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Kata A, McPhee PG, Chen YJ, Zwaigenbaum L, Singal D, Roncadin C, Bennett T, Carter M, Di Rezze B, Drmic I, Duku E, Fournier S, Frei J, Gentles SJ, Georgiades K, Hanlon-Dearman A, Hoult L, Kelley E, Koller J, de Camargo OK, Lai J, Mahoney B, Mesterman R, Ng O, Robertson S, Rosenbaum P, Salt M, Zubairi MS, Georgiades S. The Pediatric Autism Research Cohort (PARC) Study: protocol for a patient-oriented prospective study examining trajectories of functioning in children with autism. BMJ Open 2024; 14:e083045. [PMID: 38684247 DOI: 10.1136/bmjopen-2023-083045] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION The developmentally variable nature of autism poses challenges in providing timely services tailored to a child's needs. Despite a recent focus on longitudinal research, priority-setting initiatives with stakeholders highlighted the importance of studying a child's day-to-day functioning and social determinants of health to inform clinical care. To address this, we are conducting a pragmatic multi-site, patient-oriented longitudinal investigation: the Pediatric Autism Research Cohort (PARC) Study. In young children (<7 years of age) newly diagnosed with autism, we will: (1) examine variability in trajectories of adaptive functioning from the point of diagnosis into transition to school; and (2) identify factors associated with trajectories of adaptive functioning. METHODS AND ANALYSIS We aim to recruit 1300 children under 7 years of age with a recent (within 12 months) diagnosis of autism from seven sites: six in Canada; one in Israel. Participants will be followed prospectively from diagnosis to age 8 years, with assessments at 6-month intervals. Parents/caregivers will complete questionnaires administered via a customized online research portal. Following each assessment timepoint, families will receive a research summary report describing their child's progress on adaptive functioning and related domains. Analysis of the longitudinal data will map trajectories and examine child, family and service characteristics associated with chronogeneity (interindividual and intraindividual heterogeneity over time) and possible trajectory turning points around sensitive periods like the transition to school. ETHICS AND DISSEMINATION Ethics approvals have been received by all sites. All parents/respondents will provide informed consent when enrolling in the study. Using an integrated knowledge translation approach, where stakeholders are directly engaged in the research process, the PARC Study will identify factors associated with trajectories of functioning in children with autism. Resulting evidence will be shared with government policy makers to inform provincial and national programs. Findings will be disseminated at conferences and published in peer-reviewed journals.
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Affiliation(s)
- Anna Kata
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Patrick G McPhee
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Yun-Ju Chen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Deepa Singal
- Autism Alliance of Canada, Toronto, Ontario, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Carter
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
| | - Irene Drmic
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | | | - Julia Frei
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Stephen J Gentles
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Kathy Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Ana Hanlon-Dearman
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Judah Koller
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Olaf Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan Lai
- Autism Alliance of Canada, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Bill Mahoney
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Olivia Ng
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Sue Robertson
- McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Mackenzie Salt
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
- Autism Alliance of Canada, Toronto, Ontario, Canada
| | - Mohammad S Zubairi
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Gentles SJ, Ng-Cordell EC, Hunsche MC, McVey AJ, Bednar ED, DeGroote MG, Chen YJ, Duku E, Kerns CM, Banfield L, Szatmari P, Georgiades S. Trajectory research in children with an autism diagnosis: A scoping review. Autism 2024; 28:540-564. [PMID: 37194194 PMCID: PMC10913344 DOI: 10.1177/13623613231170280] [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] [Indexed: 05/18/2023]
Abstract
LAY ABSTRACT The types of outcomes studied in children on the autism spectrum include clinical characteristics, such as social functioning, communication, language, or autism symptoms. Research that measures these outcomes at multiple timepoints is useful to improve our understanding of what to expect as children develop. In trajectory studies, researchers assess outcomes at three or more timepoints. This method has advantages over two-timepoint studies because it allows researchers to describe changes in the speed of development, such as accelerations, plateaus, or slowdowns. We identified and reviewed 103 published trajectory studies in children (to age 18 years) with an autism diagnosis. Importantly, we did not include studies of treatments or their effects, nor did we summarize the results of studies. Instead, this review summarizes the characteristics of the available published research, including the methods used, the many different outcomes that have been studied over time and the ages over which they have been studied. This summary may be of interest to autistic people and caregivers (parents) who want to know about the existence of research that provides answers about what to expect during an autistic child's development. We have recommended that future trajectory research efforts try to make up for the lack of studies from low- and middle-income countries; that more attention is given to the following outcomes that are meaningful to caregivers and autistic people; and to try to fill in the age gaps where more outcome-specific data are needed.
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Janus M, Brownell M, Reid-Westoby C, Pottruff M, Forer B, Guhn M, Duku E. Neighbourhood-level socioeconomic status and prevalence of teacher-reported health disorders among Canadian kindergarten children. Front Public Health 2024; 11:1295195. [PMID: 38303964 PMCID: PMC10830680 DOI: 10.3389/fpubh.2023.1295195] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/22/2023] [Indexed: 02/03/2024] Open
Abstract
Background The evidence on the association between neighborhood-level socioeconomic status (SES) and health disorders in young children is scarce. This study examined the prevalence of health disorders in Canadian kindergarten (5-6 years old) children in relation to neighborhood SES in 12/13 Canadian jurisdictions. Methods Data on child development at school entry for an eligible 1,372,980 children out of the total population of 1,435,428 children from 2004 to 2020, collected using the Early Development Instrument (EDI), were linked with neighborhood sociodemographic data from the 2006 Canadian Census and the 2005 Taxfiler for 2,058 neighborhoods. We examined the relationship using linear regressions. Children's HD included special needs, functional impairments limiting a child's ability to participate in classroom activities, and diagnosed conditions. Results The neighborhood prevalence of health disorders across Canada ranged from 1.8 to 46.6%, with a national average of 17.3%. The combined prevalence of health disorders was 16.4%, as 225,711 children were identified as having at least one health disorder. Results of an unadjusted linear regression showed a significant association between neighborhood-level SES and prevalence of health disorders (F(1, 2051) = 433.28, p < 0.001), with an R2 of 0.17. When province was added to the model, the R2 increased to 0.40 (F(12, 2040) = 115.26, p < 0.001). The association was strongest in Newfoundland & Labrador and weakest in Ontario. Conclusion Our study demonstrated that the prevalence of health disorders among kindergarten children was higher in lower SES neighborhoods and varied by jurisdiction in Canada, which has implications for practice and resource allocation.
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Affiliation(s)
- Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Molly Pottruff
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Barry Forer
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Bennett T, Drmic I, Gross J, Jambon M, Kimber M, Zaidman-Zait A, Andrews K, Frei J, Duku E, Georgiades S, Gonzalez A, Janus M, Lipman E, Pires P, Prime H, Roncadin C, Salt M, Shine R. The Family-Check-Up® Autism Implementation Research (FAIR) Study: protocol for a study evaluating the effectiveness and implementation of a family-centered intervention within a Canadian autism service setting. Front Public Health 2024; 11:1309154. [PMID: 38292388 PMCID: PMC10826514 DOI: 10.3389/fpubh.2023.1309154] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Prevalence rates of emotional and behavior problems (EBP) in autistic children and youth are high (40-70%), and often cause severe and chronic impairment. Furthermore, autistic children are also more likely to experience family "social-ecological" adversity compared to neurotypically developing peers, including social isolation, child maltreatment, caregiver mental illness, and socioeconomic risk. These family stressors increase the risk of co-occurring EBP among autistic children and can often impede access to evidence-based care, thus amplifying long-term health inequities for autistic children and their caregivers. In the current autism services landscape, there are few scalable, evidence-based programs that adequately address these needs. The Family Check-Up (FCU®) is a brief, strength-based, and tailored family-centered intervention that supports positive parenting and explicitly assesses the social determinants of child and family mental health within an ecological framework. Studies have demonstrated long-term positive child and caregiver outcomes in other populations, but the FCU® has not been evaluated in families of autistic children and youth. Therefore, we aimed to evaluate FCU® implementation within an established, publicly funded Autism Program in Ontario, Canada, with delivery by autism therapists, to demonstrate sustainable effectiveness within real-world settings. Methods In this study, we outline the protocol for a hybrid implementation-effectiveness approach with two key components: (1) A parallel-arm randomized controlled trial of N = 80 autistic children/youth (ages 6-17 years) and high levels of EBP and their caregivers. Primary and secondary outcomes include child EBP, and caregiver well-being and parenting. (2) A mixed methods implementation study, to describe facilitators and barriers to implementation of the FCU® within an autism service setting. Discussion Scalable, ecologically focused family-centered interventions offer promise as key components of a public health framework aimed at reducing mental health inequities among autistic children, youth, and their caregivers. Results of this study will inform further program refinement and scale-up.
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Affiliation(s)
- Teresa Bennett
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Irene Drmic
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Julie Gross
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | | | - K. Andrews
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Julia Frei
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - E. Duku
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Magdalena Janus
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - E. Lipman
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Paulo Pires
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Heather Prime
- Department of Psychology, York University, Toronto, ON, Canada
| | - Caroline Roncadin
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Mackenzie Salt
- Department of Psychiatry and Behavioral Neurosciences, Offord Centre for Child Studies, McMaster University/McMaster Children’s Hospital, Hamilton, ON, Canada
| | - Rebecca Shine
- Ron Joyce Children’s Health Centre Hamilton Health Sciences/McMaster Children’s Hospital, Hamilton, ON, Canada
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Mirenda P, Zaidman-Zait A, Cost KT, Smith IM, Zwaigenbaum L, Duku E, Kerns C, Georgiades S, Vaillancourt T, Elsabbagh M, Bennett T, Szatmari P. Educators Describe the "Best Things" About Students with Autism at School. J Autism Dev Disord 2024; 54:1-17. [PMID: 36315320 DOI: 10.1007/s10803-022-05761-2] [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] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
This study examined educators' descriptions of the positive character traits of students with autism spectrum disorder at ages 7-8 and 10-11, using an adapted version of the Values in Action (VIA) Classification of Strengths. The most commonly endorsed strengths at both age intervals were kindness, specific skills, self-regulation, and perseverance. Higher scores for challenging behavior were associated with a lower likelihood of endorsement for Happiness and Courage traits. Higher autism symptom severity scores were associated with a lower likelihood of endorsement for Courage traits. Few significant differences were found for endorsement of trait categories by students' educational placement or the type of curriculum they received. Results may have implications for student-teacher relationships, educational assessments, and school-based interventions that emphasize strengths and resilience.
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Affiliation(s)
- Pat Mirenda
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada.
| | | | | | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | - Connor Kerns
- University of British Columbia, 2125 Main Mall, V6T 1Z4, Vancouver, BC, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
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Beauchamp MLH, Rezzonico S, Bennett T, Duku E, Georgiades S, Kerns C, Mirenda P, Richard A, Smith IM, Szatmari P, Vaillancourt T, Waddell C, Zaidman-Zait A, Zwaigenbaum L, Elsabbagh M. The Influence of Bilingual Language Exposure on the Narrative, Social and Pragmatic Abilities of School-Aged Children on the Autism Spectrum. J Autism Dev Disord 2023; 53:4577-4590. [PMID: 36222993 PMCID: PMC10628039 DOI: 10.1007/s10803-022-05678-w] [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] [Accepted: 07/06/2022] [Indexed: 10/17/2022]
Abstract
We examined the narrative abilities of bilingual and monolingual children on the autism spectrum (AS), whether bilinguals presented stronger social and pragmatic language abilities compared to monolinguals, and the link between narrative, social, and pragmatic language abilities.The narrative, social, and pragmatic language skills of school-aged bilinguals (n = 54) and monolinguals (n = 80) on the AS were assessed using normed measures. Language exposure was estimated through a parent questionnaire.Bilinguals performed similarly to monolinguals on measures of narrative, social, and pragmatic language skills. However, balanced bilinguals performed better on a nonliteral language task.Overall, results indicate that bilingual children on the AS can become as proficient in using language as monolinguals and may enjoy a bilingual advantage.
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Affiliation(s)
| | | | | | - Eric Duku
- McMaster University, Hamilton, Canada
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | - Pat Mirenda
- University of British Columbia, Vancouver, Canada
| | - Annie Richard
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Isabel M Smith
- Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, Canada
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7
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Wright N, Courchesne V, Pickles A, Bedford R, Duku E, Kerns CM, Bennett T, Georgiades S, Hill J, Richard A, Sharp H, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. A longitudinal comparison of emotional, behavioral and attention problems in autistic and typically developing children. Psychol Med 2023; 53:7707-7719. [PMID: 37381780 PMCID: PMC10755241 DOI: 10.1017/s0033291723001599] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort. METHODS Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2-10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children. RESULTS Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers. CONCLUSIONS Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.
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Affiliation(s)
- N. Wright
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - V. Courchesne
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - A. Pickles
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - R. Bedford
- Department of Psychology, University of Bath, Bath, UK
| | - E. Duku
- McMaster University, Hamilton, Canada
| | - C. M. Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | | | | | - J. Hill
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - A. Richard
- IWK Health Centre, Autism Research Centre, Halifax, Canada
| | - H. Sharp
- Department of Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - I. M. Smith
- Dalhousie University and IWK Health, Halifax, Canada
| | | | | | | | - P. Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - M. Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Pathways Team
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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8
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Baribeau DA, Vigod SN, Pullenayegum E, Kerns CM, Vaillancourt T, Duku E, Smith IM, Volden J, Zwaigenbaum L, Bennett T, Elsabbagh M, Zaidman-Zait A, Richard AE, Szatmari P. Developmental cascades between insistence on sameness behaviour and anxiety symptoms in autism spectrum disorder. Eur Child Adolesc Psychiatry 2023; 32:2109-2118. [PMID: 35871413 DOI: 10.1007/s00787-022-02049-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/06/2022] [Indexed: 12/28/2022]
Abstract
Autistic children experience high rates of anxiety. Insistence on sameness behaviour (IS) is a core feature of autism that appears correlated with anxiety severity. The objective of this study was to examine the longitudinal relations between anxiety and IS in autistic children using a developmental cascade model. A longitudinal cohort of 421 autistic children was followed between 4 and 11 years of age. Anxiety was quantified using items from the Anxiety Problems subscale of the Child Behavior Checklist; sameness behaviours were measured using the Repetitive Behavior Scale-Revised, Ritualistic/sameness subscale (both parent-report measures). Structural equation modelling was used to examine the longitudinal and directional associations between anxiety and IS at four time-points, through cross-lagged panel models (CLPM) with and without a random-intercepts component (RI-CLPM). Both the CLPM and the RI-CLPM had good fit. Significant directional associations were detected whereby elevated or increasing IS preceded elevated or increasing anxiety symptoms 1-2 years later, respectively. Stable baseline tendencies towards anxiety and IS as between-person traits (intercepts) were strongly associated (standardized estimate = 0.69, p < 0.001). The magnitude of the cross-sectional associations between anxiety and IS appeared to lessen with age. IS and anxiety symptoms in autism are closely related. They appear to be shared traits that mirror each other particularly in younger children. Increasing IS may be a sign of emerging future anxiety. Interventions that target IS to reduce or prevent anxiety amongst school-aged autistic children merit further study.
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Affiliation(s)
- Danielle A Baribeau
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- The Hospital for Sick Children, Toronto, ON, Canada.
- The Hospital for Sick Children, University of Toronto, 123 Edward Street, 12th floor, Room 1210, Toronto, ON, M5G 1E2, Canada.
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada
| | - Eleanor Pullenayegum
- The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Connor M Kerns
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Teresa Bennett
- Offord Centre for Child Studies, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education at the Constantiner School of Education, Tel Aviv University, Tel Aviv, Israel
- The School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Annie E Richard
- Autism Research Centre, IWK Health Centre, Halifax, NS, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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Janus M, Ryan J, Pottruff M, Reid-Westoby C, Brownell M, Bennett T, Birken CS, Duku E, Ferro MA, Forer B, Georgiades S, Gorter JW, Guhn M, Maguire J, Manson H, Pei J, Santos R, Coplan RJ. Population-Based Teacher-Rated Assessment of Anxiety Among Canadian Kindergarten Children. Child Psychiatry Hum Dev 2023; 54:1309-1320. [PMID: 35244815 PMCID: PMC8894824 DOI: 10.1007/s10578-022-01332-9] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/13/2022]
Abstract
Despite anxiety being a prevalent mental health problem in children, little data exist on the pervasiveness and levels of anxiety symptoms in kindergarteners. Data from the Early Development Instrument, a teacher-completed, population-level measure of child development, were collected across Canada from 2004 to 2015. The final analytic sample consisted of 974,319 children of whom 2.6% were classified as "highly anxious". Compared to children who exhibited "few to none" anxious behaviors, highly anxious children were more likely to be male, have English/French as a second language, and have a special needs designation. Furthermore, compared with their less anxious peers, highly anxious children had between 3.5 and 6.1 higher odds of scoring below the 10th percentile cut-off in physical, social, language/cognitive and communication domains. Our findings suggest that anxious behaviors are related to children's overall health and illustrate the consistency and extensiveness of anxiety at a very young age among Canadian children.
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Affiliation(s)
- Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada.
| | - Julia Ryan
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Molly Pottruff
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Marni Brownell
- Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Teresa Bennett
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Catherine S Birken
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Mark A Ferro
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Barry Forer
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Martin Guhn
- Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jonathon Maguire
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | | | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, AB, Canada
| | - Rob Santos
- Department of Community Health Sciences, Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada
| | - Robert J Coplan
- Department of Psychology, Carleton University, Ottawa, ON, Canada
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Joshi D, Aschner A, Atkinson L, Halili-Sychangco D, Duku E, Puffer ES, Rieder A, Tonmyr L, Gonzalez A. Predictors of harsh parenting practices and inter-partner conflict during the COVID-19 pandemic in Ontario, Canada: a cross-sectional analysis from the Ontario Parent Survey. BMJ Open 2023; 13:e066840. [PMID: 37640470 PMCID: PMC10462979 DOI: 10.1136/bmjopen-2022-066840] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVES Guided by the bioecological model, the purpose of this study was to examine the associations of (1) individual level factors (sociodemographic, health behaviour and mental health), (2) family (micro) level COVID-19 experiences (difficulty with household management, managing child mood and behaviour, and pandemic-related positive experiences) and (3) community (macro) level factors (residential instability, ethnic concentration, material deprivation and dependency, an indicator of age and labour force) with harsh parenting practices and inter-partner conflict during the early lockdown of the COVID-19 pandemic in Ontario, Canada. DESIGN A cross-sectional analysis of data from the Ontario Parent Survey. SETTING A convenience sample of 7451 caregivers living in Ontario, Canada, at the time of baseline data collection (May-June 2020). PARTICIPANTS Caregivers aged 18 years and older with children 17 years or younger. OUTCOME MEASURES Parenting practices over the past 2 months was assessed using a published modification of the Parenting Scale. The frequency of inter-partner conflict over the past month was assessed using the Marital Conflict scale. RESULTS Individual (sociodemographic factors, alcohol use, and higher depressive and anxiety symptoms) and family (difficulties with managing the household and child mood and behaviour) level factors were positively associated with inter-partner conflict and harsh parenting practices. Having fewer positive experiences (eg, performing activities with children), and economic adversity at the family level were positively associated with inter-partner conflict but inversely associated with harsh parenting. At the community level, residential instability was negatively associated with harsh parenting practices. CONCLUSIONS Individual and family level factors were associated with harsh parenting and inter-partner conflict. The associations of fewer positive experiences and economic hardship with harsh parenting practices may be more complex than initially thought. Efforts that raise awareness and address caregiver mental health concerns are needed as part of the pandemic response to promote positive inter-partner and parent-child interactions.
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Affiliation(s)
- Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Amir Aschner
- Department of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | | | - Eric Duku
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Eve S Puffer
- Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Amber Rieder
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lil Tonmyr
- Family Violence Surveillance, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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11
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Khoury JE, Atkinson L, Jack S, Bennett T, Raha S, Duku E, Gonzalez A. Protocol for the COVID-19 Wellbeing and Stress Study: a longitudinal study of parent distress, biological stress and child biopsychosocial development during the pandemic and beyond. BMJ Open 2023; 13:e071926. [PMID: 37580092 PMCID: PMC10432660 DOI: 10.1136/bmjopen-2023-071926] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/22/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a unique impact on the mental health and well-being of pregnant individuals and parents of young children. However, the impact of COVID-19-related stress during pregnancy on early child biopsychosocial development, remains unclear. The COVID-19 Wellbeing and Stress Study will: (1) investigate the impact of different forms of prenatal stress experienced during the pandemic (including objective hardship, perceived psychological distress and biological stress) on child stress biology, (2) examine the association between child stress biology and child developmental outcomes, (3) determine whether child stress biology acts as a mechanism linking prenatal stress to adverse child developmental outcomes and (4) assess whether gestational age at the onset of the COVID-19 pandemic or child sex, moderate these associations. METHODS AND ANALYSES The COVID-19 Wellbeing and Stress Study is a prospective longitudinal study, consisting of six time points, spanning from pregnancy to 3 years postpartum. The study began in June 2020, consisting of 304 pregnant people from Ontario, Canada. This multimethod study is composed of questionnaires, biological samples, behavioural observations and developmental assessments ETHICS AND DISSEMINATION: This study was approved by the Hamilton Integrated Research Ethics Board (#11034) and the Mount Saint Vincent University Research Ethics Board (#2020-187, #2021-075, #2022-008). Findings will be disseminated through peer-reviewed presentations and publications, community presentations, and electronic forums (social media, newsletters and website postings).
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Susan Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Teresa Bennett
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Sandeep Raha
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Gonzalez
- Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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12
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Kamali M, Edwards J, Anderson LN, Duku E, Georgiades K. Social Disparities in Mental Health Service Use Among Children and Youth in Ontario: Evidence From a General, Population-Based Survey. Can J Psychiatry 2023; 68:596-604. [PMID: 36503305 PMCID: PMC10411367 DOI: 10.1177/07067437221144630] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine differences in mental health-related service contacts between immigrant, refugee, racial and ethnic minoritized children and youth, and the extent to which social, and economic characteristics account for group differences. METHODS The sample for analyses includes 10,441 children and youth aged 4-17 years participating in the 2014 Ontario Child Health Study. The primary caregiver completed assessments of their child's mental health symptoms, perceptions of need for professional help, mental health-related service contacts, experiences of discrimination and sociodemographic and economic characteristics. RESULTS Adjusting for mental health symptoms and perceptions of need for professional help, children and youth from immigrant, refugee and racial and ethnic minoritized backgrounds were less likely to have mental health-related service contacts (adjusted odds ratios ranged from 0.54 to 0.79), compared to their non-immigrant peers and those who identified as White. Group differences generally remained the same or widened after adjusting for social and economic characteristics. Large differences in levels of perceived need were evident across non-migrant and migrant children and youth. CONCLUSION Lower estimates of mental health-related service contacts among immigrant, refugee and racial and ethnic minoritized children and youth underscore the importance and urgency of addressing barriers to recognition and treatment of mental ill-health among children and youth from minoritized backgrounds.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Jordan Edwards
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Katholiki Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Ron Joyce Children's Health Centre, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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13
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Amadu I, Seidu AA, Mohammed A, Duku E, Miyittah MK, Ameyaw EK, Hagan JE, Musah MH, Ahinkorah BO. Assessing the combined effect of household cooking fuel and urbanicity on acute respiratory symptoms among under-five years in sub-Saharan Africa. Heliyon 2023; 9:e16546. [PMID: 37346351 PMCID: PMC10279788 DOI: 10.1016/j.heliyon.2023.e16546] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/02/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Background This study sought to investigate the association between urbanicity (rural-urban residency), the use of solid biomass cooking fuels and the risk of Acute Respiratory Infections (ARIs) among children under the age of 5 in sub-Saharan Africa (SSA). Methods Cross-sectional data from the most recent surveys of the Demographic and Health Survey Program conducted in 31 sub-Saharan African countries were pooled for the analysis. The outcome variables, cough and rapid short breath were derived from questions that asked mothers if their children under the age of 5 suffered from cough and short rapid breath in the past two weeks preceding the survey. To examine the associations, multivariable negative log-log regression models were fitted for each outcome variable. Results Higher odds ratios of cough occurred among children in urban households that use unclean cooking fuel (aOR = 1.05 95% CI = 1.01, 1.08). However, lower odds ratios were observed for rural children in homes that use clean cooking fuel (aOR = 0.93 95% CI = 0.87, 0.99) relative to children in urban homes using clean cooking fuel. We also found higher odds ratios of short rapid breaths among children in rural households that use unclean cooking fuel compared with urban residents using clean cooking fuel (aOR = 1.12 95% CI = 1.08, 1.17). Conclusion Urbanicity and the use of solid biomass fuel for cooking were associated with an increased risk of symptoms of ARIs among children under five years in SSA. Thus, policymakers and stakeholders need to design and implement strategies that minimize children's exposure to pollutants from solid biomass cooking fuel. Such interventions could reduce the burden of respiratory illnesses in SSA and contribute to the realization of Sustainable Development Goal 3.9, which aims at reducing the number of diseases and deaths attributable to hazardous chemicals and pollution of air, water and soil.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Emperiks Research, NT0085, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Box 256, Ghana
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Queensland, Australia
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Ghana
- Hen Mpoano (Our Coast), Takoradi P.O. Box AX 296, Ghana
| | - Michael K. Miyittah
- Africa Centre of Excellence in Coastal Resilience (ACECoR)-Centre for Coastal Management, University of Cape Coast, Cape Coast, Ghana
- Department of Environmental Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | - Mohammed Hafiz Musah
- Department of Health Information Management, Tamale Teaching Hospital, Tamale, Ghana
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14
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Nurse KM, Janus M, Birken CS, Keown-Stoneman CDG, Omand JA, Maguire JL, Reid-Westoby C, Duku E, Mamdani M, Tremblay MS, Parkin PC, Borkhoff CM. Predictive Validity of the Infant Toddler Checklist in Primary Care at the 18-month Visit and School Readiness at 4 to 6 Years. Acad Pediatr 2023; 23:322-328. [PMID: 36122830 DOI: 10.1016/j.acap.2022.09.004] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/02/2022] [Accepted: 09/10/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The American Academy of Pediatrics recommends developmental surveillance and screening in early childhood in primary care. The 18-month visit may be an ideal time for identification of children with delays in language and communication, or symptoms of autism spectrum disorder (ASD). Little is known about the predictive validity of developmental screening tools administered at 18 months. Our objective was to examine the predictive validity of the Infant Toddler Checklist (ITC) at the 18-month health supervision visit, using school readiness at kindergarten age as the criterion measure. METHODS We designed a prospective cohort study, recruiting in primary care in Toronto, Canada. Parents completed the ITC at the 18-month visit. Teachers completed the Early Development Instrument (EDI) when the children were in Kindergarten, age 4-6 years. We calculated screening test properties with 95% confidence intervals (CIs). We used multivariable logistic and linear regression analyses adjusted for important covariates. RESULTS Of 293 children (mean age 18 months), 30 (10.2%) had a positive ITC including: concern for speech delay (n = 11, 3.8%), concern for other communication delay (n = 13, 4.4%), and concern for both (n = 6, 2.0%). At follow-up (mean age 5 years), 54 (18.4%) had overall EDI vulnerability, 19 (6.5%) had vulnerability on the 2 EDI communication domains. The ITC sensitivity ranged from 11% to 32%, specificity from 91% to 96%, false positive rates from 4% to 9%, PPV from 16% to 35%, NPV from 83% to 95%. A positive ITC screen and ITC concern for speech delay were associated with lower scores in EDI communication skills and general knowledge (β = -1.08; 95% CI: -2.10, -0.17; β = -2.35; 95% CI: -3.63, -1.32) and EDI language and cognitive development (β = -0.62; 95% CI: -1.25, -0.18; β = -1.22; 95% CI: -2.11, -0.58). CONCLUSIONS The ITC demonstrated high specificity suggesting that most children with a negative ITC screen will demonstrate school readiness at 4-6 years, and low false positive rates, minimizing over-diagnosis. The ITC had low sensitivity highlighting the importance of ongoing developmental surveillance and screening.
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Affiliation(s)
- Kimberly M Nurse
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University (M Janus, C Reid-Westoby, and E Duku), Hamilton, Ontario, Canada
| | - Catherine S Birken
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children (CS Birken, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto (CS Birken, JL Maguire, and PC Parkin), Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- The HUB Health Research Solutions, Li Ka Shing Knowledge Institute (CDG Keown-Stoneman), Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto (CDG Keown-Stoneman and M Mamdani), Toronto, Ontario, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, SickKids Research Institute, Hospital for Sick Children (JA Omand), Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto (CS Birken, JL Maguire, and PC Parkin), Toronto, Ontario, Canada; Department of Pediatrics, St. Michael's Hospital (JL Maguire and M Mamdani), Toronto, Ontario, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University (M Janus, C Reid-Westoby, and E Duku), Hamilton, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University (M Janus, C Reid-Westoby, and E Duku), Hamilton, Ontario, Canada
| | - Muhammad Mamdani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto (CDG Keown-Stoneman and M Mamdani), Toronto, Ontario, Canada; Department of Pediatrics, St. Michael's Hospital (JL Maguire and M Mamdani), Toronto, Ontario, Canada; Unity Health Toronto (M Mamdani), Toronto, Ontario, Canada; Temetry Faculty of Medicine, University of Toronto (M Mamdani), Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto (M Mamdani), Toronto, Ontario, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, CHEO Research Institute (MS Tremblay), Ottawa, Ontario, Canada
| | - Patricia C Parkin
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children (CS Birken, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto (CS Birken, JL Maguire, and PC Parkin), Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto (KM Nurse, CS Birken, JL Maguire, M Mamdani, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada; Pediatric Outcomes Research Team (PORT), Division of Pediatric Medicine and SickKids Research Institute, Hospital for Sick Children (CS Birken, PC Parkin, and CM Borkhoff), Toronto, Ontario, Canada.
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15
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Chen YJ, Duku E, Zaidman-Zait A, Szatmari P, Smith IM, Ungar WJ, Zwaigenbaum L, Vaillancourt T, Kerns C, Bennett T, Elsabbagh M, Thompson A, Georgiades S. Variable patterns of daily activity participation across settings in autistic youth: A latent profile transition analysis. Autism 2023; 27:13623613231154729. [PMID: 36855223 PMCID: PMC10576904 DOI: 10.1177/13623613231154729] [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] [Indexed: 03/02/2023]
Abstract
LAY ABSTRACT What people do or engage in in their daily lives, or daily life participation, is often linked to their state of being happy and healthy, as well as potential for living independently. To date, little research has been conducted on daily activity participation by autistic youth at home, at school or in the community. Learning more about individual differences in participation levels and what might influence them can help to create custom supports for autistic youth and their families. In this study, 158 caregivers of autistic youth were asked how often their children took part in 25 common activities at two assessments, about one year apart. The analysis showed three profiles for each of the home and school settings and two profiles for the community setting. These profiles reflected distinct patterns in how often autistic youth took part in various daily activities, particularly in doing homework, school club activities and community gatherings. Most autistic youth were in profiles marked by often taking part at home but less often at school and in the community, and about three-fourths of them tended to stay in the same profile over time. Autistic youth with limited participation profiles were more likely to have lower scores on measures of cognitive ability and daily life skills and more challenging behaviour, and faced more barriers in their environment. These findings show how important it is to think about each autistic person's strengths and weaknesses, and changing needs, to better support their daily life participation.
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Affiliation(s)
| | | | | | - Peter Szatmari
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
| | | | - Wendy J Ungar
- The Hospital for Sick Children, Canada
- University of Toronto, Canada
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16
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McVey AJ, Liu Q, Bedford SA, Zaidman-Zait A, Szatmari P, Smith IM, Vaillancourt T, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Kerns CM. Examining clinical characteristics of autism and links with parent perceptions of sibling relationship quality. Autism 2023; 27:309-320. [PMID: 35510331 DOI: 10.1177/13623613221094672] [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] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Sibling relationship quality is important for the well-being of children on the autism spectrum and their siblings. Little is known, however, about how varied behavior and abilities of children on the autism spectrum may be associated with parent perceptions of domains of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum (ages 10-11 years), participating in an ongoing longitudinal study. We looked at how three clinical characteristics (autism symptoms, behavioral difficulties, and communication ability) related to four areas of parent-reported sibling relationship quality (warmth/closeness, conflict, relative status/power, and rivalry). We also examined whether the strength of the association between behavioral difficulties and parent-reported sibling relationship quality was influenced by communication ability. We found that more severe autism symptoms were associated with less conflict and rivalry, and higher communication ability was associated with more relative status/power. We also found that children on the autism spectrum with more behavioral difficulties and weaker communication ability had less warmth/closeness in their sibling relationships. Our findings highlight that it is important to consider autism symptoms, behavioral difficulties, and communication ability, as well as multiple domains of relationship quality, to better understand how parents view the relationships between autistic children and their siblings. Clinically, methods for improving sibling relationships may include teaching conflict resolution strategies to children on the autism spectrum with stronger communication abilities and their siblings, and fostering sibling connection for those with lower communication abilities.
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Affiliation(s)
- Alana J McVey
- University of British Columbia, Canada.,University of Washington, USA
| | - Quinn Liu
- University of British Columbia, Canada
| | - Saashi A Bedford
- University of British Columbia, Canada.,University of Cambridge, UK
| | | | | | | | | | | | - Teresa Bennett
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
| | - Eric Duku
- McMaster University, Canada.,Offord Centre for Child Studies, Canada
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Leno VC, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith IM, Richards A, Vaillancourt T, Szatmari P, Elsabbagh M. Longitudinal associations between early childhood irritability and adolescent depression symptoms in autistic children are mediated by peer relationships but not educational engagement. Dev Psychopathol 2023; 36:1-11. [PMID: 36700357 PMCID: PMC7615659 DOI: 10.1017/s0954579422001316] [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] [Indexed: 01/27/2023]
Abstract
In the general population, irritability is associated with later depression. Despite irritability being more prevalent in autistic children, the long-term sequelae are not well explored. We tested whether irritability in early childhood predicted depression symptoms in autistic adolescents, and whether associations could be explained by difficulties in peer relationships and lower educational engagement. Analyses tested the longitudinal associations between early childhood irritability (ages 3-5) and adolescent depression symptoms (age 14) in a prospective inception cohort of autistic children (N = 390), followed from early in development shortly after they received a clinical diagnosis. Mediators were measured in mid-childhood (age 10) by a combination of measures, from which latent factors for peer relationships and educational engagement were estimated. Results showed early childhood irritability was positively associated with adolescent depression symptoms, and this association remained when adjusting for baseline depression. A significant indirect pathway through peer relationships was found, which accounted for around 13% of the association between early childhood irritability and adolescent depression, suggesting peer problems may partially mediate the association between irritability and later depression. No mediation effects were found for education engagement. Results highlight the importance of early screening and intervention for co-occurring irritability and peer problems in young autistic children.
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Affiliation(s)
- Virginia Carter Leno
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Nicola Wright
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, Manchester Metropolitan University, United Kingdom
| | - Andrew Pickles
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
| | - Rachael Bedford
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, United Kingdom
- Department of Psychology, University of Bath, United Kingdom
| | | | - Connor Kerns
- University of British Columbia, Vancouver, Canada
| | | | - Eric Duku
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Isabel M. Smith
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Annie Richards
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ontario, Canada
| | - Peter Szatmari
- University of Toronto, Canada
- Centre for Addiction and Mental Health, Canada
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, Azrieli Centre for Autism Research, McGill University, Montreal, Quebec, Canada
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18
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Tsiplova K, Ungar WJ, Szatmari P, Cost K, Pullenayegum E, Duku E, Volden J, Smith IM, Waddell C, Zwaigenbaum L, Bennett TA, Elsabbagh M, Georgiades S, Zaidman-Zait A. Measuring the association between behavioural services and outcomes in young children with autism spectrum disorder. Res Dev Disabil 2023; 132:104392. [PMID: 36493738 DOI: 10.1016/j.ridd.2022.104392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) receive a wide range of services. AIMS To examine the association between behavioural services received by children with ASD between ages 2 and 5 years and outcomes during primary school years. METHODS A total of 414 preschool-aged children diagnosed with ASD were enrolled at five Canadian sites and were assessed within four months of diagnosis (T1), six months later (T2), 12 months later (T3), at school entry (T4), and then annually (T5-T8) to 11 years of age. The association between the receipt of behavioural services during T1 to T3 and T8 outcomes related to adaptive behaviour and behavioural problems was modelled using linear regressions adjusted for immigrant status, family income, child's age at diagnosis, site, sex assigned at birth, and baseline (T1) outcome. RESULTS Children who received behavioural services during at least one time period from T1 to T3 did not have significantly different outcomes at T8 than children who did not receive any behavioural services. IMPLICATIONS Pre-school use of behavioural services was not found to affect outcomes during later childhood. Numerous challenges accompany studies of the association between pre-school service use and later outcomes in a heterogeneous ASD sample. Recommendations for study design are provided.
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Affiliation(s)
- Kate Tsiplova
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Katherine Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 114 Street, 3-48 Corbett Hall, Edmonton, Alberta T6G 2G4, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, P. O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada; Autism Research Centre, IWK Health Centre, 4th Floor Link Building, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Room 2435, 515 West Hastings Street Vancouver, British Columbia V6B 5K, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue Edmonton, Alberta T6G 1C9, Canada
| | - Teresa A Bennett
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education, Constantiner School of Education, Tel Aviv University, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
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19
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Amadu I, Seidu AA, Agyemang KK, Arthur-Holmes F, Duku E, Salifu I, Bolarinwa OA, Hagan JE, Ahinkorah BO. Joint effect of water and sanitation practices on childhood diarrhoea in sub-Saharan Africa. PLoS One 2023; 18:e0283826. [PMID: 37167213 PMCID: PMC10174539 DOI: 10.1371/journal.pone.0283826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/18/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Diarrhoea remains the major cause of morbidity and mortality of children under five years in Africa. Several studies have shown that inadequate and unsafe water, lack of sanitation, and poor hygiene practices are complex issues for different pathogens and accountable for the occurrence of diarrhoea diseases. We assessed the combined effect of household's source of drinking water and type of toilet facility and residential wellbeing on the incidence of childhood diarrhoea in 33 Sub-Saharan Africa countries while accounting for relevant compositional and contextual factors. METHODS The 2010-2019 datasets from the Demographic and Health Surveys were drawn for analyses. The outcome variable used in this study was the incidence of childhood diarrhoea. Three negative log-log generalized linear regression models were then sequentially fitted to the data to examine the joint effect of household water and sanitation practices on child diarrhoea. The results were presented using crude odds ratios (CORs) and adjusted odds ratios (AORs) at 95% confidence intervals (CIs). Using ArcGIS software, maps were design to unveil the spatial distribution of key variables. FINDINGS Approximately 16% of the 307,741 mothers interviewed reported an incidence of diarrhoea disease among children under-five years in their households. The results showed that a household depending on an unimproved source of drinking water and with an unimproved type of toilet facility was not significantly associated with childhood diarrhoea. However, those with improved drinking water but an unimproved type of toilet facility had higher odds of reporting childhood diarrhoea (AOR = 1.020, 95% CI = 1.003-1-036) compared to those in households with both improved source of drinking water and type of toilet facility. Across the geographical regions, Eastern (aOR = 1.102, 95% CI = 1.084-1.120) and Central Africa (aOR = 1.102, 95% CI = 1.083-1.121) were more likely to experience child diarrhoea. CONCLUSION Water and sanitation practices such as the source of drinking water and toilet facility, and geographic region had significant effects on childhood diarrhoea in sub-Saharan Africax. The findings suggest the need for multi-sectoral actions that recognise the geo-spatial and temporal characteristics identified in the study through regional to national policies. Water and sanitation community-based interventions that seek to improve equitable access to safe water and sanitation in the sub-region should be intensified.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
- Emperiks Research, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, PMB, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
| | | | | | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
- Hen Mpoano (Our Coast), Sekondi-Takoradi, Ghana
| | - Iddrisu Salifu
- Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Public Health & Well-being, Faculty of Health & Social Care, University of Chester, Chester, United Kingdom
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology, Sydney, NSW, Australia
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20
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Franchini M, Smith IM, Sacrey L, Duku E, Brian J, Bryson SE, Vaillancourt T, Armstrong V, Szatmari P, Roberts W, Roncadin C, Zwaigenbaum L. Continuity of trajectories of autism symptom severity from infancy to childhood. J Child Psychol Psychiatry 2022; 64:895-906. [PMID: 36562606 DOI: 10.1111/jcpp.13744] [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] [Accepted: 10/30/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Behavioral symptom trajectories are informative of the development of young children at increased likelihood for autism spectrum disorder (ASD). METHODS Developmental trajectories of early signs were examined in a cohort of siblings of children diagnosed with ASD (n = 502) from 6 to 18 months using the Autism Observation Scale for Infants (AOSI), and from 18 months to 5-7 years using the Autism Diagnostic Observation Schedule (ADOS). Diagnostic outcomes for ASD at age 3 confirmed diagnosis for 137 children. We further analyzed the conditional probability of a switch from a trajectory measured with the AOSI to a trajectory measured with the ADOS as well as predictors from age 6 months. RESULTS We derived three early trajectories of behavioral signs ("Low," "Intermediate," and "Increasing") from 6 to 18 months using the AOSI. We then derived three similar, distinct trajectories for the evolution of symptom severity between 18 and 60-84 months of age (Low, Intermediate, Increasing) using the ADOS. Globally, the Low trajectory included children showing fewer ASD signs or symptoms and the Increasing trajectory included children showing more severe symptoms. We also found that most children in the Low AOSI trajectory stayed in the corresponding ADOS trajectory, whereas children in an Increasing AOSI trajectory tended to transition to an Intermediate or Increasing ADOS trajectory. Developmental measures taken at 6 months (early signs of ASD, Fine Motor, and Visual Reception skills) were predictive of trajectory membership. CONCLUSIONS Results confirm substantial heterogeneity in the early emergence of ASD signs in children at increased likelihood for ASD. Moreover, we showed that the way those early behavioral signs emerge in infants is predictive of later symptomatology. Results yield clear clinical implications, supporting the need to repeatedly assess infants at increased likelihood for ASD as this can be highly indicative of their later development and behavior.
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Affiliation(s)
- Martina Franchini
- Fondation Pôle Autisme and Faculty of Educational Psychology and Sciences, University of Geneva, Geneva, Switzerland
| | - Isabel M Smith
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Lori Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jessica Brian
- Bloorview Research Institute and Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Susan E Bryson
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Departments of Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders, Toronto, ON, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, Canada
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21
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Farmer C, Thurm A, Condy E, Duku E, Szatmari P, Bennett T, Elsabbagh M, Kerns CM, Smith IM, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Georgiades S. Disentangling global and domain-level adaptive behavior trajectories among children with autism spectrum disorder. J Child Psychol Psychiatry 2022; 64:868-875. [PMID: 36562498 PMCID: PMC10369325 DOI: 10.1111/jcpp.13741] [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] [Accepted: 10/25/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Heterogeneity in adaptive behavior abilities among people with autism spectrum disorder (ASD) is expressed not only as uneven levels of impairment across domains, but also in the developmental trajectories of adaptive skills. We studied the question of whether, after accounting for global adaptive behavior development, we find evidence of heterogeneity in the trajectories of specific domains of adaptive behavior. METHODS A sample of 504 children with ASD was obtained by combining data from two independent natural history studies conducted in North America. We used a factor of curves model to explain growth between 36 and 138 months in Vineland Adaptive Behavior Scales, Second Edition (VABS) age equivalents as a function of domain-specific and global growth processes. RESULTS The domain-specific trajectories in all three domains (Communication, Daily Living Skills, and Socialization) reflected impairment relative to age expectations as well as slower-than-expected growth with age, and the parameters of these trajectories were moderately-to-strongly correlated across domains. The global adaptive behavior trajectory had an initial (36-41 months of age) developmental level of about 22 age-equivalent months, and eventually slowed after initially increasing by about 6 months each year. The global trajectory accounted for the majority of variance in the domain-level processes; however, additional variance remained (14%-38%) in the domain-level intercepts, slopes, and quadratic processes. CONCLUSIONS These results extend existing theoretical and empirical support for the hierarchical structure of adaptive behavior to include its development over time in clinical samples of children with ASD. A latent global trajectory may be sufficient to describe the growth of adaptive behavior in children with ASD; however, the remaining domain-specific variability after accounting for global adaptive behavior development allows for the possibility that differential effects of intervention on specific domains may be possible and detectable.
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Affiliation(s)
- Cristan Farmer
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Emma Condy
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada
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22
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Krakowski AD, Cost KT, Szatmari P, Anagnostou E, Crosbie J, Schachar R, Duku E, Georgiades S, Ayub M, Kelley E, Nicolson R, Pullenayegum E, Barnett-Tapia C. Characterizing the ASD-ADHD phenotype: measurement structure and invariance in a clinical sample. J Child Psychol Psychiatry 2022; 63:1534-1543. [PMID: 35342939 DOI: 10.1111/jcpp.13609] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) have considerable overlap, supporting the need for a dimensional framework that examines neurodevelopmental domains which cross traditional diagnostic boundaries. In the following study, we use factor analysis to deconstruct the ASD-ADHD phenotype into its underlying phenotypic domains and test for measurement invariance across adaptive functioning, age, gender and ASD/ADHD clinical diagnoses. METHODS Participants included children and youth (aged 3-20 years) with a clinical diagnosis of ASD (n = 727) or ADHD (n = 770) for a total of 1,497 participants. Parents of these children completed the Social Communication Questionnaire (SCQ), a measure of autism symptoms, and the Strengths and Weaknesses of ADHD and Normal Behaviour (SWAN) questionnaire, a measure of ADHD symptoms. An exploratory factor analysis (EFA) was performed on combined SCQ and SWAN items. This was followed by a confirmatory factor analysis (CFA) and tests of measurement invariance. RESULTS EFA revealed a four-factor solution (inattention, hyperactivity/impulsivity, social-communication, and restricted, repetitive, behaviours and interests (RRBI)) and a CFA confirmed good model fit. This solution also showed good model fit across subgroups of interest. CONCLUSIONS Our study shows that a combined ASD-ADHD phenotype is characterized by two latent ASD domains (social communication and RRBIs) and two latent ADHD domains (inattention and hyperactivity/impulsivity). We established measurement invariance of the derived measurement model across adaptive functioning, age, gender and ASD/ADHD diagnoses.
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Affiliation(s)
- Aneta D Krakowski
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Russell Schachar
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Offord Centre for Child Studies, McMaster Children's Hospital and McMaster University, Hamilton, ON, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queen's University, Kingston, ON, Canada.,Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Carolina Barnett-Tapia
- Division of Neurology, Department of Medicine, University Health Network and University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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23
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Pickles A, Wright N, Bedford R, Steiman M, Duku E, Bennett T, Georgiades S, Kerns CM, Mirenda P, Smith IM, Ungar WJ, Vaillancourt T, Waddell C, Zaidman‐Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Predictors of language regression and its association with subsequent communication development in children with autism. J Child Psychol Psychiatry 2022; 63:1243-1251. [PMID: 35098539 PMCID: PMC9786608 DOI: 10.1111/jcpp.13565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Language regression, broadly defined as the loss of acquired language skills in early childhood, is a distinctive feature of autism. Little is known about the factors underlying regression or the prognosis of children who exhibit regression. We examine potential predictors of language regression and test its association with language development in a prospective longitudinal sample of children with autism spectrum disorder (ASD) from diagnosis to age 10 years. METHODS We analysed data from Pathways in ASD, a prospective longitudinal study of 421 children enrolled around the time of an autism diagnosis between 2 and 5 years. Autism Diagnostic Interview-Revised data were available for 408 children, of whom 90 (22%) were classified as having language regression. RESULTS Demographic and other health factors including caregiver education, family income, child sex, reported seizures, and age of enrolment did not differ between children with and without language regression. Children with language regression walked earlier and attained first words sooner than those without regression. However, both groups attained phrase speech at comparable ages. Those with regression exhibited greater delays in expressive and receptive communication over the follow-up period, although this effect was attenuated when accounting for baseline differences in motor and cognitive ability. Overall, those with language regression continued to exhibit expressive but not receptive communication delay compared to those without regression. Communication trajectories were heterogeneous to age 10 years, irrespective of regression status. CONCLUSIONS Although language regression can be alarming, our findings confirm that its occurrence does not necessarily foreshadow worse developmental outcomes relative to those without regression. Although a discrepancy in age-equivalent communication skills may persist, this can be expected to be of less practical importance with rising average levels of skills. Future studies need to account for the significant variability in language trajectories by considering factors beyond developmental regression.
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Affiliation(s)
- Andrew Pickles
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Nicola Wright
- Institute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | | | - Mandy Steiman
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
| | | | | | | | | | - Pat Mirenda
- University of British ColumbiaVancouverBCCanada
| | | | - Wendy J. Ungar
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | | | | | | | | | - Peter Szatmari
- Hospital for Sick Children Research InstituteUniversity of TorontoTorontoONCanada
| | - Mayada Elsabbagh
- Azrieli Centre for Autism ResearchMontreal Neurological HospitalMcGill UniversityMontrealQCCanada
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24
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Uhlman K, Bonert M, Murphy J, Duku E, Naqvi A, Thoma A. Routine Pathological Examination of Clinically Presumed Dupuytren Disease: Does It Add Value? Hand (N Y) 2022:15589447221128982. [PMID: 36314350 DOI: 10.1177/15589447221128982] [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: 02/10/2023]
Abstract
BACKGROUND In surgery for Dupuytren disease (DD), palmar fascia specimens are routinely submitted for pathological evaluation. The purpose of this study was to determine the rate of discordant diagnosis and the value of, and costs associated with, routine pathological analysis of palmar fascia tissue extracted in surgery for clinically diagnosed DD. METHODS All pathology reports for in-house palmar fascia specimens obtained in surgery for clinically diagnosed DD (time period: January 2001 to December 2020) were retrieved from one academic institution. All specimens were classified by a hierarchical free-text string matching algorithm (HFTSMA) and searched for evidence of malignancy. The primary outcome was percentage of concordant, discrepant, and discordant diagnoses. Secondary outcomes included anatomical location and costs. The HFTSMA was used to capture the anatomical location. Costs included professional, laboratory processing, and ancillary fees based on the Ontario Schedule of Benefits. RESULTS The search retrieved 1323 pathology reports, with 1480 palmar fascia specimens, from 1078 individual patients. By diagnosis, 96.1% of specimens (1422/1480) were concordant (fibromatosis), 3.9% (58/1480) were discrepant (scarring/fibrosis, benign fascia/connective tissue, or other benign findings), and 0% (0/1480) were discordant. The most common location was ring finger (n = 381, 48.7%). Ancillary testing was minimal. The cost per palmar fascia specimen was estimated to be CAD $34.57. The institutional costs were approximately CAD $2558.18/year. CONCLUSIONS Routine pathological examination of specimens in cases of clinically diagnosed DD does not yield additional clinically important findings and may not warrant their costs.
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Affiliation(s)
| | - Michael Bonert
- McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, ON, Canada
| | | | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | - Asghar Naqvi
- McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, ON, Canada
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Nurse K, Janus M, Birken C, Keown-Stoneman C, Omand J, Maguire J, Reid-Westoby C, Duku E, Lebovic G, Mamdani M, Simpson JR, Tremblay M, Parkin P, Borkhoff C. 38 Developmental Screening Using the Infant Toddler Checklist at 18 Months and School Readiness at 4 to 6 Years. Paediatr Child Health 2022. [PMCID: PMC9586087 DOI: 10.1093/pch/pxac100.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background The American Academy of Pediatrics recommends developmental screening at multiple visits using both a general developmental tool and an autism spectrum disorder (ASD)-specific tool. The Canadian Paediatric Society recommends screening at a single visit at 18 months. There is no consensus on which tool is best suited for one-time screening. The Infant Toddler Checklist (ITC) identifies children who are at risk for communication impairment, may detect ASD, and may be a useful screening tool at the 18-month visit. Objectives To examine the screening test accuracy of the ITC at the 18-month visit to predict school readiness at kindergarten age. Design/Methods This prospective cohort study included children who attended primary care health supervision visits in Toronto, Canada. Parents completed the ITC at the 18-month visit and teachers completed the Early Development Instrument (EDI - a population-level measure of school readiness in kindergarten) at 4-6 years. An ITC screen is positive if there is concern for expressive speech delay (speech composite below the 10th percentile) and/or other communication delay (social composite, symbolic composite or the total score below the 10th percentile). Children were considered overall vulnerable on the EDI if at least one of five domains was below the 10th percentile of the Ontario population: language and cognitive development; physical health and well-being; social competence; emotional maturity; communication skills and general knowledge. We calculated screening test properties with 95% confidence intervals (CIs), using EDI vulnerability as the criterion measure. We used multivariable regression models to examine the association between the ITC and EDI domains. Results Of 293 children, 30 (10%) had a positive ITC. At follow-up, 54 (18%) children had a teacher-reported EDI vulnerability. The specificity (range, 87%-96%) and negative predictive value (range, 83%-95%) for the ITC were high; false positive rate was low (range, 4%-13%); sensitivity was low (range, 11%-37%). A positive ITC was associated with a lower score in EDI language and cognitive development (b= -0.62, 95% CI: -1.25, -0.18; P=0.046) and EDI communication skills and general knowledge (b= -1.08, 95% CI: -2.10, -0.17; P=0.036). We found no evidence of an association between ITC and EDI vulnerability. Conclusion The ITC at 18 months had high specificity (87%-96%) suggesting that most children with a negative ITC will demonstrate school readiness at 4-6 years. False positive rates were low, minimizing over-diagnosis. The ITC, with its focus on speech and language, communication disorders and ASD, may be a candidate for screening at the 18-month visit.
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Spadafora N, Reid-Westoby C, Pottruff M, Wang J, Duku E, Janus M. An investigation of kindergarten educator reported barriers and concerns and school neighbourhood composition in Ontario, Canada. Int J Popul Data Sci 2022. [PMCID: PMC9644820 DOI: 10.23889/ijpds.v7i3.1839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Duku E, Pottruff M, Janus M. Creating and Evaluating Two Cumulative Developmental Vulnerability Risk Measures. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectivesThe Early Development Instrument (EDI) is a valid and reliable population-level tool measuring child developmental vulnerability in Kindergarten. The objective of this study was to derive and validate new EDI-based development “cumulative vulnerability” risk indicators using a cumulative risk index approach (Rutter, 1979).
ApproachThe EDI has two main outcome measures: individual domain scores and vulnerability (scoring below a 10% cutpoint). To account for more complexity, we derived two new “cumulative vulnerability” measures. The Mean EDI Domain Score (MEDS) is the mean of the domain scores, and the Total EDI Vulnerability Index (TEVI) is an ordinal summative measure using domain vulnerability indicators. In Study I, we examined the relationship of the MEDS and TEVI measures with neighbourhood-level SES. In Study II, we examined the predictive/explanatory power of the MEDS and TEVI measures with Grade 3 provincial assessments in Ontario, Canada.
ResultsStudy I used EDI Kindergarten data from twelve provincial and territorial data collections between 2008 and 2013 in Canada (316,015 children) aggregated to 2,038 customized neighbourhoods. The two new cumulative vulnerability measures worked as expected, with positive association between MEDS and neighbourhood SES (r=0.58), and a negative association between TEVI and neighbourhood SES (r=-0.57). Study II used data from 61,039 Kindergarten children matched between the EDI and Grade 3 EQAO datasets. The predictive/explanatory power of Mean EDI Domain Scores (MEDS; R2=0.11 to 0.15) was twice that of new ordinal summative measure (TEVI; R2=0.06 to 0.08). Interestingly, the predictive power of the TEVI was similar to that of the composite EDI outcome measure, overall vulnerability (vulnerable on one or more domains).
ConclusionThe MEDS and TEVI work as expected and can be used for research and reporting purposes. More specifically, the TEVI can also be used as a severity metric evaluating the impact of multiple developmental vulnerabilities. It is recommended that further research be conducted to validate the measures with other datasets.
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Duku E, Forer B, Pottruff M, Guhn M, Janus M. Defying Expectations: Can We Identify Neighbourhoods with “Other Than Expected” Developmental Outcomes? Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.1814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
ObjectivesTo contribute to the evidence on the association between neighbourhood-level child development in Kindergarten and neighbourhood SES, our objective was to quantify the sociodemographic and child development characteristics of the neighbourhoods that “defy expectations”: high SES neighbourhoods with much-worse-than-expected child outcomes, and low SES neighbourhoods with much-better-than-expected child outcomes.
ApproachUsing exploratory and model-based Latent Profile Analysis (LPA), we identified homogenous profile groups of 2038 customized Canadian neighbourhoods using ten SES indicators. We identified the most parsimonious number of profile groups and validated and characterized the derived groups of neighbourhoods using neighbourhood and aggregated child characteristics. Next, as our outcome, we created quartile groups for developmental vulnerability risk, measured with the Early Development Instrument (EDI), to match the number of derived neighbourhood profile groups. Last, we used contingency table analysis to identify neighbourhoods that defy expectations, and then characterized these neighbourhoods using descriptive statistics and correlational analysis.
ResultsThe LPA identified four neighbourhood SES groups which we labelled “Low” (31.6%), “Low-moderate” (12.7%), “High-moderate” (38.4%) and “High” (17.4%). These four SES groups were cross-tabulated with quartile groups of EDI vulnerability risk. Inspection of the resulting 4-by-4 contingency table showed that within the “Low” SES profile group 57 (8.9%) neighbourhoods had much-better-than-expected developmental vulnerability risk. Conversely, within the “High” SES profile group, 12 (3.4%) neighbourhood had much-worse-than-expected developmental vulnerability risk. Additionally, these analyses identified large provincial differences in the proportion of neighbourhoods that defy expectation. In 12 provinces and territories in the study, the proportion of neighbourhoods that defied expectations within each province ranged from zero to 50%.
ConclusionThe identification of neighbourhoods that defy expectations contributes to our understanding of neighbourhood factors influencing child development. Using mixed-methods approaches, these neighbourhoods can be compared to nearby neighbourhoods from the same SES profile group that do not defy expectations, in an effort to identify contextual factors that differentiate them.
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Forer B, Pottruff M, Duku E, Guhn M, Janus M. The Canadian Neighbourhood Early Childhood Development (CanNECD) Socioeconomic Index: Stability and Measurement Invariance Over Time. Int J Popul Data Sci 2022. [DOI: 10.23889/ijpds.v7i3.2048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Objectives and ApproachThe CanNECD SES Index is a composite of 10 Canadian Census and Income Tax Filer variables, aggregated to 2,038 custom neighbourhoods covering all of Canada. The baseline 2006 Index accounted for 32% of the neighbourhood-level variance in overall developmental vulnerability in Kindergarten children, as measured by the Early Development Instrument (EDI). Other existing SES indices accounted for 17% at most.
The Index now has two additional time points (2011 and 2016), which allows an evaluation of its consistency over time. Our objective is to assess three aspects of the Index’s temporal consistency. The first is the consistency of the strength of association between the Index and vulnerability rates across EDI developmental domains. The second is the consistency of neighbourhoods’ quintile rank over time. Finally, we use Confirmatory Factor Analysis in an SEM framework to assess the Index’s measurement invariance over time.
ResultsFor each EDI domain, the strength of association between Index scores and neighbourhood-level vulnerability rates were either maintained or minimally declined over time. Additionally, neighbourhood quintile rankings were highly consistent over time with over 60% of neighbourhoods in the same quintile between 2006 and 2016, and fewer than 3% with a greater than one-quintile change. Finally, our preliminary measurement invariance results show at least configural invariance over the three time points.
Conclusion / implicationsOur results confirm the stability of the CanNECD Index, justifying its utility for: mapping SES indicators across neighbourhoods and over time, contextualizing neighbourhood-level developmental vulnerability in young children, and identifying interesting neighbourhoods for future study, especially those where the children are faring much better than predicted by the Index.
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Omand JA, Li X, Keown-Stoneman CDG, Borkhoff CM, Duku E, Lebovic G, Maguire JL, Mamdani MM, Parkin PC, Reid-Westoby C, Randall Simpson J, Tremblay MS, Janus M, Birken CS. Body Weight at Age Four Years and Readiness to Start School: A Prospective Cohort Study. Child Obes 2022. [PMID: 35834646 DOI: 10.1089/chi.2022.0018] [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: 11/13/2022]
Abstract
Background: Adolescents with obesity have lower academic performance, but little is known about the association between body weight in early childhood and school readiness. The objective was to examine the association between age- and sex-standardized body mass index (zBMI) and body weight status and school readiness in young children. Methods: A prospective cohort study in Toronto, Canada, was conducted in young children enrolled in TARGet Kids!. Children's weight and height were measured before the start of kindergarten. Children's school readiness was measured by the Early Development Instrument (EDI), a validated teacher-completed instrument that assesses children's skills and behaviors in five developmental domains in kindergarten. Generalized estimating equations, adjusted for relevant confounders, were used in the analysis. Results: The study included 1015 children (1217 observations): 52% were male and mean age at zBMI was 4.2 years [50 months (SD 12.1)] and school readiness was 5.2 years [62.7 months (SD 6.9)]. There was no evidence found that zBMI was associated with school readiness. However, in a post hoc analysis, being classified as overweight or with obesity in kindergarten was associated with twofold higher odds of vulnerability in school readiness and a lower social competence score compared with their normal weight peers. Conclusions: Being classified as overweight or with obesity was associated with poor school readiness in year 2 of kindergarten. Early interventions to promote healthy growth before school entry may help promote development and school readiness in young children. www.clinicaltrials.gov (NCT01869530).
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Affiliation(s)
- Jessica A Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Xuedi Li
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,The Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Muhammad M Mamdani
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.,Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Janis Randall Simpson
- Family Relation and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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Zhang X, Jambon M, Afifi TO, Atkinson L, Bennett T, Duku E, Duncan L, Joshi D, Kimber M, MacMillan HL, Gonzalez A. Mental Health Help-Seeking in Parents and Trajectories of Depressive and Anxiety Symptoms: Lessons Learned From the Ontario Parent Survey During the COVID-19 Pandemic. Front Psychol 2022; 13:884591. [PMID: 35783808 PMCID: PMC9243663 DOI: 10.3389/fpsyg.2022.884591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
Tracking parents’ mental health symptoms and understanding barriers to seeking professional help are critical for determining policies and services to support families’ well-being. The COVID-19 pandemic has posed enormous challenges to parents’ mental health and the access to professional help, and there are important public health lessons that must be learned from the past 2 years’ experiences to inform future mental health responses to social- and family-level stressful events. This study examines the trajectories of parents’ depressive and anxiety symptoms over a year during the pandemic as related to their mental health help-seeking. Data were collected from a sample of parents residing in Ontario, Canada at baseline (May–June, 2020; Wave 1) and again 1 year later (Wave 2; referred to as W1 and W2 below). Parents (n = 2,439; Mage = 39.47, SD = 6.65; 95.0% females) reported their depressive and anxiety symptoms at both waves. Mental health help-seeking, including self-reported contact with professional help and perceived unmet mental health needs, was measured at W2. Parents were classified into four groups by mental health help-seeking. Inconsistent seekers and non-seeking needers, both reporting perceived unmet needs for professional help, showed greater increases in depressive and anxiety symptoms, whereas parents with no need or needs met showed smaller increases in depressive symptoms and decreases in anxiety symptoms. Belief in self-reliance and time constraints were the leading reasons for not seeking help. These findings suggest that over a year into the pandemic, parents with perceived unmet mental health needs were at greater risk for worsening depressive and anxiety symptoms. Recognizing the demands for mental health services when families experience chronic stressors and targeting the identified barriers may promote family well-being during and beyond this pandemic.
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Affiliation(s)
- Xutong Zhang
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Marc Jambon
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Leslie Atkinson
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Laura Duncan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Divya Joshi
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Harriet L. MacMillan
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
- *Correspondence: Andrea Gonzalez,
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Di Rezze B, Gentles SJ, Hidecker MJC, Zwaigenbaum L, Rosenbaum P, Duku E, Georgiades S, Roncadin C, Fang H, Tajik-Parvinchi D, Viveiros H. Adaptation, Content Validity and Reliability of the Autism Classification System of Functioning for Social Communication: From Toddlerhood to Adolescent-Aged Children with Autism. J Autism Dev Disord 2022; 52:5150-5161. [PMID: 35676381 DOI: 10.1007/s10803-022-05621-z] [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] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
The Autism Classification System of Functioning: Social Communication (ACSF) describes social communication functioning levels. First developed for preschoolers with ASD, this study tests an expanded age range (2-to-18 years). The ACFS rates the child's typical and best (i.e., capacity) performance. Qualitative methods tested parent and clinician perspectives of the ACSF age expansion using content analysis. The ACSF was used twice by parents and professionals for the same child/youth. Reliabilities were assessed using weighted kappa. Content validity supported the ACSF's applicability, clarity, and usability. The ACSF adaptations did not change its original construct. Reliability were calculated from 90 parent and professional Time-1 and Time-2 ratings for children/youth (2.1-15.6 years). Results showed good-to-very good intra-rater agreement (typical) and good inter-rater agreement (capacity).
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Affiliation(s)
- Briano Di Rezze
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada.
| | - Stephen James Gentles
- Department of Community Health, Faculty of Human and Social Sciences, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada
| | - Mary Jo Cooley Hidecker
- Department of Communication Science & Disorders, College of Health Sciences, University of Kentucky, 900 South Limestone, Lexington, KY, 40508, USA
| | - Lonnie Zwaigenbaum
- Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Avenue, Edmonton, AB, T5G 0B7, Canada
| | - Peter Rosenbaum
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 408, Hamilton, ON, L8S 1C7, Canada
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, Faulty of Health Sciences, McMaster, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main Street West MIP 201A, Hamilton, ON, L8P 0A1, Canada
| | - Caroline Roncadin
- Ron Joyce Children's Health Centre, Hamilton Health Sciences, 325 Wellington Street North, Hamilton, ON, L8L 0A4, Canada
| | - Hanna Fang
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
| | - Diana Tajik-Parvinchi
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
| | - Helena Viveiros
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, 1400 Main Street West, Room 436, Hamilton, ON, L8S 1C7, Canada
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Jack SM, Duku E, Whitty H, Van Lieshout RJ, Niccols A, Georgiades K, Lipman EL. Young mothers' use of and experiences with mental health care services in Ontario, Canada: a qualitative descriptive study. BMC Womens Health 2022; 22:214. [PMID: 35672725 PMCID: PMC9172978 DOI: 10.1186/s12905-022-01804-z] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background Despite the high prevalence of mental health issues among young mothers, their subsequent needs for mental health care support does not correlate with their access and use of services. The purpose of this study, grounded in the experiences of young mothers living in Ontario, Canada, was to describe their experiences of using mental health services during the perinatal period, and to identify the attributes of services and professionals that influenced their decision to engage with mental health services.
Methods As the qualitative component of a sequential explanatory mixed methods study, the principles of qualitative description informed sampling, data collection, and analysis decisions. In-depth, semi-structured interviews were conducted with a purposeful sample of 29 young mothers (≤ 21 years) who met diagnostic criteria for at least one psychiatric disorder, and who were ≥ 2 months postpartum. Interview data were triangulated with data from ecomaps and a sub-set of demographic data for this purposeful sample from the survey conducted in the quantitative study component. Qualitative data were analyzed using both conventional content analysis and reflexive thematic analysis; the subset of survey data extracted for these 29 participants were analyzed using descriptive statistics. Results Young mothers identified the need to have at least one individual, either an informal social support or formal service provider who they could talk to about their mental health. Among participants deciding to seek professional mental health support, their hesitancy to access services was grounded in past negative experiences or fears of being judged, being medicated, not being seen as an active partner in care decisions or experiencing increased child protection involvement. Participants identified organizational and provider attributes of those delivering mental health care that they perceived influenced their use of or engagement with services. Conclusion Organizations or health/social care professionals providing mental health services to young pregnant or parenting mothers are recommended to implement trauma-and violence-informed care. This approach prioritizes the emotional and physical safety of individuals within the care environment. Applying this lens in service delivery also aligns with the needs of young mothers, including that they are actively listened to, treated with respect, and genuinely engaged as active partners in making decisions about their care and treatment.
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Affiliation(s)
- Susan M Jack
- School of Nursing, McMaster University, HSC 3H48B, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada.
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Heather Whitty
- Institute for Innovation and Implementation, School of Social Work, University of Maryland Baltimore, Baltimore, USA
| | - Ryan J Van Lieshout
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Alison Niccols
- Ron Joyce Children's Health Centre, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Ellen L Lipman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Tajik-Parvinchi D, Rosenbaum P, Hidecker MJC, Duku E, Zwaigenbaum L, Roncadin C, Georgiades S, Gentles S, Fang H, Di Rezze B. Construct Validity of the Autism Classification System of Functioning: Social Communication (ACSF:SC) Across Childhood and Adolescence. J Autism Dev Disord 2022:10.1007/s10803-022-05608-w. [PMID: 35666330 DOI: 10.1007/s10803-022-05608-w] [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] [Accepted: 05/07/2022] [Indexed: 11/24/2022]
Abstract
This study examined the construct validity of the Autism Classification System of Functioning: Social Communication (ACSF). Participants included 145 parents of children with autism (2-19 years). The degree of convergent and discriminant validity between parent reported ACSF and subscales from Social Responsiveness Scale 2nd edition and Behavior Assessment System for Children, 3rd Edition were examined against a priori hypotheses. We examined construct validity in the entire sample as well as in specific age cohorts. Our findings suggest that ACSF can provide a valid classification system of social communication ability in children with autism 2-19 years of age, and its two subscales may be used to examine different aspects of social communication ability.
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Affiliation(s)
- Diana Tajik-Parvinchi
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada.
- School of Rehabilitation Sciences, Faculty of Health Sciences, Institute of Applied Health Sciences, McMaster University, Room 436, 1400 Main St. W, L8S 1C7, Hamilton, ON, Canada.
| | - Peter Rosenbaum
- Department of Pediatrics, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 408, L8S 1C7, Hamilton, Ontario, Canada
| | - Mary Jo Cooley Hidecker
- Department of Communication Science & Disorders, College of Health Sciences, University of Kentucky, 900 South Limestone, 40508, Lexington, KY, USA
| | - Eric Duku
- Department of Psychiatry & Behavioural Neurosciences, Faulty of Health Sciences, 1280 Main Street West, L8S 4L8, McMaster, Hamilton, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Center, Glenrose Rehabilitation Hospital, Room E209, 10230 111 Avenue, T5G 0B7, Edmonton, Alberta, Canada
| | - Caroline Roncadin
- Ron Joyce Children's Health Centre, Hamilton Health Sciences, 325 Wellington Street North, L8L 0A4, Hamilton, Ontario, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main Street West, MIP 201A, L8P 0A1, Hamilton, Ontario, Canada
| | - Stephen Gentles
- Department of Community Health, Faculty of Human and Social Sciences, Wilfrid Laurier University, 75 University Avenue West, N2L 3C5, Waterloo, Ontario, Canada
| | - Hanna Fang
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
| | - Briano Di Rezze
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, 1400 Main Street West, Room 436, L8S 1C7, Hamilton, ON, Canada
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Ameis SH, Haltigan JD, Lyon RE, Sawyer A, Mirenda P, Kerns CM, Smith IM, Vaillancourt T, Volden J, Waddell C, Zwaigenbaum L, Bennett T, Duku E, Elsabbagh M, Georgiades S, Ungar WJ, Zaidman‐Zait A, Lai M, Szatmari P. Middle-childhood executive functioning mediates associations between early-childhood autism symptoms and adolescent mental health, academic and functional outcomes in autistic children. J Child Psychol Psychiatry 2022; 63:553-562. [PMID: 34382216 PMCID: PMC9291328 DOI: 10.1111/jcpp.13493] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 12/03/2022]
Abstract
BACKGROUND Executive functioning (EF) varies in children with autism spectrum disorder (ASD) and is associated with clinical symptoms, academic, and adaptive functioning. Here, we examined whether middle-childhood EF mediates associations between early-childhood autism symptoms and adolescent outcomes in children with ASD. METHODS The Pathways in ASD Cohort comprising children recruited at the time of ASD diagnosis (at 2-4 years-of-age) and followed prospectively across eight subsequent timepoints over ~10 years was used. A subset of Pathways participants (n = 250) with Behavior Rating Inventory of Executive Function (BRIEF)-Parent Form data from at least one timepoint when participants were school-aged was analyzed. A mediation framework was used to examine whether BRIEF-measured EF across age 7-10 years (middle-childhood) mediated associations between early-childhood autism symptoms (measured using the parent-report Social Responsiveness Scale across age 2-6 years) and clinical, academic, and functional outcomes, indexed at age >10-11.8 years (early-adolescence) using the Child Behavior Checklist (CBCL)-Internalizing and Externalizing Scales, Academic Performance from the Teacher's Report Form, and Vineland Adaptive Behavior Scales. Models were rerun substituting clinician-rated and teacher-rated measures, where possible. RESULTS Mediation models indicated a significant indirect effect of middle-childhood EF on associations between early-childhood autism symptoms and externalizing behavior, academic performance, or adaptive functioning in early adolescence; kappa squared (κ2 ) effect sizes ranged from large to small. Model findings were stable across raters. Middle-childhood EF did not mediate associations between early-childhood autism symptoms and adolescent internalizing behavior. CONCLUSIONS Among children with an ASD diagnosis, middle-childhood EF may be one pathway through which early-childhood autism symptoms influence a variety of outcomes in early-adolescence. An experimental study targeting middle-childhood EF to improve adolescent academic, emotional/behavioral, and adaptive functioning is needed to evaluate the clinical meaningfulness of these findings.
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Affiliation(s)
- Stephanie H. Ameis
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - John D. Haltigan
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of Applied Psychology and Human DevelopmentUniversity of TorontoTorontoONCanada
| | - Rachael E. Lyon
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada
| | - Amanda Sawyer
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada
| | - Pat Mirenda
- Department of Educational and Counselling Psychology and Special EducationUniversity of British ColumbiaVancouverBCCanada
| | - Connor M. Kerns
- Department of PsychologyUniversity of British ColumbiaVancouverBCCanada
| | - Isabel M. Smith
- Department of PediatricsDalhousie UniversityHalifaxNSCanada,Autism Research CentreDalhousie University and IWK Health CentreHalifaxNSCanada
| | | | - Joanne Volden
- Faculty of Rehabilitation MedicineUniversity of AlbertaEdmontonABCanada
| | - Charlotte Waddell
- Children's Health Policy CentreFaculty of Health SciencesSimon Fraser UniversityVancouverBCCanada
| | - Lonnie Zwaigenbaum
- Department of PediatricsUniversity of AlbertaEdmontonABCanada,Autism Research CentreEdmontonABCanada
| | - Teresa Bennett
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Eric Duku
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Mayada Elsabbagh
- Montreal Neurological InstituteMcGill UniversityMontrealQCCanada
| | - Stelios Georgiades
- Offord Centre for Child StudiesHamiltonONCanada,Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonONCanada
| | - Wendy J. Ungar
- Child Health Evaluative SciencesThe Hospital for Sick Children Research InstituteTorontoONCanada,Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoONCanada
| | - Anat Zaidman‐Zait
- Department of School Counseling and Special EducationConstantiner School of EducationTel Aviv UniversityTel AvivIsrael,School of Population and Public HealthFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Meng‐Chuan Lai
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
| | - Peter Szatmari
- Cundill Centre for Child and Youth DepressionMargaret and Wallace McCain Centre for Child, Youth & Family Mental HealthCampbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoONCanada,Faculty of Medicine, Department of PsychiatryUniversity of TorontoTorontoONCanada,Department of PsychiatryThe Hospital for Sick ChildrenTorontoONCanada
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Kamali M, Sivapalan S, Kata A, Kim N, Shanmugalingam N, Duku E, Zwaigenbaum L, Georgiades S. Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario. BMC Health Serv Res 2022; 22:426. [PMID: 35361202 PMCID: PMC8973535 DOI: 10.1186/s12913-022-07789-7] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/16/2022] [Indexed: 04/13/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario. Methods This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives. Results Between September 2018–February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program’s success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder. Conclusions The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07789-7.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada. .,Offord Centre for Child Studies, Hamilton, Canada.
| | | | - Anna Kata
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Nicole Kim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | - Eric Duku
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Stelios Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
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37
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Vanderloo LM, Janus M, Omand JA, Keown-Stoneman CDG, Borkhoff CM, Duku E, Mamdani M, Lebovic G, Parkin PC, Simpson JR, Tremblay MS, Maguire JL, Birken CS. Children's screen use and school readiness at 4-6 years: prospective cohort study. BMC Public Health 2022; 22:382. [PMID: 35197009 PMCID: PMC8864975 DOI: 10.1186/s12889-022-12629-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background The primary aim of this study was to determine if screen use in early childhood is associated with overall vulnerability in school readiness at ages 4 to 6 years, as measured by the Early Development Instrument (EDI). Secondary aims were to: (1) determine if screen use was associated with individual EDI domains scores, and (2) examine the association between screen use and EDI domains scores among a subgroup of high screen users. Methods This prospective cohort study was carried out using data from young children participating in a large primary care practice-based research network in Canada. Logistic regression analyses were run to investigate the association between screen use and overall vulnerability in school readiness. Separate linear regression models examined the relationships between children’s daily screen use and each separate continuous EDI domain. Results A total of 876 Canadian participants participated in this study. Adjusted logistic regression revealed an association between increased screen use and increased vulnerability in school readiness (p = 0.05). Results from adjusted linear regression demonstrated an association between higher screen use and reduced language and cognitive development domain scores (p = 0.004). Among high screen users, adjusted linear regression models revealed associations between increased screen use and reduced language and cognitive development (p = 0.004) and communication skills and general knowledge domain scores (p = 0.042). Conclusions Screen use in early childhood is associated with increased vulnerability in developmental readiness for school, with increased risk for poorer language and cognitive development in kindergarten, especially among high users. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12629-8.
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Affiliation(s)
- Leigh M Vanderloo
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cornelia M Borkhoff
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Muhammad Mamdani
- Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Unity Health Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Paediatric Medicine, Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
| | - Janis Randall Simpson
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, CHEO Research Institute, Ottawa, ON, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Paediatric Medicine, Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
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38
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Vanderloo LM, Omand J, Keown-Stoneman CDG, Janus M, Tremblay MS, Maguire JL, Borkhoff CM, Lebovic G, Parkin P, Mamdani M, Simpson JR, Duku E, Birken CS. Association Between Physical Activity, Screen Time and Sleep, and School Readiness in Canadian Children Aged 4 to 6 Years. J Dev Behav Pediatr 2022; 43:96-103. [PMID: 34387247 DOI: 10.1097/dbp.0000000000000986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 04/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE School readiness is strongly associated with a child's future school success and well-being. The primary objective of this study was to determine whether meeting 24-hour movement guidelines (national physical activity, sedentary behaviors, and sleep recommendations) was associated with school readiness measured with mean scores in each of the 5 developmental domains of the Early Development Instrument (EDI) in Canadian children aged 4 to 6 years. Secondary objectives include examining the following: (1) the association between meeting 24-hour movement guidelines and overall vulnerability in school readiness and (2) the association between meeting individual physical activity, screen use and sleep recommendations, and overall school readiness. METHODS A prospective cohort study was performed using data from children (aged 4-6 years) who participated in a large-scale primary care practice-based research network. RESULTS Of the 739 participants (aged 5.9 + 0.12 years) in this prospective cohort study, 18.2% met the 24-Hour Movement Guidelines. Linear regression models (adjusted for child/family demographic characteristics, number of siblings, immigration status, and annual household income) revealed no evidence of an association between meeting all 24-hour movement guidelines and any of the 5 domains of the EDI (p > 0.05). Adjusted linear regression models revealed evidence of an association between meeting screen use guidelines and the "language and cognitive development" (β = 0.16, p = 0.004) domain, and for the sleep guideline, there was a statistically significant association with the "physical health and well-being" (β = 0.23, p = 0.001), the "language and cognitive development" (β = 0.10, p = 0.003), and the "communication skills and general knowledge" (β = 0.18, p < 0.001) domain. CONCLUSION Early lifestyle interventions targeting screen use and sleep may be beneficial for improving a child's readiness for school.
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Affiliation(s)
- Leigh M Vanderloo
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Jessica Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, CHEO Research Institute, Ottawa, ON, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Patricia Parkin
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
| | - Muhammad Mamdani
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada
- Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Janis Randall Simpson
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
- Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada
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Carter Leno V, Wright N, Pickles A, Bedford R, Zaidman-Zait A, Kerns C, Mirenda P, Zwaigenbaum L, Duku E, Bennett T, Georgiades S, Smith I, Vaillancourt T, Szatmari P, Elsabbagh M. Exposure to family stressful life events in autistic children: Longitudinal associations with mental health and the moderating role of cognitive flexibility. Autism 2022; 26:1656-1667. [PMID: 36113122 PMCID: PMC9483693 DOI: 10.1177/13623613211061932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mental health problems are prevalent in autistic youth, but the underpinning
mechanisms are not well explored. In neurotypical youth, stressful life events
are an established risk factor for mental health problems. This study tested
longitudinal bidirectional associations between family-level stressful life
events and mental health problems and whether these were moderated by cognitive
flexibility, in a cohort of autistic children (N = 247).
Family-stressful life events, assessed using the parent-reported Family
Inventory of Life Events and Changes, and mental health problems, assessed using
the teacher-reported Child Behavior Checklist Internalizing and Externalizing
Symptoms subscales, were measured at multiple points between 7 and 11 years.
Analyses showed no significant pathways from internalizing or externalizing
symptoms to family-stressful life events or from family-stressful life events to
internalizing or externalizing symptoms. There was some evidence of moderation
by cognitive flexibility; the family-stressful life events to internalizing
symptoms pathway was non-significant in the group with typical shifting ability
but significant in the group with clinically significant shifting problems.
Information about family-level stressful life event exposure and cognitive
flexibility may be helpful in identifying autistic youth who may be at higher
risk of developing mental health problems. Established risk factors for mental
health problems in neurotypical populations are relevant for understanding
mental health in autistic youth.
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Affiliation(s)
| | | | | | | | - Anat Zaidman-Zait
- Tel Aviv University, Israel
- The University of British Columbia, Canada
| | | | | | | | - Eric Duku
- Offord Centre for Child Studies, Canada
- McMaster University, Canada
| | - Teresa Bennett
- Offord Centre for Child Studies, Canada
- McMaster University, Canada
| | | | - Isabel Smith
- Dalhousie University, Canada
- IWK Health Centre, Canada
| | | | - Peter Szatmari
- University of Toronto, Canada
- The Hospital for Sick Children, Canada
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Abstract
Recent advances in longitudinal methodologies for observational studies have contributed to a better understanding of Autism as a neurodevelopmental condition characterized by within-person and between-person variability over time across behavioral domains. However, this finer-grained approach to the study of developmental variability has yet to be applied to Autism intervention science. The widely adopted experimental designs in the field-randomized control trials and quasi-experimental designs-hold value for inferring treatment effects; at the same time, they are limited in elucidating what works for whom, why, and when, given the idiosyncrasies of neurodevelopmental disorders where predictors and outcomes are often dynamic in nature. This perspective paper aims to serve as a primer for Autism intervention scientists to rethink the way we approach predictors of treatment response and treatment-related change using a dynamic lens. We discuss several empirical gaps, and potential methodological challenges and opportunities pertaining to: (1) capturing finer-grained treatment effects in specific behavioral domains as indexed by micro-level within-person changes during and beyond intervention; and (2) examining and modeling dynamic prediction of treatment response. Addressing these issues can contribute to enhanced study designs and methodologies that generate evidence to inform the development of more personalized interventions and stepped care approaches for individuals on the heterogeneous spectrum of Autism with changing needs across development.
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Affiliation(s)
- Yun-Ju Chen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Amadu I, Seidu AA, Duku E, Boadu Frimpong J, Hagan Jnr JE, Aboagye RG, Ampah B, Adu C, Ahinkorah BO. Risk factors associated with the coexistence of stunting, underweight, and wasting in children under 5 from 31 sub-Saharan African countries. BMJ Open 2021; 11:e052267. [PMID: 34930735 PMCID: PMC8689177 DOI: 10.1136/bmjopen-2021-052267] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE This study investigated the risk factors associated with the coexistence of stunting, underweight, and wasting among children under age 5 in sub-Saharan Africa (SSA). DESIGN Data of 127, 487 under-5 children from 31 countries in SSA were pooled from the Demographic and Health Surveys collected between 2010 and 2019. We examined the risk of coexistence of stunting, underweight, and wasting using multinomial logistic regression models. The results were presented using relative risk ratios (RRR) with corresponding confidence intervals (CIs). SETTING Thirty-one sub-Saharan African countries. PARTICIPANTS Children under age 5. OUTCOME MEASURES The outcome variables were three child anthropometrics: stunting (height-for-age z-scores); underweight (weight-for-age z-scores) and wasting (weight-for-height z-scores). RESULTS The prevalence of coexistence of stunting, underweight, and wasting varied across countries, with the highest (12.14%) and lowest (0.58%) prevalences of coexistence of stunting, underweight and wasting in Benin and Gambia respectively. The risk of coexistence of the three indicators of undernutrition was higher among children aged 1 year (RRR=3.714; 95% CI 3.319 to 4.156) compared with those aged 0. The risk of coexistence of the three dimensions was lower among female children (RRR=0.468 95% CI 0.420 to 0.51), but higher for those with small size at birth (RRR=3.818; CI 3.383 to 4.308), those whose mothers had no education (RRR=3.291; 95% CI 1.961 to 5.522), not working (RRR=1.195; 95% CI 1.086 to 1.314), had no antenatal visits during pregnancy (RRR=1.364; 95% CI 1.20 to 1.541), children delivered at home (RRR=1.372; CI 1.232 to 1.529), those from poor households (RRR=1.408; 95% CI 1.235 to 1.605), those whose mothers had no access to media (RRR=1.255; 95% CI 1.144 to 1.377) and living in households with an unimproved toilet facility (RRR=1.158; 95% CI 1.032 to 1.300). CONCLUSIONS Findings suggest the urgent need for consideration of the coexistence of stunting, wasting and underweight among under-5 children in policy design and programming of interventions to eradicate child malnutrition in SSA. In the short-term, national-level policies and interventions need to be well tailored considering the compositional characteristics.
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Affiliation(s)
- Iddrisu Amadu
- Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
- Emperiks Research, Tamale, Ghana
| | - Abdul-Aziz Seidu
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Eric Duku
- Africa Centre of Excellence in Coastal Resilience, University of Cape Coast, Cape Coast, Ghana
- Department of Fisheries and Aquatic Sciences, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Central, Ghana
| | - John Elvis Hagan Jnr
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Central, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Belinda Ampah
- Department of Academics, Nursing and Midwifery Training College, Esiama, Ghana
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Ultimo NSW, Australia
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Omand JA, Janus M, Maguire JL, Parkin PC, Aglipay M, Randall Simpson J, Keown-Stoneman CDG, Duku E, Reid-Westoby C, Birken CS. Nutritional Risk in Early Childhood and School Readiness. J Nutr 2021; 151:3811-3819. [PMID: 34587245 DOI: 10.1093/jn/nxab307] [Citation(s) in RCA: 3] [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] [Received: 06/23/2021] [Revised: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Nutrition in early childhood is important for healthy growth and development. Achieving school readiness is considered one of the most important developmental milestones for young children. OBJECTIVES The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten. METHODS A prospective cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) primary care research network in Toronto, Canada, 2015-2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4-6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders. RESULTS The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P < 0.001). NutriSTEP total score and high nutritional risk were associated with lower scores on all 5 EDI domains, with the strongest association observed for the domains of language and cognitive development and communication skills and general knowledge. CONCLUSIONS Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered www.clinicaltrials.gov as NCT01869530.
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Affiliation(s)
- Jessica A Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jonathon L Maguire
- The Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Mary Aglipay
- Department of Pediatrics, St. Michael's Hospital, Pediatric Research, Toronto, Ontario, Canada
| | | | - Charles D G Keown-Stoneman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Division of Pediatric Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.,Joannah & Brian Lawson Centre for Child Nutrition, Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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43
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Zwaigenbaum L, Brian J, Smith IM, Sacrey LAR, Franchini M, Bryson SE, Vaillancourt T, Armstrong V, Duku E, Szatmari P, Roberts W, Roncadin C. Symptom trajectories in the first 18 months and autism risk in a prospective high-risk cohort. J Child Psychol Psychiatry 2021; 62:1435-1443. [PMID: 33782970 DOI: 10.1111/jcpp.13417] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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] [Accepted: 02/19/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although early autism spectrum disorder (ASD) detection strategies tend to focus on differences at a point in time, behavioral symptom trajectories may also be informative. METHODS Developmental trajectories of early signs of ASD were examined in younger siblings of children diagnosed with ASD (n = 499) and infants with no family history of ASD (n = 177). Participants were assessed using the Autism Observation Scale for Infants (AOSI) from 6 to 18 months. Diagnostic outcomes were determined at age 3 years blind to previous assessments. RESULTS Semiparametric group-based modeling using AOSI scores identified three distinct trajectories: Group 1 ('Low', n = 435, 64.3%) was characterized by a low level and stable evolution of ASD signs, group 2 ('Intermediate', n = 180, 26.6%) had intermediate and stable levels, and group 3 ('Inclining', n = 61, 9.3%) had higher and progressively elevated levels of ASD signs. Among younger siblings, ASD rates at age 3 varied by trajectory of early signs and were highest in the Inclining group, membership in which was highly specific (94.5%) but poorly sensitive (28.5%) to ASD. Children with ASD assigned to the inclining trajectory had more severe symptoms at age 3, but developmental and adaptive functioning did not differ by trajectory membership. CONCLUSIONS These prospective data emphasize variable early-onset patterns and the importance of a multipronged approach to early surveillance and screening for ASD.
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Affiliation(s)
| | - Jessica Brian
- Department of Paediatrics, Bloorview Research Institute, University of Toronto, Toronto, ON, Canada
| | - Isabel M Smith
- Departments of Pediatrics and Psychology and Neuroscience, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Lori-Ann R Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | | | - Susan E Bryson
- Departments of Pediatrics and Psychology and Neuroscience, IWK Health Centre, Dalhousie University, Halifax, NS, Canada
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | | | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Peter Szatmari
- Department of Psychiatry, Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Wendy Roberts
- Integrated Services for Autism and Neurodevelopmental Disorders, Toronto, ON, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton Health Sciences, Hamilton, ON, Canada
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44
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Koziarz F, Roncadin C, Kata A, Duku E, Cauwenbergs A, Mahoney W, Di Rezze B, Anderson C, Drmic I, Eerkes J, Dekker K, Georgiades K, Hoult L, Kraus de Camargo O, Ng O, Rosenbaum P, Mesterman R, Gentles SJ, Robertson S, Bennett T, Georgiades S. Investigating the Associations Between Child Autistic Symptoms, Socioeconomic Context, and Family Life: A Pilot Study. Front Rehabilit Sci 2021; 2:748346. [PMID: 36188822 PMCID: PMC9397991 DOI: 10.3389/fresc.2021.748346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022]
Abstract
Objective: The day-to-day experience of families with an Autistic child may be shaped by both, child characteristics and available resources, which often are influenced by the socioeconomic context of the family. Using a socioecological approach, this study explored the quantitative associations between child autistic symptoms, family socioeconomic status, and family life. Methods: Data came from the Pediatric Autism Research Cohort—PARC Study (pilot). Parents of children with a recent diagnosis of autism completed a set of assessments, including the Autism Family Experience Questionnaire, Autism Impact Measure, and a Sociodemographic Questionnaire. A series of multiple, iterative linear regression models were constructed to ascertain quantitative associations between child autistic symptoms, socioeconomic context, and family life. Results: A total of 50 children (mean age: 76 months; SD: 9.5 months; and 84% male) with data on the variables of interest were included in the analysis. The frequency of child autistic symptoms was associated with family life outcomes (p = 0.02 and R2 = 24%). Once autistic symptom frequency, symptom impact, and sociodemographic variables were considered, parents of higher educational attainment reported worse family life outcomes compared to their lesser-educated counterparts. This cumulative regression model had considerable explanatory capability (p = 0.01, R2 = 40%). Conclusion: This study demonstrates the utility of using a socioecological approach to examine the dynamic interplay between child characteristics and family circumstances. Our findings suggest that family life for parents (of an autistic child) who have obtained higher education is reported (by the parents themselves) as less satisfactory compared to that of parents without higher education, once adjusted for the autistic symptom frequency of child, symptom impact, and income. These findings can inform the design and delivery of more family-centered care pathways during the years following a diagnosis of autism.
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Affiliation(s)
- Frank Koziarz
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- *Correspondence: Frank Koziarz
| | - Caroline Roncadin
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Anna Kata
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Amber Cauwenbergs
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - William Mahoney
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Briano Di Rezze
- Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Colleen Anderson
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Irene Drmic
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Judy Eerkes
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Kathleen Dekker
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Lorraine Hoult
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Olaf Kraus de Camargo
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olivia Ng
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Ronit Mesterman
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Stephen J. Gentles
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Community Health, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sue Robertson
- Autism Program, McMaster Children's Hospital, Hamilton Health Sciences, Hamilton, ON, Canada
| | - Teresa Bennett
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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45
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Patterson JW, Armstrong V, Duku E, Richard A, Franchini M, Brian J, Zwaigenbaum L, Bryson SE, Sacrey LAR, Roncadin C, Smith IM. Early trajectories of motor skills in infant siblings of children with autism spectrum disorder. Autism Res 2021; 15:481-492. [PMID: 34826349 DOI: 10.1002/aur.2641] [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] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/12/2021] [Accepted: 11/06/2021] [Indexed: 11/06/2022]
Abstract
Delays in motor development are not considered a core feature of autism spectrum disorder (ASD). Yet, recent studies of infant siblings of children with ASD suggest that early delays in motor skills may be associated with later delays in developmental areas considered to be core features of an ASD diagnosis. While these studies demonstrate the longitudinal association between core features and motor delays observed at single time points, there is considerable interest in studying the trajectories of motor development over the first 3 years of life. To accomplish this, we investigated early trajectories of motor development in a cohort of 499 infant siblings of children with ASD and 176 children with no family history of ASD. Data for the current study were drawn from the prospective, multi-site, Canadian Infant Sibling Study. We evaluated trajectories of fine and gross motor development over the first 3 years using group-based trajectory modeling. Our results show that membership for both fine and gross motor trajectory groups was related to expressive language skills, receptive language skills, ASD symptom severity scores, and diagnostic classification at age 3. These results provide evidence that the trajectory of a child's early motor development may have important prognostic implications in ASD.
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Affiliation(s)
| | | | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Annie Richard
- Autism Research Centre, IWK Health Centre, Halifax, Canada
| | | | - Jessica Brian
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Center, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Susan E Bryson
- Department of Pediatrics, Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lori-Ann R Sacrey
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.,Autism Research Center, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Caroline Roncadin
- McMaster Children's Hospital Autism Program, Hamilton, Ontario, Canada
| | - Isabel M Smith
- Autism Research Centre, IWK Health Centre, Halifax, Canada.,Department of Pediatrics, Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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46
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Gentles S, Duku E, Kerns C, McVey AJ, Hunsche MC, Ng Cordell EC, Bednar ED, Banfield L, Szatmari P, Georgiades S. Trajectory research in children on the autism spectrum: a scoping review protocol. BMJ Open 2021; 11:e053443. [PMID: 34810191 PMCID: PMC8609941 DOI: 10.1136/bmjopen-2021-053443] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Longitudinal trajectory methods, featuring outcome assessments at three or more time points, are increasingly being used as appropriate approaches to understand developmental pathways of people on the autism spectrum across the lifespan. Understanding the scope of this rapidly expanding body of research can help inform future trajectory studies and identify areas for potential meta-analysis as well as key evidence gaps. We present the protocol for a scoping review whose objective is to identify and summarise the scope of research that uses a longitudinal trajectory study design to examine development in children diagnosed with autism. Specifically, we will identify outcome domains and age intervals that have been well characterised, areas where further research is needed and the historical use of various longitudinal trajectory analytical approaches. METHODS AND ANALYSIS We outline the methods for the proposed scoping review according to the framework outlined by Arksey and O'Malley, with subsequent clarifications and enhancements by other authors. Using a search strategy developed by a medical librarian, we will search six databases for relevant publications. Titles and abstracts will be screened in duplicate, followed by full-text screening. Data extraction fields developed predominantly a priori from a set of guiding subquestions will be used to chart relevant data. The findings will include quantitative aggregate summaries, narrative summaries, and appraisal of trajectory studies according to our methodological subquestions. We will consult autistic self-advocate and parent-caregiver stakeholders to facilitate interpretation of the findings. ETHICS AND DISSEMINATION Research ethics approval is not required for this scoping review. The results will be presented to researcher, care professional, policy-maker and stakeholder audiences at local and international conferences, other dissemination activities and published in a peer-reviewed journal.
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Affiliation(s)
- Stephen Gentles
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Connor Kerns
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Alana J McVey
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Michelle C Hunsche
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Elise C Ng Cordell
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - E Dmitra Bednar
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Peter Szatmari
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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47
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Gagné M, Guhn M, Janus M, Georgiades K, Emerson SD, Milbrath C, Duku E, Magee C, Schonert-Reichl KA, Gadermann AM. Thriving, catching up, falling behind: Immigrant and refugee children’s kindergarten competencies and later academic achievement. Journal of Educational Psychology 2021. [DOI: 10.1037/edu0000634] [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: 11/08/2022]
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48
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Andrews K, Dunn JR, Prime H, Duku E, Atkinson L, Tiwari A, Gonzalez A. Effects of household chaos and parental responsiveness on child executive functions: a novel, multi-method approach. BMC Psychol 2021; 9:147. [PMID: 34548106 PMCID: PMC8456676 DOI: 10.1186/s40359-021-00651-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022] Open
Abstract
Background Executive functions can be adversely affected by contextual risks in the home environment including chaos and parenting challenges. Furthermore, household chaos negatively influences parenting practices. Few studies, however, have examined the role of parenting in the association between household chaos and child executive functions. Methods Using a sample of 128 school-aged children (mean = 61.9 months, SD = 2.0, range 58–68 months) and their mothers, the present study examined direct and indirect effects (via parental responsiveness) of household chaos on child executive functioning. Multi-measures were used including performance-based assessments, behavioural observations, questionnaires, and video-home tours. Results Household chaos had both a direct effect on child executive functions (β = − .31, 95% CI [− .58, − .04]) and an indirect effect (β = − .05, 95% [− .13, − .01]) via parental responsiveness. Further, the indirect effect was only significant for household instability. Conclusion These findings indicate that parental responsiveness may be compromised by household chaos, with implications for the executive functions of school-aged children. Preventative strategies are needed to improve the stability in the home and strengthen parenting practices.
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Affiliation(s)
- Krysta Andrews
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W, MIP 201A, Hamilton, ON, L8S 4K1, Canada
| | - James R Dunn
- Department of Health, Aging, and Society, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada
| | - Heather Prime
- Department of Psychology, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada
| | - Eric Duku
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W, MIP 201A, Hamilton, ON, L8S 4K1, Canada.,Offord Centre for Child Studies, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada
| | - Leslie Atkinson
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada
| | - Ashwini Tiwari
- Institute of Public and Preventive Health, Augusta University, 1120 15th St., Augusta, GA, 30912, USA
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main St. W, MIP 201A, Hamilton, ON, L8S 4K1, Canada. .,Offord Centre for Child Studies, McMaster University, 1280 Main St. W, Hamilton, ON, L8S 4K1, Canada.
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49
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Courchesne V, Bedford R, Pickles A, Duku E, Kerns C, Mirenda P, Bennett T, Georgiades S, Smith IM, Ungar WJ, Vaillancourt T, Zaidman-Zait A, Zwaigenbaum L, Szatmari P, Elsabbagh M. Non-verbal IQ and change in restricted and repetitive behavior throughout childhood in autism: a longitudinal study using the Autism Diagnostic Interview-Revised. Mol Autism 2021; 12:57. [PMID: 34391468 PMCID: PMC8364071 DOI: 10.1186/s13229-021-00461-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 12/07/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development. METHODS The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years. RESULTS The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age. LIMITATIONS The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children. CONCLUSIONS These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.
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Affiliation(s)
- V Courchesne
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
| | - R Bedford
- King's College London, London, UK
- University of Bath, Bath, UK
| | | | - E Duku
- McMaster University, Hamilton, Canada
| | - C Kerns
- University of British Columbia, Vancouver, Canada
| | - P Mirenda
- University of British Columbia, Vancouver, Canada
| | - T Bennett
- McMaster University, Hamilton, Canada
| | | | - I M Smith
- Dalhousie University, IWK Health Centre, Halifax, Canada
| | - W J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, and the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | | | | | | | - P Szatmari
- Centre for Addiction and Mental Health, Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Elsabbagh
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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50
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Cost KT, Zaidman-Zait A, Mirenda P, Duku E, Zwaigenbaum L, Smith IM, Ungar WJ, Kerns C, Bennett T, Szatmari P, Georgiades S, Waddell C, Elsabbagh M, Vaillancourt T. Correction to: "Best Things": Parents Describe Their Children with Autism Spectrum Disorder Over Time. J Autism Dev Disord 2021; 51:4575-4576. [PMID: 34286396 DOI: 10.1007/s10803-021-05144-z] [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: 11/26/2022]
Affiliation(s)
- Katherine T Cost
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
| | | | - Pat Mirenda
- University of British Columbia, Vancouver, BC, Canada.
| | - Eric Duku
- McMaster University, Hamilton, ON, Canada
| | | | - Isabel M Smith
- Dalhousie University/IWK Health Centre, Halifax, NS, Canada
| | - Wendy J Ungar
- Hospital for Sick Children, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
| | - Connor Kerns
- University of British Columbia, Vancouver, BC, Canada
| | | | - Peter Szatmari
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | | | | | - Mayada Elsabbagh
- McGill University/Montreal Children's Hospital, Montreal, PQ, Canada
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