Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents.

Evidence indicates an overrepresentation of youth with co-occurring autism spectrum disorders (ASD) and gender dysphoria (GD). The clinical assessment and treatment of adolescents with this co-occurrence is often complex, related to the developmental aspects of ASD. There are no guidelines for clinical care when ASD and GD co-occur; however, there are clinicians and researchers experienced in this co-occurrence. This study develops initial clinical consensus guidelines for the assessment and care of adolescents with co-occurring ASD and GD, from the best clinical practices of current experts in the field. Expert participants were identified through a comprehensive international search process and invited to participate in a two-stage Delphi procedure to form clinical consensus statements. The Delphi Method is a well-studied research methodology for obtaining consensus among experts to define appropriate clinical care. Of 30 potential experts identified, 22 met criteria as expert in co-occurring ASD and GD youth and participated. Textual data divided into the following data nodes: guidelines for assessment; guidelines for treatment; six primary clinical/psychosocial challenges: social functioning, medical treatments and medical safety, risk of victimization/safety, school, and transition to adulthood issues (i.e., employment and romantic relationships). With a cutoff of 75% consensus for inclusion, identified experts produced a set of initial guidelines for clinical care. Primary themes include the importance of assessment for GD in ASD, and vice versa, as well as an extended diagnostic period, often with overlap/blurring of treatment and assessment.

BrainSTARS: pilot data on a team-based intervention program for students who have acquired brain injury.

UNLABELLED: To conduct and evaluate an educational/consultation program for parents and teachers of children who have acquired brain injury (ABI). PARTICIPANTS: Parents, regular and special educators, and related school personnel of 30 students who had ABI and serious school problems. INTERVENTION: BrainSTARS (Brain Injury: Strategies for Teams and Re-education for Students), an individualized consultation program that includes a comprehensive manual on pediatric ABI. The intervention included 3 meetings in the school of the child identified with ABI. DESIGN: A pre/post single group design assessed the impact of BrainSTARS on ABI-related competencies in the adult participants as well as on measures of child behaviors. RESULTS: Significant improvement was shown in the participants' self-rated proficiency in working with children who have ABI as well as on their ratings of student performance in targeted neurodevelopmental areas. There was no significant change on standardized measures of child behavior (the Behavior Rating Inventory of Executive Functions and the Behavior Assessment System for Children). CONCLUSIONS: BrainSTARS appears to increase the competencies of parents and educators related to students who have ABI; further study of BrainSTARS' impact on student performance and capacity to produce long-standing results is called for.