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Zabel T, Jacobson L, Pritchard A, Mahone E, Kalb L. Pre-appointment online assessment of patient complexity: Towards a personalized model of neuropsychological assessment. Child Neuropsychol 2021; 27:232-250. [PMID: 32969304 PMCID: PMC8112741 DOI: 10.1080/09297049.2020.1822310] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
Recent events such as the global pandemic of COVID-19 have challenged neuropsychologists to scale up their capacity to conduct portions of their assessment remotely. While more complex patients will likely continue to require on-site, office-based interaction and assessment, the current emergency-based expansion of online and telehealth evaluation practices may ultimately lay the groundwork for more routine, online assessment of patients with less complex presentations in the future. To this end, the current study evaluated a pre-appointment, online methodology for differentiating referred pediatric patients based upon the scope and severity of their caregiver-reported adaptive, academic, attentional, behavioral, and emotional impairment. Prior to on-site assessment, parents/caregivers of 2197 children (Mean age = 10.0y, range = 4-19y, 62% male) completed an online developmental history form screening for symptoms of adaptive, attentional, learning, affective, and behavioral impairment; 71% of those children eventually underwent assessment. Using latent class analysis, the data supported a reproducible 4-class model consisting of groups of children at increased risk for: 1) severe multi-domain dysfunction; the "High Complexity" group, 30%, 2) behavioral-affective (but not academic) dysregulation; the "Behavioral Focus" group, 13%, 3) academic (but not behavioral-affective) problems; the "Academic and Inattention" group, 37%, and 4) patients with minimal clinical complexity; the "Low Complexity" group, 20%. Comparison of pre-visit classification with day-of-assessment standardized test scores supported the validity of patient subtypes. Moving forward, pre-appointment clarification of patient complexity may support efficient patient triage with regard to assessment modality (e.g., on-site or online) and length of appointment (e.g., comprehensive or targeted).
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Affiliation(s)
- T.A. Zabel
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - L.A. Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - A.E. Pritchard
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - E.M. Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - L. Kalb
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
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Kalb L, Jacobson L, Zisman C, Mahone E, Landa R, Azad G, Menon D, Singh V, Zabel A, Pritchard A. Interest in Research Participation Among Caregivers of Children with Neurodevelopmental Disorders. J Autism Dev Disord 2019; 49:3786-3797. [PMID: 31172337 DOI: 10.1007/s10803-019-04088-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/26/2022]
Abstract
The goal of this study was to examine caregiver agreement to hear about local research opportunities by joining a clinical research registry. Data from this cross-sectional study were gathered, between 2014 and 2017, across two outpatient clinics: (1) a multidisciplinary Autism Spectrum Disorder (ASD) clinic (N = 5228) and (2) a general psychology clinic serving youth with, or at risk for, a neurodevelopmental disorder (NDD; N = 5040). Overall, more than 8 in 10 caregivers agreed to join the registry. Several child clinical characteristics, as well as racial and sociodemographic factors, were predictive of parental agreement. Findings suggest caregivers of youth with ASD and NDD are amenable to joining the local research enterprise, however further work is needed to understand why some caregivers decline.
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Affiliation(s)
- L Kalb
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA. .,Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA. .,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - L Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - C Zisman
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA
| | - E Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - R Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - G Azad
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - D Menon
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - V Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - A Zabel
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - A Pritchard
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
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Kalb L, Jacobson L, Zisman C, Mahone E, Landa R, Azad G, Pinkett-Davis M, Menon D, Singh V, Zabel A, Pritchard A. Correction to: Interest in Research Participation Among Caregivers of Children with Neurodevelopmental Disorders. J Autism Dev Disord 2019; 49:4707. [PMID: 31468274 DOI: 10.1007/s10803-019-04197-5] [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: 11/30/2022]
Abstract
During the publication process, an author "M. Pinkett-Davis", who helped conceptualize and revise this study was accidentally excluded from the authorship list. The revised author group is now: Kalb, L., Jacobson, L., Zisman, C., Mahone, E., Landa, R., Azad, G., Pinkett-Davis, M., Menon, D., Singh, V., Zabel, A., & Pritchard, A. Please use this authorship list when citing this manuscript.
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Affiliation(s)
- L Kalb
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA. .,Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA. .,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - L Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - C Zisman
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA
| | - E Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - R Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - G Azad
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA.,Department of Mental Health, Johns Hopkins School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - M Pinkett-Davis
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - D Menon
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - V Singh
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Creamer Family Building, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
| | - A Zabel
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
| | - A Pritchard
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 707 N. Broadway, Baltimore, MD, 21205, USA
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Keefer A, Kalb L, Mazurek M, Kanne S, Freedman B, Vasa R. Methodological considerations when assessing restricted and repetitive behaviors and aggression. Res Autism Spectr Disord 2014; 8:1527-1534. [PMID: 27239223 PMCID: PMC4883588 DOI: 10.1016/j.rasd.2014.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Methodological issues impacting the relationship between aggression and restricted, repetitive, and stereotyped behaviors and interests (RRSBI) were examined in 2648 children and adolescents with autism spectrum disorders (ASD) using a multi-method, multi-informant analysis model to assess the effects of informant, assessment method, and aggression phenotype. Overall, a significant, but small relationship was found between RRSBI and aggression (p < .05). There was significant heterogeneity of estimates with large effect sizes observed when utilizing teacher report and a broad phenotype of aggression. Variance in estimates was attributed to differences in informant and assessment method with two times greater effect attributed to informant. Results suggest strategies to optimize future investigations of the relationship between RRSBI and aggression. Findings also provide the opportunity for the development of targeted interventions for aggression in youth with ASD.
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Affiliation(s)
- A.J. Keefer
- Center for Autism and Related Disorders, Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, MD 21211, USA
| | - L. Kalb
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Hampton House, 624 N. Broadway, 8th Floor, Baltimore, MD 21205, USA
| | - M.O. Mazurek
- University of Missouri, Department of Health Psychology and Thompson Center for Autism and Neurodevelopmental Disorders, 205 Portland Street, Columbia, MO 65211, USA
| | - S.M. Kanne
- University of Missouri, Department of Health Psychology and Thompson Center for Autism and Neurodevelopmental Disorders, 205 Portland Street, Columbia, MO 65211, USA
| | - B. Freedman
- Center for Disabilities Studies, University of Delaware, 461 Wyoming Road, Newark, DE 19716, USA
| | - R.A. Vasa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Department of Psychiatry, Johns Hopkins University School of Medicine, 3901 Greenspring Avenue, Baltimore, MD 21211
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Kalb L, Vogel L. Untersuchungen in der Indigo-Gruppe, VI.: 4.4′-Dichlor-5.7.5′.7′-tetrajod-indigo, 5.6.7.5′.6′.7′-Hexajod-indigo und verwandte Verbindungen. ACTA ACUST UNITED AC 2006. [DOI: 10.1002/cber.19240571126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
OBJECTIVE The prevalence, persistence, and desistance of boys' physical fighting was examined over a 7-year period. The importance of persistent physical fighting compared with other risk factors in the prediction of later mental health problems was explored. METHOD One hundred seventy-seven boys, aged 7 to 12 years, who had been referred to clinics for mental health problems were followed up annually for 7 years, with the boys, their parents, and teachers as informants. RESULTS Agreement among different informants about the boys' fighting tended to be low. The prevalence of fighting over time remained quite similar for different age cohorts. Almost 9 of 10 fighters in year 1 continued to fight in one or more successive years, and about one third of the boys could be classified as persistent fighters. Only 13.1% of the boys desisted in fighting. Boys who desisted, compared with those who persisted, had higher intelligence and their mothers scored lower on measures of antisocial personality disorder. At year 7, persistent fighting was significantly associated with impairment. The prevalence of psychiatric diagnoses in year 7 was 3 times higher for persistent fighters than for nonfighters. Using regression analyses with several control variables, conduct disorder was best predicted by earlier oppositional defiant disorder in year 1 and persistent fighting. Global impairment was best predicted by oppositional defiant disorder in year 1, persistent fighting, and low IQ. Finally, the number of diagnoses at year 7 was best predicted by persistent fighting. CONCLUSION Physical fighting constitutes a significant mental health risk in referred boys.
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Affiliation(s)
- R Loeber
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical School, PA 15213, USA. rloe+@pitt.edu
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