Effectiveness of delivering evidence-based eating disorder treatment via telemedicine for children, adolescents, and youth.

Barriers limit access to eating disorder treatment. Evidence-based treatment delivered using telemedicine could expand access. This study determined the effectiveness of enhanced Family-Based Treatment (FBT+) delivered using telemedicine for children and adolescents with eating disorders. Participants had a confirmed eating disorder diagnosis, lived in states where treatment was available, and lived with a family member willing to participate. Virtual FBT+ was administered by a five-person team including a therapist, dietitian, medical provider, peer mentor, and family mentor for up to 12 months. Measures were recorded at baseline and varying frequencies throughout treatment. Weight was self-reported. Eating disorder symptoms were assessed with the Eating Disorder Examination-Questionnaire Short Form (EDE-QS) and depression and anxiety were measured using the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7). Caregiver burden and self-efficacy were measured using the Burden Assessment Scale, and Parent Versus Eating Disorder scale. The majority of patients (N = 210; 6 to 24 years old [mean 16 · 1 years]) were cisgender female (83%) White, (71%), required weight restoration (78%), and had anorexia nervosa, restricting type (63%). After 16 weeks, patients on weight restoration gained on average 11 · 3 [9 · 86, 12 · 8] pounds and the average change in EDE-QS score was -6 · 31 [-8 · 67, -4 · 10] points. Similar reductions were seen for depression (-2 · 62 [-4 · 24, -1 · 04]), anxiety (-1 · 44 [-1 · 12, 0 · 78]), and caregiver burden (-4 · 41 [2 · 45, 6 · 31]). Caregiver self-efficacy increased by 4 · 56 [3 · 53, 5 · 61] points. Patients and caregivers reported satisfaction with treatment. Virtual FBT+ for eating disorders can transcend geographical and psychosocial treatment barriers, expanding access to evidence-based eating disorder treatment.

Regional differences in the developmental trajectory of lateralization of the language network.

The timing and developmental factors underlying the establishment of language dominance are poorly understood. We investigated the degree of lateralization of traditional frontotemporal and modulatory prefrontal-cerebellar regions of the distributed language network in children (n = 57) ages 4 to 12--a critical period for language consolidation. We examined the relationship between the strength of language lateralization and neuropsychological measures and task performance. The fundamental language network is established by four with ongoing maturation of language functions as evidenced by strengthening of lateralization in the traditional frontotemporal language regions; temporal regions were strongly and consistently lateralized by age seven, while frontal regions had greater variability and were less strongly lateralized through age 10. In contrast, the modulatory prefrontal-cerebellar regions were the least strongly lateralized and degree of lateralization was not associated with age. Stronger core language skills were significantly correlated with greater right lateralization in the cerebellum.

Virtually delivered family-based eating disorder treatment using an enhanced multidisciplinary care team: A case study.

Both patients experienced meaningful clinical improvements with this virtual approach and the augmented treatment team in regards to weight gain, acceptability, and clinical assessment scores. These findings offer preliminary support for this model.

An fMRI study of sentence-embedded lexical-semantic decision in children and adults.

Lexical-semantic knowledge is a core language component that undergoes prolonged development throughout childhood and is therefore highly amenable to developmental studies. Most previous lexical-semantic functional MRI (fMRI) studies have been limited to single-word or word-pair tasks, outside a sentence context. Our objective was to investigate the development of lexical-semantic language networks in typically developing children using a more 'ecological' sentence-embedded semantic task that permitted performance monitoring while minimizing head movement by avoiding overt speech. Sixteen adults and 23 children completed two fMRI runs of an auditory lexical-semantic decision task with a button-press response, using reverse speech as control condition. Children and adults showed similar activation in bilateral temporal and left inferior frontal regions. Greater activation in adults than in children was seen in left inferior parietal, premotor, and inferior frontal regions, and in bilateral supplementary motor area (SMA). Specifically for semantically incongruous sentences, adults also showed greater activation than children in left inferior frontal cortex, possibly related to enhanced 'top-down' control. Age-dependent activation increases in motor-related regions were shown to be unrelated to overt motor responses, but could be associated with covert speech accompanying semantic decision. Unlike previous studies, age-dependent differences were not detected in posterior sensory cortices (such as extrastriate cortex), nor in middle temporal gyrus.