Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities.

Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students' correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD.

Outcomes and Acceptability of Telehealth-Based Coaching for Caregivers in Asian Countries.

Recent studies evaluating the effectiveness of using telehealth to train caregivers across large geographical distances in the United States and internationally indicate that this modality can increase families' accessibility to evidence-based interventions for problem behavior. In this study, experimenters and interpreters in the United States remotely coached nine caregivers of children with disabilities residing in three countries in Asia to implement functional analyses (FA) and functional communication training (FCT). Five of the nine families were culturally matched to either the experimenter or the interpreter. Problem behavior was reduced to near-zero levels for all but one participant. Furthermore, all caregivers implemented the procedures with high levels of integrity and rated the assessment and treatment as highly acceptable, regardless of cultural matching or use of interpreters. Overall, findings suggest telehealth-based caregiver coaching and caregiver-implemented FA plus FCT is feasible and acceptable in Asia.

Protein Delivery of an Artificial Transcription Factor Restores Widespread Ube3a Expression in an Angelman Syndrome Mouse Brain.

Angelman syndrome (AS) is a neurological genetic disorder caused by loss of expression of the maternal copy of UBE3A in the brain. Due to brain-specific genetic imprinting at this locus, the paternal UBE3A is silenced by a long antisense transcript. Inhibition of the antisense transcript could lead to unsilencing of paternal UBE3A, thus providing a therapeutic approach for AS. However, widespread delivery of gene regulators to the brain remains challenging. Here, we report an engineered zinc finger-based artificial transcription factor (ATF) that, when injected i.p. or s.c., crossed the blood-brain barrier and increased Ube3a expression in the brain of an adult mouse model of AS. The factor displayed widespread distribution throughout the brain. Immunohistochemistry of both the hippocampus and cerebellum revealed an increase in Ube3a upon treatment. An ATF containing an alternative DNA-binding domain did not activate Ube3a. We believe this to be the first report of an injectable engineered zinc finger protein that can cause widespread activation of an endogenous gene in the brain. These observations have important implications for the study and treatment of AS and other neurological disorders.