Infusing intellectual and Developmental disability training into Medical School curriculum: a Pilot intervention.

PURPOSE: Despite the rising prevalence of developmental disabilities (DD) in the US, there remains insufficient training for healthcare professionals to care for this medically underserved population - particularly adults. The National Inclusive Curriculum for Health Education (NICHE) aims to improve attitudes and knowledge towards people with intellectual and developmental disabilities (PWIDD); herein we describe one such intervention. METHOD: The intervention integrated didactic, panel presentation and clinical skills components into a 2nd year medical school curriculum.  The didactic session, covering  health and assessment of PWIDDs, history of IDD, stigma, etc., was co-taught by a developmental pediatrician, family medicine physician and social worker.  A panel of 3 adult self-advocates (SAs) with DD and a parent of a child with DD spoke about their lived experiences.  One week later, students practiced taking clinical histories of SAs within small group settings with adult PWIDDs, facilitated by medical school faculty. Students completed the NICHE Knowledge(49 items) and Attitudes (60 items) surveys. The evaluation analyzed pre/post intervention differences in a) knowledge and attitude scores overall and b) by student age, gender, intended medical specialty, and prior experiences with PWIDDs. Open-ended comments were analyzed with content analysis. RESULTS: Overall Knowledge scores increased from pre-to posttest (n = 85; 65[19] vs. 73[17], p = 0.00), while Attitudes score improved (i.e., decreased) (n = 88; 0.55 [.06] vs. 0.53 [0.06]); p = 0.00).  Higher pretest knowledge was found among female identified students (vs. others; p = 0.01) and those knowing > = 5 PWIDD (vs < 5; p = 0.02).  Students characterize their IDD training and experience prior to intervention as 'lacking' and described the sessions as effective. CONCLUSIONS: A brief (4 hours total) intervention was associated with modest but significant improved knowledge and attitudes towards PWIDDs. Replication and sustainability of this and other NICHE interventions are needed to fill gaps in PWIDDs' health care.

Treatment of Attention-Deficit/Hyperactivity Disorder with Medication in Children with Autism Spectrum Disorder With and Without Intellectual Disability: A DBPNet Study.

Children with autism spectrum disorder (ASD) and intellectual disability (ID)/global delay (GD) frequently have symptoms of attention-deficit/hyperactivity disorder (ADHD). We describe the practice patterns of developmental behavioral pediatricians (DBPs) in the treatment of children with ASD and coexisting ADHD and compare medication classes for children with and without intellectual disability. In bivariate analyses, we compared demographic characteristics, co-occurring conditions, and medication classes for children with and without intellectual disability. Significantly more patients with ID/GD were prescribed α-agonists than patients without ID/GD, but the difference was no longer significant when controlling for age in logistic regression children with ID/GD had more comorbidities and were more likely to be prescribed more than on psychotropic medication. In conclusion, age rather than ID/GD was associated with medication choice.

Family routines and social-emotional school readiness among preschool-age children.

OBJECTIVE: To determine whether preschool-age children's participation in family routines is associated with greater likelihood of having high social-emotional health (SEH). METHODS: Data come from the Early Childhood Longitudinal Study-Birth Cohort preschool wave, a nationally representative sample of children born in 2001. Based on the literature and distribution of responses, 5 routines were categorized as present if children participated in family dinners ≥5 days per week, reading, storytelling, or singing ≥3 times per week, and play ≥few times per week. A total routines score (0-5) was also computed. Mothers rated children's SEH on 24 items scored 1 through 5. Items were summed into a total score, which was dichotomized at >1 SD above the mean, to reflect low/high SEH. Multivariable analyses assessed associations between SEH, routines score, and individual routines, adjusting for confounders. RESULTS: Among ∼8550 children, 16.6% had high SEH. For each additional routine in which a child participated, there was a 1.47 greater odds of having high SEH. In adjusted models, participating in dinners: 1.4 (95% confidence interval [CI], 1.3-1.6), storytelling: 1.9 (95% CI, 1.6-2.4), singing: 1.5 (95% CI, 1.2-1.9), and play: 1.3 (95% CI, 1.1-1.5) was associated with increased odds of high SEH. Reading was not associated with greater odds of high SEH (1.2, 95% CI, 0.9-1.5). CONCLUSIONS: Participation in a higher number of routines and in select routines was associated with increased likelihood of having high SEH. Promoting family routines may contribute to greater SEH before school entry.