Secondary analysis of one State's Youth Risk Behavior Surveillance System (YRBSS) data by Individualized Education Program (IEP) status.

BACKGROUND: Children with disabilities may be at increased risk for engaging in health risk behaviors compared to their peers without disabilities. OBJECTIVE: This secondary analysis aims to assess if Individualized Education Program (IEP) status, a proxy for having a disability, is a risk factor for youth to engage in health risk behaviors such as alcohol use, marijuana use, other substance use, bullying or cyberbullying victimization, and sexual activity. METHODS: Data from Connecticut Youth Risk Behavior Surveillance System (YRBSS) 2013, 2015, 2017, and 2019 were combined for a representative sample of 9243 students, 850 reporting having an IEP. Having a disability was measured by an item that asked if participants received special education services as part of an IEP. Logistic regression that accounted for the YRBSS sample design was used to assess main effects. RESULTS: Having an IEP significantly predicted the likelihood of being bullied (OR = 1.81), cyberbullied (OR = 1.49), and other drug use (OR = 1.65), but did not predict engaging in sexual activity. CONCLUSIONS: Students with disabilities in CT, as defined by the receipt of special education services as specified on an IEP, are at increased risk to engage in health risk behaviors than are students without disabilities during their high school years. Further analyses and comparisons across sites, years, and type of disability are limited as there is no current item on the national YRBSS questionnaire that measures a participant's special education status or disability status.

Nutritional Deficiency Disease Secondary to ARFID Symptoms Associated with Autism and the Broad Autism Phenotype: A Qualitative Systematic Review of Case Reports and Case Series.

BACKGROUND: The demographics, weight statuses, and dietary patterns of people with autism or the broad autism phenotype who experience a severe nutrient deficiency disease due to symptoms of avoidant/restrictive food intake disorder have not been well established. OBJECTIVE: The primary objective of this review was to examine the relationship between the demographics, weight statuses, dietary patterns, and nutrient deficiency diseases that characterize the most severe manifestations of avoidant/restrictive food intake disorder symptomology associated with autism or the broad autism phenotype. METHODS: A systematic review of English and non-English articles published up to August 29, 2019, on the Scopus, PubMed, and Cumulative Index to Nursing and Allied Health Literature Plus electronic databases was conducted. Additional cases were identified through the reference list of all included articles. The search terms used were "autis∗ AND (deficiency OR scurvy)". Only case reports or case series in which a person of any age who had been identified as having a formal diagnosis of autism or autism symptoms and a disease of nutritional deficiency due to self-imposed dietary restrictions were included. Data were independently extracted by 8 authors using predefined data fields. RESULTS: A total of 76 cases (patients were aged 2.5 to 17 years) from 63 articles that were published from 1993 through 2019 were found. More than 85% cases (65 of 76 patients) were from articles published in the past 10 years. The largest percentage of published cases (69.7% [53 of 76]) involved scurvy, a vitamin C deficiency. The second-largest percentage of published cases (17.1% [13 of 76]) involved eye disorders secondary to vitamin A deficiency. Other primary nutrient deficiencies reported were thiamin, vitamin B-12, and vitamin D. In 62.9% (22 of 35) of the patients for which a body mass index or a weight percentile for age was provided, the patient was within normal weight parameters, per Centers for Disease Control weight status categories. CONCLUSIONS: Based on the 63 articles extracted for this systematic review, nutritional deficiency diseases related to inadequate intakes of vitamin A, thiamin, vitamin B-12, vitamin C, and vitamin D were found in individuals with autism and the broad autism phenotype who had severe self-imposed dietary restrictions. When weight information was provided, most of the youth in these cases were not reported to be underweight. Individuals of any weight who present with symptoms of avoidant/restrictive food intake disorder can benefit from early and frequent screening for adequacy of micronutrient intake, regardless of whether they have a clinical diagnosis of autism.

A Retrospective Chart Review of Children with ASD's Individual Education Plans Compared to Subsequent Independent Psychological Evaluations.

The heterogeneity of Autism Spectrum Disorder (ASD) makes it difficult for school-based professionals to develop effective Individual Education Plans (IEP) for this group. Limited research exists on the quality of IEP programs for individuals with ASD. This article summarizes the results of a retrospective chart review from an outpatient diagnostic center. Researchers collected data from IEPs and subsequent psychological evaluations of 75 individuals diagnosed with ASD. The implications of these results for future research and practice are discussed.

Quality comparison of websites related to developmental disabilities.

The Internet is commonly used to seek health-related information, but little is known about the quality of websites on developmental disabilities. Therefore, we sought to evaluate the characteristics and quality of websites located by searching ten common terms related to developmental disabilities and explore relations between website characteristics and website quality in order to make recommendations on ways to ensure locating good online information. We located 208 unique websites in our November 2012 US searches of Google and Bing. Two independent coders evaluated 10 characteristics of the websites and two different coders assessed the quality of the websites. From the 208 websites, 104 (50%) provided relevant information about the disability being searched. Of these 104 websites, those found to be of highest quality were least likely to be a sponsored result, contain advertisements, be from a for-profit company, and did contain references to peer-reviewed publications or had a top-level domain of .gov or .org. Individuals with developmental disabilities and their family members who choose to obtain disability-related information online should remain vigilant to ensure that they locate high-quality and accurate information and should not replace information obtained from health-care professionals and educational specialists with information found online.

Brief report: the medical care of adults with autism spectrum disorders: identifying the needs.

There is a lack of information concerning adults with autism spectrum disorder (ASD), especially with regards to their access to health care. A paper and electronic survey was sent to 1,580 primary care physicians in Connecticut. 346 respondents returned a survey and provided care to adults with an ASD. This physician survey provides data on adults with ASD such as: reasons for physician visits, living arrangements, employment status, and any services they are receiving. Responses revealed inadequate training in the care of adults with an ASD and physicians interest in obtaining additional training. The ability to provide a medical home for adults with autism will need to address effective strategies to train current and future physicians.

A survey assessing the presence of "medical home" for adults with disabilities in Connecticut.

BACKGROUND: The medical home model has been recommended as the best design for healthcare management for individuals with disabilities by the American Academy of Pediatrics and the American Academy of Family Physicians. As set forth by these guidelines, a medical home contains the following elements: access to health care, usual source of care, personal doctor or nurse, referrals for specialty care, coordinated care, andperson-centered care. OBJECTIVE/HYPOTHESIS: This study aimed to gather information from adults with disabilities in Connecticut, and the barriers to achieving the medical home model. The study focused on each of the components that make up the medical home model definition. METHODS: An adultwith a disabilitywas defined as a person 18 years or older with any physical or mental disability that significantly impacted one or more major life activities, as defined by the Americans with Disabilities Act. The adults with disabilities were recruited by email through a variety of list servers and flyers that were mailed to employers of people with disabilities. The study consisted of 88 adults with disabilities who were interviewed via telephone with a 54-item survey that was developed based on the research of medical home models. RESULTS: The most common types of disabilities represented were physical (51%), psychiatric (28%), and neurological (24%). The results ofthe study found that 22% of participants were found to have access to health care, 92% of participants reported they had a usual place they go to receive health care, 77% of participants reported having no problems with the process of referrals, 37% of participants were found to have adequate coordinated care, and 90% of participants were identified as having person-centered care. CONCLUSIONS: Overall, only 7% of participants met the criteria for all aspects of the medical home model. The conclusions drawn from this study indicate a need for increased access to health care, more efficiently designed coordinated care, and more accessible referrals to specialists for adults with disabilities, with access being the largest barrier to adequate health care.

Medical conditions and medication use in adults with Down syndrome: a descriptive analysis.

BACKGROUND: We examined the presence of medical conditions and medication use within a sample of adults with Down syndrome. METHODS: Retrospective chart review using a sample of 141 adults with Down syndrome and age range of 30 to 65 years. RESULTS: We identify 23 categories of commonly occurring medical conditions and 24 categories of medications used by adults with Down syndrome. CONCLUSION: Approximately 75 of older adults with Down syndrome in our sample experience memory loss and dementia. Hypothyroidism, seizures, and skin problems also occur commonly. The prevalence of cancer (i.e., solid tumours) and hypertension is extremely low. Older adults with Down syndrome use anticonvulsant more often than younger adults with Down syndrome. The use of multivitamins and medications such as pain relievers, prophylactic antibiotics, and topical ointments is common.

Young children's natural learning environments: contrasting approaches to early childhood intervention indicate differential learning opportunities.

1,000 parents of infants and toddlers enrolled in early childhood intervention programs were surveyed about the number of learning opportunities provided their preschool children using different approaches to early intervention. Findings showed that more learning opportunities were reported when participation in everyday activity settings was conceptualized as a type of intervention rather than as settings for professionals to conduct their interventions.

University faculty preparation of students in using natural environment practices with young children.

155 university faculty teaching students in physical therapy, occupational therapy, speech and language pathology, early childhood special education, or multidisciplinary studies programs were surveyed to assess how the students were taught how to use everyday family and community activities as natural learning opportunities for young children. Analysis showed that the faculty provided very little training in using community activity settings as contexts for children's learning and that physical therapy faculty provided less training in using natural environments as sources of children's learning opportunities than faculty in the other disciplines.

Physician attitudes and practices on providing care to individuals with intellectual disabilities: an exploratory study.

A dearth of literature exists regarding barriers to physicians providing medical care to patients with intellectual disabilities. Using an exploratory study, we assessed current physician practice for this population of patients. We mailed a 17-question anonymous survey to primary care physicians (PCPs) in Connecticut. Results showed that many physicians care for patients with intellectual disabilities, but approximately 62% of physicians believed caring for this group to be more difficult compared to other groups. Lack of training and education pertaining to patients with intellectual disabilities, issues of communication, and interruptions in continuity of patient care affect physicians' ability to care for this population. Future research should establish best practices and examine nationwide practices in providing care to patients with intellectual disabilities.

Young children's participation in everyday family and community activity.

Patterns of participation in everyday family and community activities are described for children from birth to 6 years of age. Parents or other primary caregivers completed a survey of either family life or community life as sources of children's learning opportunities and experiences. Rates of children's participation in 50 family activities and 50 community activities at different ages were identified and analyzed in terms of similarities and differences in participation patterns. Findings indicated considerable variability in involvement in 100 family and community activities by young children of different ages. Implications for using everyday family and community activities as sources of enriched learning opportunities that enhance children's development are discussed.