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Russell LA, Tinker SC, Rice CE, Ryerson AB, Gonzalez MG. Variation in identifying children and adolescents with disability and developmental disability in population-based public health surveys. Disabil Health J 2024; 17:101556. [PMID: 38001004 PMCID: PMC10999331 DOI: 10.1016/j.dhjo.2023.101556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/01/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The term "developmental disability" (DD) is inconsistently defined and applied depending on purpose and across sources, including in legislation. OBJECTIVE This project aimed to identify existing definitions of disability and DD and to determine the extent to which each definition could be operationalized to produce prevalence estimates using data from U.S. national surveys. METHODS Using data among children <18 years from the 2016-2018 National Health Interview Survey (NHIS) and National Survey of Children's Health (NSCH), we estimated the prevalence of two definitions of disability (Washington Group Short Set on Functioning, American Community Survey) and seven definitions of DD [Health and Human Services (ever/current), Developmental Disabilities Assistance and Bill of Rights Act of 2000 (1+, 2+, or 3+ components), and Diagnostic and Statistical Manual of Mental Disorders, 5th ed (ever/current)]. Complex sample design variables and weights were used to calculate nationally representative prevalence. RESULTS Disability (NHIS: 5.2-6.3%; NSCH: 9.2-11.9%) and DD prevalence (NHIS: 0.6-18.0% and NSCH: 0.2-22.2%) varied depending on the definition and data source. For the same definition, NSCH prevalence estimates tended to be higher than NHIS estimates. CONCLUSIONS The substantial variability in estimated prevalence of disability and DD among children in the United States may be in part due to the surveys not representing all components of each definition. Different or additional questions in national surveys may better capture existing definitions of disability and DD. Considering the data collection goals may help determine the optimal definition to provide useful information for public health action.
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Affiliation(s)
- Lauren A Russell
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA; Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs, Oak Ridge, TN, USA.
| | - Sarah C Tinker
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Catherine E Rice
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - A Blythe Ryerson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Maria G Gonzalez
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control & Prevention, Atlanta, GA, USA
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2
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Massetti GM, Stamatakis C, Charania S, Annor FB, Rice CE, Hegle J, Ramphalla P, Sechache M, Motheo M. Prevalence of Functional Disabilities and Associations Among Disabilities, Violence, and HIV Among Adolescents and Young Adults in Lesotho. J Epidemiol Glob Health 2024; 14:223-233. [PMID: 38498114 PMCID: PMC11043310 DOI: 10.1007/s44197-023-00184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/22/2023] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION Lesotho has the second-highest prevalence of HIV. Despite progress in achieving HIV epidemic control targets, inequities persist among certain groups, particularly associations between disability, HIV, and violence. We assessed the prevalence of disability and examined associations between disability and HIV and violence using data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS). METHODS Lesotho VACS was a nationally representative survey of females and males ages 13-24. We assessed the associations between disability status and HIV, sexual risk behaviours, and violence using logistic regression, incorporating survey weights. RESULTS Weighted functional disability prevalence was 14.1% for females (95% confidence interval [CI] 12.7-15.4) and 7.3% for males (5.3-9.2). Compared with females with no disabilities, females with disabilities had higher odds of being HIV positive (adjusted odds ratio [aOR] 1.92, 1.34-2.76), having transactional sex (aOR 1.79, 1.09-2.95), and experiencing any lifetime violence (aOR 2.20, 1.82-2.65), sexual violence (aOR 1.77, 1.36-2.31), emotional violence (2.02. 1.61-2.53), physical violence (aOR 1.85, 1.54-2.24), witnessing interparental violence (aOR 1.71, 1.46-2.01), and witnessing community violence (aOR 1.52, 1.26-1.84). Males with disabilities had higher odds of having transactional sex (aOR 4.30, 1.35-13.73), having recent multiple sex partners (aOR 2.31, 1.13-4.75), experiencing emotional violence (aOR 2.85, 1.39-5.82), and witnessing interparental violence (aOR 1.78, 1.12-2.84). HIV models for males did not converge due to low numbers. CONCLUSION Findings emphasize the importance of inclusion and accessibility for adolescents and young adults with disabilities in prevention and services for violence and HIV. Ending HIV in Lesotho depends on addressing the vulnerabilities that lead to potential infection including violence and ensuring equitable services for all.
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Affiliation(s)
- Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA, 30341, USA.
| | - Caroline Stamatakis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
| | - Sana Charania
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA, 30341, USA
| | - Catherine E Rice
- Divison of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Atlanta, USA
| | - Jennifer Hegle
- Division of Global HIV and TB, Global Health Center, Centers for Disease Control and Prevention, Atlanta, USA
| | - Puleng Ramphalla
- Division of Global HIV and TB, Centers for Disease Control and Prevention, Maseru, Lesotho
| | | | - Mookho Motheo
- Ministry of Social Development, Government of Lesotho, Maseru, Lesotho
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Rattay K, Thierry JM, Yeargin-Allsopp M, Griffin-Blake S, Rice CE, Chatham-Stephens K, Remley K. Lessons learned: COVID-19 vaccinations and people with disabilities. Vaccine 2024:S0264-410X(24)00028-8. [PMID: 38267333 DOI: 10.1016/j.vaccine.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 01/26/2024]
Abstract
This manuscript is being submitted as a Commentary; Abstract not applicable.
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Affiliation(s)
- Karyl Rattay
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - JoAnn M Thierry
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shannon Griffin-Blake
- Office of Health Equity, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kevin Chatham-Stephens
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen Remley
- National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Patel P, Schrader KE, Rice CE, Rowley E, Cree RA, DeSilva MB, Embi PJ, Gaglani M, Grannis SJ, Ong TC, Stenehjem E, Naleway AL, Ball S, Natarajan K, Klein NP, Adams K, Kharbanda A, Ray C, Link-Gelles R, Tenforde MW. Effectiveness of the Original Monovalent Coronavirus Disease 2019 Vaccines in Preventing Emergency Department or Urgent Care Encounters and Hospitalizations Among Adults With Disabilities: VISION Network, June 2021-September 2022. Open Forum Infect Dis 2023; 10:ofad474. [PMID: 37965644 PMCID: PMC10642729 DOI: 10.1093/ofid/ofad474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/18/2023] [Indexed: 11/16/2023] Open
Abstract
Adults with disabilities are at increased risk for severe coronavirus disease 2019 (COVID-19). Using data across 9 states during Delta- and Omicron-predominant periods (June 2021-September 2022), we evaluated the effectiveness of the original monovalent COVID-19 messenger RNA vaccines among 521 206 emergency department/urgent care encounters (11 471 [2%] in patients with a documented disability) and 139 548 hospitalizations (16 569 [12%] in patients with a disability) for laboratory-confirmed COVID-19 illness in adults (aged ≥18 years). Across variant periods and for the primary series or booster doses, vaccine effectiveness was similar in those with and those without a disability. These findings highlight the importance of adults with disabilities staying up to date with COVID-19 vaccinations.
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Affiliation(s)
- Palak Patel
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Catherine E Rice
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Rowley
- Department of Clinical Research, Westat, Rockville, Maryland, USA
| | - Robyn A Cree
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Malini B DeSilva
- Department of Research, Health Partners Institute, Minneapolis, Minnesota, USA
| | - Peter J Embi
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Manjusha Gaglani
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Baylor Scott & White Health, Temple, Texas, USA
- Department of Medical Education, Texas A&M University College of Medicine, Temple, Texas, USA
| | - Shaun J Grannis
- Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana, USA
- School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Toan C Ong
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Edward Stenehjem
- Division of Infectious Diseases and Clinical Epidemiology, Intermountain Healthcare, Salt Lake City, Utah, USA
| | - Allison L Naleway
- Department of Science Programs, Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Sarah Ball
- Department of Clinical Research, Westat, Rockville, Maryland, USA
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, NewYork, New York, USA
- Medical Informatics Services, NewYork-Presbyterian Hospital, NewYork, New York, USA
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California Division of Research, Oakland, California, USA
| | - Katherine Adams
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Anupam Kharbanda
- Department of Emergency Medicine, Children’s Minnesota, Minneapolis, Minnesota, USA
| | - Caitlin Ray
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ruth Link-Gelles
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark W Tenforde
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Hollis ND, Zhou T, Rice CE, Yeargin-Allsopp M, Cree RA, Singleton JA, Santibanez TA, Ryerson AB. Inequities in COVID-19 vaccination coverage for adolescents with and without disability, national immunization Survey-Child COVID module, July 22, 2021-February 26, 2022. Disabil Health J 2023; 16:101509. [PMID: 37558552 PMCID: PMC10961908 DOI: 10.1016/j.dhjo.2023.101509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/14/2023] [Revised: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Some people with disabilities are likely at increased risk of health impacts from coronavirus disease 2019 (COVID-19). OBJECTIVE To describe parent-reported COVID-19 vaccination status of adolescents (aged 13-17 years) and parental intent to get their child vaccinated, among adolescents with versus without disability. METHODS National Immunization Survey-Child COVID Module data from interviews conducted July 22, 2021-February 26, 2022, were analyzed to assess disability status and type and COVID-19 vaccination status for adolescents (n = 12,445). Prevalence estimates with 95% confidence intervals were calculated; T-tests were conducted. RESULTS A lower percentage of adolescents with disability received ≥1 dose of COVID-19 vaccine compared to adolescents without disability (52.5% vs. 58.6%), [those with cognition (50.8%) or not performing errands independently (49.5%) disabilities were significantly lower]; and a higher percentage of parents reported intent to definitely vaccinate (9.9% vs. 6.5%) and definitely not vaccinate (14.9% vs. 11.8%) their adolescent. Among the unvaccinated adolescents, parents of those with disability were more likely to report difficulty getting their child vaccinated (19.1% vs. 12.9%), inconvenient vaccination-site operating hours (7.6% vs. 3.9%), difficulty knowing where to get their child vaccinated (7.2% vs. 2.7%), and difficulty getting to vaccination sites (6.0% vs. 3.0%), than parents of those without disability. CONCLUSIONS Adolescents with disability had lower vaccination coverage compared to adolescents without disability. Parents of adolescents with disability reported higher intent to get their adolescents vaccinated, but among unvaccinated adolescents with disability, parents reported greater difficulty in accessing COVID-19 vaccines. Findings highlight the need for prioritized outreach to increase COVID-19 vaccination for this population.
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Affiliation(s)
- NaTasha D Hollis
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA; Commissioned Corps, U.S. Public Health Service, Atlanta, GA, USA.
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA; Leidos, Inc. Atlanta, GA, USA
| | - Catherine E Rice
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marshalyn Yeargin-Allsopp
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robyn A Cree
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - James A Singleton
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tammy A Santibanez
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Blythe Ryerson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Morrier MJ, Schwartz AJ, Rice CE, Platner A, Ousley OY, Kassem S, Krishnan AV, Lord C, Smith CJ, Oberleitner R. Validation of an Enhanced Telehealth Platform for Toddlers at Increased Likelihood for a Diagnosis of Autism Spectrum Disorder (ASD). J Autism Dev Disord 2023:10.1007/s10803-023-06116-1. [PMID: 37740876 DOI: 10.1007/s10803-023-06116-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/25/2023]
Abstract
Use of telehealth assessments for toddlers at increased likelihood of autism spectrum disorder (ASD) began prior to the global COVID-19 pandemic; however, the value of telehealth assessments as an alternative to in-person assessment (IPA) became clearer during the pandemic. The Naturalistic Observation Diagnosis Assessment (NODA™), previously demonstrated as a valid and reliable tool to evaluate asynchronous behaviors for early diagnosis, was enhanced to add synchronous collection of behaviors to assist clinicians in making a differential diagnosis of ASD. This study was conducted to validate the information gathered through NODA-Enhanced (NODA-E™) as compared to a gold standard IPA. Forty-nine toddlers aged 16.0-32.1 months of age, recruited through community pediatric offices and a tertiary ASD clinic, participated in both NODA-E and IPA assessments. There was high agreement between the two assessment protocols for overall diagnosis (46 of 49 cases; 93.6%; κ = .878), specific diagnostic criteria for social communication and social interaction (SCI; range 95.9-98%; κ = .918-.959), and for two of four criteria specified for restricted and repetitive behaviors (RRB; range 87.8-98%; κ = .755 and .959). There was lower agreement for two subcategories of RRBs (range 65.3-67.3%; κ = .306 and .347). NODA-E is a tool that can assist clinicians in making reliable and valid early ASD diagnoses using both asynchronous and synchronous information gathered via telehealth and offers an additional tool within a clinician's assessment toolbox.
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Affiliation(s)
- Michael J Morrier
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA.
| | - Allison J Schwartz
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Catherine E Rice
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Amanda Platner
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Opal Y Ousley
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Sara Kassem
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | | | - Catherine Lord
- Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
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Cogswell ME, Coil E, Tian LH, Tinker SC, Ryerson AB, Maenner MJ, Rice CE, Peacock G. Health Needs and Use of Services Among Children with Developmental Disabilities — United States, 2014–2018. MMWR Morb Mortal Wkly Rep 2022; 71:453-458. [PMID: 35324879 PMCID: PMC8956340 DOI: 10.15585/mmwr.mm7112a3] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rice CE, Carpenter LA, Morrier MJ, Lord C, DiRienzo M, Boan A, Skowyra C, Fusco A, Baio J, Esler A, Zahorodny W, Hobson N, Mars A, Thurm A, Bishop S, Wiggins LD. Defining in Detail and Evaluating Reliability of DSM-5 Criteria for Autism Spectrum Disorder (ASD) Among Children. J Autism Dev Disord 2022; 52:5308-5320. [PMID: 34981308 DOI: 10.1007/s10803-021-05377-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 12/24/2022]
Abstract
This paper describes a process to define a comprehensive list of exemplars for seven core Diagnostic and Statistical Manual (DSM) diagnostic criteria for autism spectrum disorder (ASD), and report on interrater reliability in applying these exemplars to determine ASD case classification. Clinicians completed an iterative process to map specific exemplars from the CDC Autism and Developmental Disabilities Monitoring (ADDM) Network criteria for ASD surveillance, DSM-5 text, and diagnostic assessments to each of the core DSM-5 ASD criteria. Clinicians applied the diagnostic exemplars to child behavioral descriptions in existing evaluation records to establish initial reliability standards and then for blinded clinician review in one site (phase 1) and for two ADDM Network surveillance years (phase 2). Interrater reliability for each of the DSM-5 diagnostic categories and overall ASD classification was high (defined as very good .60-.79 to excellent ≥ .80 Kappa values) across sex, race/ethnicity, and cognitive levels for both phases. Classification of DSM-5 ASD by mapping specific exemplars from evaluation records by a diverse group of clinician raters is feasible and reliable. This framework provides confidence in the consistency of prevalence classifications of ASD and may be further applied to improve consistency of ASD diagnoses in clinical settings.
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Affiliation(s)
- C E Rice
- Emory University, Atlanta, GA, USA. .,Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - L A Carpenter
- Medical University of South Carolina, Charleston, SC, USA
| | | | - C Lord
- University of California Los Angeles, Los Angeles, CA, USA
| | - M DiRienzo
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Boan
- Medical University of South Carolina, Charleston, SC, USA
| | - C Skowyra
- Washington University in St. Louis, St. Louis, MO, USA
| | - A Fusco
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - J Baio
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - A Esler
- University of Minnesota, Minneapolis, MN, USA
| | - W Zahorodny
- Rutgers New Jersey Medical School, Newark, NJ, USA
| | - N Hobson
- Independent Consultant, Keller, TX, USA
| | - A Mars
- Hunterdon Healthcare System, Flemington, NJ, USA
| | - A Thurm
- National Institute of Mental Health, Bethesda, MD, USA
| | - S Bishop
- University of California San Francisco, San Francisco, CA, USA
| | - L D Wiggins
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Ryerson AB, Rice CE, Hung MC, Patel SA, Weeks JD, Kriss JL, Peacock G, Lu PJ, Asif AF, Jackson HL, Singleton JA. Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status - National Immunization Survey Adult COVID Module, United States, May 30-June 26, 2021. MMWR Morb Mortal Wkly Rep 2021; 70:1365-1371. [PMID: 34591826 PMCID: PMC8486390 DOI: 10.15585/mmwr.mm7039a2] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Estimates from the 2019 American Community Survey (ACS) indicated that 15.2% of adults aged ≥18 years had at least one reported functional disability (1). Persons with disabilities are more likely than are those without disabilities to have chronic health conditions (2) and also face barriers to accessing health care (3). These and other health and social inequities have placed persons with disabilities at increased risk for COVID-19-related illness and death, yet they face unique barriers to receipt of vaccination (4,5). Although CDC encourages that considerations be made when expanding vaccine access to persons with disabilities,* few public health surveillance systems measure disability status. To describe COVID-19 vaccination status and intent, as well as perceived vaccine access among adults by disability status, data from the National Immunization Survey Adult COVID Module (NIS-ACM) were analyzed. Adults with a disability were less likely than were those without a disability to report having received ≥1 dose of COVID-19 vaccine (age-adjusted prevalence ratio [aPR] = 0.88; 95% confidence interval [CI] = 0.84-0.93) but more likely to report they would definitely get vaccinated (aPR = 1.86; 95% CI = 1.43-2.42). Among unvaccinated adults, those with a disability were more likely to report higher endorsement of vaccine as protection (aPR = 1.29; 95% CI = 1.16-1.44), yet more likely to report it would be or was difficult to get vaccinated than did adults without a disability (aPR = 2.69; 95% CI = 2.16-3.34). Reducing barriers to vaccine scheduling and making vaccination sites more accessible might improve vaccination rates among persons with disabilities.
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Grosse SD, Ji X, Nichols P, Zuvekas SH, Rice CE, Yeargin-Allsopp M. Spending on Young Children With Autism Spectrum Disorder in Employer-Sponsored Plans, 2011-2017. Psychiatr Serv 2021; 72:16-22. [PMID: 33076792 PMCID: PMC7879423 DOI: 10.1176/appi.ps.202000099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Rapid increases in the prevalence of autism spectrum disorder (ASD) and increased access to intensive behavioral interventions have likely increased health care spending. This study estimated recent changes in spending among privately insured children with and without current ASD. METHODS A repeated cross-sections analysis of 2011-2017 claims data from large-employer-sponsored health plans assessed changes in annual expenditures by service type for children ages 3-7 enrolled for ≥1 year and with two or more claims with ASD billing codes within a calendar year and for all other children. RESULTS Mean spending per child with a current-year ASD diagnosis increased by 51% in 2017 U.S. dollars, from roughly $13,000 in 2011 to $20,000 in 2017. Among children who did not meet the current-year ASD case definition, per-child spending increased by 8%. Spending on children with ASD accounted for 41% of spending growth for children ages 3-7 during 2011-2017. Outpatient behavioral intervention-related spending per child with ASD increased by 376%, from $1,746 in 2011 to $8,317 in 2017; spending on all other services increased by 2%. Their share of behavioral intervention-related spending increased from 13.2% in 2011 to 41.7% in 2017. In 2011, 2.5% of children with current-year ASD diagnoses incurred ≥$20,000 in outpatient behavioral intervention-related spending, which increased to 14.4% in 2017. CONCLUSIONS During 2011-2017, spending increased six times as much for privately insured children ages 3-7 with current-year ASD as for children without ASD, largely from increased behavioral intervention-related spending. One in seven children received at least $20,000 in services in 2017.
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Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
| | - Xu Ji
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
| | - Phyllis Nichols
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
| | - Samuel H Zuvekas
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
| | - Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), Atlanta (Grosse, Nichols, Yeargin-Allsopp); Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta (Ji); Center for Financing, Access and Cost Trends, Agency for Healthcare Research and Quality, Rockville, Maryland (Zuvekas); Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Rice). This work was performed when Dr. Ji was a Prevention Effectiveness Fellow at the CDC
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Shulman C, Esler A, Morrier MJ, Rice CE. Diagnosis of Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:583-603. [PMID: 33126997 DOI: 10.1016/j.psc.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders it is also one of the most heterogeneous conditions, making identification and diagnosis complex. The importance of a stable and consistent diagnosis cannot be overstated. An accurate diagnosis is the basis for understanding the individual and establishing an individualized treatment plan. We present those elements that should be included in any assessment for ASD and describe the ways in which ASD typically manifests itself at various developmental stages. The implications and challenges for assessment at different ages and levels of functioning are discussed.
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Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
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Shulman C, Rice CE, Morrier MJ, Esler A. The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan. Psychiatr Clin North Am 2020; 43:605-628. [PMID: 33126998 DOI: 10.1016/j.psc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.
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Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
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Wells R, Daniel P, Barger B, Rice CE, Bandlamudi M, Crimmins D. Impact of medical home-consistent care and child condition on select health, community, and family level outcomes among children with special health care needs. Children's Health Care 2020. [DOI: 10.1080/02739615.2020.1852085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Rebecca Wells
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Patricia Daniel
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Brian Barger
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Catherine E. Rice
- Emory Autism Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Maitreyi Bandlamudi
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Daniel Crimmins
- Center for Leadership in Disability, School of Public Health, Georgia State University, Atlanta, GA, USA
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Bernhardt JB, Lam GYH, Thomas T, Cubells JF, Bohlke K, Reid M, Rice CE. Meaning in Measurement: Evaluating Young Autistic Adults' Active Engagement and Expressed Interest in Quality-of-Life Goals. Autism Adulthood 2020; 2:227-242. [PMID: 36601444 PMCID: PMC8992872 DOI: 10.1089/aut.2019.0081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The need for support programs and meaningful measurement of outcomes with autistic adults is growing. To date, success in autism intervention has been defined based on changes in discretely defined, observable behaviors with limited consideration of the person's experience, motivations, or the complex contexts in which these skills are used. Behavioral skill-building interventions are effective at increasing or decreasing specific behaviors, but a purely behavioral focus is not enough for meaningful improvements in adult quality of life (QoL). To reflect real-life impact, intervention and measurement must go beyond quantitative estimates of changes in skills regardless of context of use and focus on enhancing and evaluating functional outcomes and adult QoL that includes active engagement with the adult and provides rigor in qualitative evaluation. This article reports on efforts to assess active engagement of verbally fluent young autistic adults in a supported university-based residential pilot program built around self-set wellness goals for healthy, engaged, responsible, and empowered adult living. Program evaluation used an exploratory process for evaluating QoL learning, while also being open to how future work can discern participant meanings in measurement. The pilot used a mixed-methods approach to measure entry skills and interests, codetermine personal wellness goals, inform program content with participants, and measure QoL learning in terms of active engagement, expressed interest, and changes in self-appraisal of competence, confidence, and identity. Participants' QoL learning, replication of QoL learning measurement methods, and further exploration of strategies to put participant meanings in QoL learning measurement are discussed. Lay summary Why was this study done?: This study piloted a measurement strategy for deciding what to measure and support in real-world contexts of independent living and on-campus experiences in a 3-week residential program for young autistic adults.What was the purpose of this study?: The study aimed to measure and support autistic adults' quality of life (QoL) learning in terms of the extent to which pursuing self-set wellness goals, with supports, positively impacted autistic adults' active engagement (e.g., participation in wellness activities), and expressed interest (e.g., willingness to participate).Why was this program developed?: The program was developed because more young adults on the spectrum are aging into adulthood without personalized, respectful, and meaningful supports to promote engaged adult living. We wanted to build on our experience and feedback from autistic adults, family, and partners who have engaged in weekly social engagement groups on a university campus and called for more comprehensive transition programs.What did the program do?: The project was a pilot of an on-campus program aimed at facilitating personally meaningful improvements in QoL through empowering autistic adults to act on their personal motivations, interests, and goals. It also emphasized learning through experiences in real-life contexts, in collaboration with other participants, campus resources, community members, and program staff.How did the researchers evaluate the new program?: The program team used both quantitative and qualitative methods. Quantitative methods included standard self-report tools that autistic adults used to rate their safety needs, adult self-direction skills, autism-related self-concept, priority of self-set wellness goals, and confidence in abilities to achieve and learn more about one's own wellness goals. Predetermined qualitative methods included analysis of themes from participants' narrative data from their wellness interviews with participants and open-response items from self-report tools. The program was also responsive through a preprogram wellness interview with parents, staff's field notes about of participants' behaviors, conversational interactions with participants, and team discussions. Researchers contextualized and synthesized the data into narrative case studies about each participant's wellness journey.What were the early findings and what do they add to what was already known?: Results showed that the program was able to facilitate participants' QoL learning in personal wellness goals in collaboration with campus and community resources. Participants expressed meaningful changes in their expressed interests, active engagement, and self-concept through participating in this brief residential on-campus program.What are potential weaknesses of this pilot?: Weaknesses included a short time period of 3 weeks, a small participant count of 5, and the resource-intense supports needed for the program.What are the next steps?: The next steps are to adjust the program based on participant feedback and pursue creation of a multiyear program to continue piloting the measurement and support strategies for facilitating autistic adults' active wellness engagement and self-determined independent living.How will these findings and this work help autistic adults now or in the future?: This work informs future wellness interventions for measuring and supporting autistic adults' efforts to self-determine meaningful changes to their QoL.
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Affiliation(s)
- Jamie B. Bernhardt
- Department of Psychiatry and Behavioral Sciences, Emory Autism Center, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Gary Yu Hin Lam
- Department of Educational Psychology, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Toni Thomas
- Department of Psychiatry and Behavioral Sciences, Emory Autism Center, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Joseph F. Cubells
- Department of Psychiatry and Behavioral Sciences, Emory Autism Center, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Kelsey Bohlke
- Department of Psychiatry and Behavioral Sciences, Emory Autism Center, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Morganne Reid
- Department of Psychology, Catholic University of America, Washington, District of Columbia, USA
| | - Catherine E. Rice
- Department of Psychiatry and Behavioral Sciences, Emory Autism Center, School of Medicine, Emory University, Atlanta, Georgia, USA.,Address correspondence to: Catherine E. Rice, PhD, Emory Autism Center, Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, 1551 Shoup Court, Atlanta, GA 30322, USA
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Abstract
Although autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders it is also one of the most heterogeneous conditions, making identification and diagnosis complex. The importance of a stable and consistent diagnosis cannot be overstated. An accurate diagnosis is the basis for understanding the individual and establishing an individualized treatment plan. We present those elements that should be included in any assessment for ASD and describe the ways in which ASD typically manifests itself at various developmental stages. The implications and challenges for assessment at different ages and levels of functioning are discussed.
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Affiliation(s)
- Cory Shulman
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Mount Scopus, Jerusalem, 91905, Israel.
| | - Amy Esler
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota 2540 Riverside Ave S., RPB 550, Minneapolis, MN 55454, USA
| | - Michael J Morrier
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
| | - Catherine E Rice
- Emory Autism Center, 1551 Shoup Court, Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Decatur, GA 30033, USA
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16
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Affiliation(s)
| | - Li-Ching Lee
- 2 Johns Hopkins Bloomberg School of Public Health, USA
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17
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Rice CE, Fish JN, Russell ST, Lanza ST. DISCRIMINATION AND SUICIDAL BEHAVIOR AMONG SEXUAL MINORITY ADULTS IN THE UNITED STATES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C E Rice
- The Pennsylvania State University, Methodology Center, University Park, Pennsylvania, United States
| | - J N Fish
- The University of Texas at Austin Population Research Center, Austin, TX, USA
| | - S T Russell
- The University of Texas at Austin Department of Human Development and Family Sciences and Population Research Center, Austin, TX, USA
| | - S T Lanza
- The Pennsylvania State University Department of Biobehavioral Health and Edna Bennett Pierce Prevention Research Center, University Park, PA, USA
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18
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Rubenstein E, Daniels J, Schieve LA, Christensen DL, Van Naarden Braun K, Rice CE, Bakian AV, Durkin MS, Rosenberg SA, Kirby RS, Lee LC. Trends in Special Education Eligibility Among Children With Autism Spectrum Disorder, 2002-2010. Public Health Rep 2017; 133:85-92. [PMID: 29257937 DOI: 10.1177/0033354917739582] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Although data on publicly available special education are informative and offer a glimpse of trends in autism spectrum disorder (ASD) and use of educational services, using these data for population-based public health monitoring has drawbacks. Our objective was to evaluate trends in special education eligibility among 8-year-old children with ASD identified in the Autism and Developmental Disabilities Monitoring Network. METHODS We used data from 5 Autism and Developmental Disabilities Monitoring Network sites (Arizona, Colorado, Georgia, Maryland, and North Carolina) during 4 surveillance years (2002, 2006, 2008, and 2010) and compared trends in 12 categories of special education eligibility by sex and race/ethnicity. We used multivariable linear risk regressions to evaluate how the proportion of children with a given eligibility changed over time. RESULTS Of 6010 children with ASD, more than 36% did not receive an autism eligibility in special education in each surveillance year. From surveillance year 2002 to surveillance year 2010, autism eligibility increased by 3.6 percentage points ( P = .09), and intellectual disability eligibility decreased by 4.6 percentage points ( P < .001). A greater proportion of boys than girls had an autism eligibility in 2002 (56.3% vs 48.8%). Compared with other racial/ethnic groups, Hispanic children had the largest increase in proportion with autism eligibility from 2002 to 2010 (15.4%, P = .005) and the largest decrease in proportion with intellectual disability (-14.3%, P = .004). CONCLUSION Although most children with ASD had autism eligibility, many received special education services under other categories, and racial/ethnic disparities persisted. To monitor trends in ASD prevalence, public health officials need access to comprehensive data collected systematically, not just special education eligibility.
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Affiliation(s)
- Eric Rubenstein
- 1 Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Julie Daniels
- 1 Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Laura A Schieve
- 2 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deborah L Christensen
- 2 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kim Van Naarden Braun
- 2 National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Catherine E Rice
- 3 Emory University School of Medicine, Atlanta, GA, USA.,4 Emory Autism Center, Atlanta, GA, USA
| | - Amanda V Bakian
- 5 Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Maureen S Durkin
- 6 Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Steven A Rosenberg
- 7 Department of Epidemiology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Russell S Kirby
- 8 Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Li-Ching Lee
- 9 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Rice CE, Zablotsky B, Avila RM, Colpe LJ, Schieve LA, Pringle B, Blumberg SJ. Reported Wandering Behavior among Children with Autism Spectrum Disorder and/or Intellectual Disability. J Pediatr 2016; 174:232-239.e2. [PMID: 27157446 PMCID: PMC4983701 DOI: 10.1016/j.jpeds.2016.03.047] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/15/2016] [Accepted: 03/21/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To characterize wandering, or elopement, among children with autism spectrum disorder (ASD) and intellectual disability. STUDY DESIGN Questions on wandering in the previous year were asked of parents of children with ASD with and without intellectual disability and children with intellectual disability without ASD as part of the 2011 Survey of Pathways to Diagnosis and Services. The Pathways study sample was drawn from the much larger National Survey of Children with Special Health Care Needs conducted in 2009-2010. RESULTS For children with special healthcare needs diagnosed with either ASD, intellectual disability, or both, wandering or becoming lost during the previous year was reported for more than 1 in 4 children. Wandering was highest among children with ASD with intellectual disability (37.7%) followed by children with ASD without intellectual disability (32.7%), and then children with intellectual disability without ASD (23.7%), though the differences between these groups were not statistically significant. CONCLUSIONS This study affirms that wandering among children with ASD, regardless of intellectual disability status, is relatively common. However, wandering or becoming lost in the past year was also reported for many children with intellectual disability, indicating the need to broaden our understanding of this safety issue to other developmental disabilities.
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Affiliation(s)
- Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA.
| | - Benjamin Zablotsky
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
| | - Rosa M Avila
- University of Washington, School of Public Health, Seattle, WA
| | - Lisa J Colpe
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | - Beverly Pringle
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - Stephen J Blumberg
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD
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20
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Wu YT, Maenner MJ, Wiggins LD, Rice CE, Bradley CC, Lopez ML, Kirby RS, Lee LC. Retention of autism spectrum disorder diagnosis: The role of co-occurring conditions in males and females. Res Autism Spectr Disord 2016; 25:76-86. [PMID: 28936232 PMCID: PMC5603237 DOI: 10.1016/j.rasd.2016.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This study examined associations between ASD diagnosis retention and non-ASD co-occurring conditions (CoCs) by child sex. The sample included 7077 males and 1487 females who had an ASD diagnosis documented in their school or health records in a population-based ASD surveillance system for 8-year-old children. ASD diagnosis retention status was determined when an initial ASD diagnosis was not later ruled out by a community professional. We found that ASD diagnosis remains fairly stable, with only 9% of children who had an initial documented ASD diagnosis later being ruled-out. Although most of the associations between the ASD diagnosis retention status and CoCs are similar in both sexes, the co-occurrence of developmental diagnoses (e.g., intellectual disability or sensory integration disorder) was predictive of ASD diagnostic changes in males, whereas the co-occurrence of specific developmental (e.g., personal/social delay) and neurological diagnosis (e.g., epilepsy) was associated with ASD diagnostic change in females. More ASD-related evaluations and less ASD-related impairment were associated with later ASD rule outs in both sexes. Our findings highlight that CoCs can complicate the diagnostic picture and lead to an increased likelihood of ambiguity in ASD diagnosis. Using sensitive and appropriate measures in clinical practice is necessary for differential diagnosis, particularly when there are co-occurring developmental conditions.
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Affiliation(s)
- Yen-Tzu Wu
- School and Graduate Institute of Physical Therapy, National Taiwan University College of Medicine, Taiwan
| | - Matthew J. Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States
| | - Catherine E. Rice
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States
| | - Catherine C. Bradley
- Division of Developmental and Behavioral Pediatrics, Medical University of South Carolina, United States
| | - Maya L. Lopez
- Section of Developmental Behavioral Pediatrics and Rehabilitative Medicine, University of Arkansas for Medical Sciences, United States
| | - Russell S. Kirby
- Department of Community and Family Health, University of South Florida, United States
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
- Corresponding author at: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Suite E6032, Baltimore, MD 21205, United States. (L.-C. Lee)
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21
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Affiliation(s)
- Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina; and
| | - Catherine E Rice
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia
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22
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Marks KP, Griffen AK, Herrera P, Macias MM, Rice CE, Robinson C. Systemwide Solutions to Improve Early Intervention for Developmental-Behavioral Concerns. Pediatrics 2015; 136:e1492-4. [PMID: 26553188 DOI: 10.1542/peds.2015-1723] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/18/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kevin P Marks
- Department of Pediatrics, PeaceHealth Medical Group, Eugene, Oregon; Division of General Pediatrics; Department of Pediatrics, Oregon Health & Science University School of Medicine, Portland, Oregon;
| | - Adriane K Griffen
- Association of University Centers on Disabilities, Silver Spring, Maryland
| | - Patricia Herrera
- Director of Developmental Screening & Care Coordination, 211 LA County, Los Angeles, California
| | - Michelle M Macias
- Division of Developmental & Behavioral Pediatrics, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Catherine E Rice
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - Cordelia Robinson
- Departments of Pediatrics and Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
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23
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Rice CE, Norris AH, Davis JA, Lynch CD, Fields KS, Ervin M, Turner AN. P11.07 The spectrum of sexual behaviours among msm and associations with prevalent sexually transmitted infections and hiv. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.455] [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: 11/03/2022]
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24
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Maierhofer C, Rice CE, Fields KS, Ervin M, Turner AN. P11.03 Lubricant use during receptive anal intercourse and rectal chlamydial and gonococcal infections among men who have sex with men. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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25
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Jo H, Schieve LA, Rice CE, Yeargin-Allsopp M, Tian LH, Blumberg SJ, Kogan MD, Boyle CA. Age at Autism Spectrum Disorder (ASD) Diagnosis by Race, Ethnicity, and Primary Household Language Among Children with Special Health Care Needs, United States, 2009-2010. Matern Child Health J 2015; 19:1687-97. [PMID: 25701197 PMCID: PMC4500845 DOI: 10.1007/s10995-015-1683-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We examined prevalence of diagnosed autism spectrum disorder (ASD) and age at diagnosis according to child's race/ethnicity and primary household language. From the 2009-2010 National Survey of Children with Special Health Care Needs, we identified 2729 3-17-year-old US children whose parent reported a current ASD diagnosis. We compared ASD prevalence, mean diagnosis age, and percentage with later diagnoses (≥5 years) across racial/ethnic/primary household language groups: non-Hispanic-white, any language (NHW); non-Hispanic-black, any language (NHB); Hispanic-any-race, English (Hispanic-English); and Hispanic-any-race, other language (Hispanic-Other). We assessed findings by parent-reported ASD severity level and adjusted for family sociodemographics. ASD prevalence estimates were 15.3 (NHW), 10.4 (NHB), 14.1 (Hispanic-English), and 5.2 (Hispanic-Other) per 1000 children. Mean diagnosis age was comparable across racial/ethnic/language groups for 3-4-year-olds. For 5-17-year-olds, diagnosis age varied by race/ethnicity/language and also by ASD severity. In this group, NHW children with mild/moderate ASD had a significantly higher proportion (50.8 %) of later diagnoses than NHB (33.5 %) or Hispanic-Other children (18.0 %). However, NHW children with severe ASD had a comparable or lower (albeit non-significant) proportion (16.4 %) of later diagnoses than NHB (37.8 %), Hispanic-English (30.8 %), and Hispanic-Other children (12.0 %). While NHW children have comparable ASD prevalence and diagnosis age distributions as Hispanic-English children, they have both higher prevalence and proportion of later diagnoses than NHB and Hispanic-Other children. The diagnosis age findings were limited to mild/moderate cases only. Thus, the prevalence disparity might be primarily driven by under-representation (potentially under-identification) of older children with mild/moderate ASD in the two minority groups.
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Affiliation(s)
- Heejoo Jo
- Division of Birth Defects and Developmental Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, MS-E86, 1600 Clifton Road, Atlanta, GA, 30333, USA,
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Bakian AV, Bilder DA, Carbone PS, Hunt TD, Petersen B, Rice CE. Brief report: independent validation of autism spectrum disorder case status in the Utah Autism and Developmental Disabilities Monitoring (ADDM) Network Site. J Autism Dev Disord 2015; 45:873-80. [PMID: 25022251 DOI: 10.1007/s10803-014-2187-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An independent validation was conducted of the Utah Autism and Developmental Disabilities Monitoring Network's (UT-ADDM) classification of children with autism spectrum disorder (ASD). UT-ADDM final case status (n = 90) was compared with final case status as determined by independent external expert reviewers (EERs). Inter-rater reliability (ICC = 0.84), specificity [0.83 (95 % CI 0.74-0.90)], and sensitivity [0.99 (95 % CI 0.96-1.00)] were high for ASD case versus non-case classification between UT-ADDM and EER. At least one EER disagreed with UT-ADDM on ASD final case status on nine out of 30 records; however, all three EERs disagreed with UT-ADDM for only one record. Findings based on limited data suggest that children with ASD as identified by UT-ADDM are consistently classified as ASD cases by independent autism experts.
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Affiliation(s)
- Amanda V Bakian
- Department of Psychiatry, University of Utah, 650 Komas Drive Suite 206, Salt Lake City, UT, 84108, USA,
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Rice CE, Naarden Braun KV, Kogan MD, Smith C, Kavanagh L, Strickland B, Blumberg SJ. Screening for developmental delays among young children--National Survey of Children's Health, United States, 2007. MMWR Suppl 2014; 63:27-35. [PMID: 25208255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
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Maenner MJ, Rice CE, Arneson CL, Cunniff C, Schieve LA, Carpenter LA, Van Naarden Braun K, Kirby RS, Bakian AV, Durkin MS. Potential impact of DSM-5 criteria on autism spectrum disorder prevalence estimates. JAMA Psychiatry 2014; 71:292-300. [PMID: 24452504 PMCID: PMC4041577 DOI: 10.1001/jamapsychiatry.2013.3893] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE The DSM-5 contains revised diagnostic criteria for autism spectrum disorder (ASD) from the DSM-IV-TR. Potential impacts of the new criteria on ASD prevalence are unclear. OBJECTIVE To assess potential effects of the DSM-5 ASD criteria on ASD prevalence estimation by retrospectively applying the new criteria to population-based surveillance data collected for previous ASD prevalence estimation. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based ASD surveillance based on clinician review of coded behaviors documented in children's medical and educational evaluations from 14 geographically defined areas in the United States participating in the Autism and Developmental Disabilities Monitoring (ADDM) Network in 2006 and 2008. This study included 8-year-old children living in ADDM Network study areas in 2006 or 2008, including 644 883 children under surveillance, of whom 6577 met surveillance ASD case status based on the DSM-IV-TR. MAIN OUTCOMES AND MEASURES Proportion of children meeting ADDM Network ASD criteria based on the DSM-IV-TR who also met DSM-5 criteria; overall prevalence of ASD using DSM-5 criteria. RESULTS Among the 6577 children classified by the ADDM Network as having ASD based on the DSM-IV-TR, 5339 (81.2%) met DSM-5 ASD criteria. This percentage was similar for boys and girls but higher for those with than without intellectual disability (86.6% and 72.5%, respectively; P < .001). A total of 304 children met DSM-5 ASD criteria but not current ADDM Network ASD case status. Based on these findings, ASD prevalence per 1000 for 2008 would have been 10.0 (95% CI, 9.6-10.3) using DSM-5 criteria compared with the reported prevalence based on DSM-IV-TR criteria of 11.3 (95% CI, 11.0-11.7). CONCLUSIONS AND RELEVANCE Autism spectrum disorder prevalence estimates will likely be lower under DSM-5 than under DSM-IV-TR diagnostic criteria, although this effect could be tempered by future adaptation of diagnostic practices and documentation of behaviors to fit the new criteria.
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Affiliation(s)
- Matthew J. Maenner
- University of Wisconsin–Madison. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Catherine E. Rice
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Laura A. Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kim Van Naarden Braun
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Rice CE, Fields KS, Ervin M, Norris AH, Lynch C, Davis JA, Turner AN. P3.150 Alternative Sexual Practises and Prevalent STI/HIV Among STD Care-Seeking Men Who Have Sex with Men. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0609] [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: 11/03/2022]
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Maenner MJ, Schieve LA, Rice CE, Cunniff C, Giarelli E, Kirby RS, Lee LC, Nicholas JS, Wingate MS, Durkin MS. Frequency and pattern of documented diagnostic features and the age of autism identification. J Am Acad Child Adolesc Psychiatry 2013; 52:401-413.e8. [PMID: 23582871 PMCID: PMC4051284 DOI: 10.1016/j.jaac.2013.01.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 01/28/2013] [Accepted: 01/31/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The DSM-IV-TR specifies 12 behavioral features that can occur in hundreds of possible combinations to meet diagnostic criteria for autism spectrum disorder (ASD). This paper describes the frequency and variability with which the 12 behavioral features are documented in a population-based cohort of 8-year-old children under surveillance for ASD, and examines whether documentation of certain features, alone or in combination with other features, is associated with earlier age of community identification of ASD. METHOD Statistical analysis of behavioral features documented for a population-based sample of 2,757 children, 8 years old, with ASD in 11 geographically-defined areas in the US participating in the Autism and Developmental Disabilities Monitoring Network in 2006. RESULTS The median age at ASD identification was inversely associated with the number of documented behavioral features, decreasing from 8.2 years for children with only seven behavioral features to 3.8 years for children with all 12. Documented impairments in nonverbal communication, pretend play, inflexible routines, and repetitive motor behaviors were associated with earlier identification, whereas impairments in peer relations, conversational ability, and idiosyncratic speech were associated with later identification. CONCLUSIONS The age dependence of some of the behavioral features leading to an autism diagnosis, as well as the inverse association between age at identification and number of behavioral features documented, have implications for efforts to improve early identification. Progress in achieving early identification and provision of services for children with autism may be limited for those with fewer ASD behavioral features, as well as features likely to be detected at later ages.
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Abstract
PURPOSE To present the current state of the evidence regarding translation of genetics (the study of single genes) and genomics (the study of all genes and gene-gene or gene-environment interactions) into health care of children with autism spectrum disorder (ASD). METHODS This article presents an overview of ASD as an international health challenge, the emerging science related to broad diagnostic criteria, and the role of the nurse in research, education, and practice. FINDINGS Much progress is being made in the understanding of genetics and genomics of ASD. Environmental factors are thought to contribute to the risk of developing ASD by interacting with a number of genes in different ways, thus suggesting causal heterogeneity. The rising identified prevalence of ASD, the changing diagnostic criteria for ASD, and the complexity of the core and associated features have made it difficult to define the ASD phenotype (observable behaviors that result from gene-environment interaction). Because early identification improves opportunities for intervention, researchers are looking for a useful biomarker to detect ASD. This search is complicated by the likelihood that there are multiple causes for multiple expressions that are defined as the autism spectrum. CONCLUSIONS To date, genetic and genomic research on ASD have underscored the complexity of the causes of ASD indicating that there are very complex genetic processes involved that are still not well understood. CLINICAL RELEVANCE Nurses will benefit from new knowledge related to early identification, diagnosis, and implications for the family to promote early intervention. Families who have a child with ASD will require nursing support for advocacy for optimal health outcomes.
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Affiliation(s)
- Norah L Johnson
- Marquette University College of Nursing, Milwaukee, WI 53201, USA.
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Miller JS, Bilder D, Farley M, Coon H, Pinborough-Zimmerman J, Jenson W, Rice CE, Fombonne E, Pingree CB, Ritvo E, Ritvo RA, McMahon WM. Autism spectrum disorder reclassified: a second look at the 1980s Utah/UCLA Autism Epidemiologic Study. J Autism Dev Disord 2013; 43:200-10. [PMID: 22696195 PMCID: PMC4467195 DOI: 10.1007/s10803-012-1566-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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] [Indexed: 10/28/2022]
Abstract
The purpose of the present study was to re-examine diagnostic data from a state-wide autism prevalence study (n = 489) conducted in the 1980s to investigate the impact of broader diagnostic criteria on autism spectrum disorder (ASD) case status. Sixty-four (59 %) of the 108 originally "Diagnosed Not Autistic" met the current ASD case definition. The average IQ estimate in the newly identified group (IQ = 35.58; SD = 23.01) was significantly lower than in the original group (IQ = 56.19 SD = 21.21; t = 5.75; p < .0001). Today's diagnostic criteria applied to participants ascertained in the 1980s identified more cases of autism with intellectual disability. The current analysis puts this historic work into context and highlights differences in ascertainment between epidemiological studies performed decades ago and those of today.
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Affiliation(s)
- Judith S. Miller
- Department of Psychiatry, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
| | - Deborah Bilder
- Department of Psychiatry, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
| | - Megan Farley
- Department of Psychiatry, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
| | - Hilary Coon
- Department of Psychiatry and the Brain Institute, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
| | | | - William Jenson
- Department of Educational Psychology, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
| | - Catherine E. Rice
- Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-86, Atlanta, GA 30333, USA
| | - Eric Fombonne
- Department of Psychiatry, Montreal Children’s Hospital, McGill University, 4018 Ste-Catherine West, Montreal, QC H3Z 1P2, Canada
| | - Carmen B. Pingree
- The Carmen B. Pingree Center for Children with Autism, 780 Guardsman Way, Salt Lake City, UT 84108, USA
| | - Edward Ritvo
- University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | | | - William M. McMahon
- Department of Psychiatry and the Brain Institute, University of Utah, 650 Komas Drive, Suite 206, Salt Lake City, UT 84108, USA
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Rice CE, Rosanoff M, Dawson G, Durkin MS, Croen LA, Singer A, Yeargin-Allsopp M. Evaluating Changes in the Prevalence of the Autism Spectrum Disorders (ASDs). Public Health Rev 2012; 34:1-22. [PMID: 26236074 DOI: 10.1007/bf03391685] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Autism spectrum disorders (ASDs) are estimated to occur among about one percent of children in the United States. This estimate is in line with estimates from other industrialized countries. However, the identified prevalence of ASDs has increased significantly in a short time period based on data from multiple studies including the U.S. Centers for Disease Control and Prevention's (CDC) Autism and Developmental Disabilities Monitoring (ADDM) Network. Whether increases in ASD prevalence are partly attributable to a true increase in the risk of developing ASD or solely to changes in community awareness and identification patterns is not known. It is clear that more children are identified with an ASD now than in the past and the impact on individuals, families, and communities is significant. However, disentangling the many potential reasons for ASD prevalence increases has been challenging. Understanding the relative contribution of multiple factors such as variation in study methods, changes in diagnostic and community identification, and potential changes in risk factors is an important priority for the ADDM Network and for CDC. This article summarizes the discussion from a workshop that was co-sponsored by CDC and Autism Speaks as a forum for sharing knowledge and opinions of a diverse range of stakeholders about changes in ASD prevalence. Panelists discussed recommendations for building on existing infrastructure and developing new initiatives to better understand ASD trends. The information, research, and opinions shared during this workshop add to the knowledge base about ASD prevalence in an effort to stimulate further work to understand the multiple reasons behind increasing ASD prevalence.
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Affiliation(s)
- Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA
| | | | - Geraldine Dawson
- Autism Speaks, USA ; University of North Carolina at Chapel Hill, USA
| | | | | | | | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA
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Schieve LA, Gonzalez V, Boulet SL, Visser SN, Rice CE, Van Naarden Braun K, Boyle CA. Concurrent medical conditions and health care use and needs among children with learning and behavioral developmental disabilities, National Health Interview Survey, 2006-2010. Res Dev Disabil 2012; 33:467-476. [PMID: 22119694 DOI: 10.1016/j.ridd.2011.10.008] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 10/07/2011] [Indexed: 05/31/2023]
Abstract
Studies document various associated health risks for children with developmental disabilities (DDs). Further study is needed by disability type. Using the 2006-2010 National Health Interview Surveys, we assessed the prevalence of numerous medical conditions (e.g. asthma, frequent diarrhea/colitis, seizures), health care use measures (e.g. seeing a medical specialist and >9 office visits in past year), health impact measures (e.g. needing help with personal care), and selected indicators of unmet health needs (e.g. unable to afford needed prescription medications) among a nationally representative sample of children ages 3-17 years, with and without DDs. Children in four mutually exclusive developmental disability groups: autism (N = 375), intellectual disability (ID) without autism (N = 238); attention-deficit/hyperactivity disorder (ADHD) without autism or ID (N = 2901); and learning disability (LD) or other developmental delay without ADHD, autism, or ID (N = 1955); were compared to children without DDs (N = 35,775) on each condition or health care measure of interest. Adjusted odds ratios (aORs) were calculated from weighted logistic regression models that accounted for the complex sample design. Prevalence estimates for most medical conditions examined were moderately to markedly higher for children in all four DD groups than children without DDs. Most differences were statistically significant after adjustment for child sex, age, race/ethnicity, and maternal education. Children in all DD groups also had significantly higher estimates for health care use, impact, and unmet needs measures than children without DDs. This study provides empirical evidence that children with DDs require increased pediatric and specialist services, both for their core functional deficits and concurrent medical conditions.
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Affiliation(s)
- Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States.
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Rice CE. The changing prevalence of the autism spectrum disorders. Am Fam Physician 2011; 83:515-520. [PMID: 21391518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Tompa GS, Sun S, Rice CE, Cuchiaro J, Dons E. Metal-Organic Chemical Vapor Deposition (MOCVD) of GeSbTe-based Chalcogenide Thin Films. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-0997-i10-08] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractChalcogenide Random Access Memory (C-RAM) has shown significant promise in combining the desired attributes of an ideal memory, including: nonvolatility, fast read/write/erase speed, low read/write/erase voltage/power, high endurance, and radiation hardness. Current C-RAM production technology relies on sputtering to deposit the active chalcogenide layer. The sputtering process leads to difficulties in meeting requirements for device conformality (in particular – filling vias), film adherence, compositional control, wafer yield, and surface damage. Ultimately, a viable CVD manufacturing process is needed for high-density products to realize the full potential of C-RAM. In this work, we discuss the Metal-Organic Chemical Vapor Deposition (MOCVD) tool technology used to produce the films and report the materials properties of GeSbTe-based chalcogenide thin films grown in small research scale and in large production scale MOCVD reactors. Films were grown at low pressures at temperatures ranging from 350 C to 600 C. X-Ray Fluorescence (XRF) and Auger Electron Spectroscopy (AES) were performed and determined that the film composition is controllable and uniform.
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Giarelli E, Wiggins LD, Rice CE, Levy SE, Kirby RS, Pinto-Martin J, Mandell D. Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Disabil Health J 2010; 3:107-16. [PMID: 21122776 PMCID: PMC4767258 DOI: 10.1016/j.dhjo.2009.07.001] [Citation(s) in RCA: 208] [Impact Index Per Article: 14.9] [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: 03/09/2009] [Revised: 05/30/2009] [Accepted: 07/06/2009] [Indexed: 02/03/2023]
Abstract
BACKGROUND One of the most consistent features of the autism spectrum disorders (ASDs) is the predominance among males, with approximately four males to every female. We sought to examine sex differences among children who met case definition for ASD in a large, population-based cohort with respect to age at first developmental evaluation, age of diagnosis, influence of cognitive impairment on these outcomes, and sex-specific behavioral characteristics. METHODS We conducted a secondary analysis of data collected for a population-based study of the prevalence of ASD. The sample comprised 2,568 children born in 1994 who met the case definition of ASD as established by the Autism and Developmental Disabilities Monitoring (ADDM) Network for ASD surveillance. Children who had a history of developmental disability and behavioral features consistent with the DSM-IV-TR criteria for autistic disorder, Asperger's disorder, and Pervasive Developmental Disorder-Not Otherwise Specified in existing evaluation records were classified as ASD cases via two paths: streamlined and nonstreamlined. Streamlined reviews were conducted if there was an ASD diagnosis documented in the records. Data were collected in 13 sites across the United States through the ADDM Network, funded by the Centers for Disease Control and Prevention. RESULTS Males constituted 81% of the sample. There were no differences by sex in average age at first evaluation or average age of diagnosis among those with an existing documented chart diagnosis of an ASD. Girls were less likely than boys to have a documented diagnosis (odds ratio [OR] = 0.76, p = .004). This analysis was adjusted for cognitive impairment status. In the logistic model, with the interaction term for sex and cognitive impairment, girls with IQ of 70 or less were less likely than boys with IQ of 70 or less to have a documented diagnosis (OR = 0.70, 95% confidence interval [CI] = 0.50-0.97, p = .035). Boys with IQ greater than 70 were less likely than boys with IQ of 70 or less to have a documented diagnosis (OR = 0.60, 95% CI = 0.49-0.74, p < .001). This finding (less likely to have a documented diagnosis) was also true for girls with IQ greater than 70 (OR = 0.45, 95% CI = 0.32-0.66, p < .001). Girls were more likely to have notations of seizure-like behavior (p < .001). Boys were more likely to have notations of hyperactivity or a short attention span and aggressive behavior (p < .01). CONCLUSIONS Girls, especially those without cognitive impairment, may be formally identified at a later age than boys. This may delay referral for early intervention. Community education efforts should alert clinicians and parents to the potential of ASDs in boys and girls.
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Affiliation(s)
- Ellen Giarelli
- University of Pennsylvania School of Nursing, Philadelphia, 19104, USA.
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Schieve LA, Baio J, Rice CE, Durkin M, Kirby RS, Drews-Botsch C, Miller LA, Nicholas JS, Cunniff CM. Risk for cognitive deficit in a population-based sample of U.S. children with autism spectrum disorders: variation by perinatal health factors. Disabil Health J 2010; 3:202-12. [PMID: 21122785 DOI: 10.1016/j.dhjo.2009.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Revised: 11/24/2009] [Accepted: 12/15/2009] [Indexed: 12/12/2022]
Abstract
BACKGROUND From 30% to 60% of children with an autism spectrum disorder (ASD) have an IQ measure that falls in the intellectual disability (ID) range. It is not well studied whether, for children within this ASD subgroup, there is variation in the risk for low IQ based on a child's perinatal risk factors. OBJECTIVE/HYPOTHESES We assessed whether preterm delivery and term small-for-gestational-age (tSGA) were associated with various measures of cognitive deficit among children with ASDs. METHODS A sample of 1129 singleton children born in 1994 and identified through school and health record review as having an ASD by age 8 years were selected from a U.S. population-based surveillance network. Mean IQ and dichotomous IQ outcomes indicating various levels of ID were examined according to whether a child was preterm (<37 weeks' gestation) or tSGA (term delivery and birth weight <10th percentile for gestational age of a U.S. referent). Results for the total sample and within race-ethnicity/maternal education strata were adjusted for child sex and ASD subtype classification. RESULTS Mean IQ was significantly (p < .05) lower in children delivered preterm (69.5) than term (74.5) and tSGA (69.3) than term appropriate-for gestational age (75.3). In stratified analyses, the preterm-IQ association was significant only among non-Hispanic white (NHW) children with maternal education at birth of high school or less; adjusted mean IQ was 8 points lower among those delivered preterm (65.4) than term (73.8). Term-SGA was associated with a significant 8-point deficit in adjusted mean IQ (75.5 vs. 83.8) in NHW children with maternal education greater than high school and a 6-point deficit that approached significance (68.4 vs. 74.5, p=0.10) in NHW children with maternal education of high school or less. Non-Hispanic black children in both maternal education groups had significantly lower mean IQs than NHW children with little variation by preterm or tSGA. CONCLUSIONS In children with ASDs, the risk for concurrent ID or IQ deficit is associated with both preterm delivery and tSGA; these associations may vary by race-ethnicity and SES. Further studies of ASD-ID co-occurrence and the effectiveness of intervention strategies should consider both perinatal and sociodemographic factors.
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Affiliation(s)
- Laura A Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Wiggins LD, Rice CE, Baio J. Developmental regression in children with an autism spectrum disorder identified by a population-based surveillance system. Autism 2009; 13:357-74. [PMID: 19535466 DOI: 10.1177/1362361309105662] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluated the phenomenon of autistic regression using population-based data. The sample comprised 285 children who met the autism spectrum disorder (ASD) case definition within an ongoing surveillance program. Results indicated that children with a previously documented ASD diagnosis had higher rates of autistic regression than children who met the ASD surveillance definition but did not have a clearly documented ASD diagnosis in their records (17-26 percent of surveillance cases). Most children regressed around 24 months of age and boys were more likely to have documented regression than girls. Half of the children with regression had developmental concerns noted prior to the loss of skills. Moreover, children with autistic regression were more likely to show certain associated features, including cognitive impairment.These data indicate that some children with ASD experience a loss of skills in the first few years of life and may have a unique symptom profile.
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Affiliation(s)
- Lisa D Wiggins
- Centers for Disease Control and Prevention, Atlanta, USA.
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Newschaffer CJ, Croen LA, Daniels J, Giarelli E, Grether JK, Levy SE, Mandell DS, Miller LA, Pinto-Martin J, Reaven J, Reynolds AM, Rice CE, Schendel D, Windham GC. The epidemiology of autism spectrum disorders. Annu Rev Public Health 2007; 28:235-58. [PMID: 17367287 DOI: 10.1146/annurev.publhealth.28.021406.144007] [Citation(s) in RCA: 604] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Autism spectrum disorders (ASDs) are complex, lifelong, neurodevelopmental conditions of largely unknown cause. They are much more common than previously believed, second in frequency only to mental retardation among the serious developmental disorders. Although a heritable component has been demonstrated in ASD etiology, putative risk genes have yet to be identified. Environmental risk factors may also play a role, perhaps via complex gene-environment interactions, but no specific exposures with significant population effects are known. A number of endogenous biomarkers associated with autism risk have been investigated, and these may help identify significant biologic pathways that, in turn, will aid in the discovery of specific genes and exposures. Future epidemiologic research should focus on expanding population-based descriptive data on ASDs, exploring candidate risk factors in large well-designed studies incorporating both genetic and environmental exposure data and addressing possible etiologic heterogeneity in studies that can stratify case groups and consider alternate endophenotypes.
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Affiliation(s)
- Craig J Newschaffer
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA 19102, USA.
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Abstract
Autism spectrum disorders (ASDs) represent a range of behavioural phenotypes defined by impaired development in social interaction, communication, imagination, and range of interests or behaviours. The aetiology and epidemiology of these serious developmental disabilities (DDs) are poorly understood. Estimates of the population prevalence of ASDs have varied widely within the US and abroad, with increasing estimates in most of the recent studies. In an effort to improve our understanding of the prevalence, population characteristics and public health impact of these conditions, the Centers for Disease Control and Prevention has funded a multi-site surveillance network for ASDs and other DDs that consists of programmes known as the Autism and Developmental Disabilities Monitoring (ADDM) network which conducts surveillance activities and the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) which also conducts surveillance in addition to special research studies related to the ASDs. This collaboration will be referred to hereafter as the ADDM Network. The ADDM Network is implementing a multiple-source surveillance programme to determine population prevalence and characteristics of ASDs and other DDs. This paper describes the collaborative efforts and explains the methods in developing this coordinated public health surveillance network to provide an ongoing source of high-quality data on ASDs.
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Affiliation(s)
- Catherine E Rice
- National Center on Birth Defects and Developmental Disabilities (NCBDDD), Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
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Affiliation(s)
- G B Reed
- Department of Bacteriology, Queen's University, Kingston, Ontario
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Rice CE. Abortion, euthanasia, and the need to build a new 'culture of life'. Notre Dame J Law Ethics Public Policy 2003; 12:497-528. [PMID: 12755092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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Mervis CB, Morris CA, Klein-Tasman BP, Bertrand J, Kwitny S, Appelbaum LG, Rice CE. Attentional characteristics of infants and toddlers with Williams syndrome during triadic interactions. Dev Neuropsychol 2003; 23:243-68. [PMID: 12730027 DOI: 10.1080/87565641.2003.9651894] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Two studies were conducted to consider the looking behavior of infants and toddlers with Williams syndrome (WS). In Study 1,the looking behavior of a 10-month-old girl with WS during play sessions with her mother and with a stranger was compared to that of 2 groups of infants who were developing normally (ND),1 matched for chronological age and the other for developmental age. The infant with WS spent more than twice as much time looking at her mother as the infants in either contrast group did. She also spent twice as much time looking at the stranger. In addition, during 78%of this time, her gaze at the stranger was coded as extremely intense. Looks of this intensity were virtually never made by the ND infants. In Study 2,the looking behavior of 31 individuals with WS ages 8 to 43 months during a genetics evaluation was compared to that of 319 control children in the same age range (242 with developmental delay due to causes other than WS).Twenty-three of the 25 participants with WS aged 33 months or younger demonstrated extended and intense looking at the geneticist. In contrast, none of the control participants looked extensively or intently at the geneticist. Findings are discussed in the context of previous research on arousal and focused attention during normal development and on temperament and personality of older children and adults with WS. It is argued that the unusual looking patterns evidenced by infants and toddlers with WS presage the unusual temperament and personality of older individuals with WS, and the possibility of a genetic basis for these behaviors is addressed.
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Affiliation(s)
- Carolyn B Mervis
- Department of Psychological and Brain Sciences, University of Louisville, KY 40292, USA.
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Cotton FA, Riess JG, Rice CE, Stults BR. Structure, bonding, and chemistry of closo-tetraphosphorus hexabis(methylimide), P4(NCH3)6, and its derivatives. 3. Structures of the dithio and trithio derivatives. Inorg Chem 2002. [DOI: 10.1021/ic00138a040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rice CE, Robinson WR, Tofield BC. Crystal structure of a condensed phosphatosilicate, oxovanadium(IV) diphosphatomonosilicate, VO(SiP2O8). Inorg Chem 2002. [DOI: 10.1021/ic50156a021] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Casabianca F, Cotton FA, Riess JG, Rice CE, Stults BR. Structure, bonding, and chemistry of closo-tetraphosphorus hexakis(methylimide), P4(NCH3)6, and its derivatives. I. The structures of the tetra-p-thio and tetra-p-oxo derivatives. Inorg Chem 2002. [DOI: 10.1021/ic50189a055] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cotton FA, Riess JG, Rice CE, Stults BR. Structure, bonding, and chemistry of closo-tetraphosphorus hexakis(methylimide), P4(NCH3)6, and its derivatives. 2. Polymorphs of the monothio derivative. Inorg Chem 2002. [DOI: 10.1021/ic50190a038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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