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Aranbarri A, Aizpitarte A, Arranz-Freijo E, Fano E, de Miguel MS, Stahmer AC, Ibarluzea JM. What influences early cognitive development? Family context as a key mediator. Journal of Applied Developmental Psychology 2023. [DOI: 10.1016/j.appdev.2022.101480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Aranbarri A, Stahmer AC, Talbott MR, Miller ME, Drahota A, Pellecchia M, Barber AB, Griffith EM, Morgan EH, Rogers SJ. Examining US Public Early Intervention for Toddlers With Autism: Characterizing Services and Readiness for Evidence-Based Practice Implementation. Front Psychiatry 2021; 12:786138. [PMID: 34975582 PMCID: PMC8716593 DOI: 10.3389/fpsyt.2021.786138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/24/2021] [Indexed: 12/15/2022] Open
Abstract
As the rates of Autism Spectrum Disorder (ASD) increase and early screening efforts intensify, more toddlers with high likelihood of ASD are entering the United States' (US') publicly funded early intervention system. Early intervention service delivery for toddlers with ASD varies greatly based on state resources and regulations. Research recommends beginning ASD-specific evidence-based practices (EBP), especially caregiver-implemented intervention, as early as possible to facilitate the development of social-communication skills and general learning. Translating EBP into practice has been challenging, especially in low-resourced areas. The main goal of this study was to obtain a more comprehensive understanding of public early intervention system structure, service delivery practices, and factors influencing EBP use for children with ASD in the US. Participants (N = 133) included 8 early intervention state coordinators in 7 states, 29 agency administrators in those states, 57 early intervention providers from those agencies, and 39 caregivers of children with ASD receiving services from those providers. Online surveys gathered stakeholder and caregiver perspectives on early intervention services as well as organizational factors related to EBP implementation climate and culture. Stakeholders identified key intervention needs for young children with ASD. In general, both agency administrators and direct providers reported feeling somewhat effective or very effective in addressing most needs of children with ASD. They reported the most difficulty addressing eating, sleeping, family stress, and stereotyped behaviors. Data indicate that children from families with higher income received significantly higher service intensity. While administrators and providers reported high rates of high-quality caregiver coaching (>60%), caregivers reported low rates (23%). Direct providers with more favorable attitudes toward EBP had greater EBP use. In turn, provider attitudes toward EBP were significantly associated with implementation leadership and culture at their agency. Results suggest that publicly funded early intervention programs in the US require additional resources and training for providers and leaders to support improved implementation climate and attitudes toward ASD EBPs. Results also suggest that more state system support is needed to increase use of ASD-specific EBP use, including high-quality caregiver coaching, to better serve toddlers with ASD. Recommendations for implementation strategies are addressed.
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Affiliation(s)
- Aritz Aranbarri
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- Child and Adolescent Mental Health Area, Psychiatry and Psychology, Hospital Sant Joan de Déu Barcelona, Esplugues de Llobregat, Spain
- Child and Adolescent Mental Health Research Group, Psychiatry and Psychology, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Aubyn C. Stahmer
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Meagan R. Talbott
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Marykate E. Miller
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Amy Drahota
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Melanie Pellecchia
- Center for Mental Health, Psychiatry Department, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States
| | - Angela B. Barber
- Department of Communicative Disorders, University of Alabama, Tuscaloosa, AL, United States
| | | | - Elizabeth H. Morgan
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
- College of Education, California State University, Sacramento, CA, United States
| | - Sally J. Rogers
- Collaborative START Lab, The MIND Institute, Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
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Stahmer AC, Vejnoska S, Iadarola S, Straiton D, Segovia FR, Luelmo P, Morgan EH, Lee HS, Javed A, Bronstein B, Hochheimer S, Cho E, Aranbarri A, Mandell D, Hassrick EM, Smith T, Kasari C. Caregiver Voices: Cross-Cultural Input on Improving Access to Autism Services. J Racial Ethn Health Disparities 2019; 6:752-773. [PMID: 30859514 PMCID: PMC6936957 DOI: 10.1007/s40615-019-00575-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/17/2019] [Accepted: 02/12/2019] [Indexed: 01/16/2023]
Abstract
Decades of research have established that racial ethnic minority, low-income, and/or non-English speaking children with autism spectrum disorder (ASD) are diagnosed later than white children, and their families experience greater difficulty accessing services in the USA. Delayed access to timely diagnosis and early intervention may impact child outcomes and family quality of life. Despite their cognition of these disparities and their significant impact on the lives of those affected, explanations for the barriers experienced by underserved families are elusive, likely due to the complex interaction between structural and family factors. This study used qualitative methods to gather family and provider perspectives of perceived barriers and facilitators to obtaining an ASD diagnosis and accessing ASD-related services for underserved families. Themes from focus groups and interviews with families from three cultural groups (black, Hispanic/Latino, and Korean) and three primary languages (English, Korean, and Spanish) highlight specific barriers related to family, community, and systemic challenges as well as facilitators to accessing care for these populations. Family experiences are expanded upon with viewpoints from the providers who work with them. Recommendations are made for reducing disparities in the existing ASD service system including increasing professional, family, and community education; increasing culturally responsive care; improving provider-family partnerships; and addressing practical challenges to service access.
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Affiliation(s)
- Aubyn C Stahmer
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA.
| | - Sarah Vejnoska
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Suzannah Iadarola
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Diondra Straiton
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
- Department of Psychology, Michigan State University, 316 Physics, Rd., East Lansing, MI, 48824, USA
| | - Francisco Reinosa Segovia
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Paul Luelmo
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
- Department of Special Education, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Elizabeth H Morgan
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
| | - Hyon Soo Lee
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
| | - Asim Javed
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Briana Bronstein
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Samantha Hochheimer
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - EunMi Cho
- College of Education, California State University, Sacramento, 6000 J St., Sacramento, CA, 95819, USA
| | - Aritz Aranbarri
- Departments of Psychiatry, Psychology & Human Development, University of California, Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA
- Mental Health Department, Sant Juan de Deu Barcelona Children's Hospital, Itaka Building 1st floor, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Catalonia, Spain
| | - David Mandell
- Perelman School of Medicine, Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market St., Rm. 3100, Philadelphia, PA, 19104, USA
| | - Elizabeth McGhee Hassrick
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street | Suite 560, Philadelphia, PA, 19104, USA
| | - Tristram Smith
- Division of Developmental and Behavioral Pediatrics & Strong Center for Developmental Disabilities, University of Rochester Medical Center, 265 Crittenden Blvd., Rochester, NY, 14642, USA
| | - Connie Kasari
- Department of Psychiatry, University of California, Los Angeles Graduate School of Education & Information Studies & Center for Autism Research & Treatment, UCLA Semel Institute 68-268, Los Angeles, CA, 90024, USA
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Stahmer AC, Aranbarri A, Drahota A, Rieth S. Toward a more collaborative research culture: Extending translational science from research to community and back again. Autism 2017; 21:259-261. [DOI: 10.1177/1362361317692950] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Aubyn C Stahmer
- Department of Psychiatry and Behavioral Sciences, The MIND Institute, University of California Davis, CA, USA
| | - Aritz Aranbarri
- Department of Psychiatry and Behavioral Sciences, The MIND Institute, University of California Davis, CA, USA
| | - Amy Drahota
- Department of Psychology, Michigan State University, MI, USA
| | - Sarah Rieth
- Department of Child and Family Development, San Diego State University, CA, USA
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Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, Porta D, Giorgis-Allemand L, Almqvist C, Aranbarri A, Beelen R, Badaloni C, Cesaroni G, de Nazelle A, Estarlich M, Forastiere F, Forns J, Gehring U, Ibarluzea J, Jaddoe VW, Korek M, Lichtenstein P, Nieuwenhuijsen MJ, Rebagliato M, Slama R, Tiemeier H, Verhulst FC, Volk HE, Pershagen G, Brunekreef B, Sunyer J. Air Pollution Exposure during Pregnancy and Childhood Autistic Traits in Four European Population-Based Cohort Studies: The ESCAPE Project. Environ Health Perspect 2016; 124:133-40. [PMID: 26068947 PMCID: PMC4710593 DOI: 10.1289/ehp.1408483] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/08/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Prenatal exposure to air pollutants has been suggested as a possible etiologic factor for the occurrence of autism spectrum disorder. OBJECTIVES We aimed to assess whether prenatal air pollution exposure is associated with childhood autistic traits in the general population. METHODS Ours was a collaborative study of four European population-based birth/child cohorts-CATSS (Sweden), Generation R (the Netherlands), GASPII (Italy), and INMA (Spain). Nitrogen oxides (NO2, NOx) and particulate matter (PM) with diameters of ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and between 2.5 and 10 μm (PM(coarse)), and PM2.5 absorbance were estimated for birth addresses by land-use regression models based on monitoring campaigns performed between 2008 and 2011. Levels were extrapolated back in time to exact pregnancy periods. We quantitatively assessed autistic traits when the child was between 4 and 10 years of age. Children were classified with autistic traits within the borderline/clinical range and within the clinical range using validated cut-offs. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. RESULTS A total of 8,079 children were included. Prenatal air pollution exposure was not associated with autistic traits within the borderline/clinical range (odds ratio = 0.94; 95% CI: 0.81, 1.10 per each 10-μg/m3 increase in NO2 pregnancy levels). Similar results were observed in the different cohorts, for the other pollutants, and in assessments of children with autistic traits within the clinical range or children with autistic traits as a quantitative score. CONCLUSIONS Prenatal exposure to NO2 and PM was not associated with autistic traits in children from 4 to 10 years of age in four European population-based birth/child cohort studies. CITATION Guxens M, Ghassabian A, Gong T, Garcia-Esteban R, Porta D, Giorgis-Allemand L, Almqvist C, Aranbarri A, Beelen R, Badaloni C, Cesaroni G, de Nazelle A, Estarlich M, Forastiere F, Forns J, Gehring U, Ibarluzea J, Jaddoe VW, Korek M, Lichtenstein P, Nieuwenhuijsen MJ, Rebagliato M, Slama R, Tiemeier H, Verhulst FC, Volk HE, Pershagen G, Brunekreef B, Sunyer J. 2016. Air pollution exposure during pregnancy and childhood autistic traits in four European population-based cohort studies: the ESCAPE Project. Environ Health Perspect 124:133-140; http://dx.doi.org/10.1289/ehp.1408483.
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Affiliation(s)
- Mònica Guxens
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
- Address correspondence to M. Guxens, Centre for Research in Environmental Epidemiology, Carrer Doctor Aiguader 88, 08003-Barcelona, Spain. Telephone: 34 932147394. E-mail:
| | - Akhgar Ghassabian
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
- The Generation R Study, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Tong Gong
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Raquel Garcia-Esteban
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniela Porta
- Department of Epidemiology Lazio Regional Health Service, Rome Italy
| | - Lise Giorgis-Allemand
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Inserm (National Institute of Health and Medical Research) (U823), Grenoble, France
- University Grenoble-Alpes, Institut Albert Bonniot, Grenoble, France
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Aritz Aranbarri
- Psychobiology area, Department of Basic Psychological Processes and Their Development, Faculty of Psychology, University of The Basque Country (UPV/EHU), Donostia-San Sebastian, Spain
- Health Research Institute BIODONOSTIA, Donostia-San Sebastian, Spain
| | - Rob Beelen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Chiara Badaloni
- Department of Epidemiology Lazio Regional Health Service, Rome Italy
| | - Giulia Cesaroni
- Department of Epidemiology Lazio Regional Health Service, Rome Italy
| | - Audrey de Nazelle
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Centre for Environmental Policy, Imperial College London, London, UK
| | - Marisa Estarlich
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, University of Valencia–University Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
| | | | - Joan Forns
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute BIODONOSTIA, Donostia-San Sebastian, Spain
- Sub-Directorate of Public Health of Gipukzoa, Department of Health, Government of Basque Country, San Sebastian, Spain
| | - Vincent W.V. Jaddoe
- The Generation R Study, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Pediatrics, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Michal Korek
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark J. Nieuwenhuijsen
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marisa Rebagliato
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, University of Valencia–University Jaume I Joint Research Unit of Epidemiology and Environmental Health, Valencia, Spain
- Department of Medicine, University Jaume I, Castelló de la Plana, Spain
| | - Rémy Slama
- Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Inserm (National Institute of Health and Medical Research) (U823), Grenoble, France
- University Grenoble-Alpes, Institut Albert Bonniot, Grenoble, France
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Psychiatry, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Frank C. Verhulst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Heather E. Volk
- Department of Preventive Medicine, and
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles, California, USA
- Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands
| | - Jordi Sunyer
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
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Lertxundi A, Baccini M, Lertxundi N, Fano E, Aranbarri A, Martínez MD, Ayerdi M, Álvarez J, Santa-Marina L, Dorronsoro M, Ibarluzea J. Exposure to fine particle matter, nitrogen dioxide and benzene during pregnancy and cognitive and psychomotor developments in children at 15 months of age. Environ Int 2015; 80:33-40. [PMID: 25881275 DOI: 10.1016/j.envint.2015.03.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 02/14/2015] [Accepted: 03/02/2015] [Indexed: 05/05/2023]
Abstract
BACKGROUND Prenatal exposure to air pollutants has recently been identified as a potential risk factor for neuropsychological impairment. OBJECTIVES To assess whether prenatal exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and benzene were associated with impaired development in infants during their second year of life. METHODS Regression analyses, based on 438 mother-child pairs, were performed to estimate the association between mother exposure to air pollutants during pregnancy and neurodevelopment of the child. The average exposure to PM2.5, NO2 and benzene over the whole pregnancy was calculated for each woman. During the second year of life, infant neuropsychological development was assessed using the Bayley Scales of Infant Development. Regression analyses were performed to estimate the association between exposure and outcomes, accounting for potential confounders. RESULTS We estimated that a 1 μg/m(3) increase during pregnancy in the average levels of PM2.5 was associated with a -1.14 point decrease in motor score (90% CI: -1.75; -0.53) and that a 1 μg/m(3) increase of NO2 exposure was associated with a -0.29 point decrease in mental score (90% CI: -0.47; -0.11). Benzene did not show any significant association with development. Considering women living closer (≤ 100 m) to metal processing activities, we found that motor scores decreased by -3.20 (90% CI: -5.18; -1.21) for PM2.5 and -0.51 (-0.89; -0.13) for NO2, while mental score decreased by -2.71 (90% CI: -4.69; -0.74) for PM2.5, and -0.41 (9% CI: -0.76; -0.06) for NO2. CONCLUSIONS Our findings suggest that prenatal residential exposure to PM2.5 and NO2 adversely affects infant motor and cognitive developments. This negative effect could be higher in the proximity of metal processing plants.
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Affiliation(s)
- Aitana Lertxundi
- Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, Basque Country, Spain; BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain
| | - Michela Baccini
- Department of Statistics, Informatics and Applications "G. Parenti", University of Florence, Italy; Biostatistics Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Nerea Lertxundi
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Faculty of Psychology, University of the Basque Country UPV/EHU, San Sebastian, Basque Country, Spain
| | - Eduardo Fano
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Faculty of Psychology, University of the Basque Country UPV/EHU, San Sebastian, Basque Country, Spain
| | - Aritz Aranbarri
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Faculty of Psychology, University of the Basque Country UPV/EHU, San Sebastian, Basque Country, Spain
| | - Maria Dolores Martínez
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Department of the Environment and Regional Planning, Government of the Basque Country, Vitoria, Spain
| | - Mikel Ayerdi
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Sub-Directorate for Public Health of Guipúzcoa, Department of Health, Government of the Basque Country, San Sebastian, Spain
| | - Jon Álvarez
- Public Health Laboratory, Department of Health, Government of the Basque Country, Bilbao, Spain
| | - Loreto Santa-Marina
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Sub-Directorate for Public Health of Guipúzcoa, Department of Health, Government of the Basque Country, San Sebastian, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Spain
| | - Miren Dorronsoro
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Sub-Directorate for Public Health of Guipúzcoa, Department of Health, Government of the Basque Country, San Sebastian, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Spain
| | - Jesus Ibarluzea
- BIODONOSTIA Health Research Institute, San Sebastian, Basque Country, Spain; Sub-Directorate for Public Health of Guipúzcoa, Department of Health, Government of the Basque Country, San Sebastian, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Spain.
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Velasco D, Sánchez de Miguel M, Egurza M, Arranz E, Aranbarri A, Fano E, Ibarluzea J. Family context assessment in a public health study. Gac Sanit 2014; 28:356-62. [PMID: 24929614 DOI: 10.1016/j.gaceta.2014.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 03/14/2014] [Accepted: 03/20/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To analyze the factorial structure of a new instrument to assess the quality of the family context (Etxadi-Gangoiti Scale) in a sample from the Gipuzkoa cohort of the Environment and Childhood (Infancia y Medio Ambiente [INMA]) study. METHODS Families in a sample of 433 two-year-old children were assessed in a home visit with subsequent analysis of the factorial structure and psychometric properties of the data. RESULTS An exploratory factorial analysis (principal axis factoring and varimax rotation) and a confirmatory factorial analysis were carried out; partial confirmation of the original factorial structure of the instrument was obtained, which revealed the following factorial structures. Subscale (1): promotion of cognitive and linguistic development, social skills, psychomotor skills, and pretend play and imitation; subscale (2): promotion of independence and self-esteem, provision of optimal frustration, social and emotional quality of the relationship, and absence of physical punishment; subscale (3): paternal involvement, low exposure to family conflict, low frequency of family conflict, relationship with the extended family, social support, diversity of experiences, low frequency of stressful events, and low parental perception of stress. DISCUSSION The structure of the original instrument structure was partially confirmed, which was attributed to the characteristics of the sample. We stress the importance of the variability obtained in the evaluation of the families, as well as of adequate indicators of reliability in such evaluation. The new instrument could be used in public health to identify deficient family contexts and to design preventive interventions focused on parenting skills.
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Affiliation(s)
- David Velasco
- Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain
| | | | - Maitane Egurza
- U.P.V-E.H.U-Facultad de Psicología. San Sebastián, Spain
| | - Enrique Arranz
- Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain; U.P.V-E.H.U-Facultad de Psicología. San Sebastián, Spain
| | - Aritz Aranbarri
- Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain; U.P.V-E.H.U-Facultad de Psicología. San Sebastián, Spain
| | - Eduardo Fano
- Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain; U.P.V-E.H.U-Facultad de Psicología. San Sebastián, Spain
| | - Jesús Ibarluzea
- Instituto de Investigación Sanitaria BIODONOSTIA, San Sebastián, Spain; Subdirección de Salud Pública de Gipúzkoa, San Sebastián, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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Rebagliato M, Murcia M, Alvarez-Pedrerol M, Espada M, Fernández-Somoano A, Lertxundi N, Navarrete-Muñoz EM, Forns J, Aranbarri A, Llop S, Julvez J, Tardón A, Ballester F. Iodine supplementation during pregnancy and infant neuropsychological development. INMA Mother and Child Cohort Study. Am J Epidemiol 2013; 177:944-53. [PMID: 23548753 DOI: 10.1093/aje/kws333] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Iodine supplementation during pregnancy is a common practice in developed countries. However, scant evidence is available regarding the safety and effectiveness of maternal iodine supplementation with regard to child neuropsychological development. We previously reported an inverse association between iodine supplementation and the psychomotor development of infants in a birth cohort from Valencia, Spain. In the present study, we assessed this association in a wider sample of mother and child pairs from 3 other regions in Spain. Neuropsychological development was assessed using the Bayley Scales of Infant Development in 1,519 infants (median age, 16 months) between 2006 and 2009. In multivariate analyses, maternal consumption of 150 μg/day or more of iodine from supplements was related to a 1.5-fold increase in the odds of a psychomotor score less than 85 (95% confidence interval: 0.8, 2.9) and to a 1.7-fold increase in the odds of a mental score less than 85 (95% confidence interval: 0.9, 3.0). Findings previously reported in the Valencia cohort were only partially verified. The results of the present study suggest that, at least in these regions, iodine supplementation does not improve infant neuropsychological development at 1 year of age. Further research is needed on the risks and benefits of supplementary iodine for both maternal thyroid function and child neurodevelopment.
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Forns J, Lertxundi N, Aranbarri A, Murcia M, Gascon M, Martinez D, Grellier J, Lertxundi A, Julvez J, Fano E, Goñi F, Grimalt JO, Ballester F, Sunyer J, Ibarluzea J. Prenatal exposure to organochlorine compounds and neuropsychological development up to two years of life. Environ Int 2012; 45:72-77. [PMID: 22575806 DOI: 10.1016/j.envint.2012.04.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/12/2012] [Accepted: 04/14/2012] [Indexed: 05/31/2023]
Abstract
Polychlorinated biphenyls (PCB), hexachlorobenzene (HCB), and dichlorodiphenyl dichloroethylene (pp'DDE) are persistent, bioaccumulative, and toxic environmental pollutants with potential neurotoxic effects. Despite a growing body of studies investigating the health effects associated with these compounds, their specific effects on early neuropsychological development remain unclear. We investigated such neuropsychological effects in a population-based birth cohort based in three regions in Spain (Sabadell, Gipuzkoa, and Valencia) derived from the INMA [Environment and Childhood] Project. The main analyses in this report were based on 1391 mother-child pairs with complete information on maternal levels of organochlorine compounds and child neuropsychological assessment (Bayley Scales of Infant Development) at age 14 months. We found that prenatal PCB exposure, particularly to congeners 138 and 153, resulted in impairment of psychomotor development (coefficient=-1.24, 95% confidence interval=-2.41, -0.07), but found no evidence for effects on cognitive development. Prenatal exposure to pp'DDE or HCB was not associated with early neuropsychological development. The negative effects of exposure to PCBs on early psychomotor development suggest that the potential neurotoxic effects of these compounds may be evident even at low doses.
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Affiliation(s)
- Joan Forns
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
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Forns J, Aranbarri A, Grellier J, Julvez J, Vrijheid M, Sunyer J. A Conceptual Framework in the Study of Neuropsychological Development in Epidemiological Studies. Neuroepidemiology 2012; 38:203-8. [DOI: 10.1159/000337169] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 02/13/2012] [Indexed: 11/19/2022] Open
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