What Parents Need to Know About Autism Screening and Early Treatment.

This JAMA Pediatrics Patient Page describes autism screening for children and how to access therapies.

Associations between executive functioning, challenging behavior, and quality of life in children and adolescents with and without neurodevelopmental conditions.

The present study sought to clarify the impact of executive and social functioning on challenging behavior and the downstream influence of challenging behavior on quality of life and functioning in a large transdiagnostic sample. Understanding these relationships is crucial for developing and designing tailored intervention strategies. In a cross-sectional study, parent informants of 2,004 children completed measures of executive and social functioning, challenging behavior, child and family quality of life, and reported on functional impacts of challenging behavior. Using structural (path) modeling, analyses evaluated the associations between executive and social functioning, including emotion regulation and risk avoidance, with overall and specific types of challenging behavior. Structural models also examined the influence of challenging behavior on child and family quality of life, including measures of the immediate and extended environment, and functional impacts on the parent/child as well as interactions with the medical/legal systems. Finally, mediational models explored the direct and indirect effects of executive and social functioning on quality of life and impact measures via challenging behavior. Results indicated that executive functioning accounts for substantial variance (R 2 = 0.47) in challenging behavior. In turn, challenging behavior accounts for substantial variance in child and family quality of life (R 2 = 0.36) and parent/child impacts (R 2 = 0.31). Exploratory mediational models identified direct effects from executive and social functioning measures on quality of life and functional impacts and indirect effects for executive functioning via challenging behavior. These findings support the development of new intervention strategies and suggest the need to measure executive functioning when assessing and tailoring the treatment of challenging behavior in clinical practice.

Food insecurity in households of children with ASD in COVID-19 pandemic: A comparative analysis with the Household Pulse Survey data using stabilized inverse probability treatment weights.

BACKGROUND: Before the COVID-19 pandemic, households of children on the autism spectrum were more likely to be food insecure than households of children without disabilities. With the unprecedented social, public health, and economic disruption caused by the pandemic, food insecurity has likely increased among families of children on the autism spectrum. OBJECTIVE: This analysis aims to compare the prevalence of food insecurity between the Autism Speaks' Food Insecurity Survey (ASFIS) administered during the Fall of 2020 and a nationally representative sample from the Household Pulse Survey (HPS) data collected during a similar timeframe. METHODS: A propensity score analysis was utilized to create stabilized inverse probability treatment weights for adjusting background differences between the two groups. A logistic regression model was computed to estimate the odds of food insecurity in the ASFIS participants compared with those in the HPS data. RESULTS: After adjusting for background differences, households of children on the autism spectrum in the ASFIS were about four times more likely to be food insecure than households in the general population contained in the HPS data (OR = 3.7; 95% CI: 3.1-4.4). CONCLUSIONS: The breakdown of social and economic supports during the COVID-19 pandemic contributed to a significantly higher likelihood of food insecurity among families of children on the autism spectrum.

Brief Report: Impact of COVID-19 in Individuals with Autism Spectrum Disorders: Analysis of a National Private Claims Insurance Database.

The COVID-19 pandemic continues to have a detrimental impact on individuals with disabilities. Data from FAIR Health's FH® NPIC (National Private Insurance Claims) database, one of the nation's largest databases of private insurance claim records, were analyzed to understand the experiences of individuals with ASD in the COVID-19 pandemic. Multivariate logistic regression models revealed that individuals with ASD + ID were nine times more likely to be hospitalized following COVID-19 infection (OR = 9.3; 95% CI: 6.9-12.5) and were nearly six times more likely to have an elevated length of hospital stay (OR = 5.9; 95% CI: 3.5-10.1) compared to those without ASD + ID. These findings point to the need for prioritizing access to vaccines to prevent COVID-19 infection and morbidities. This is the first study to illustrate a higher likelihood of hospitalization and elevated length of hospital stay from COVID-19 in individuals with ASD and other comorbidities.

Food insecurity in the households of children with autism spectrum disorders and intellectual disabilities in the United States: Analysis of the National Survey of Children's Health Data 2016-2018.

LAY ABSTRACT: Families of children with autism spectrum disorder are more likely to experience financial strain and resulting food insecurity due to additional cost of care, disparate access to needed services, and loss of income resulting from parental job loss. Utilizing nationally representative data, this analysis indicates that the families of children with autism spectrum disorder and co-occurring intellectual disabilities are twice as likely to experience food insecurity than families of children without disabilities after adjusting for various factors. Several factors, ranging from state-level policies such as Medicaid expansion to individual-level factors such as higher utilization of emergency room services, were associated with the higher prevalence of food insecurity in families of children with autism spectrum disorder and co-occurring intellectual disabilities. Implications of these findings on programs and policies supporting families in the COVID-19 pandemic are discussed.

Likelihood of Meeting Physical Activity Guidelines of Veterans Who Are Obese by Disability Status.

PURPOSE: The purpose of this study was to explore the likelihood of meeting the physical activity guidelines in veterans who are obese by disability status. DESIGN: We used data from the 2017 Behavioral Risk Factor Surveillance System, a cross-sectional telephone survey. The mean response rate was 44.9%. SETTING: Respondents came from all 50 states, District of Columbia, and 3 US territories. PATIENTS: Respondents included veterans self-reporting being obese (N = 13 798). MEASURES: We created a mutually exclusive disability variable: no disability, multiple disability, and limitations only with hearing, vision, cognitive, mobility, Activities of Daily Living, or Instrumental Activities of Daily Living. Physical activity guidelines were defined as 150 minutes/week of aerobic activity and 2 days/week of strength activities. ANALYSIS: Prevalence ratios (PRs) were calculated by performing separate log-binomial regression models for meeting strength and aerobic recommendations on veterans who were obese. RESULTS: Obese veterans with mobility limitations only or multiple disabilities were significantly less likely to meet the aerobic (PR = 0.74, P = .002 and PR = .62, P = .021, respectively) or strength (PR = .76, P < .001 and PR = 0.74, P < .001, respectively) recommendations, compared to not having a disability (n = 7964). CONCLUSIONS: Inactivity could be explained by a lack of inclusive weight loss programs for veterans with disabilities and barriers to physical activity encountered by people with disabilities. Two primary limitations of this study are self-report of obesity and physical activity and exclusion of adults in institutional settings.

An exploration of healthy eating and physical activity habits of Hmong high-school students by disability status: A pilot study.

BACKGROUND: Immigrants are at risk of being obese from obesogenic environments and face factors which limit physical activity and healthy eating. While Hmong immigrants acknowledge the importance of healthy eating and physical activity, to our knowledge no studies have looked at health promoting behaviors among Hmong adolescents with and without disabilities. OBJECTIVE: In this paper, we seek to provide baseline data about physical activity and healthy eating among Hmong high school students with disabilities in Minnesota. METHODS: We used data from the 2016 Minnesota Student Survey. The study included responses from 1,824 Hmong high school students. We compared physical activity and healthy eating of Hmong high school students by disability status. RESULTS: Approximately 13% of Hmong had a disability (n = 239). A greater percentage of Hmong high school students with disabilities reported zero days of 60 min of physical activity (20.5% vs 14.8%, p < 0.10) and zero days participation in sports teams outside of school (69.0% vs. 64.3%, p < 0.10). Compared to Hmong students without disabilities, a significantly lower percentage of Hmong students with disabilities reported not receiving free/reduced lunch (66.5% vs 73.1%, p < 0.05) and significantly more likely to skip meals because their family did not have enough money (14.2% vs 9.7%, p < 0.05). CONCLUSION: Adolescent Hmong with disabilities encounter both cultural and disability specific factors which could contribute to poorer health promoting behaviors. This study shines light on the need for social policy that promotes disability inclusive, culturally specific health promotion information and advocacy for immigrant youth with disabilities and their families in schools and communities.

Hierarchical structures on nickel-titanium fabricated by ultrasonic nanocrystal surface modification.

Hierarchical structures on metallic implants can enhance the interaction between cells and implants and thus increase their biocompatibility. However, it is difficult to directly fabricate hierarchical structures on metallic implants. In this study, we used a simple one-step method, ultrasonic nanocrystal surface modification (UNSM), to fabricate hierarchical surface structures on a nickel-titanium (NiTi) alloy. During UNSM, a tungsten carbide ball hits metal surfaces at ultrasonic frequency. The overlapping of the ultrasonic strikes generates hierarchical structures with microscale grooves and embedded nanoscale wrinkles. Cell culture experiments showed that cells adhere better and grow more prolifically on the UNSM-treated samples. Compared with the untreated samples, the UNSM-treated samples have higher corrosion resistance. In addition, the surface hardness increased from 243 Hv to 296 Hv and the scratch hardness increased by 22%. Overall, the improved biocompatibility, higher corrosion resistance, and enhanced mechanical properties demonstrate that UNSM is a simple and effective method to process metallic implant materials.

Does the built environment moderate the relationship between having a disability and lower levels of physical activity? A systematic review.

The relationship between the built environment and physical activity has been well documented. However, little is known about how the built environment affects physical activity among people with disabilities, who have disproportionately higher rates of physical inactivity and obesity. This study is the first systematic review to examine the role of the built environment as a moderator of the relationship between having a disability (physical, sensory or cognitive) and lower levels of physical activity. After conducting an extensive search of the literature published between 1990 and 2015, 2039 articles were screened, 126 were evaluated by abstract and 66 by full text for eligibility in the review. Data were abstracted using a predefined coding guide and synthesized from both qualitative and quantitative studies to examine evidence of moderation. Nine quantitative and six qualitative articles met the inclusion criteria. Results showed that most research to date has been on older adults with physical disabilities. People with disabilities described how aspects of the built environment affect neighborhood walking, suggesting a positive moderating role of features related to safety and aesthetic qualities, such as benches, lighting and stop light timing. There were mixed results among studies that examined the relationship quantitatively. Most of the studies were not designed to appropriately examine moderation. Future research should utilize valid and reliable built environment measures that are more specific to disability and should include people with and without disabilities to allow for testing of moderation of the built environment.

Surface amorphization of NiTi alloy induced by Ultrasonic Nanocrystal Surface Modification for improved mechanical properties.

We report herein the effects of Ultrasonic Nano-crystal Surface Modification (UNSM), a severe surface plastic deformation process, on the microstructure, mechanical (hardness, wear), wettability and biocompatibility properties of NiTi shape memory alloy. Complete surface amorphization of NiTi was achieved by this process, which was confirmed by X-ray diffraction and high-resolution transmission electron microscopy. The wear resistance of the samples after UNSM processing was significantly improved compared with the non-processed samples due to increased surface hardness of the alloy by this process. In addition, cell culture study demonstrated that the biocompatibility of the samples after UNSM processing has not been compromised compared to the non-processed sample. The combination of high wear resistance and good biocompatibility makes UNSM an appealing process for treating alloy-based biomedical devices.

Development of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments.

BACKGROUND: Despite the widely known benefits of physical activity, people with disabilities are more likely to be inactive when compared to people without disabilities. Previous questionnaires that measure barriers physical activity for people with disabilities do not measure barriers from an ecological perspective. OBJECTIVE: The purpose of this study was to develop the Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) that measures barriers using an ecological framework. METHODS: This study consisted of two phases. In Phase one, developed the content validity by (a) developing an item bank, (b) identifying missing items and combining items using a Delphi panel, and (c) refine item wording via cognitive interviews. In Phase two, people with mobility impairments took part in in-person interviews to establish test-retest reliability, internal consistency, and construct validity of the BPAQ-MI. RESULTS: Exploratory factor analysis revealed the BPAQ-MI was comprised of eight subscales or factors: health; beliefs and attitudes; family; friends; fitness center built environment; staff and policy; community built environment; and safety. The BPAQ-MI demonstrated very good test-retest reliability. Cronbach's alpha ranged from 0.792 to 0.935. The BPAQ-MI showed significant negative correlations with exercise (minutes/week) and significant positive correlations between BPAQ-MI subscales and inactivity (hours/day). CONCLUSIONS: The BPAQ-MI is the first questionnaire that places greater equity at measuring barriers to physical activity across the intrapersonal, interpersonal, organizational, and community domains. The BPAQ-MI has the potential to assist researchers in understanding the complex relationship between barriers and ultimately develop physical activity interventions that address these barriers.

Florida mammographer disability training vs needs.

BACKGROUND: There is currently no minimum required competency for mammographers regarding imaging patients with physical disabilities. Yet, as disability prevalence rates increase, mammographers interact with more women with disabilities at breast imaging facilities. PURPOSE: To better understand the disability training that mammographers receive and desire, and the advice they would extend to colleagues regarding improving the experience when performing mammography on women with disabilities. METHODS: Within the context of a community and academic partnership, in-depth telephone interviews were conducted with 14 mammographers practicing in north central Florida. Grounded theory techniques facilitated analysis for major themes. RESULTS: The extent, content, and delivery of disability training varied among participants. Analysis revealed respondents' personal desires for training focused on positioning to "get the best breast image," while mammographers' advice to colleagues focused on the need to afford patience and respect to the patient. Four identified themes included learning on the job, asking for help, desired training to acquire the best possible image, and advice to other mammographers regarding patience. CONCLUSION: Mammographers value the disability training they receive as a foundation for continued learning on the job. Training should comprise both technical and social aspects of performing mammography on women with disabilities, including positioning, disability etiquette, and disability advocacy.

Roles of surface Te, Nb, and Sb oxides in propane oxidation to acrylic acid over bulk orthorhombic Mo-V-O phase.

The outermost surfaces and subsurface layers of the orthorhombic (M1) Mo-V-O catalysts promoted with Te, Nb, and Sb oxide species at submonolayer surface coverage were examined by low-energy ion scattering (LEIS). This study indicated that the Nb oxide species was preferentially located at the topmost surface, while the subsurface Te and Sb concentrations declined gradually into the bulk. Although the original Mo-V-O catalyst was essentially unselective in propane oxidation to acrylic acid, significant improvement in the selectivity to acrylic acid was observed when Te, Nb, and Sb oxides were present as the surface species at submonolayer coverage. These findings further suggested that the formation of the surface V-O-M bonds (M = Nb, Te, or Sb) was highly beneficial for both the activity and selectivity of the orthorhombic Mo-V-O catalysts in propane oxidation to acrylic acid. The highest selectivity was observed when both Nb and Te (or Sb) oxide species were present at the surface. The selectivity trends established for the surface-promoted Mo-V-O catalyst parallel those found previously for the corresponding bulk Mo-V-M-O catalysts. These results further indicated that the introduction of surface metal oxide species is a highly promising method to prepare well-defined model catalysts for studies of the structure-activity/selectivity relationships as well as optimize the catalytic performance of the bulk mixed Mo-V-M-O catalysts for selective (amm)oxidation of propane.