Rapid and Deferred Help Seeking Among African American Parents of Children With Emotional and Behavioral Difficulties.

OBJECTIVE: Little is known about the factors African American parents consider when seeking care for their child after emotional and behavioral difficulties emerge. This study aimed to examine factors associated with seeking professional care within 30 days after identifying a child's need (i.e., rapid care seeking) and with deferring care for ≥1 year. METHODS: This cross-sectional study surveyed African American parents raising a child with emotional or developmental challenges (N=289). Logistic regression was used to examine associations of parent activation, medical mistrust, and care-seeking barriers with two outcomes: rapidly seeking care and deferring care seeking. RESULTS: About 22% of parents rapidly sought care, and 49% deferred care for 1 year or longer. Parents were more likely to rapidly seek care if they had higher parent activation scores; lived with other adults with mental health challenges; or, contrary to the authors' hypothesis, mistrusted doctors. Parents were less likely to rapidly seek care if the challenge did not initially bother them much or if their health insurance would not cover the service. Parents were more likely to defer care if they feared involuntary hospitalization for their child or if their health insurance would not cover the service. Parents were less likely to defer care if they had at least some college education or lived with other adults with mental health challenges. CONCLUSIONS: Community-based pediatric and child welfare professionals should be informed about facilitators and barriers to mental health care seeking as part of efforts to develop interventions that support African American families.

Meaningful Transitions: Enhancing Clinician Roles in Transition Planning for Adolescents With Autism Spectrum Disorders.

Purpose The purpose of this tutorial is to provide speech-language pathologists (SLPs) with foundational information that will assist them in transition planning for students with autism spectrum disorder (ASD) based on a review of current literature. SLPs must be knowledgeable of transition planning in order to assist students with ASD and their families with preparing for their future. An appreciation and awareness of pertinent assessments, functional goals, and factors associated with successful postsecondary outcomes are essential competencies that SLPs need when planning for the transition process. SLPs are ideal workforce development partners. They facilitate independence, communication, and interaction skills necessary for postsecondary and workplace success. Speech-language services are one of the most common special education services received by high school students with Individualized Education Programs. However, SLPs receive little preparation on the specifics or nuances of transition planning prior to working in the educational settings, despite the high incidence of speech-language services in secondary education. Method This tutorial reviews and synthesizes research findings related to assessment planning, goal-setting, and Individualized Education Program implementation for achieving meaningful postsecondary transitions for students with ASD. Additionally, it highlights some of the key postsecondary skillsets related to speech-language therapy services, including the development of self-determination, self-advocacy, social competence, and adaptive behaviors. Conclusion Greater focus on higher quality transition planning requires SLPs to develop high levels of knowledge and competencies in the transition planning process. This tutorial educates clinicians on the unique challenges faced by individuals with ASD and provides evidence-based strategies to help students and families successfully plan for and navigate postsecondary transitions.

Parent Activation and Child Mental Health Service use in African American Families in a Large Cross-Sectional Study.

OBJECTIVES: 1) To describe activation skills of African American parents on behalf of their children with mental health needs. 2) To assess the association between parent activation skills and child mental health service use. METHODS: Data obtained in 2010 and 2011 from African American parents in North Carolina raising a child with mental health needs (n = 325) were used to identify child mental health service use from a medical provider, counselor, therapist, or any of the above or if the child had ever been hospitalized. Logistic regression was used to model the association between parent activation and child mental health service use controlling for predisposing, enabling, and need characteristics of the family and child. RESULTS: Mean parent activation was 65.5%. Over two-thirds (68%) of children had seen a medical provider, 45% had seen a therapist, and 36% had seen a counselor in the past year. A quarter (25%) had been hospitalized. A 10-unit increase in parent activation was associated with a 31% higher odds that a child had seen any outpatient provider for their mental health needs (odds ratio = 1.31, confidence interval = 1.03-1.67, p = 0.03). The association varied by type of provider. Parent activation was not associated with seeing a counselor or a therapist or with being hospitalized. CONCLUSION: African American families with activation skills are engaged and initiate child mental health service use. Findings provide a rationale for investing in the development and implementation of interventions that teach parent activation skills and facilitate their use by practices in order to help reduce disparities in child mental health service use.

The first year inventory: retrospective parent responses to a questionnaire designed to identify one-year-olds at risk for autism.

The First Year Inventory (FYI) is a parent questionnaire designed to assess behaviors in 12-month-olds that suggest risk for an eventual diagnosis of autism. We examined the construct validity of the FYI by comparing retrospective responses of parents of preschool children with autism spectrum disorders (ASD; n = 38), other developmental disabilities (DD; n = 15), and typical development (TD; n = 40). Children with ASD were rated at significantly higher risk on the FYI than children with DD or TD. The DD group was at intermediate risk, also significantly higher than the TD group. These retrospective data strengthen the validity of the FYI and have implications for refining the FYI to improve its utility for prospective screening of 12-month-olds.

Brief report: parental child-directed speech as a predictor of receptive language in children with autism symptomatology.

Facilitative linguistic input directly connected to children's interest and focus of attention has become a recommended component of interventions for young children with autism spectrum disorder (ASD). This longitudinal correlational study used two assessment time points and examined the association between parental undemanding topic-continuing talk related to the child's attentional focus (i.e., follow-in comments) and later receptive language for 37 parent-child dyads with their young (mean = 21 months, range 15-24 months) children with autism symptomology. The frequency of parental follow-in comments positively predicted later receptive language after considering children's joint attention skills and previous receptive language abilities.

Behavioral and physiological responses to child-directed speech as predictors of communication outcomes in children with autism spectrum disorders.

PURPOSE: To determine the extent to which behavioral and physiological responses during child-directed speech (CDS) correlate concurrently and predictively with communication skills in young children with autism spectrum disorders (ASD). METHOD: Twenty-two boys with ASD (initial mean age: 35 months) participated in a longitudinal study. At entry, behavioral (i.e., percentage looking) and physiological (i.e., vagal activity) measures were collected during the presentation of CDS stimuli. A battery of standardized communication measures was administered at entry and readministered 12 months later. RESULTS: Percentage looking during CDS was strongly correlated with all entry and follow-up communication scores; vagal activity during CDS was moderately to strongly correlated with entry receptive language, follow-up expressive language, and social-communicative adaptive skills. After controlling for entry communication skills, vagal activity during CDS accounted for significant variance in follow-up communication skills, but percentage looking during CDS did not. CONCLUSIONS: Behavioral and physiological responses to CDS are significantly related to concurrent and later communication skills of children with ASD. Furthermore, higher vagal activity during CDS predicts better communication outcomes 12 months later, after initial communication skills are accounted for. Further research is needed to better understand the physiological mechanisms underlying variable responses to CDS among children with ASD.