Comparison of Parent Questionnaires, Examiner-Led Assessment and Parents' Concerns at 14 Months of Age as Indicators of Later Diagnosis of Autism.
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SUBMITTER: Pasco G
PROVIDER: S-EPMC7954743 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeThere is a need for interventions for traumatized children that are easily accessible and effective, and that involve parents directly in the recovery process. To meet this challenge, stepped care trauma-focused cognitive behavioral treatment (SC TF-CBT), which consists of a parent-led therapist-assisted intervention as the first step, was developed. Parent-led trauma-treatment is a promising, but novel approach. The aim of this study was therefore to gain knowledge on how parents experience the model.MethodsParents who participated in a SC TF-CBT feasibility study were consecutively recruited and interviewed with semi-structured interviews, which were then analysed using interpretative phenomenological analysis.ResultsThe parents described that the intervention gave them insights that led to a sense of parental agency. Through the analysis we identified and labelled four themes: (i) understanding my child: how the trauma has affected my child and our relationship; (ii) understanding myself: how my reactions have stood in the way of helping my child; (iii) gaining competence: how to learn specific tasks that were not part of my normal parenting skills; and (iv) receiving support: how guidance, warmth and encouragement was necessary.ConclusionsThe results from this study show how the shifting of therapeutic tasks to parents may facilitate parental empowerment and improve the parent-child relationship. This knowledge may guide clinicians on how to provide support to parents so they can take a leading role in their child's recovery process after trauma.Trial registrationClinicalTrials.gov, NCT04073862. Retrospectively registered 03 June 2019 (first patient recruited May 2019), https://clinicaltrials.gov/ct2/show/NCT04073862.
| S-EPMC10064603 | biostudies-literature
Project description:Retrospective parental reports have often been used to identify the early characteristics of children later diagnosed with a developmental disorder.We applied this methodology to document 13 parents' initial concerns about the development of their 17 children later diagnosed with fragile X syndrome (FXS). Parents were additionally asked about when they noticed the emergence of behavioural signs related to FXS.More than half of the parents reported initial concerns prior to the child's first birthday and in most cases it was deviant motor behaviours that caused the first concerns. Behavioural signs related to the FXS phenotype were also reported to be perceptible in the first year of the child's life.Due to limitations of retrospective parental questionnaires, we suggest that other methodologies, such as home video analysis, are needed to complement our understanding of the pathways of developmental disorders with late clinical onsets.
| S-EPMC5985965 | biostudies-literature
Project description:BackgroundDevelopmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD.AimsTo test the predictive relationship between parent-reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population-based sample.MethodsData were leveraged from the prospective Raine Study (n = 1626 second-generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well-established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years.ResultsNo single parent-reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85-1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59-1.32, p = 0.563) were also non-significant.ConclusionsParent reports of early indicators of DLD are well-intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed.What this paper addsWhat is already known on the subject DLD is a relatively common childhood condition; however, children with DLD are under-identified and under-served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge No one parent-reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work? The broad dissemination and use of 'red flags' is well-intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation-based interventions.
| S-EPMC10952803 | biostudies-literature
Project description:OBJECTIVES:The proportion of older adults who are unpartnered has increased significantly over the past 25 years. Unpartnered older adults often rely on their adult children for support. Most previous studies have focused on proximal factors associated with adult children's support of their parents, while few have examined distal factors, such as parent-child relationships formed during childhood. This study fills the gap by investigating the direct and indirect associations between early-life parent-child relationships and adult children's upward transfers to unpartnered parents. METHOD:Data came from two supplements to the Panel Study of Income Dynamics, in which respondents were asked about their relationships with mothers and fathers before age 17 and their transfers of time and money to parents in 2013. Path models were estimated for unpartnered mother-adult child dyads and father-adult child dyads separately. RESULTS:For adult children of unpartnered mothers, psychological closeness has a direct, positive association with time transfer, while physical violence has an indirect association with time transfer through adult children's marital status. For adult children of unpartnered fathers, psychological closeness has neither a direct nor an indirect association with time or money transfer, but physical violence has a direct, negative association with time transfer. DISCUSSION:Early-life parent-child relationships play a pivotal role in influencing adult children's caregiving behavior, both directly and indirectly. Our findings suggest that by improving their relationships with children early in life, parents may be able to increase the amount of time transfer that they receive in late life.
| S-EPMC6566332 | biostudies-literature
Project description:It is widely believed that reading to preschool children promotes their language and literacy skills. Yet, whether early parent-child book reading is an index of generally rich linguistic input or a unique predictor of later outcomes remains unclear. To address this question, we asked whether naturally occurring parent-child book reading interactions between 1 and 2.5 years-of-age predict elementary school language and literacy outcomes, controlling for the quantity of other talk parents provide their children, family socioeconomic status, and children's own early language skill. We find that the quantity of parent-child book reading interactions predicts children's later receptive vocabulary, reading comprehension, and internal motivation to read (but not decoding, external motivation to read, or math skill), controlling for these other factors. Importantly, we also find that parent language that occurs during book reading interactions is more sophisticated than parent language outside book reading interactions in terms of vocabulary diversity and syntactic complexity.
| S-EPMC6927670 | biostudies-literature
Project description:BackgroundThe treatment for children with eating disorders (EDs) requires extensive involvement of parents. The parents of children with EDs have voiced a need for greater support, including connecting with other parents with lived experience of caring for a child with an ED. We aimed to qualitatively explore parental experiences of these groups, including their benefits and areas for improvement.MethodsThis study examined the delivery of four virtual parent-led peer support groups in Ontario, Canada for parents of children with EDs with approximately 10 parent participants per group and two parent facilitators leading each group. Parents (n = 44) were asked to attend 12 bi-weekly support group sessions over 6 months, and then complete an individual end-of-study qualitative interview. Interview data were analyzed using content analysis, following the qualitative description design.ResultsThirty-six parents completed the end-of-study qualitative interview. Participants shared their experiences and impressions related to the group's structure and content. Notable helpful aspects of the group included being able to receive support from those with similar experiences, access to education and resources about EDs, and being able to support others. Suggestions for improvements were made, which included organizing groups according to the child's ED diagnosis or duration of illness.ConclusionThe findings indicate that this intervention is acceptable to parents and is perceived as helpful. Future research is needed to strengthen this support group model and to study its effects for parents in different settings and for parents of children with various EDs.Trial registrationClinicalTrials.gov NCT04686864.
| S-EPMC9754305 | biostudies-literature
Project description:OBJECTIVES:Feedback is a powerful learning tool, but a lack of appropriate feedback is a very common complaint from learners to teachers. To improve opportunities for feedback on objective structured clinical examinations (OSCEs), a modified examiner role, termed the "shadow" examiner, was tested. This study aims to present and analyze comparisons between the "shadow" examiner and the original OSCE examiner format. METHODS:In 2011, experiments were carried out with modifications to the examiner's role to define the "shadow" examiner format. From February 2012 to May 2014, research was conducted with 415 6th-year medical students. Of these students, 316 were randomly assigned to assessments by both "shadow" and "fixed" examiners. Pearson correlation analysis with linear regression, Student's t-tests and Bland-Altman plots were the statistical methods used to compare the assessment modes. To strengthen the analysis, checklist items were classified by domain. RESULTS:High correlations between the "shadow" and "fixed" examiners' global scores were observed. The results of the analysis of specific domains demonstrated higher correlations for cognitive scores and lower correlations for affective scores. No statistically significant differences between the mean examiner global scores were found. The Bland-Altman analysis showed that the "shadow" examiners' affective scores were significantly higher than those of the "fixed" examiners, but the magnitude of this difference was small. CONCLUSION:The modified examiner role did not lead to any important bias in the students' scores compared with the original OSCE examiner format. This new strategy may provide important insights for formative assessments of clinical performance.
| S-EPMC6827324 | biostudies-literature
Project description:Study objectivesTo investigate parental knowledge about adolescent sleep needs, and other beliefs that may inform their support for or objection to later school start times.MethodsIn 2014, we conducted a cross-sectional, Internet-based survey of a nationally representative sample of parents as part of the C.S. Mott Children's Hospital National Poll on Children's Health. Parents with teens aged 13-17 years reported their children's sleep patterns and school schedules, and whether the parents supported later school start times (8:30 am or later). Responses associated with parental support of later school start times were examined with logistic regression analysis.ResultsOverall, 88% of parents reported school start times before 8:30 am, and served as the analysis sample (n = 554). In this group, 51% expressed support for later school start times. Support was associated with current school start times before 7:30 am (odds ratio [OR] = 3.1 [95% confidence interval (CI) 1.2, 8.4]); parental opinion that their teen's current school start time was "too early" (OR = 3.8 [1.8, 7.8]); and agreement with American Academy of Pediatrics recommendations about school start times (OR = 4.7 [2.2, 10.1]). Support also was associated with anticipation of improved school performance (OR = 3.0 [1.5, 5.9]) or increased sleep duration (OR = 4.0 [1.8, 8.9]) with later school start times. Conversely, parents who anticipated too little time for after-school activities (OR = 0.5 [0.3, 0.9]) and need for different transportation plans (OR = 0.5 [0.2, 0.9]) were often less supportive.ConclusionsParental education about healthy sleep needs and anticipated health benefits may increase their support for later school start times. Educational efforts should also publicize the positive experiences of communities that have made this transition, with regard to limited adverse effect on after-school activity schedules and transportation.
| S-EPMC5482580 | biostudies-literature
Project description:Former preterm and very low birthweight infants require close neurodevelopmental surveillance after hospital discharge, but in-person professional testing is resource-intensive and inconvenient for families. A standardised developmental questionnaire completed by parents offers an alternative to in-person testing, but few such questionnaires have been validated. Our aim was to validate the Motor and Social Development (MSD) scale in a sample of former preterm infants.We studied 321 visits to a neonatal follow-up clinic. Parents completed the MSD, which measures cognitive, motor and social abilities. Psychologists and physical therapists administered the Bayley Scales of Infant Development, 3rd edition (Bayley-III) cognitive and motor scales.The median (range) gestational age was 28 (23, 34) weeks and birthweight 980 (400, 2700)?g. Corrected age at study participation ranged 5-35 months. The mean (standard deviation) Bayley-III motor score was 94 (16), cognitive 98 (16) and MSD 91 (18). Internal consistency of the MSD was moderate to high (Cronbach alpha of 0.65 to 0.88). The MSD was moderately correlated with the Bayley-III motor (Pearson r?=?0.49, P?<?0.001) and cognitive (r?=?0.45, P?<?0.001) scales. The area under the receiver operating characteristic curve was 0.88 [95% confidence interval (CI) 0.81, 0.95] for the MSD to detect a low Bayley-III motor score (<70), and 0.88 [95% CI 0.82, 0.95] for a low cognitive score, indicating good discrimination.The MSD has good internal and concurrent validity, and may be useful for neurodevelopmental assessment of former preterm and very low birthweight infants in clinical and research settings.
| S-EPMC3564502 | biostudies-literature
Project description:Here we tested the hypothesis that intrauterine infusion of pathogenic bacteria leads to changes in the transcriptome of the reproductive tract in dairy cattle three months later. We used virgin Holstein heifers to avoid the confounding effects of periparturient problems, metabolic stress and lactation. Animals were infused intrauterine with endometrial pathogenic bacteria Escherichia coli and Trueperella pyogenes to induce clinical endometritis (n = 4) and compared with control animals (n = 6). Three months after infusion, the caruncular and intercaruncular endometrium, isthmus and ampulla of the oviduct, and granulosa cells from dominant ovarian follicles were profiled by RNA-sequencing. Compared with control, bacterial infusion altered the transcriptome of all the tissues. Most differentially expressed genes were tissue-specific, with 109 differentially expressed genes unique to the caruncular endometrium, 57 in the intercaruncular endometrium, 65 in the isthmus, 298 in the ampulla, and 83 in granulosa cells. Surprisingly, despite infusing the bacteria into the uterus, the granulosa cells had more predicted upstream regulators of differentially expressed genes than all the other tissues combined. In conclusion, there was evidence of long-term changes to the transcriptome of the endometrium, oviduct and even the granulosa cells after intrauterine infusion of pathogenic bacteria, which implies that all these tissues contribute to the infertility that persists after endometritis.
2019-11-30 | GSE140469 | GEO