 %). Analyses showed a statistically significant relationship between fatalities caused by neglect and diagnoses of attention deficit hyperactivity disorder, autism spectrum disorder, cerebral palsy, and/or traumatic brain injury. Overall, physical abuse and/or neglect resulting in a fatality among children with disabilities were significantly correlated with the relationship of the perpetrator to the victim. CONCLUSIONS Children with disabilities who died as a result of abuse were more likely to have autism spectrum disorder, a developmental disability, or other physical impairment, with physical abuse being the most prevalent type of abuse that resulted in death. To decrease the likelihood of abuse of disabled children, healthcare practitioners and caseworkers should work together to create strategies to help caregivers cope with the financial, mental, and physical stress that comes with raising children with disabilities.
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Affiliation(s)
- Devona Samuel
- Meharry Medical College, 1005 Dr DB Todd Jr Blvd, Nashville, TN 37208, United States of America
| | - Fiona O'Malley
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Farah W Brink
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Kristin G Crichton
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Bridget Duffy
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America
| | - Megan M Letson
- The Center for Family Safety and Healing, Nationwide Children's Hospital, 655 E Livingston Ave, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America
| | - Nichole L Michaels
- Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, United States of America; The Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, United States of America.
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2
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Khazaei S, Salehi A, Molavi Vardanjani H. Prevalence and correlates of child maltreatment among mothers in the Kurdistan province, Western Iran. Int J Psychiatry Med 2023:912174231163740. [PMID: 36932644 DOI: 10.1177/00912174231163740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
OBJECTIVE Parental child maltreatment is a serious public health issue worldwide. As mothers take on a significant proportion of parenting duties in two-parent families, knowledge of maternal risk factors for child maltreatment is essential. METHODS In this cross-sectional study, 135 mothers with their last child below 18 years old in Kurdistan province were enrolled. A validated Persian version of the ISPCAN Child Abuse Screening Tool-Parent version, Beck Anxiety Inventory, and Beck Depression Inventory were administered. RESULTS The prevalence of severe and moderate physical punishment was 78.5% and 71.9%, respectively. Psychological punishment was reported by 99.3% of respondents, and 48.9% reported neglect. A relationship was found between child physical and emotional abuse and low maternal education (P < 0.01), domestic violence (P = 0.02), maternal exposure to maltreatment during childhood (P = 0.03), maternal depression (p < 0.01), and maternal anxiety (P < 0.01). A relationship was found between neglect and residence in rural areas (P < 0.01), domestic violence, and low maternal education (P = 0.02). CONCLUSION Maternal child maltreatment in Iran is increased in mothers with psychological disorders and those with certain demographic characteristics. Clinicians should be alert to these potential risk factors.
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Affiliation(s)
- Sahel Khazaei
- MPH Department, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- MPH Department, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Acorda DE, Brown JN, Lambert EM, Gibbs KD. Psychosocial Measures and Outcomes Among Caregivers of Children With Tracheostomies: A Systematic Review. Otolaryngol Head Neck Surg 2023; 168:979-987. [PMID: 36939578 DOI: 10.1002/ohn.202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/26/2022] [Accepted: 10/30/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Children with tracheostomies have complex medical issues that require long-term technology dependence and continuous medical care at home. Parents of tracheostomy-dependent children often assume the majority of their child's home care leading to a shift in family dynamics and a decrease in caregiver quality of life. This systematic review sought to identify instruments to measure caregiver psychosocial outcomes after their child's tracheostomy and report on the findings. DATA SOURCES A systematic review was performed using Medline, CINAHL, and EMBASE. REVIEW METHODS Studies that evaluated psychosocial outcomes in caregivers of tracheostomy-dependent children were included. RESULTS We screened a total of 1286 nonduplicate records to include a total of 12 studies assessing the psychosocial outcomes of parents of tracheostomy-dependent children. Fourteen instruments were identified. Caregivers reported lower quality of life when compared to other chronic caregiver groups. They experienced high degrees of stress, struggled to cope individually and as a family unit, and experienced decision regret and conflict. CONCLUSION Findings from this review suggest a significant impact on caregiver psychosocial well-being, but few quantitative studies investigated this dynamic with measures validated in this caregiver population. This review demonstrates the need for longitudinal studies using validated tools to assess the long-term impacts and outcomes of caregivers of the tracheostomy-dependent child.
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Affiliation(s)
- Darlene E Acorda
- Department of Nursing, Texas Children's Hospital, Texas, Houston, USA
| | - Jennifer N Brown
- Department of Nursing, Texas Children's Hospital, Texas, Houston, USA
| | - Elton M Lambert
- Department of Nursing, Texas Children's Hospital, Texas, Houston, USA.,Section of Otorhinolaryngology, Baylor College of Medicine, Section of Otorhinolaryngology, Texas, Houston, USA
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4
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Yamaguchi A, Niimura M, Sonehara H, Sekido Y, Kishimoto M, Tachibana Y, Takehara K. The characteristics of children referred to a child protection team in Japan and factors associated with decision-making: A retrospective study using a medical database. CHILD ABUSE & NEGLECT 2022; 134:105867. [PMID: 36099685 DOI: 10.1016/j.chiabu.2022.105867] [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: 05/08/2022] [Revised: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite the potential efficacy of hospital-based multidisciplinary child protection team (CPTs), research analyzing Japanese CPT databases is scarce. OBJECTIVE We aimed to describe the characteristics of children and families reported to a CPT in Japan and investigate factors associated with the substantiation of maltreatment. PARTICIPANTS AND SETTING This retrospective, cross-sectional study took place in a national children's hospital in Japan and included 350 children who were reported to CPTs between April 2014 and March 2018. METHODS Univariable and multivariable logistic regression analyses were conducted using the CPT database and medical records. RESULTS Among 350 cases, 33.4 % were substantiated. Children of <6 years of age comprised 73.4 % of the cases. The majority (67.7 %) received an injury-related diagnosis and physical maltreatment was suspected in 68.3 % of cases. In the univariable analysis, older age, a primary diagnosis other than injury, reporting department, psychological maltreatment, witnessing intimate partner violence, maltreatment by relatives other than biological father or mother, developmental disability, emotional/behavioral difficulty or psychological disorder, maternal/paternal psychological difficulty, and maternal history of maltreatment were significantly associated with substantiation. When adjusted for demographic, child and familial factors, a diagnosis other than injury (AOR 2.02, 95 % CI = 1. 11-3.65) and parental psychological difficulties (AOR 2.49, 95 % CI = 1.37-4.55) were independently associated with substantiation. CONCLUSION Most cases reported to our CPT were young children with an injury-related diagnosis. Substantiation was associated with a diagnosis other than injury and parental psychological difficulties. Further prospective and comprehensive studies are needed to establish universal guidelines for databases of hospital-based CPTs.
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Affiliation(s)
- Arisa Yamaguchi
- Department of Psychosocial Medicine, National Center for Child Health and Development; Center for Child Abuse Prevention.
| | - Michi Niimura
- Department of Health Policy, National Center for Child Health and Development
| | - Harumi Sonehara
- Department of Psychosocial Medicine, National Center for Child Health and Development
| | - Yuki Sekido
- Department of Psychosocial Medicine, National Center for Child Health and Development
| | - Makiko Kishimoto
- Department of Psychosocial Medicine, National Center for Child Health and Development
| | - Yoshiyuki Tachibana
- Department of Psychosocial Medicine, National Center for Child Health and Development
| | - Kenji Takehara
- Department of Health Policy, National Center for Child Health and Development
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5
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Noyek S, Davies C, Champagne M, Batorowicz B, Fayed N. Emotional Well-Being of Children and Youth with Severe Motor and Communication Impairment: A Conceptual Understanding. Dev Neurorehabil 2022; 25:554-575. [PMID: 35900109 DOI: 10.1080/17518423.2022.2099997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children and youth with severe motor and communication impairment (SMCI) have difficulty providing self-expression through typical speech, writing with a paper and pencil, or using a standard keyboard. Their emotional expressions can be missed by peers and novel caregivers. PURPOSE To describe the indicators and components of emotional experiences for children/youth with SMCI. METHODS Primary guardians of nine children/youth with SMCI were involved in photo/video data collection and follow-up qualitative interviews. Twenty-one familiar people (e.g., friends, family members, and/or care team) participated in semi-structured qualitative interviews. RESULTS A conceptual understanding of emotional well-being specific to the population has been developed consisting of nine themes, encompassed by four domains i) Core Attributes, ii) Personal Experiences, iii) Surroundings, iv) Expression and Reception. CONCLUSIONS Emotional experiences of children/youth with SMCI are diversely expressed. Primary guardian and familiar person insight can be amplified to positively impact care and participation.
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Affiliation(s)
- Samantha Noyek
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Claire Davies
- Mechanical and Materials Engineering, Queen's University, Kingston, ON, Canada
| | - Maude Champagne
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Beata Batorowicz
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Nora Fayed
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Munger KF, Stegenga SM, Storie SO, Wennerstrom EK. Addressing challenges at the intersection of early intervention and child welfare. CHILD ABUSE & NEGLECT 2022:105852. [PMID: 36137817 DOI: 10.1016/j.chiabu.2022.105852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The Keep Children and Families Safe Act amendment to the Child Abuse Prevention and Treatment Act (CAPTA) of 2003 mandated children under age three who are involved with Child Welfare (CW) to receive a referral to the system for early intervention (EI). While there is strong rationale for providing developmental services to young children and families impacted by maltreatment, the early implementation of this policy brought about many challenges related to interagency coordination and readiness of providers to provide cross-systems care. Currently, as the system and providers within the system recover from the effects of Covid-19, a predicted increase in need of services may exacerbate historical gaps in the provision of services to families involved with CW. PARTICIPANTS AND SETTING This policy-focused paper explores issues impacting CW and EI providers who coordinate care between CW and EI services. METHODS This paper provides a historical examination of these challenges and proposes an approach for improving developmental services for families referred from CW, specifically through the lens of addressing resources and supports available to providers. RESULTS The proposed approach includes an increase and reprioritization of resources to support provider readiness and well-being. CONCLUSIONS By focusing on support for providers, the authors propose a reduction of stress and improvement of services at each level of the "well-being" system.
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Affiliation(s)
- Kelley F Munger
- Research and Development, FuelEd Schools, United States of America.
| | - Sondra M Stegenga
- Department of Special Education, University of Utah, United States of America
| | - Sloan O Storie
- Department of Special Education and Child Development, University of North Carolina-Charlotte, United States of America
| | - Erin Kinavey Wennerstrom
- Department of Special Education and Clinical Sciences, University of Oregon, United States of America
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7
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Michna GA, Trudel SM, Bray MA, Reinhardt J, Dirsmith J, Theodore L, Zhou Z, Patel I, Jones P, Gilbert ML. Best practices and emerging trends in assessment of trauma in students with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- George A. Michna
- Neag School of Education University of Connecticut Storrs Connecticut USA
| | - Sierra M. Trudel
- Neag School of Education University of Connecticut Storrs Connecticut USA
| | - Melissa A. Bray
- Neag School of Education University of Connecticut Storrs Connecticut USA
| | - Jessica Reinhardt
- College of Education and Human Development Temple University Philadelphia Pennsylvania USA
| | - Jessica Dirsmith
- Department of Counseling, Psychology, & Special Education Duquesne University Pittsburgh Pennsylvania USA
| | - Lea Theodore
- Gordon F. Derner School of Psychology Adelphi University Garden City New York USA
| | - Zheng Zhou
- Department of Psychology St. John's University New York City New York USA
| | - Ishani Patel
- Neag School of Education University of Connecticut Storrs Connecticut USA
| | - Paul Jones
- College of Education and Human Development Temple University Philadelphia Pennsylvania USA
| | - Matthew L. Gilbert
- Neag School of Education University of Connecticut Storrs Connecticut USA
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8
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Fang Z, Cerna-Turoff I, Zhang C, Lu M, Lachman JM, Barlow J. Global estimates of violence against children with disabilities: an updated systematic review and meta-analysis. THE LANCET CHILD & ADOLESCENT HEALTH 2022; 6:313-323. [DOI: 10.1016/s2352-4642(22)00033-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/30/2022]
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9
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Azzopardi C, Cohen E, Pépin K, Netten K, Birken C, Madigan S. Child Welfare System Involvement Among Children With Medical Complexity. CHILD MALTREATMENT 2022; 27:257-266. [PMID: 34219484 PMCID: PMC9003756 DOI: 10.1177/10775595211029713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Children with medical complexity may be at elevated risk of experiencing child maltreatment and child welfare system involvement, though empirical data are limited. This study examined the extent of child welfare system involvement among children with medical complexity and investigated associated health and social factors. A retrospective chart review of children with medical complexity (N = 208) followed at a pediatric hospital-based complex care program in Canada was conducted. Descriptive statistics and odds ratios using logistic regression were computed. Results showed that nearly one-quarter (23.6%) had documented contact with the child welfare system, most commonly for neglect; of those, more than one-third (38.8%) were placed in care. Caregiver reported history of mental health problems (aOR = 3.19, 95%CI = 1.55-6.56), chronic medical conditions (aOR = 2.86, 95%CI = 1.09-7.47), and interpersonal violence or trauma (aOR = 17.58, 95%CI = 5.43-56.98) were associated with increased likelihood of child welfare system involvement, while caregiver married/common-law relationship status (aOR = 0.35, 95%CI = 0.16-0.74) and higher number of medical technology supports (aOR = 0.75, 95%CI = 0.57-0.99) were associated with decreased likelihood. Implications for intervention and prevention of maltreatment in children with high healthcare needs are discussed.
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Affiliation(s)
- Corry Azzopardi
- Suspected Child Abuse and Neglect Program, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Eyal Cohen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Department of Paediatrics and Institute of Health Policy, Management & Evaluation, Edwin S.H. Leong Centre for Healthy Children, University of Toronto, Ontario, Canada
| | - Karine Pépin
- Department of Paediatric, Centre Hospitalier Universitaire Sainte-Justine, Université de Montréal, Quebec, Canada
| | - Kathy Netten
- Department of Social Work, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Catherine Birken
- Department of Paediatrics, University of Toronto, Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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10
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Suresh S, Heineman E, Meyer L, Richichi R, Conger S, Young S, Coombs C, Berger R. Improved Detection of Child Maltreatment with Routine Screening in a Tertiary Care Pediatric Hospital. J Pediatr 2022; 243:181-187.e2. [PMID: 34929244 DOI: 10.1016/j.jpeds.2021.11.073] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To evaluate the impact of layering routine child abuse screening on top of a preexisting electronic health record-embedded Child Abuse Clinical Decision Support System (CA-CDSS) in a pediatric emergency department. STUDY DESIGN The Pittsburgh Child Abuse Screening Tool (P-CAST) was performed in all children aged <13 years and in nonverbal children aged ≥13 years who presented to a pediatric tertiary care center over a 6-month period. The P-CAST was layered on top of a preexisting CA-CDSS that included passive triggers, alerts, and abuse-specific order sets. RESULTS Of the 28 797 screens performed, 1.8% were positive in children aged <13 years and 1.6% were positive in nonverbal children aged ≥13 years. One-half of the children with a positive P-CAST also triggered the CA-CDSS; the other one-half triggered only because of the P-CAST. Nineteen percent of the patients with a positive P-CAST were reported to Child Protective Services (CPS). There was no relationship between race and the odds of a positive P-CAST or between race and the likelihood of a report being made to CPS. CONCLUSIONS Active routine child abuse screening improves identification of suspected child maltreatment in a children's hospital above and beyond what is identified with a CA-CDSS, which depends on passive triggers. The lack of a relationship between race and a positive P-CAST or a report to CPS suggest that systematic child abuse screening may mitigate well-recognized racial disparities in identifying and reporting suspected child maltreatment.
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Affiliation(s)
- Srinivasan Suresh
- Division of Health Informatics, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA; Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Emily Heineman
- Division of Child Advocacy, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Lisa Meyer
- Division of Health Informatics, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Rudolph Richichi
- Statistical Analysis and Measurement Consultants, Inc, Williamsburg, VA
| | - Scott Conger
- Division of Child Advocacy, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Shanon Young
- Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Carmen Coombs
- Division of Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA; Division of Child Advocacy, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA
| | - Rachel Berger
- Division of Child Advocacy, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
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11
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Hildebrandt C, Wilson CR, Kritzer A. Standardizing genetic and metabolic consults for non-accidental trauma at a large pediatric academic center. CHILD ABUSE & NEGLECT 2022; 125:105480. [PMID: 35033936 DOI: 10.1016/j.chiabu.2021.105480] [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: 07/16/2021] [Revised: 12/09/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evaluations of suspected non-accidental trauma (NAT) often include consultation with genetic and metabolic teams to assess patients for rare genetic conditions that can mimic or exacerbate child abuse. Diagnoses that may be questioned during court proceedings include osteogenesis imperfecta (OI) and glutaric aciduria type 1 (GA1). Currently there are no official society guidelines for the genetic or metabolic workup of suspected NAT. OBJECTIVE To standardize consult recommendations for suspected NAT through collaboration between the Genetics and Genomics Division and the Child Protection Team (CPT). PARTICIPANTS AND SETTINGS Children evaluated for suspected NAT at a single pediatric referral center. METHODS A year of inpatient consult requests for suspected NAT to the genetics division were reviewed. The most common indications for consult were fractures and subdural hematoma. Consult recommendations for similar indications varied between providers. A standard operating procedure (SOP) with specific recommendations for suspected NAT consults for fractures, intracranial hemorrhage, and other indications was created based on expert reviews and other relevant literature. A questionnaire assessing division practice patterns for these consults was distributed both pre (n = 17) and post-introduction of the SOP (n = 11). RESULTS Adherence to the SOP and impact on suspected NAT consult recommendations were assessed at 18 months after SOP introduction. Consult recommendations were in line with the SOP for 7/11 consults pre-intervention and 6/7 consults post-intervention. Providers were more likely to report feeling extremely or very confident they were using evidence-based medicine for NAT consults post-intervention.
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Affiliation(s)
- Clara Hildebrandt
- Boston Children's Hospital, Metabolism Program, Division of Genetics and Genomics, 300 Longwood Ave, Boston, MA, USA
| | - Celeste R Wilson
- Boston Children's Hospital, Child Protection Program, Division of General Pediatrics, 300 Longwood Ave, Boston, MA, USA
| | - Amy Kritzer
- Boston Children's Hospital, Metabolism Program, Division of Genetics and Genomics, 300 Longwood Ave, Boston, MA, USA.
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12
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Debelle G, Morris H, Shaw N, Oates A. Fifteen-minute consultation: Fractures in non-ambulant children with cerebral palsy. Arch Dis Child Educ Pract Ed 2022; 107:15-20. [PMID: 33361095 DOI: 10.1136/archdischild-2020-319882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/16/2020] [Accepted: 12/09/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To describe a safeguarding decision pathway for the assessment of osteopenic fractures in non-ambulant children with cerebral palsy. METHOD Literature review and consensus practice of a child safeguarding team, including clinicians and social workers. CONCLUSION Low-energy fractures of the lower limb in non-ambulant children with cerebral palsy are relatively common and explained by the presence of reduced bone strength, in the absence of any other unexplained injuries or safeguarding concerns.
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Affiliation(s)
- Geoff Debelle
- Safeguarding Team, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Helen Morris
- Department of General Paediatrics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nick Shaw
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,Department of Radiology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Adam Oates
- Department of Radiology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
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13
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Dembo RS, Mitra M, Akobirshoev I, Manning SE. Symptom Sequelae Following Violence Against Youth With Disabilities. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP11555-NP11576. [PMID: 31766955 DOI: 10.1177/0886260519889928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The objective of this study was to examine the physical and mental health impact of violence against youth with and without disabilities. We analyzed data from the National Crime Victimization Survey (2008-2016), a nationally representative survey on crime in the United States. Respondents included 729 adolescents (12-17 years) and 953 young adults (18-24 years) who experienced violence in the previous 6 months. Disability status was determined using a six-item screener. Outcome measures included several physical and mental health symptoms experienced for at least one month following violence. Data were analyzed using multivariable logistic, Poisson, and negative binomial regression models. The results indicated that, for at least one month following a violent incident, adolescents and young adults with disabilities were more likely to experience headaches, sleep difficulty, changes in eating or drinking habits, fatigue, muscle pain, and severe distress compared to peers without disabilities. Young adults with disabilities were also more likely to experience stomach problems, depression, and anxiety. Adolescents and young adults with disabilities experienced a greater number of concurrent physical and mental health symptoms compared to peers without disabilities. The results suggest that the health effects of violence are worse for youth with disabilities compared to their nondisabled peers. These findings emphasize the importance of screening young people with disabilities for violence exposure and ensuring that trauma and health services are universally accessible.
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14
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Goldner D, Vittorio J, Barrios DM, McGuire J, Brodlie S, Brown J, Lobritto S, Martinez M. Bone Fractures in Children With Cholestatic Liver Disease May Mimic Those Seen in Child Abuse. Pediatr Emerg Care 2021; 37:e636-e639. [PMID: 30672906 DOI: 10.1097/pec.0000000000001740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Certain fractures in children are highly specific for child abuse. Metabolic bone disease frequently develops in patients with cholestatic liver disease (CLD); this can result in weakened bones and a predisposition to pathologic fractures. Fractures that occur in patients with rickets and osteopenia may mimic a bone response to inflicted injury, which in children raise the concern of child abuse. Here we report a series of 15 patients with CLD who developed pathologic fractures in the setting of metabolic bone disease. During initial evaluation, the caretakers of 5 of these 15 patients were reported to child protective services and investigated for child abuse. Pediatricians should be aware that children with CLD have an increased incidence of pathologic fractures, even after the cholestasis has resolved.
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Affiliation(s)
- Dana Goldner
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
| | - Jennifer Vittorio
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
| | | | - Jillian McGuire
- Department of Social Work, New York Presbyterian Hospital, New York, NY
| | - Susan Brodlie
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
| | - Jocelyn Brown
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
| | - Steven Lobritto
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
| | - Mercedes Martinez
- From the Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York
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15
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Morgart K, Harrison JN, Hoon AH, Wilms Floet AM. Adverse childhood experiences and developmental disabilities: risks, resiliency, and policy. Dev Med Child Neurol 2021; 63:1149-1154. [PMID: 33938573 DOI: 10.1111/dmcn.14911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 01/11/2023]
Abstract
Thanks to the seminal work of Robert Anda and Vincent Felitti, it is now widely accepted that adverse childhood experiences (ACEs) can have lifelong effects on physical, behavioral, and mental health and that many adult diseases can be considered developmental disorders that began early in life. Genomics has advanced the neurobiological understanding that underpins ACEs, wellness, and disease, which are modulated through stress pathways and epigenetic modifications. While data are currently limited, children with developmental disabilities have an increased ACE risk compared to typically developing peers. This recognition has important ramifications for health and policy interventions that address the root causes of ACEs, especially in this vulnerable population. With increased societal recognition, advances in policy will lead to medical, financial, and public benefits in years to come, hopefully changing healthcare models from 'sick care' to 'well care'. What this paper adds Adverse childhood experience (ACE) research has refocused medicine from the question 'What is wrong with you?' to 'What happened to you?'. Adopting ACE research into public policy can redirect healthcare models from providing 'sick care' to promoting 'well care'. Not exploring the role of ACEs in children with developmental disabilities leads to further vulnerability and morbidity. ACEs can be mitigated by early identification and implementation of evidence-based interventions.
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Affiliation(s)
| | - Joyce Nolan Harrison
- Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander H Hoon
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Anna Maria Wilms Floet
- Kennedy Krieger Institute, Baltimore, MD, USA.,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
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16
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Rajaraman A, Austin JL, Gover HC, Cammilleri AP, Donnelly DR, Hanley GP. Toward trauma-informed applications of behavior analysis. J Appl Behav Anal 2021; 55:40-61. [PMID: 34525220 DOI: 10.1002/jaba.881] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/29/2022]
Abstract
Despite a growing acknowledgement of the importance of understanding the impacts of trauma on therapeutic approaches across human service disciplines, discussions of trauma have been relatively infrequent in the behavior analytic literature. In this paper, we delineate some of the barriers to discussing and investigating trauma in applied behavior analysis (ABA) and describe how the core commitments of trauma-informed care could be applied to behavior analysis. We then provide some examples of how trauma-informed care might be incorporated into ABA practice. We conclude by suggesting opportunities to approach trauma as a viable avenue for behavior analytic research and argue that omitting trauma-informed care from ABA could be detrimental not only to the public perception of ABA, but to the effectiveness of our assessment and treatment procedures.
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17
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Sieberg CB, Lebel A, Silliman E, Holmes S, Borsook D, Elman I. Left to themselves: Time to target chronic pain in childhood rare diseases. Neurosci Biobehav Rev 2021; 126:276-288. [PMID: 33774086 PMCID: PMC8738995 DOI: 10.1016/j.neubiorev.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic pain is prevalent among patients with rare diseases (RDs). However, little is understood about how biopsychosocial mechanisms may be integrated in the unique set of clinical features and therapeutic challenges inherent in their pain conditions. METHODS This review presents examples of major categories of RDs with particular pain conditions. In addition, we provide translational evidence on clinical and scientific rationale for psychosocially- and neurodevelopmentally-informed treatment of pain in RD patients. RESULTS Neurobiological and functional overlap between various RD syndromes and pain states suggests amalgamation and mutual modulation of the respective conditions. Emotional sequelae could be construed as an emotional homologue of physical pain mediated via overlapping brain circuitry. Given their clearly defined genetic and molecular etiologies, RDs may serve as heuristic models for unraveling pathophysiological processes inherent in chronic pain. CONCLUSIONS Systematic evaluation of chronic pain in patients with RD contributes to sophisticated insight into both pain and their psychosocial correlates, which could transform treatment.
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Affiliation(s)
- Christine B Sieberg
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, 02115, USA; Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Alyssa Lebel
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA
| | - Erin Silliman
- Biobehavioral Pediatric Pain Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, MA, 02115, USA; Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Scott Holmes
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA
| | - David Borsook
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Department of Anesthesiology, Harvard Medical School, Boston, MA, 02115, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, 02139, USA
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18
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Cleveland RW, Ullrich C, Slingsby B, Keefer P. Children at the Intersection of Pediatric Palliative Care and Child Maltreatment: A Vulnerable and Understudied Population. J Pain Symptom Manage 2021; 62:91-97. [PMID: 33197523 DOI: 10.1016/j.jpainsymman.2020.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
Abstract
CONTEXT Concerns for child maltreatment can complicate the provision of pediatric palliative care (PPC). Little is known about the vulnerable population of children with life-threatening conditions involved with PPC and state Child Protective Services (CPS) or hospital Child Protection Teams (CPTs). More information is needed to inform and optimize collaborative care. OBJECTIVES Define and describe the population of children with PPC involvement for whom there was concern for maltreatment. METHODS Single-center retrospective chart review of children with PPC involvement for whom there was concern for maltreatment, defined as involvement of CPS/CPT between 2005 and 2017. Medical and demographic variables were abstracted and analyzed. Analyses include descriptive tabulation and measurements of association between PPC and CPS/CPT variables. RESULTS Among 1804 children followed by PPC, 189 (10.4%) had documented CPS/CPT involvement. Among those, 113 (60%) had CPT involvement, 88 (47%) had concerns of medical neglect, and 100 (53%) had simultaneous CPS/CPT and PPC involvement. Goals of PPC consultation varied by clinical characteristics and concerns for medical neglect. Frequency of CPT involvement and physical abuse concerns also varied by child clinical characteristics. CONCLUSION PPC practitioners regularly encounter children with CPS/CPT involvement. PPC practitioners should be aware of the risk of maltreatment in their patients. Although rare in the general pediatric population, medical neglect is a relatively frequent maltreatment concern in children cared for by PPC. PPC practitioners have an opportunity to aid in proper evaluation of medical neglect in children they care for. Closer PPC collaboration with CPS/CPT may further optimize care.
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Affiliation(s)
- Ross William Cleveland
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
| | - Christina Ullrich
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Department of Pediatrics, Division of Pediatric Hematology/Oncology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Brett Slingsby
- Brown University, Providence, Rhode Island, USA; Aubin Child Protection Center, Hasbro Children's Hospital, Providence, Rhode Island, USA
| | - Patricia Keefer
- Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan, USA; Department of Pediatrics, Stepping Stones Pediatric Palliative Care Program, University of Michigan, Ann Arbor, Michigan, USA
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19
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Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic. J Autism Dev Disord 2021; 51:2155-2158. [PMID: 32816170 PMCID: PMC7438977 DOI: 10.1007/s10803-020-04670-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Amidst the ongoing novel Coronavirus disease pandemic, children with developmental disabilities warrant specific attention to minimise having disproportionate consequences. These children are especially vulnerable to the effects of the pandemic due to (1) Greater healthcare needs, (2) Dependency on community-based services and (3) Mental health concerns. Healthcare professionals, public health systems and the society needs to come together to advocate for these children by optimising access to healthcare and community intervention services, promoting mental well-being and caregiver welfare. The consequences of missed present-day opportunities might only be evident in the years to come in these children. Hence, despite the prolonged pandemic, with consequent limitations in availability of resources, children with developmental disabilities should continue to be supported.
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20
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Legano LA, Desch LW, Messner SA, Idzerda S, Flaherty EG. Maltreatment of Children With Disabilities. Pediatrics 2021; 147:peds.2021-050920. [PMID: 33875536 DOI: 10.1542/peds.2021-050920] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Over the past decade, there have been widespread efforts to raise awareness about maltreatment of children. Pediatric providers have received education about factors that make a child more vulnerable to being abused and neglected. The purpose of this clinical report is to ensure that children with disabilities are recognized as a population at increased risk for maltreatment. This report updates the 2007 American Academy of Pediatrics clinical report "Maltreatment of Children With Disabilities." Since 2007, new information has expanded our understanding of the incidence of abuse in this vulnerable population. There is now information about which children with disabilities are at greatest risk for maltreatment because not all disabling conditions confer the same risks of abuse or neglect. This updated report will serve as a resource for pediatricians and others who care for children with disabilities and offers guidance on risks for subpopulations of children with disabilities who are at particularly high risk of abuse and neglect. The report will also discuss ways in which the medical home can aid in early identification and intervene when abuse and neglect are suspected. It will also describe community resources and preventive strategies that may reduce the risk of abuse and neglect.
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Affiliation(s)
- Lori A Legano
- Department of Pediatrics, Grossman School of Medicine, New York University, New York, New York;
| | - Larry W Desch
- Department of Pediatrics, Chicago Medical School, Rosalind Franklin University of Medicine and Science and Advocate Children's Hospital, Oak Lawn, Illinois
| | - Stephen A Messner
- Stephanie V. Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sheila Idzerda
- Billings Clinic, Department of Medicine, University of Washington School of Medicine, Bozeman, Montana; and
| | - Emalee G Flaherty
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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21
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Haque MA, Salwa M, Sultana S, Tasnim A, Towhid MII, Karim MR, Abdullah Al Mamun M. Parenting stress among caregivers of children with neurodevelopmental disorders: A cross-sectional study in Bangladesh. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:17446295211002355. [PMID: 33882755 DOI: 10.1177/17446295211002355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This cross-sectional study explored stressful situations of caregivers related to life events of their children suffering from neurodevelopmental disorders along with potential contributing factors. A total of 906 caregivers of children with diagnosed neurodevelopmental disorder, from eight administrative districts and two city corporation areas in Bangladesh were interviewed. The Family Stress and Coping Interview scale was used to evaluate parenting stress. The diagnosis of neurodevelopmental disorder at the outset, feelings about the cause of the disorder, future planning for employment and accommodation for the child and dealing with child sexuality were some important stressful situations for parents. Parenting stress is found to be higher among female [regression coefficient (B) = 5.09, p < 0.001] and less educated caregivers [B = 2.69, p < 0.01]. Increasing age of child [B = 0.82, p < 0.001] and diagnosis of neurodevelopmental disorder before child's second birthday [B = 4.22, p < 0.001] are also associated with higher parenting stress.
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Affiliation(s)
- M Atiqul Haque
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Marium Salwa
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Sarmin Sultana
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
| | - Anika Tasnim
- 74464Bangabandhu Sheikh Mujib Medical University, Bangladesh
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22
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The Role of the Family Network When Raising a Child with a Disability in Low- and Middle-Income Countries. ACTA ACUST UNITED AC 2021. [DOI: 10.3390/disabilities1010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Family plays a role in supporting child development, by facilitating caregiving and other parental practices. Low- and middle-income families typically have a complex structure with many relatives living together in the same household. The role of family and family complexity in the caregiving of children with disabilities is still unknown. In this study, we use data from N = 22,405 children with severe (N = 876) and mild or no disability (N = 21,529) from a large dataset collected in the 2005–2007 Multiple Indicator Cluster Survey. In particular, we adopt PageRank, a well-known algorithm used by search engines, to quantify the importance of each child in the family network. We then analyze the level of caregiving the child received in light of the child’s importance and developmental status, using a generalized linear model. Results show a main effect of child’s importance and of the interaction of child’s importance and developmental status. Post hoc analysis reveals that higher child importance is associated with a better caregiving outcome only for children with mild or no disability.
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23
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Somani R, Corboz J, Karmaliani R, Chirwa ED, McFarlane J, Khuwaja HMA, Asad N, Somani Y, Van Der Heijden I, Jewkes R. Peer victimization and experiences of violence at school and at home among school age children with disabilities in Pakistan and Afghanistan. Glob Health Action 2021; 14:1857084. [PMID: 33357165 PMCID: PMC7782892 DOI: 10.1080/16549716.2020.1857084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Children with disabilities are more likely to experience violence or injury at school and at home, but there is little evidence from Central Asia. Objective: To describe the prevalence of disability and associations with peer violence perpetration and victimization, depression, corporal punishment, school performance and school attendance, among middle school children in Pakistan and Afghanistan. Method: This is a secondary analysis of data gathered in the course of evaluations of interventions to prevent peer violence conducted in Pakistan and Afghanistan as part of the 'What Works to Prevent Violence against Women and Girls Global Programme'. In Pakistan, the research was conducted in 40 schools, and disability was assessed at midline in 1516 interviews with Grade 7s. In Afghanistan, the data were from the baseline study conducted in 11 schools with 770 children. Generalized Linear Mixed Modeling was used to assess associations with disability. Results: In Afghanistan, the prevalence of disability was much higher for girls (22.1%) than boys (12.9%), while in Pakistan 6.0% of boys and girls reported a disability. Peer violence victimization was strongly associated with disability in Afghanistan and marginally associated in Pakistan. In Pakistan, perpetration of peer violence was associated with disability. In both countries, disability was significantly associated with higher depression scores. Food insecurity was strongly associated with disability in Afghanistan. Conclusion: Disability is highly prevalent in Afghanistan and Pakistan schools and this is associated with a greater risk of experiencing and perpetrating peer violence. It is important to ensure that all children can benefit from school-based prevention interventions.
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Affiliation(s)
- Rozina Somani
- Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Julienne Corboz
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rozina Karmaliani
- School of Nursing & Midwifery and Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Esnat D. Chirwa
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | | | | | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
| | - Yasmeen Somani
- School of Nursing & Midwifery, Aga Khan University, Karachi, Pakistan
| | - Ingrid Van Der Heijden
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
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24
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Children and Adolescents with Disabilities and Exposure to Disasters, Terrorism, and the COVID-19 Pandemic: a Scoping Review. Curr Psychiatry Rep 2021; 23:80. [PMID: 34643813 PMCID: PMC8511280 DOI: 10.1007/s11920-021-01295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW This paper reviews the empirical literature on exposures to disaster or terrorism and their impacts on the health and well-being of children with disabilities and their families since the last published update in 2017. We also review the literature on studies examining the mental health and functioning of children with disabilities during the COVID-19 pandemic. RECENT FINDINGS Few studies have examined the effects of disaster or terrorism on children with disabilities. Research shows that children with disabilities and their families have higher levels of disaster exposure, lower levels of disaster preparedness, and less recovery support due to longstanding discriminatory practices. Similarly, many reports of the COVID-19 pandemic have documented its negative and disproportionate impacts on children with disabilities and their families. In the setting of climate change, environmental disasters are expected to increase in frequency and severity. Future studies identifying mitigating factors to disasters, including COVID-19; increasing preparedness on an individual, community, and global level; and evaluating post-disaster trauma-informed treatment practices are imperative to support the health and well-being of children with disabilities and their families.
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25
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Weaver MS, Anderson V, Beck J, Delaney JW, Ellis C, Fletcher S, Hammel J, Haney S, Macfadyen A, Norton B, Rickard M, Robinson JA, Sewell R, Starr L, Birge ND. Interdisciplinary care of children with trisomy 13 and 18. Am J Med Genet A 2020; 185:966-977. [PMID: 33381915 DOI: 10.1002/ajmg.a.62051] [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: 07/15/2020] [Revised: 11/21/2020] [Accepted: 12/12/2020] [Indexed: 01/20/2023]
Abstract
Children with trisomy 13 and 18 (previously deemed "incompatible with life") are living longer, warranting a comprehensive overview of their unique comorbidities and complex care needs. This Review Article provides a summation of the recent literature, informed by the study team's Interdisciplinary Trisomy Translational Program consisting of representatives from: cardiology, cardiothoracic surgery, neonatology, otolaryngology, intensive care, neurology, social work, chaplaincy, nursing, and palliative care. Medical interventions are discussed in the context of decisional-paradigms and whole-family considerations. The communication format, educational endeavors, and lessons learned from the study team's interdisciplinary care processes are shared with recognition of the potential for replication and implementation in other care settings.
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Affiliation(s)
- Meaghann S Weaver
- Division of Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Venus Anderson
- Division of Cardiology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jill Beck
- Division of Oncology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jeffrey W Delaney
- Division of Cardiology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Cynthia Ellis
- Division of Developmental Pediatrics, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA.,Munroe-Meyer Institute for Genetics and Rehabilitation, Omaha, Nebraska, USA
| | - Scott Fletcher
- Division of Cardiology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA.,Division of Cardiology, Department of Pediatrics, Creighton University, Omaha, Nebraska, USA
| | - James Hammel
- Division of Cardiothoracic Surgery, Department of Surgery, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Suzanne Haney
- Division of Child Advocacy, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andrew Macfadyen
- Division of Critical Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Bridget Norton
- Division of Critical Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Mary Rickard
- Division of Neurology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jeffrey A Robinson
- Division of Cardiology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Ryan Sewell
- Division of Otolaryngology, Department of Pediatrics, Children's Hospital and Medical Center and ENT Specialists PC, Omaha, Nebraska, USA
| | - Lois Starr
- Munroe-Meyer Institute for Genetics and Rehabilitation, Omaha, Nebraska, USA.,Division of Genetics, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Nicole D Birge
- Division of Neonatology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
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26
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Bizzego A, Lim M, Schiavon G, Setoh P, Gabrieli G, Dimitriou D, Esposito G. Child disability and caregiving in low and middle income countries: Big data approach on open data. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 107:103795. [PMID: 33142260 DOI: 10.1016/j.ridd.2020.103795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/28/2020] [Accepted: 10/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The presence of child disabilities might affect the amount of caregiving attention the child receives, with potential ramifications on the development of the child and increasing the likelihood of developing a more severe condition. Little is known about the association between child disabilities and caregiving practices in less developed countries, penalized by both lack of data and a research bias toward western societies. METHOD In this study, we apply data mining methods on a large (N = 29,525) dataset from UNICEF to investigate the association between caregiving practices and developmental disabilities of the children, and highlight the differences between intellectual and other disabilities. RESULTS Our results highlight that, compared to other types of disabilities, intellectual disabilities increased the risk of being neglected by the caregiver in those activities oriented to the cognitive development. The education of the caregiver and the socioeconomical development of the country are actively involved in the moderation of the risk. CONCLUSION We demonstrated that educational policies of parental training, such as psychoeducation regarding intellectual disabilities and destigmatization campaigns, are needed to benefit parental practices in low- and middle-income countries.
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Affiliation(s)
- Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Mengyu Lim
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Greta Schiavon
- Department of Psychology and Cognitive Science, University of Trento, Italy
| | - Peipei Setoh
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Giulio Gabrieli
- School of Social Sciences, Nanyang Technological University, Singapore
| | - Dagmara Dimitriou
- UCL Institute of Education, University College London, London, United Kingdom
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Italy; School of Social Sciences, Nanyang Technological University, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
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27
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Mood D, Szarkowski A, Brice PJ, Wiley S. Relational Factors in Pragmatic Skill Development: Deaf and Hard of Hearing Infants and Toddlers. Pediatrics 2020; 146:S246-S261. [PMID: 33139438 PMCID: PMC11215649 DOI: 10.1542/peds.2020-0242d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/24/2022] Open
Abstract
In this article, we review relational factors in early childhood believed to contribute in unique ways to pragmatic skill development in deaf and hard of hearing (DHH) infants and toddlers. These factors include attending to infant interactions with caregivers and others, supporting development of theory of mind through play and use of mental state language (ie, describing one's own or others' thoughts, feelings, and beliefs), and providing accessible opportunities for social interaction. On the basis of a review of the literature and clinical experience, we offer prescriptive strategies for supporting DHH children's development in these areas. To improve outcomes for DHH children, medical care providers and allied health professionals have a responsibility to support the development of young DHH children's pragmatic abilities by understanding these variables, coaching caregivers regarding their importance, and facilitating referrals for support when necessary.
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Affiliation(s)
- Deborah Mood
- Section of Developmental Pediatrics, Department of Pediatrics, University of Colorado, Aurora, Colorado;
- Contributed equally as co-first authors
| | - Amy Szarkowski
- Children's Center for Communication/Beverly School for the Deaf, Beverly, Massachusetts
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
- Contributed equally as co-first authors
| | | | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinatti Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
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28
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Karni-Visel Y, Hershkowitz I, Hershkowitz F, Flaisher M, Schertz M. Increased risk for child maltreatment in those with developmental disability: A primary health care perspective from Israel. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 106:103763. [PMID: 32957007 DOI: 10.1016/j.ridd.2020.103763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/19/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child Maltreatment (CM) is a worldwide phenomenon. Literature suggests that children with disabilities are at increased risk for CM. However, limited information exists regarding if such increased risk is noted in community primary care clinics. AIM To report on the incidence of CM in children with and without disabilities attending community primary care clinics. METHOD This was a cohort study of children belonging to a Health Maintenance Organization (HMO) in Israel. The study group consisted of children with disabilities and the control group consisted of children without disabilities. Formal reports to child protection services, medical and sociodemographic data were extracted from designated documentation and medical records. RESULTS The odds to be identified as suspected CM, after adjusting for sociodemographic variables, was 6.2 times higher among children with disabilities compared to children without disabilities and 5.0 times higher among children with severe vs. mild disability. CONCLUSIONS Developmental disability is a risk factor for CM, and is noted even more seriously in community primary care clinics. CM positively correlated with the severity of disability. The presented data marks higher figures than previously reported, enhancing understanding of the scope of the problem and its relation to the type of organization being examined.
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Affiliation(s)
- Yael Karni-Visel
- Child Development and Pediatric Neurology Service, Meuhedet-Northern Region, Israel; Department of Psychology, University of Cambridge, UK.
| | | | | | - Michal Flaisher
- Social Work Service, Meuhedet, Northern Region, Haifa, Israel.
| | - Mitchell Schertz
- Child Development and Pediatric Neurology Service, Meuhedet-Northern Region, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
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Bizzego A, Lim M, Schiavon G, Esposito G. Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7009. [PMID: 32992729 PMCID: PMC7579206 DOI: 10.3390/ijerph17197009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022]
Abstract
Little is known about parenting in the context of developmental disabilities in low- and middle-income countries (LMIC), penalized by both lack of data and a research bias toward western societies. In this study, we apply data mining methods on a large (N = 25,048) dataset from UNICEF to highlight patterns of association between developmental disabilities of children and parental involvement. We focus on the co-presence of multiple disabilities and the quality of childcare in three parenting domains: discipline, caregiving, and education. Our results show that, in LMIC, children with more severe developmental conditions are also more likely to receive low-quality parental care. Specific policies of parental training are needed to improve parental practices in LMIC.
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Affiliation(s)
- Andrea Bizzego
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (A.B.); (G.S.)
| | - Mengyu Lim
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 636921, Singapore;
| | - Greta Schiavon
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (A.B.); (G.S.)
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy; (A.B.); (G.S.)
- Psychology Program, School of Social Sciences, Nanyang Technological University, Singapore 636921, Singapore;
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
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30
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Coller RJ, Komatz K. Children with Medical Complexity and Neglect: Attention Needed. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:293-298. [PMID: 33088386 PMCID: PMC7561630 DOI: 10.1007/s40653-017-0154-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Ryan J. Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Madison, WI 53792 USA
| | - Kelly Komatz
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville, FL USA
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Okazaki K, Ota T, Makinodan M, Kishimoto N, Yamamuro K, Ishida R, Takahashi M, Yasuda Y, Hashimoto R, Iida J, Kishimoto T. Associations of childhood experiences with event-related potentials in adults with autism spectrum disorder. Sci Rep 2020; 10:13447. [PMID: 32778726 PMCID: PMC7417533 DOI: 10.1038/s41598-020-70409-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 07/09/2020] [Indexed: 12/16/2022] Open
Abstract
Childhood maltreatment is defined as experiencing of physical, emotional and sexual abuse and neglect in childhood. Maltreatment in childhood leads to substantial psychosocial problems later in life in the general population. Individuals with autism spectrum disorder (ASD) have a higher risk of experiencing stressful and traumatic events, such as maltreatment, during childhood. Although childhood maltreatment reportedly leads to psychosocial problems in adults with ASD, the biological associations between childhood experiences and brain function in this population remain understudied. Here, we evaluated the relationships between childhood experiences and event-related potential (ERP) components during the auditory odd-ball task in adults with ASD (N = 21) and typically developed (TD) individuals (N = 22). We found that the higher the severity of sexual abuse, the larger the amplitude of P300 at Fz, Cz, C3, and C4 in individuals with ASD. Conversely, the severity of child maltreatment was associated with P300 latency at Cz and C3 in TD individuals. Moreover, full IQ was significantly associated with the MMN amplitude at Fz, Cz, C3, and C4 in TD individuals. These findings provide the first evidence that ERPs could be used to study the impacts childhood experiences on the brain of individuals with ASD and that childhood sexual abuse has salient impacts on brain function in this population.
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Affiliation(s)
- Kosuke Okazaki
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Toyosaku Ota
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
| | - Naoko Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Kazuhiko Yamamuro
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Rio Ishida
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Masato Takahashi
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
| | - Yuka Yasuda
- Life Grow Brilliant Mental Clinic, Osaka, Japan.,Department of Pathology of Mental Disease, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Disease, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Junzo Iida
- Faculty of Nursing, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan
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Weaver MS, Hauschild K, Beavers AJ, Birge N, Lisowyj E, Norton BM, Shostrom VK, Haney S. Bone fractures in children with trisomy 13 and 18. Am J Med Genet A 2020; 182:2187-2190. [PMID: 32648347 DOI: 10.1002/ajmg.a.61745] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Meaghann S Weaver
- Division of Palliative Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kelly Hauschild
- Division of Cardiac Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Angela J Beavers
- Division of Pediatric Radiology, Department of Radiology, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Nicole Birge
- Division of Neonatology, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Elizabeth Lisowyj
- Division of Nutrition, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Bridget M Norton
- Division of Critical Care, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Valerie K Shostrom
- Division of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Suzanne Haney
- Division of Child Abuse Pediatrics, Department of Pediatrics, Children's Hospital and Medical Center and the University of Nebraska Medical Center, Omaha, Nebraska, USA
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Fortin K, Bertocci G, Nicholas JL, Lorenz DJ, Pierce MC. Long bone fracture characteristics in children with medical conditions linked to bone health. CHILD ABUSE & NEGLECT 2020; 103:104396. [PMID: 32135374 DOI: 10.1016/j.chiabu.2020.104396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Knowledge of fracture characteristics among children with medical conditions affecting bone could help to distinguish medical causes from child abuse. OBJECTIVE Characterize long bone fracture morphology among children diagnosed with medical conditions linked to bone health. PARTICIPANTS AND SETTING Patients <18 years at a single pediatric hospital diagnosed with a medical condition linked to bone health and ≥1 long bone fracture were studied. METHODS This retrospective medical record review categorized underlying medical diagnoses as: metabolic bone disease, genetic disorder of connective tissue, neurologic disorder and other chronic disease. A pediatric radiologist reviewed plain films to determine fracture type and location. Descriptive statistics, as well as logistic regression were used to compare fracture types by clinical characteristics. RESULTS Ninety-four patients were included and their diagnoses were genetic connective disorder (19; 20.2 %), metabolic bone disease (16; 17.0 %), neurologic disorder (27; 28.7 %), and other (32; 34.0 %). A total of 216 long bone fractures were sustained; 52.1 % of children had >1 long bone fracture. Of the 216 fractures, 55 (25.5 %) were in children < 1 year, 118 (54.6 %) were associated with known trauma, and 122 (56.5 %) were in non-ambulatory patients. Lower extremity fractures occurred with greatest frequency and most fractures occurred at the mid-diaphysis. Transverse was the most common fracture type in all diagnostic categories. Children with metabolic disorders had highest odds of transverse fracture (COR 3.55, CI 1.45-8.67; neurologic disorders as reference group). CONCLUSIONS Diseases affecting bone health can influence fracture morphology. Transverse fractures were most common in bones impacted by disease.
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Affiliation(s)
- Kristine Fortin
- Perelman School of Medicine at the University of Pennsylvania, Division of General Pediatrics, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States.
| | - Gina Bertocci
- Department of Bioengineering, University of Louisville, J.B. Speed School of Engineering, 500 S. Preston St., Louisville, KY 40202, United States.
| | | | - Douglas John Lorenz
- University of Louisville School of Public Health & Information Sciences, 485 E. Gray St., Louisville, KY 40202, United States.
| | - Mary Clyde Pierce
- Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, Il 60611, United States
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34
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Neurodisability among Children at the Nexus of the Child Welfare and Youth Justice System. J Youth Adolesc 2020; 50:803-819. [PMID: 32300912 PMCID: PMC7979606 DOI: 10.1007/s10964-020-01234-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/24/2020] [Indexed: 01/05/2023]
Abstract
Although neurodisability features significantly across child welfare and youth justice cohorts, little research investigates neurodisability among crossover children with dual systems involvement. This study examined differences in childhood adversity, child protection involvement, and offending among crossover children by neurodisability status. Data were from a sample of 300 children (68% male, 31% female, 1% transgender; mean age = 16.2 years, range 10–21) who were charged and appeared in three Australian children’s courts, and who also had statutory child protection involvement in the study jurisdiction. The results indicated that nearly one-half of crossover children had a neurodisability (48%) and this group experienced greater cumulative maltreatment and adversity, earlier out-of-home care entry and offending onset, more caregiver relinquishment and residential care placement, and a greater volume of charges. While substantial differences between specific neurodisabilities were evident, crossover children with any neurodisability had greater odds of having charges related to criminal damage and motor vehicle theft, however they were no more likely to have violent charges relative to other crossover children. The study’s findings demonstrated that the prevalence of neurodisability, and child welfare system responses to this phenomenon, contributes to several offending-related trends observed among crossover children.
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35
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Haruvi-Lamdan N, Horesh D, Zohar S, Kraus M, Golan O. Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:884-898. [PMID: 32245333 DOI: 10.1177/1362361320912143] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
LAY ABSTRACT People with Autism Spectrum Disorder show an increased risk of experiencing traumatic events, particularly social victimization. However, Autism Spectrum Disorder and Post-Traumatic Stress Disorder co-occurrence was hardly studied. We examined exposure to traumatic life events and Post-Traumatic Stress Disorder symptoms in adults with Autism Spectrum Disorder vs typical adults. Two groups took part in this study: Twenty-five adults with Autism Spectrum Disorder and 25 typical adults of similar age and male to female ratio. Participants completed questionnaires on potentially traumatic life events of social and non-social nature, as well as on Post-Traumatic Stress Disorder symptoms related to their most distressing event. Participants also filled out an autism traits questionnaire. Results showed a higher Post-Traumatic Stress Disorder rate in the Autism Spectrum Disorder group (32%) compared with the typical group (4%). Individuals with Autism Spectrum Disorder reported more Post-Traumatic Stress Disorder symptoms, particularly re-experiencing and increased physiological arousal, compared with typical adults, although the latter was elevated only in females with Autism Spectrum Disorder. Participants with Autism Spectrum Disorder, especially females, reported more negative life events, particularly social events, than typical adults. Sixty percent of Autism Spectrum Disorder participants, but only 20% of typical participants, chose a social event as their most distressing event. Individuals with Autism Spectrum Disorder who were also suspected as having Post-Traumatic Stress Disorder (based on their questionnaires) presented poorer social skills compared with those with Autism Spectrum Disorder alone. Results indicate that individuals with Autism Spectrum Disorder are more susceptible to trauma and Post-Traumatic Stress Disorder, particularly due to social stressors. Females with Autism Spectrum Disorder may be especially vulnerable to Post-Traumatic Stress Disorder.
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Affiliation(s)
| | - Danny Horesh
- Bar-Ilan University, Israel.,New York University, USA.,Autism Treatment & Research Center, Association for Children at Risk, Israel
| | | | | | - Ofer Golan
- Bar-Ilan University, Israel.,Autism Treatment & Research Center, Association for Children at Risk, Israel.,University of Cambridge, UK
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36
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Reese S, Deutsch SA. Sexual Assault Victimization Among Children and Youth With Developmental Disabilities: Responding With Trauma-Informed Care. JOURNAL OF FORENSIC NURSING 2020; 16:55-60. [PMID: 32068678 DOI: 10.1097/jfn.0000000000000278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual assault victimization is a traumatic experience for children and youth, and care of survivors requires a trauma-informed approach. Children and youth with developmental disabilities are sexually victimized at higher rates than those without disabilities. Children with autism spectrum disorder (ASD), in particular, may be at an increased risk for both traumatic events and developing traumatic sequelae after sexual assault victimization. In this report, we present the case of a youth with ASD who sought acute sexual assault care, but whose care was compromised because of multiple systems failures, including gaps in communication regarding her unique needs, and inconsistent knowledge among multidisciplinary team members regarding necessary adaptations in the implementation of trauma-informed care for youth with ASD. Lessons learned, including proposed solutions to improve communication and education, and approaches to prevent unintended retraumatization are discussed.
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37
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Peterson JL, Earl R, Fox EA, Ma R, Haidar G, Pepper M, Berliner L, Wallace A, Bernier R. Trauma and Autism Spectrum Disorder: Review, Proposed Treatment Adaptations and Future Directions. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:529-547. [PMID: 31819782 PMCID: PMC6901292 DOI: 10.1007/s40653-019-00253-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Empirical investigations of trauma and post-traumatic stress disorder (PTSD) in individuals with autism spectrum disorder (ASD) are lacking despite indications of increased risk for exposure to potentially traumatic events in this population. Research on the treatment of traumatic stress psychopathology in ASD is even more limited and suggests a critical need for guidance in the area of ASD-specific treatment adaptations. The current paper provides preliminary recommendations for adapting current evidenced-based, trauma-specific interventions, specifically trauma-focused cognitive behavioral therapy (TF-CBT), for individuals with ASD based on well-established and evidence-based practices for working with this population. These adaptations highlight the need to incorporate treatment goals related to ASD core symptoms and associated characteristics during treatment targeting traumatic stress symptoms. Future directions are discussed, including the development of instruments measuring trauma reactions in ASD, empirical investigations of modified trauma interventions for children with ASD to evaluate effectiveness, and collaboration between professionals specializing in ASD and trauma/PTSD to advance research and facilitate effective care for this community.
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Affiliation(s)
- Jessica L Peterson
- Seattle Children's Autism Center, , 4909 25th Ave NE, Seattle, WA 98105, M/S CAC, PO Box 5371, Seattle, WA 98145-5005
| | - Rachel Earl
- University of Washington, Psychiatry and Behavioral Sciences / Seattle Children's Hospital
| | - Emily A Fox
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA / Seattle Children's Hospital, M/S CAC PO Box 5371, 508.851.0996
| | - Ruqian Ma
- University of Washington College of Education and Department of Psychiatry & Behavioral Sciences, CHDD Box 357920, Seattle, WA 98195
| | - Ghina Haidar
- University of Washington College of Education & Department of Psychiatry and Behavioral Sciences, CHDD Box 357920, Seattle, WA 98195
| | - Micah Pepper
- University of Washington Department of Psychiatry and Behavioral Sciences, CHDD Box 357920, Seattle, WA 98195
| | - Lucy Berliner
- University of Washington Medicine, Mailing Address: 325 Ninth Avenue, MS 359947 Seattle, WA 98104, 206 744-1600 (main line)
| | - Arianne Wallace
- University of Washington Department of Psychiatry and Behavioral Sciences, CHDD Box 357920, Seattle, WA 98195
| | - Raphael Bernier
- Department of Psychiatry & Behavioral Sciences, University of Washington, ,
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Abstract
Despite significant declines over the past 2 decades, the United States continues to experience birth rates among teenagers that are significantly higher than other high-income nations. Use of emergency contraception (EC) within 120 hours after unprotected or underprotected intercourse can reduce the risk of pregnancy. Emergency contraceptive methods include oral medications labeled and dedicated for use as EC by the US Food and Drug Administration (ulipristal and levonorgestrel), the "off-label" use of combined oral contraceptives, and insertion of a copper intrauterine device. Indications for the use of EC include intercourse without use of contraception; condom breakage or slippage; missed or late doses of contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring, and injectable contraception; vomiting after use of oral contraceptives; and sexual assault. Our aim in this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on the safety, efficacy, and use of EC in teenagers; and (3) encourage routine counseling and advance EC prescription as 1 public health strategy to reduce teenaged pregnancy.
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O’Sullivan D, Watts JR, Strauser DR. Trauma-sensitive rehabilitation counseling: Paradigms and principles. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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40
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Verlenden JV, Bertolli J, Warner L. Contraceptive Practices and Reproductive Health Considerations for Adolescent and Adult Women with Intellectual and Developmental Disabilities: A Review of the Literature. SEXUALITY AND DISABILITY 2019; 37:541-557. [PMID: 33005065 PMCID: PMC7527256 DOI: 10.1007/s11195-019-09600-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Whereas progress has been made on increasing access to comprehensive healthcare for individuals with intellectual and developmental disabilities (I/DD), disparities continue in health outcomes, including those related to the reproductive health of adolescent and adult women with I/DD. This review summarizes reproductive care considerations for adolescent and adult women with I/DD and current practices regarding the delivery of contraceptive services to these women. Forty-seven (47) articles based on research conducted in the US between 1999 and 2019 were selected for inclusion in the review. Primary themes discussed include (1) common reproductive health concerns for adolescent and adult women with I/DD, other than pregnancy prevention; (2) contraceptive methods and disability-related concerns; (3) informed consent and reproductive decision-making; and (4) provider knowledge and education. The management of menses and hormonal dysregulation were identified as concerns that providers encounter among patients with I/DD and their families. Disability-related concerns with regard to use of contraception in general and considerations regarding certain methods in particular include challenges with prescription adherence, physical effects of hormonal therapies, drug interactions for individuals with additional health conditions, and legal and ethical concerns involved with decision-making and consent. The results of this review also suggest that focused efforts in partnership with health care providers may be needed to address barriers that adolescent and adult women with I/DD face when trying to obtain quality reproductive health services and contraceptive guidance.
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Affiliation(s)
- Jorge V. Verlenden
- Morehouse School of Medicine, Satcher Health Leadership Institute, Atlanta, USA
- Atlanta, USA
| | - Jeanne Bertolli
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, USA
| | - Lee Warner
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, USA
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Crouch E, Radcliff E, Brown M, Hung P. Exploring the association between parenting stress and a child's exposure to adverse childhood experiences (ACEs). CHILDREN AND YOUTH SERVICES REVIEW 2019; 102:186-192. [PMID: 32489224 PMCID: PMC7266302 DOI: 10.1016/j.childyouth.2019.05.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Nearly half of U.S. children age 0-17 have been exposed to adverse childhood experiences (ACEs), accounting for over 34 million of children nationwide. Parenting stress (negative feelings related to the demands of parenting) is a primary risk factor for child maltreatment and neglect; yet has been an overlooked factor for ACEs. Understanding the degree of parenting stress and its subsequent associations with ACEs will facilitate future designations of relevant interventions to keep children safe. We analyzed 2016 data from the National Survey of Children's Health to examine whether increased levels of parenting stress are associated with higher counts of ACEs among children. About 4.4% of caregivers reported "high parenting stress" and children living with them were three times more likely (OR: 3.05; 95% CI: 2.23-4.15) to experience four or more ACEs by the age of 18. Lowering parenting stress through parenting interventions could decrease the level of childhood trauma experienced by a child or may lessen one type of stress in a home where many other stressors exist.
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Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, USA
| | - Elizabeth Radcliff
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, USA
| | - Monique Brown
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Peiyin Hung
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 204, Columbia, SC 29210, USA
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Stack A, Lucyshyn J. Autism Spectrum Disorder and the Experience of Traumatic Events: Review of the Current Literature to Inform Modifications to a Treatment Model for Children with Autism. J Autism Dev Disord 2019; 49:1613-1625. [PMID: 30539370 DOI: 10.1007/s10803-018-3854-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Children with autism incur trauma and have increased vulnerabilities for experiencing trauma. This paper summarizes the current literature in the study of trauma in typically developing children and those with autism. A treatment model for children with autism, drawing on components from cognitive behavior therapy (CBT), trauma-focused CBT, and CBT to teach emotion regulation and treat anxiety in children with autism is suggested. Components include: (a) Functional Behavior Assessment; (b) behavior plans and behavioral skills training; (c) teaching emotion regulation; (d) exposure therapy; (e) cognitive restructuring; (f) parent and child support between sessions; (g) safety plan; and (h) programming for generalization and maintenance. Future research should establish evidence-based treatment of trauma in this population by evaluating the modified treatment package.
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Affiliation(s)
- Alexia Stack
- A Block Above Behavioral Consulting, 3185 Sunnyhurst Rd., North Vancouver, BC, V7K 2G4, Canada.
| | - Joseph Lucyshyn
- Department of Educational and Counselling Psychology, Faculty of Education, University of British Columbia, 2125 Main Mall, Vancouver, BC, V6T 1Z4, Canada
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Abstract
OBJECTIVES Although there is agreement that childhood disability is both a risk and result of maltreatment, the extent of disability in the child welfare system remains unclear. Our objective is to determine the prevalence and severity of child impairment in a national sample of child abuse and neglect investigations in the United States. METHODS We used data from the National Survey of Child and Adolescent Well-Being II, a study of 2644 children older than 3 years who were subjects of child abuse and neglect investigations. Groups of children were identified by latent profile analysis using continuous standardized measures of intelligence, emotional or behavioral impairments, adaptive behaviors, and social skills. RESULTS Whether the child remained in home or was removed to foster care after an investigation, 3 classes of children were identified: (1) slightly over one-tenth were in an intellectual disability subgroup characterized by marked intellectual impairments alongside delays in daily living functioning, (2) over one-third were in an emotional or behavioral impairment subgroup characterized by both frequent and severe internalizing and externalizing behaviors, and (3) slightly over half were in a typically developing subgroup. CONCLUSION When using standardized measures of disability, nearly half of the children investigated by child protection in the United States are not typically developing. These findings suggest that those working for the child welfare system need to be attentive to the complex needs of children with intellectual disabilities and emotional or behavioral impairments and their families, many of whom are under significant stress.
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Tuakli-Wosornu YA, Sun Q, Gentry M, Ona Ayala KE, Doolan FC, Ottesen TD, Caldwell B, Naushad N, Huang P, Kirby S. Non-accidental harms (‘abuse’) in athletes with impairment (‘para athletes’): a state-of-the-art review. Br J Sports Med 2019; 54:129-138. [DOI: 10.1136/bjsports-2018-099854] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2019] [Indexed: 11/03/2022]
Abstract
ObjectivePara athletes reap significant health benefits from sport but are vulnerable to non-accidental harms. Little is known about the types and impacts of non-accidental harms Para athletes face. In this literature review, we summarise current knowledge and suggest priorities for future research related to non-accidental harms in Para athletes.DesignSix electronic databases were searched between August and September 2017. 2245 articles were identified in the initial title/abstract review, and 202 records were selected for full-text review following preliminary screening. Two independent examiners evaluated each full text, and eight citations were selected based on inclusion/exclusion criteria.Data sourcesMEDLINE, Embase, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, Scopus and Academic Search Premier.Eligibility criteria for selecting studiesInclusion criteria: (A) human participants; (B) written in English; (C) descriptive, cohort and case series, case–control, qualitative, mixed methods studies and all clinical trials; and (D) data pertain to harassment/abuse of youth, recreational, collegiate, national-level and/or elite-level athletes with a physical and/or intellectual impairment.ResultsMost studies focused on young, visually impaired athletes and approximately half of all studies described high rates of bullying and its social implications. One study confirmed remarkably high rates of psychological, physical and sexual harms in Para athletes, compared with able-bodied peers.ConclusionsBullying in young, visually impaired athletes is described most commonly in the available literature. Due to the limited amount of data, the prevalence of non-accidental harms in Para athletes remains unclear and information on trends over time is similarly unavailable.
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Rao T, Reiman E, Ausikaitis A. Child Welfare Caseworkers and Children with Developmental Disabilities: An Exploratory Study. SOCIAL WORK 2019; 64:131-138. [PMID: 30715530 DOI: 10.1093/sw/swz004] [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: 05/22/2018] [Revised: 09/06/2018] [Accepted: 10/11/2018] [Indexed: 06/09/2023]
Abstract
Children with developmental disabilities are overrepresented in the child welfare system. Although caseworkers play a key role in ensuring that the special needs of these children are met, little is known regarding caseworkers' knowledge about, exposure to, and comfort with people with developmental disabilities. In this exploratory study, through use of an online anonymous survey, local county caseworkers (N = 251) were asked to self-rate their knowledge, exposure, and comfort levels. Findings indicated caseworker agreement regarding the relevance of having knowledge and training about this population within the child welfare system. Furthermore, caseworkers with more training felt more knowledgeable and comfortable than those with less training. In addition, personal exposure to individuals with developmental disabilities was considered relevant.
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Affiliation(s)
- Trupti Rao
- Trupti Rao, PsyD, is director of psychology training; Elizabeth Reiman, PhD, LCSW-R, is coordinator of forensic and clinical services; and Ashley Ausikaitis, PhD, NCSP, is psychology postdoctoral fellow, Westchester Institute for Human Development, Valhalla, NY
| | - Elizabeth Reiman
- Trupti Rao, PsyD, is director of psychology training; Elizabeth Reiman, PhD, LCSW-R, is coordinator of forensic and clinical services; and Ashley Ausikaitis, PhD, NCSP, is psychology postdoctoral fellow, Westchester Institute for Human Development, Valhalla, NY
| | - Ashley Ausikaitis
- Trupti Rao, PsyD, is director of psychology training; Elizabeth Reiman, PhD, LCSW-R, is coordinator of forensic and clinical services; and Ashley Ausikaitis, PhD, NCSP, is psychology postdoctoral fellow, Westchester Institute for Human Development, Valhalla, NY
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Child Developmental Disabilities, Caregivers' Role in Kenya and Its Implications on Global Migration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061010. [PMID: 30897762 PMCID: PMC6466070 DOI: 10.3390/ijerph16061010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 11/16/2022]
Abstract
Background: This paper is a summary of the findings from an ethnographic study on child developmental disabilities conducted partly in Nairobi and Kiambu Counties in Kenya. Methods: Quantitative and qualitative data collection methods were applied for the period between mid August and mid November 2018. The study was conducted through the Kenya Institute of Special Education (KISE) situated in Nairobi County. Results: There are parents who are willing to migrate in search of better education and healthcare options for their children who have developmental disabilities (DDs). However, there are also government reforms taking place in the field of disability that may help to support the caregiving role for children with special needs. The challenges, bargaining position and power play between parents or guardians and other actors implicated in the debates on inclusion and integration of persons with developmental disabilities in Kenya has been brought to the forefront. Conclusions: In Kenya, more needs to be done to change the attitude towards disability from the medical and moral (religious/cultural) models to an approach leaning towards the social model, so that developmental disabilities are not viewed negatively.
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Cidav Z, Xie M, Mandell DS. Foster Care Involvement Among Medicaid-Enrolled Children with Autism. J Autism Dev Disord 2019; 48:176-183. [PMID: 28929296 DOI: 10.1007/s10803-017-3311-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The prevalence and risk of foster care involvement among children with autism spectrum disorder (ASD) relative to children with intellectual disability (ID), children with ASD and ID, and typically developing children were examined using 2001-2007 Medicaid data. Children were followed up to the first foster care placement or until the end of 2007; a discrete time logistic regression analysis was conducted. Both the prevalence and risk of foster care involvement were greatest for children with ASD, and the prevalence increased substantially over the study period among children with ASD. Continued examination of the factors contributing to the higher risk of foster placement is warranted to unravel the complex circumstances facing these vulnerable children and their families.
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Affiliation(s)
- Zuleyha Cidav
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA. .,Leonard Davis Institute of Economics, University of Pennsylvania, Philadelphia, PA, USA.
| | - Ming Xie
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA
| | - David S Mandell
- Center for Mental Health Policy and Services Research, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd Floor, Philadelphia, PA, 19104, USA.,Leonard Davis Institute of Economics, University of Pennsylvania, Philadelphia, PA, USA
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Mills R, Kisely S, Alati R, Strathearn L, Najman JM. Cognitive and educational outcomes of maltreated and non-maltreated youth: A birth cohort study. Aust N Z J Psychiatry 2019; 53:248-255. [PMID: 29696988 DOI: 10.1177/0004867418768432] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Previous research suggests that child maltreatment is associated with adverse outcomes, but the potential impact on cognitive and educational outcomes into adulthood has rarely been studied using a birth cohort design. The aim of this study is to investigate whether child maltreatment is associated with adverse outcomes in cognitive function, high school completion and employment by the age of 21. METHODS Longitudinal birth cohort study commencing in the prenatal period, with mothers and infants followed up to age 21. Of the original birth cohort of 7223, 3778 (52.3%) young people participated at age 21. Child maltreatment was identified by linkage with prospectively collected data from the relevant government agency. Associations between child maltreatment (abuse and neglect) and the outcomes were adjusted for relevant sociodemographic and perinatal variables. RESULTS After full adjustment, young people who had been notified as cases of child maltreatment had reduced performance on the Peabody Picture Vocabulary Test by over a quarter of a standard deviation (coefficient = -2.85, p = 0.004). Maltreated young people also had three times the odds of failing to complete high school (odds ratio = 3.12, p < 0.001) and more than twice the odds of not being engaged in either study or employment at age 21 (odds ratio = 2.38, p < 0.001). Both abuse and neglect were similarly associated with adverse outcomes. CONCLUSION Child maltreatment, including both abuse and neglect, is associated with adverse cognitive, educational and employment outcomes in young adulthood. This adds further impetus to efforts to prevent child maltreatment and assist young people who have experienced it.
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Affiliation(s)
- Ryan Mills
- 1 School of Medicine, The University of Queensland, Herston, QLD, Australia.,2 Department of Paediatrics, Logan Hospital, Meadowbrook, QLD, Australia
| | - Steve Kisely
- 1 School of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Rosa Alati
- 3 Institute for Social Science Research, The University of Queensland, Herston, QLD, Australia
| | - Lane Strathearn
- 4 Division of Developmental and Behavioral Pediatrics, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Jake M Najman
- 5 Queensland Alcohol and Drug Research and Education Centre, School of Public Health and School of Social Sciences, The University of Queensland, Herston, QLD, Australia
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Verd S, Aguiló G, Kraemer M, Fernández M, Servera C, Colom M, Palmer P, López-Sureda M, Juan M, Ripoll J, Llobera J. Past medical history: A comparison between children at the point of entry into the care system and children at home. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/15379418.2018.1521761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sergio Verd
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Gloria Aguiló
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Milanka Kraemer
- Family Medicine Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Mercedes Fernández
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Catalina Servera
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Marina Colom
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Patricia Palmer
- Family Medicine Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Mar López-Sureda
- Pediatric Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Marta Juan
- Child Protection Department, Majorcan Local Authority, Palma de Mallorca, Spain
| | - Joana Ripoll
- Research Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
| | - Juan Llobera
- Research Unit, Department of Primary Care, Balearic Health Authority, Palma de Mallorca, Spain
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Mattson G, Kuo DZ, Yogman M, Baum R, Gambon TB, Lavin A, Esparza RM, Nasir AA, Wissow LS, Apkon S, Brei TJ, Davidson LF, Davis BE, Ellerbeck KA, Hyman SL, Leppert MO, Noritz GH, Stille CJ, Yin L. Psychosocial Factors in Children and Youth With Special Health Care Needs and Their Families. Pediatrics 2019; 143:peds.2018-3171. [PMID: 30559121 DOI: 10.1542/peds.2018-3171] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Children and youth with special health care needs (CYSHCN) and their families may experience a variety of internal (ie, emotional and behavioral) and external (ie, interpersonal, financial, housing, and educational) psychosocial factors that can influence their health and wellness. Many CYSHCN and their families are resilient and thrive. Medical home teams can partner with CYSHCN and their families to screen for, evaluate, and promote psychosocial health to increase protective factors and ameliorate risk factors. Medical home teams can promote protective psychosocial factors as part of coordinated, comprehensive chronic care for CYSHCN and their families. A team-based care approach may entail collaboration across the care spectrum, including youth, families, behavioral health providers, specialists, child care providers, schools, social services, and other community agencies. The purpose of this clinical report is to raise awareness of the impact of psychosocial factors on the health and wellness of CYSHCN and their families. This clinical report provides guidance for pediatric providers to facilitate and coordinate care that can have a positive influence on the overall health, wellness, and quality of life of CYSHCN and their families.
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Affiliation(s)
- Gerri Mattson
- Children and Youth Branch, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina; and
| | - Dennis Z. Kuo
- Department of Pediatrics, University at Buffalo, Buffalo, New York
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