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Frank MC, Alcock KJ, Arias-Trejo N, Aschersleben G, Baldwin D, Barbu S, Bergelson E, Bergmann C, Black AK, Blything R, Böhland MP, Bolitho P, Borovsky A, Brady SM, Braun B, Brown A, Byers-Heinlein K, Campbell LE, Cashon C, Choi M, Christodoulou J, Cirelli LK, Conte S, Cordes S, Cox C, Cristia A, Cusack R, Davies C, de Klerk M, Delle Luche C, Ruiter LD, Dinakar D, Dixon KC, Durier V, Durrant S, Fennell C, Ferguson B, Ferry A, Fikkert P, Flanagan T, Floccia C, Foley M, Fritzsche T, Frost RLA, Gampe A, Gervain J, Gonzalez-Gomez N, Gupta A, Hahn LE, Kiley Hamlin J, Hannon EE, Havron N, Hay J, Hernik M, Höhle B, Houston DM, Howard LH, Ishikawa M, Itakura S, Jackson I, Jakobsen KV, Jarto M, Johnson SP, Junge C, Karadag D, Kartushina N, Kellier DJ, Keren-Portnoy T, Klassen K, Kline M, Ko ES, Kominsky JF, Kosie JE, Kragness HE, Krieger AAR, Krieger F, Lany J, Lazo RJ, Lee M, Leservoisier C, Levelt C, Lew-Williams C, Lippold M, Liszkowski U, Liu L, Luke SG, Lundwall RA, Macchi Cassia V, Mani N, Marino C, Martin A, Mastroberardino M, Mateu V, Mayor J, Menn K, Michel C, Moriguchi Y, Morris B, Nave KM, Nazzi T, et alFrank MC, Alcock KJ, Arias-Trejo N, Aschersleben G, Baldwin D, Barbu S, Bergelson E, Bergmann C, Black AK, Blything R, Böhland MP, Bolitho P, Borovsky A, Brady SM, Braun B, Brown A, Byers-Heinlein K, Campbell LE, Cashon C, Choi M, Christodoulou J, Cirelli LK, Conte S, Cordes S, Cox C, Cristia A, Cusack R, Davies C, de Klerk M, Delle Luche C, Ruiter LD, Dinakar D, Dixon KC, Durier V, Durrant S, Fennell C, Ferguson B, Ferry A, Fikkert P, Flanagan T, Floccia C, Foley M, Fritzsche T, Frost RLA, Gampe A, Gervain J, Gonzalez-Gomez N, Gupta A, Hahn LE, Kiley Hamlin J, Hannon EE, Havron N, Hay J, Hernik M, Höhle B, Houston DM, Howard LH, Ishikawa M, Itakura S, Jackson I, Jakobsen KV, Jarto M, Johnson SP, Junge C, Karadag D, Kartushina N, Kellier DJ, Keren-Portnoy T, Klassen K, Kline M, Ko ES, Kominsky JF, Kosie JE, Kragness HE, Krieger AAR, Krieger F, Lany J, Lazo RJ, Lee M, Leservoisier C, Levelt C, Lew-Williams C, Lippold M, Liszkowski U, Liu L, Luke SG, Lundwall RA, Macchi Cassia V, Mani N, Marino C, Martin A, Mastroberardino M, Mateu V, Mayor J, Menn K, Michel C, Moriguchi Y, Morris B, Nave KM, Nazzi T, Noble C, Novack MA, Olesen NM, John Orena A, Ota M, Panneton R, Esfahani SP, Paulus M, Pletti C, Polka L, Potter C, Rabagliati H, Ramachandran S, Rennels JL, Reynolds GD, Roth KC, Rothwell C, Rubez D, Ryjova Y, Saffran J, Sato A, Savelkouls S, Schachner A, Schafer G, Schreiner MS, Seidl A, Shukla M, Simpson EA, Singh L, Skarabela B, Soley G, Sundara M, Theakston A, Thompson A, Trainor LJ, Trehub SE, Trøan AS, Tsui ASM, Twomey K, Von Holzen K, Wang Y, Waxman S, Werker JF, Wermelinger S, Woolard A, Yurovsky D, Zahner K, Zettersten M, Soderstrom M. Quantifying Sources of Variability in Infancy Research Using the Infant-Directed-Speech Preference. ADVANCES IN METHODS AND PRACTICES IN PSYCHOLOGICAL SCIENCE 2020. [DOI: 10.1177/2515245919900809] [Show More Authors] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychological scientists have become increasingly concerned with issues related to methodology and replicability, and infancy researchers in particular face specific challenges related to replicability: For example, high-powered studies are difficult to conduct, testing conditions vary across labs, and different labs have access to different infant populations. Addressing these concerns, we report on a large-scale, multisite study aimed at (a) assessing the overall replicability of a single theoretically important phenomenon and (b) examining methodological, cultural, and developmental moderators. We focus on infants’ preference for infant-directed speech (IDS) over adult-directed speech (ADS). Stimuli of mothers speaking to their infants and to an adult in North American English were created using seminaturalistic laboratory-based audio recordings. Infants’ relative preference for IDS and ADS was assessed across 67 laboratories in North America, Europe, Australia, and Asia using the three common methods for measuring infants’ discrimination (head-turn preference, central fixation, and eye tracking). The overall meta-analytic effect size (Cohen’s d) was 0.35, 95% confidence interval = [0.29, 0.42], which was reliably above zero but smaller than the meta-analytic mean computed from previous literature (0.67). The IDS preference was significantly stronger in older children, in those children for whom the stimuli matched their native language and dialect, and in data from labs using the head-turn preference procedure. Together, these findings replicate the IDS preference but suggest that its magnitude is modulated by development, native-language experience, and testing procedure.
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Woolard A, Hill NTM, McQueen M, Martin L, Milroy H, Wood FM, Bullman I, Lin A. The psychological impact of paediatric burn injuries: a systematic review. BMC Public Health 2021; 21:2281. [PMID: 34906121 PMCID: PMC8670283 DOI: 10.1186/s12889-021-12296-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/23/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To review and synthesise qualitative literature regarding the psychological outcomes following paediatric burn injuries, and to determine if children and adolescents who experience a burn injury have elevated risk of psychopathology following the injury. DESIGN Systematic review of quantitative and qualitative studies. DATA SOURCES Informit health, Medline, Embase, and PsycINFO were searched from January 2010 to December 2020. DATA EXTRACTION AND SYNTHESIS Two reviewers screened articles, and one reviewer extracted data (with cross-checking from another reviewer) from the included studies and assessed quality using an established tool. Narrative synthesis was used to synthesise the findings from the quantitative studies, and thematic synthesis was used to synthesise the findings of included qualitative studies. RESULTS Searches yielded 1240 unique titles, with 130 retained for full-text screening. Forty-five studies from 17 countries were included. The psychological outcomes included in the studies were mental health diagnoses, medication for mental illness, depression, anxiety, stress, fear, post-traumatic stress, post-traumatic growth, emotional issues, self-harm, self-esteem, self-concept, stigmatisation, quality of life, level of disability, resilience, coping, and suicidality. CONCLUSIONS Our findings highlight paediatric burn patients as a particularly vulnerable population following a burn injury. Studies suggest elevated anxiety and traumatic stress symptoms, and higher rates of psychopathology in the long-term. Further research is recommended to determine the psychological outcomes in the other mental health domains highlighted in this review, as findings were mixed. Clinical care teams responsible for the aftercare of burn patients should involve psychological support for the children and families to improve outcomes.
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Systematic Review |
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Mallise CA, Lane AE, Woolard AJ, Whalen OM, Murphy VE, Karayanidis F, Campbell LE. The temperament features associated with autism spectrum disorder in childhood: A systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103711. [PMID: 32599501 DOI: 10.1016/j.ridd.2020.103711] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 03/14/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Temperament is an important construct that shapes child development. Temperament is suggested to present differently in different groups, such as children with neurodevelopmental disorders. However, it is not known whether there are specific temperament features associated with Autism Spectrum Disorder (ASD). AIM This systematic review aimed to synthesise extant literature to determine whether there are temperament features associated with ASD in infancy, toddlerhood and childhood. METHODS AND PROCEDURES Following the PRISMA guidelines for systematic reviews, we searched PsycINFO, CINAHL, Academic Search Ultimate and ProQuest for all available articles from database conception until January 2020. The Joanna Briggs Institute Critical Appraisal checklists were used to assess the methodological quality of included articles. OUTCOMES AND RESULTS Twenty-six articles met the selection criteria: (1) reported on the temperament of children (0-12 years of age) diagnosed with ASD, (2) peer-reviewed; and (3) published in English. Articles varied in overall methodological quality. Infants later diagnosed with ASD were found to more frequently be described as having 'easy' temperament features in early infancy, compared to typically developing infants and infants with developmental concerns but not ASD. Once diagnosed, children with ASD were reported to, as a group, display more negative affect, less extraversion and less effortful control than typically developing children. CONCLUSIONS AND IMPLICATIONS The literature suggests that more challenging temperament features are associated with ASD in childhood, but less is known about within group variability. Overall, this review highlights the need for further investigation into the variability of temperament in children with ASD.
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Whalen OM, Campbell LE, Murphy VE, Lane AE, Gibson PG, Mattes J, Collison A, Mallise CA, Woolard A, Karayanidis F. Observational study of mental health in asthmatic women during the prenatal and postnatal periods. J Asthma 2019; 57:829-841. [PMID: 31148493 DOI: 10.1080/02770903.2019.1621888] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective: We aimed to examine the prevalence and severity of psychological distress of women with asthma in both the prenatal and postnatal periods, and to determine whether asthmatic women with and without mental health problems differ in self-management, medications knowledge, and asthma symptoms.Methods: We assessed spirometry performance and asthma symptoms in 120 women (mean age 29.8 years) before 23 weeks gestation, as part of the Breathing for Life Trial (Trial ID: ACTRN12613000202763). Prenatal depression data was obtained from medical records. At 6 weeks postpartum, we assessed general health, self-reported asthma control, depression symptoms (with the Edinburgh Postnatal Depression Scale) and adaptive functioning (with the Achenbach System of Empirically Based Assessment scales).Results: Twenty percent of our sample reported having a current mental health diagnosis, 14% reported currently receiving mental health care, while 47% reported having received mental health care in the past (and may/may not have received a diagnosis). The sample scored high on the Aggressive Behavior, Avoidant Personality, and Attention Deficit/Hyperactivity scales. Poorer self-reported postnatal asthma control was strongly correlated with elevated somatic complaints, externalizing problems, antisocial personality problems, and greater withdrawal. Prenatal spirometry or asthma severity and control were largely not associated with measures of psychopathology.Conclusions: These findings indicate that pregnant women with asthma frequently report issues with psychopathology during the prenatal and postnatal periods, and that the subjective perception of asthma control may be more related to psychopathology than objective asthma measures. However, due to sample bias, these findings are likely to be understated.
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Woolard A, Bullman I, Allahham A, Long T, Milroy H, Wood F, Martin L. Resilience and Posttraumatic Growth after Burn: A Review of Barriers, Enablers, and Interventions to Improve Psychological Recovery. EUROPEAN BURN JOURNAL 2022; 3:89-121. [PMID: 39604178 PMCID: PMC11575369 DOI: 10.3390/ebj3010009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/29/2024]
Abstract
Burn injuries are traumatic experiences that can detrimentally impact an individual's psychological and emotional wellbeing. Despite this, some survivors adapt to psychosocial challenges better than others despite similar characteristics relating to the burn. Positive adaptation is known as resilience or posttraumatic growth, depending on the trajectory and process. This review aimed to describe the constructs of resiliency and growth within the burn injury context, examine the risk factors that inhibit resilience or growth after burn (barriers), the factors that promote resilience or growth after burn (enablers), and finally to assess the impact of interventions that have been tested that may facilitate resilience or growth after burn. This review was performed according to the recently updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. An electronic search was conducted in November 2021 on the databases PubMed, Medline (1966-present), Embase (1974-present), PsycINFO for English-language peer-reviewed academic articles. There were 33 studies included in the review. Findings were mixed for most studies; however, there were factors related to demographic information (age, gender), burn-specific characteristics (TBSA, time since burn), person-specific factors (personality, coping style), psychopathology (depression, PTSD), and psychosocial factors (social support, spirituality/religion, life purpose) that were evidenced to be related to resilience and growth. One qualitative study evaluated an intervention, and this study showed that a social camp for burn patients can promote resilience. This study has presented a variety of factors that inhibit or encourage resilience and growth, such as demographic, individual, and social factors. We also present suggestions on interventions that may be used to promote growth following this adverse event, such as improving social support, coping styles and deliberate positive introspection.
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Peterson EM, Shigei JT, Woolard A, de la Maza LM. Identification of viridans streptococci by three commercial systems. Am J Clin Pathol 1988; 90:87-91. [PMID: 3389348 DOI: 10.1093/ajcp/90.1.87] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The API 20S (Analytab Products, Plainview, NY), the GPI card (Vitek Systems, St. Louis, MO) and the RapSTR system (Innovative Diagnostics, Atlanta, GA) were compared with conventional biochemicals for the identification of viridans streptococci. One hundred nine clinical isolates were tested that included the following species: intermedius (38) sanguis II (20), bovis (variant) (14), mitis (14), salivarius (11), sanguis I (6), constellatus (3), mutans (2), and uberis (1). With initial testing, a correct species call was made with 72% of the isolates with the GPI card, 62% with the RapSTR, and 50% with the API 20S. Identifications of viridans streptococci group or those that needed additional biochemicals for species identification occurred with 28% of isolates with the API 20S, 8% with the RapSTR, and 9% with the GPI card. Incorrect identifications occurred with 6% of the isolates tested by the GPI card, 20% with the API 20S, and 30% with the RapSTR. Most discrepancies with the RapSTR were with 66% of the intermedius isolates, whereas most, 55%, of misidentifications with the API 20S were with sanguis II isolates. No identifications were made with 2% and 13% of isolates with the API 20S and GPI, respectively.
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Comparative Study |
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Woolard A, Stratton E, Demetriou EA, Boulton KA, Pellicano E, Glozier N, Gibbs V, Rogerson N, Quinn P, Hickie IB, Guastella AJ. Perceptions of social and work functioning are related to social anxiety and executive function in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2124-2134. [PMID: 34271838 DOI: 10.1177/13623613211013664] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Many autistic adults have trouble in social situations and at work. Researchers do not know exactly why autistic people might find it difficult in these environments, and no studies to date have looked the way anxiety or other cognitive processes might affect autistic peoples' ability to socialise and succeed in getting and keeping jobs. Anxiety (how much you worry) and difficulty with getting stuff done or switching attention (known as executive function) can be concerns for autistic people and may contribute to social and work difficulties. This study looked at the relationships between the way autistic people perceived their anxiety and executive functioning and their ability to socialise and work. Sixty-two autistic participants completed questionnaires related to their ability to socialise and work, their social anxiety and their executive function. We found that participants who thought that they had poorer ability to work also found themselves to have more difficulties with executive function and they were more socially anxious. Our results showed that how autistic participants perceived their social anxiety and executive function were important in their perception of their social skills and work ability. This study supports the idea that anxiety and executive function could be targeted in interventions to support autistic people and their social and work outcomes.
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Woolard A, Lane AE, Campbell LE, Whalen OM, Swaab L, Karayanidis F, Barker D, Murphy V, Benders T. Infant and Child-Directed Speech Used with Infants and Children at Risk or Diagnosed with Autism Spectrum Disorder: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00253-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Woolard A, Wickens N, McGivern L, de Gouveia Belinelo P, Martin L, Wood F, Janse van Rensburg E, Milroy H. "I just get scared it's going to happen again": a qualitative study of the psychosocial impact of pediatric burns from the child's perspective. BMC Pediatr 2023; 23:280. [PMID: 37277713 PMCID: PMC10240749 DOI: 10.1186/s12887-023-04105-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/31/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Advances in medicine have improved the chances of survival following burn injuries, however, psychosocial outcomes have not seen the same improvement, and burn injuries can be distressing for both the child or young person, negatively affecting their wellbeing. Pediatric burn patients are at a higher risk of developing psychopathology compared to the general population. In order to promote resilience and prevent psychopathology post-burn injury for pediatric burn patients, it is crucial to understand the experience of children and young people after a burn. This study aimed to understand the psychosocial impact that a pediatric burn has as perceived by the pediatric burn patient. METHODS Seven pediatric burn patients were interviewed from the Perth Metropolitan area on average 3.1 years after their injury. All participants had been admitted to hospital for their acute injury and stayed for a median length of 2 days in hospital. Interviews with pediatric patients took place online, and the patients were asked about their mental health, coping strategies, changes to lifestyle and supports following their burn injury. The interviews were transcribed and then thematically analysed using an inductive approach. RESULTS Three overarching themes were developed from the interviews: burn-specific impact on the child or young person (including appearance concerns, family factors, and lifestyle factors), the psychological impact (including positive and negative impact on mental health), and factors supporting the recovery journey (including coping strategies and support services). The participants in our study highlighted issues they faced during recovery, the positive and negative impacts of the injury and recovery process and provided suggestions for future opportunities to bolster resilience and promote growth for pediatric burn patients who may face similar challenges in the future. CONCLUSION Factors that improve the mental health and wellbeing of pediatric burn patients should be promoted, such as mental health and social supports, the promotion of adaptive coping mechanisms, and meeting the needs of the family unit as a whole. Ultimately, the implementation of trauma-focused, family centred interventions is crucial for the psychosocial recovery of pediatric burn survivors.
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Gilbey D, Brealey G, Mateo-Arriero I, Waters Z, Ansell M, Janse van Rensburg E, De Gouveia Belinelo P, Milroy H, Pace G, Runions K, Salmin I, Woolard A. The effectiveness of a day hospital mentalization-based therapy programme for adolescents with borderline personality traits: Findings from Touchstone-Child and Adolescent Mental Health Service. Clin Psychol Psychother 2023; 30:1303-1312. [PMID: 37078825 DOI: 10.1002/cpp.2854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Individuals with borderline personality disorder (BPD) are at a substantial risk of harm to themselves and others, experience high levels of functional impairment and typically are high users of tertiary healthcare to address their mental health concerns. As indicators for BPD typically emerge in adolescence, a day therapy service in Bentley, Western Australia, Touchstone Child and Adolescent Mental Health Service (CAMHS), was developed as an intensive intervention for adolescents with indicators for BPD and its associated symptomology. Touchstone utilizes mentalization-based therapy (MBT) in a therapeutic community setting, where the current study sought to document the anecdotal outcomes using the data provided at Touchstone, to enable a greater understanding of this treatment approach for adolescents with indicators for BPD. METHOD Forty-six participants attended the Touchstone programme between 2015 and 2020. The programme involved 6 months of MBT (group and individual), occupational therapy, education and creative therapies. Measures of self-injury, mood and emergency department presentations were collected pre- and post-programme. RESULTS Results indicate that participants show a reduction in non-suicidal acts and thoughts, as well as a reduction in negative moods and feelings from pre-Touchstone to post-Touchstone. There is also a decrease in participant presentation to tertiary emergency departments for mental health concerns. CONCLUSIONS The current study shows evidence for the efficacy of Touchstone as an MBT therapeutic community intervention to reduce symptoms of emerging BPD and effectively reduce presentations to emergency departments for mental health presentations, alleviating pressure on tertiary hospitals and reducing economic impact of adolescents within this demographic.
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Wickens N, van Rensburg EJ, de Gouveia Belinelo P, Milroy H, Martin L, Wood F, Woolard A. "It's a big trauma for the family": A qualitative insight into the psychological trauma of paediatric burns from the perspective of mothers. Burns 2024; 50:262-274. [PMID: 37821283 DOI: 10.1016/j.burns.2023.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/11/2023] [Accepted: 06/15/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Despite the medical and surgical improvements of paediatric burn injuries, burn injuries can be a painful and traumatic experience for the child and their family. It is therefore important to explore the experiences of caregivers who support their child throughout the burn journey. Thus, the purpose of this study was to explore the traumatic nature of paediatric burns on the family from a caregiver's perspective. METHODS This study used a descriptive qualitative approach to conduct online semi-structured interviews with caregivers (18 years and older) of children (aged four to 17 years) that had previously been admitted with an unintentional acute burn injury to a paediatric burns unit in Western Australia. Interviews explored the child's and caregiver's experiences throughout the burn journey from the perspective of the caregiver and were digitally recorded and transcribed verbatim. Transcripts were analysed using Braun and Clarke's six stages of reflexive thematic analysis. RESULTS Eleven mothers participated in the interviews and identified a range of poor psychological and psychosocial outcomes that themselves and their child experienced. Three overarching themes were elaborated from the interviews: Child and caregiver mental health difficulties during and after the burn (including medical trauma, mental health outcomes and caregiver guilt); Lifestyle and physical changes following the burn (including disruptions to routine, appearance concerns and puberty); and factors supporting or inhibiting the recovery journey (including personality factors, coping strategies, family dynamics and support). FINAL CONSIDERATIONS This study has presented the difficulties that children, young people, and their family face throughout a paediatric burn injury, which makes the implementation of timely and effective family centred interventions imperative. Meeting the needs and supporting these families with their mental health throughout this traumatic recovery journey, can ensure positive psychosocial outcomes and adaptive coping strategies are adopted early on.
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Stratton E, Glozier N, Woolard A, Gibbs V, Demetriou EA, Boulton KA, Hickie I, Pellicano E, Guastella AJ. Understanding the vocational functioning of autistic employees: the role of disability and mental health. Disabil Rehabil 2022; 45:1508-1516. [PMID: 35508414 DOI: 10.1080/09638288.2022.2066207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Employment rates for autistic people are low, despite increasing employment-focused programmes. Given the reported complexities for autistic people in finding and keeping work and flourishing there, further exploration is needed to understand how best to help employers accommodate autistic employees. MATERIAL AND METHODS We assessed 88 employed autistic adults, without comorbid intellectual disability and examined whether self-reported disability and mental health symptoms were associated with two measures of vocational functioning: disability days off work and vocational disability. RESULTS Nearly half (47%) reported at least one disability day absence in the previous month. Autism severity and IQ were not associated with either measure of vocational functioning. Greater disability and higher mental health symptoms were associated with both types of vocational functioning. However, the associations of anxiety and stress with both vocational outcomes were attenuated to null in a multivariable model. Disability (B = 6.74, p = 0.009; B = 1.18, p < 0.001) and depression (B = 4.46, p = 0.035; B = 1.01, p = 0.049) remained independently associated with both outcomes. CONCLUSIONS Clinicians and vocational support programmes addressing modifiable factors may need to focus on addressing mental health comorbidities, specifically depression rather than anxiety, or core features of autism to improve vocational outcomes for autistic people. Implications for RehabilitationIndividual-level interventions that reduce disablement, particularly in social areas, and depressive symptoms as a way of reducing days off work and improving workplace activities in autistic employees are recommended.Organisations can accommodate autistic employees by encouraging use of mental health programmes or looking at how the workplace environment can be adapted to limit social disability.
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Mallise CA, Murphy VE, Karayanidis F, Armstrong H, Whalen OM, Woolard AJ, Gibson PG, Mattes J, Collison A, Lane AE, Campbell LE. Parenting stress in mothers with asthma during the postpartum period. J Asthma 2021; 59:2091-2099. [PMID: 34641750 DOI: 10.1080/02770903.2021.1993246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Maternal asthma often complicates pregnancy and is linked with poorer quality of life. Additionally, individuals with asthma are at an increased risk of depression and anxiety. We examined whether asthma during pregnancy is related to parenting stress in the first year postpartum and if this relationship varies with level of asthma control. METHODS This cohort survey-based study included mothers with (n = 157) and without (n = 79) asthma. Mothers with asthma participated in this study following participation in a randomized controlled trial of a novel asthma management strategy during pregnancy. Mothers completed the Parenting Stress Index - Short Form during the first 12 months postpartum. Mothers with asthma also completed the Asthma Control Questionnaire. RESULTS Parenting stress did not differ between mothers with and without asthma. Additionally, for mothers with asthma, there were no differences in levels of parenting stress based on asthma control. CONCLUSIONS This study suggests that mothers with asthma are not at an increased risk for excessive parenting stress. However, due to response and sampling bias, levels of parenting stress in asthmatic mothers may be underreported in our sample.
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Janse van Rensburg E, Woolard A, Hill NTM, Reid C, Milroy H, Ohan JL, Lin A, Chamberlain C. The effect of childhood maltreatment on adult survivors' parental reflective function, and attachment of their children: A systematic review. Dev Psychopathol 2023:1-15. [PMID: 37052290 DOI: 10.1017/s0954579423000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND Parental reflective function (PRF) is a candidate mechanism in the transmission of intergenerational trauma. This systematic review examined (1) the association between parental history of childhood maltreatment and PRF, (2) how PRF relates to attachment in children of parent survivors, and (3) whether PRF moderates the association between parental maltreatment history and child attachment. METHODS Ten databases were searched (from inception to 10th November 2021). Inclusion criteria were primary study, quantitative, parent participants, measures of childhood maltreatment, and postnatal PRF. Exclusion criteria were qualitative, intervention follow-up, gray literature, or a review study. Risk of bias was assessed using recommended tools. Data were narratively synthesized. RESULTS One-thousand-and-two articles were retrieved, of which eleven met inclusion criteria (N = 974 participants). Four studies found a significant association between parental childhood maltreatment and disrupted PRF, six did not, one found mixed results. One study reported the association between childhood maltreatment and attachment (nonsignificant results). DISCUSSION There is no clear evidence PRF is routinely disrupted in parent survivors, though there is high heterogeneity in studies. Future research should standardize design to better understand whether PRF is a candidate mechanism in intergenerational trauma. OTHER PROSPERO CRD42020223594.
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Swaab L, Goodwin J, Wroe J, Woolard A, McCormack L, Campbell L. Stigma Associated with Parenting an Autistic Child with Aggressive Behaviour: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wickens N, McGivern L, de Gouveia Belinelo P, Milroy H, Martin L, Wood F, Bullman I, Janse van Rensburg E, Woolard A. A wellbeing program to promote mental health in paediatric burn patients: Study protocol. PLoS One 2024; 19:e0294237. [PMID: 38359022 PMCID: PMC10868872 DOI: 10.1371/journal.pone.0294237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/27/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND One of the most traumatic injuries a child can experience is a severe burn. Despite improvements in medical treatments which have led to better physical outcomes and reduced mortality rates for paediatric burns patients, the psychological impact associated with experiencing such a traumatic injury has mostly been overlooked. This is concerning given the high incidence of psychopathology amongst paediatric burn survivors. OBJECTIVES This project will aim to pilot test and evaluate a co-designed trauma-focused intervention to support resilience and promote positive mental health in children and adolescents who have sustained an acute burn injury. Our first objective is to collect pilot data to evaluate the efficacy of the intervention and to inform the design of future trauma-focussed interventions. Our second objective is to collect pilot data to determine the appropriateness of the developed intervention by investigating the changes in mental health indicators pre- and post-intervention. This will inform the design of future interventions. METHODS This pilot intervention study will recruit 40 children aged between 6-17 years who have sustained an acute burn injury and their respective caregivers. These participants will have attended the Stan Perron Centre of Excellence for Childhood Burns at Perth Children's Hospital. Participants will attend a 45-minute weekly or fortnightly session for six weeks that involves building skills around information gathering, managing reactions (behaviours and thoughts), identifying, and bolstering coping skills, problem solving and preventing setbacks. The potential effects and feasibility of our intervention will be assessed through a range of age-appropriate screening measures which will assess social behaviours, personal qualities, mental health and/or resilience. Assessments will be administered at baseline, immediately post-intervention, at 6- and 12-months post-intervention. CONCLUSION The results of this study will lay the foundation for an evidence-based, trauma-informed approach to clinical care for paediatric burn survivors and their families in Western Australia. This will have important implications for the design of future support offered to children with and beyond burn injuries, and other medical trauma populations.
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Munro E, Wells G, Paciente R, Wickens N, Ta D, Mandzufas J, Lombardi K, Woolard A. Diet culture on TikTok: a descriptive content analysis. Public Health Nutr 2024; 27:e169. [PMID: 39310984 PMCID: PMC11504184 DOI: 10.1017/s1368980024001381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 04/23/2024] [Accepted: 06/26/2024] [Indexed: 10/27/2024]
Abstract
OBJECTIVE To investigate how dieting is portrayed on TikTok and the potential implications for public health considering the effect of diet culture on eating disorders amongst young people. DESIGN A cross-sectional descriptive content analysis of 250 videos from the five most popular diet-related hashtags. A codebook was developed to analyse the content of the videos and collect the engagement for each video (likes, comments and shares). SETTING TikTok website. PARTICIPANTS There were no participants in this study. RESULTS More than half of the videos portrayed 'body checking', a potentially harmful practice for body image. Of the videos that represented body image, almost half represented body image negatively. However, most videos promoted the idea of 'healthy eating', and only 6·4 % displayed disordered eating behaviours. Over half of the videos provided dietary advice, and of those videos, most content creators claimed to be experts (64 %). Claiming expertise was not significantly associated with engagement; however, the use of humour was significantly associated with engagement. Additionally, males were more likely than females to disclose their goals of the diet. CONCLUSIONS Overall, it appears that TikTok is commonly used to share nutrition tips and personal experiences around dieting and eating in general, often employing humour as an effective technique. The popularity of the platform and rapid dissemination of information would be a useful tool for health professionals, especially those working with eating disorders, to utilise.
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Murphy VE, Whalen OM, Williams EJ, Gibson PG, Campbell LE, Karayanidis F, Mallise CA, Woolard A, Robijn AL, Mattes J, Collison AM, Lane AE, Baines KJ. Autism likelihood in infants born to mothers with asthma is associated with blood inflammatory gene biomarkers in pregnancy. Brain Behav Immun Health 2024; 40:100845. [PMID: 39247132 PMCID: PMC11378081 DOI: 10.1016/j.bbih.2024.100845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 08/09/2024] [Accepted: 08/10/2024] [Indexed: 09/10/2024] Open
Abstract
Mothers with asthma or atopy have a higher likelihood of having autistic children, with maternal immune activation in pregnancy implicated as a mechanism. This study aimed to determine, in a prospective cohort of mothers with asthma and their infants, whether inflammatory gene expression in pregnancy is associated with likelihood of future autism. Mothers with asthma were recruited to the Breathing for Life Trial. RNA was extracted from blood samples collected at mid-pregnancy. 300 ng total RNA was hybridized with the nCounter Human Inflammation gene expression panel (Nanostring Technologies, 249 inflammation-related genes). Parents completed the First Year Inventory (FYI) at 12-month follow-up, which assessed an infant's likelihood for autism across 2 behavioural domains: social communication and sensory regulation. A total score ≥19.2 indicated increased likelihood for future autism. Inflammatory gene expression was profiled from 24 mothers: four infants scored in the high autism likelihood range; 20 scored in the low autism likelihood range. Six inflammatory genes were differentially expressed and significantly up-regulated in the high autism likelihood group: CYSLTR2, NOX1, C1QA, CXCL10, C8A, IL23R. mRNA count significantly correlated with social communication FYI score for CYSLTR2 (Pearson r = 0.46, p = 0.024) and CXCL10 (r = 0.43, p = 0.036) and with sensory regulation score for ALOX5 (r = -0.43, p = 0.038) and MAFK (r = -0.46, p = 0.022). In this proof-of-concept study, inflammatory gene expression during pregnancy in mothers with asthma was associated with an infant's likelihood of future autism as well as scores relating to social communication and sensory regulation.
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Hill NTM, Walker R, Andriessen K, Bouras H, Tan SR, Amaratia P, Woolard A, Strauss P, Perry Y, Lin A. Reach and perceived effectiveness of a community-led active outreach postvention intervention for people bereaved by suicide. Front Public Health 2022; 10:1040323. [PMID: 36620290 PMCID: PMC9815599 DOI: 10.3389/fpubh.2022.1040323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Postvention is a core component of suicide prevention strategies, internationally. However, the types of supports provided to people impacted by suicide vary widely. This study examines the perceived effectiveness of the Primary Care Navigator (PCN) model for people bereaved by suicide. The PCN model was implemented in response to a suicide cluster. It is an active outreach postvention intervention, initiated by police in response to a suspected suicide and links individuals to support in the immediate aftermath of their loss. Methods A retrospective cross-sectional mixed methods approach was used to (1) identify the reach of the PCN model, (2) describe the type of support provided to people bereaved by a suspected suicide and (3) identify the perceived effectiveness of the PCN model from the perspective of WA police, postvention stakeholders and individuals bereaved by suicide. Quantitative data was used to examine the characteristics of suicide in the region, the characteristics of people who received bereavement support, and the types of support that were provided. Interviews with police, postvention stakeholders, and people bereaved by a suspected suicide were conducted to identify the perceived effectiveness of the intervention. Results Between 1 January 2019 and 31 March 2021 there were 80 suspected suicides. Active outreach was provided to 347 bereaved individuals via the PCN model. Just under half of those who were offered outreach accepted further support (N = 164) in the form of suicide bereavement information (98%), mental health or clinical support (49.6%), specialized postvention counseling (38.4%), financial assistance (16%) and assistance with meals (16%), followed by housing assistance (14%) and referral to community services (11%). Police, stakeholders, and people with lived experience of a suspected suicide perceived the PCN model to be effective at connecting them to the community, linking people to support, and preventing suicide. Conclusion The results provide evidence supporting the perceived effectiveness of an active outreach approach to postvention that provides acute support to people bereaved by suicide. Findings highlight important practical areas of support such as providing referral pathways and information on grief and suicide loss in the immediate aftermath of a suicide loss.
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Woolard A, Benders T, Campbell LE, Whalen OM, Mallise C, Karayanidis F, Barker D, Murphy VE, Tait J, Gibson P, Korostenski L, Lane AE. The relationship between pitch contours in infant-directed speech and early signs of autism in infancy. Infant Behav Dev 2023; 72:101860. [PMID: 37478500 DOI: 10.1016/j.infbeh.2023.101860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
PURPOSE Mother-infant interactions during the first year of life are crucial to healthy infant development. The infant-directed speech (IDS), and specifically pitch contours, used by mothers during interactions are associated with infant language and social development. However, little research has examined pitch contours towards infants with socio-communication and language differences, such as those displaying early signs of autism spectrum disorder (autism). This study aimed to explore the association of infant autism signs and pitch contours used by mothers with their 12-month-old infants. METHOD Mother-infant dyads (n = 109) were recruited from the University of Newcastle BabyLab. Parent-infant dyads completed a 15-min interaction, from which a total of 36,128 pitch contours were measured and correlated with infant autism signs. Infant autism signs were assessed via parent-report (First Year Inventory; Reznick et al., 2007). A subset of high-risk infants (admitted to a neonatal intensive care unit, n = 29) also received an observation-based assessment (Autism Detection in Early Childhood; Young & Nah, 2016). RESULTS Mothers used fewer sinusoidal contours when they rated their infant as displaying more autism signs (rs = - .30, p = .004) and more autism-related sensory regulation issues (rs = - .31, p = .001). Mothers used fewer flat contours if their infant displayed more researcher-rated autism signs (r2 = - .39, p = .04). CONCLUSIONS This study provides the early evidence that maternal pitch contours in IDS are related to early autism signs in infancy. If our findings are replicated in follow up studies where infants are followed to diagnosis, maternal IDS may be an important element of future early intervention protocols that focus on communication for infants with risk for autism.
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Hill NTM, Woolard A, Perry Y, Lin A. The role of health professionals in suicide prevention in young people. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:513-515. [PMID: 35597244 DOI: 10.1016/s2352-4642(22)00156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/04/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
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Woolard A, Boutrus M, Bullman I, Wickens N, Gouveia Belinelo PD, Solomon T, Milroy H. Treatment for childhood and adolescent dissociation: A systematic review. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024:2024-46723-001. [PMID: 38271004 DOI: 10.1037/tra0001615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Dissociative symptoms are linked to experiences of trauma, often originating in childhood and adolescence. Dissociative disorders are associated with a high burden of illness and a poor quality of life. Despite evidence suggesting that early intervention can improve outcomes, little research exists on the treatment of dissociative disorders in childhood and adolescence. The current study aimed to systematically review the existing body of literature to identify current treatments applied within child and adolescent populations diagnosed with a dissociative disorder. METHOD This review was conducted in line with PRISMA guidelines. Databases were searched for relevant publications, resulting in 3,064 papers to be screened. Articles were included if they involved child or adolescent populations experiencing dissociation and undergoing treatment. Seven articles were included in the current review: two quantitative and five case studies. RESULTS Treatment duration varied greatly, ranging from 1 to 29 months. Treatments were mostly combinations of psychotherapy, dialectical behavior therapy, eye movement desensitization and reprocessing, as well as adjunctive therapies such as mindfulness and psychoeducation. CONCLUSIONS Our study demonstrated that the literature on current treatment for children and adolescents is clearly scarce, with only seven studies, five of which were case studies and two of which were over 20 years old. The treatments used for dissociation in children and adolescents experiencing dissociation were varied, but psychotherapy was the most used treatment method. This review has revealed that there is no clear framework that exists for the treatment of dissociation in child and adolescent patients, despite the need for one. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Woolard A, Coleman A, Johnson T, Wakely K, Campbell LE, Mallise CA, Whalen OM, Murphy VE, Karayanidis F, Lane AE. Parent-infant interaction quality is related to preterm status and sensory processing. Infant Behav Dev 2022; 68:101746. [PMID: 35809531 DOI: 10.1016/j.infbeh.2022.101746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 03/21/2022] [Accepted: 06/18/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Parent-infant interactions provide the foundation for the development of infant socioemotional wellbeing. Preterm birth can have a substantial, and often detrimental, impact on the quality of early parent-infant interactions. Sensory processing difficulties, common in preterm infants, are further associated with poorer interaction quality. There is a paucity of research, however, examining the links between the quality of parent-infant interaction, preterm birth, and sensory processing difficulties. This study aimed to characterise the quality of interactions of parent-infant dyads involving preterm infants who may display sensory processing differences and examine the associations between parent-infant interaction quality, preterm status and infant sensory processing. METHOD 67 parent-infant dyads (12-months infant age, 22 preterm, 45 full-term) participated in a recorded, semi-structured 15-minute play interaction. Parents also filled out questionnaires on demographics, and infant sensory processing (Infant and Toddler Sensory Profile-2; ITSP-2). Interaction quality was rated using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO). RESULTS Preterm and full-term infants differed in sensory processing and parent-infant interaction. Infant prematurity was associated with the sensory domains of; visual (r = - 0.37, p = .005), touch (r = - 0.39, p = .002), and movement (rs = - .32, p = .01), as well as the interaction domains of; responsivity (rs;= - .43, p = .001), teaching (rs = - .31, p = .02), and interaction total score (r = - 0.34, p = .01). Interaction quality was related to sensory registration (rs = - .38, p = .008), auditory (rs = - .34, p = .02), seeking (rs = .29, p = .05) and sensory behavioural scores (rs = - .52, p < .001). Overall, interaction quality was best predicted by infant prematurity and auditory scores, R2 = .15, F(1, 47) = 4.01, p = .02. DISCUSSION Preterm infants differed from their full-term peers in both their sensory processing and in their dyadic interactions with parents. Preterm status was associated with less responsivity and teaching and was found to predict overall interaction quality. Poorer infant sensory processing was associated with less parental teaching, affection and responsivity during interactions. Our results suggest that preterm birth is related to sensory processing difficulties, and that prematurity and sensory processing are differentially associated with aspects of interaction quality. These findings support the further examination of the interplay between preterm birth, sensory processing, and parent-infant interaction quality.
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Mallise CA, Murphy VE, Campbell LE, Woolard AJ, Whalen OM, Milton G, Mattes J, Collison A, Gibson PG, Karayanidis F, Lane AE. Early Sensory and Temperament Features in Infants Born to Mothers With Asthma: A Cross-Sectional Study. Front Psychol 2021; 12:713804. [PMID: 34690871 PMCID: PMC8531526 DOI: 10.3389/fpsyg.2021.713804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
Maternal asthma in pregnancy is associated with an increased risk of adverse perinatal outcomes. Adverse perinatal outcomes may result in poorer infant developmental outcomes, such as temperament and sensory difficulties. This study aimed to (1) assess differences in temperament and sensory features between infants born to mothers with and without asthma and (2) investigate differences in these infant behaviours as a function of maternal asthma severity and asthma control. Mothers completed the Carey Temperament Scales and the Sensory Profile 2 at either 6 weeks, 6 months, or 12 months postpartum. Overall, we observed no significant differences between infants born to mothers with and without asthma in their temperament or sensory features; scores in both domains fell within the normative range. More infants in the asthma group, however, were reported to be highly distractible. When compared with normative data, infants in both groups were reported to have poor predictability of biological functions and fewer infants engaged in low levels of sensory behaviours. Some infants were observed to experience difficulties with hyper-reactivity within several domains. Maternal asthma severity and control during pregnancy were not linked to significant differences between infant temperament and sensory features. The present findings indicate that infants born to mothers with asthma are not at an increased risk overall for temperament or sensory difficulties, compared to control infants. However, a subset of infants across both groups may be at risk for attention or sensory hyper-reactivity difficulties. Further research into the developmental outcomes of infants born to mothers with asthma is warranted.
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Whalen OM, Campbell LE, Lane AE, Karayanidis F, Mallise CA, Woolard AJ, Holliday EG, Mattes J, Collison A, Gibson PG, Murphy VE. Effect of fractional exhaled nitric oxide (F ENO)-based asthma management during pregnancy versus usual care on infant development, temperament, sensory function and autism signs. Eur J Pediatr 2024; 183:3199-3210. [PMID: 38691129 PMCID: PMC11263417 DOI: 10.1007/s00431-024-05578-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 05/03/2024]
Abstract
Asthma during pregnancy is associated with a range of adverse perinatal outcomes. It is also linked to increased rates of neurodevelopmental conditions in the offspring. We aimed to assess whether fractional exhaled nitric oxide (FENO)-based asthma management during pregnancy improves child developmental and behavioural outcomes compared to usual care. The Breathing for Life Trial was a randomised controlled trial that compared FENO-based asthma management during pregnancy to usual care. Participants were invited to the developmental follow-up, the Breathing for Life Trial - Infant Development study, which followed up infants at 6 weeks, 6 months and 12 months. The primary outcomes were measured in infants at 12 months using the Bayley-III: Cognitive, Language and Motor composite scores. Secondary outcomes included Bayley-III social-emotional and adaptive behaviour scores, autism likelihood and sensory and temperament outcomes. The exposure of interest was the randomised intervention group. Two hundred and twenty-two infants and their 217 participating mothers were recruited to the follow-up; 107 mothers were in the intervention group and 113 were in the control group. There was no evidence of an intervention effect for the primary outcomes: Bayley-III cognitive (mean = 108.9 control, 108.5 intervention, p = 0.93), language (mean = 95.9 control, 95.6 intervention, p = 0.87) and motor composite scores (mean = 97.2 control, 97.9 intervention, p = 0.25). Mean scores for secondary outcomes were also similar among infants born to control and FENO group mothers, with few results reaching p < 0.05. CONCLUSION In this sample, FENO-guided asthma treatment during pregnancy did not improve infant developmental outcomes in the first year of life. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ACTRN12613000202763. WHAT IS KNOWN • Maternal asthma during pregnancy has been associated with increased rates of neurodevelopmental conditions in offspring, including intellectual disability and autism. WHAT IS NEW • This is the first study to examine how managing asthma during pregnancy via a FENO-guided algorithm or usual care affects infant developmental and behavioural outcomes. While the results of the study showed no impact of the intervention, and therefore do not support the integration of FENO-based management of asthma in antenatal settings for optimal infant development, they do send a positive message about the implications of active asthma management during pregnancy on infant developmental outcomes.
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