Reduced renal function and sleep-disordered breathing in community-dwelling elderly men

BACKGROUND: Sleep-disordered breathing (SDB) may increase the risk of cardiovascular disease (CVD) and death in chronic kidney disease (CKD). However, the association between mild reductions in renal function and SDB is uncertain. METHODS: We studied 508 community-dwelling men aged>or=67 years (mean 76.0+/-5.3) who were enrolled at the Minnesota site for the Minneapolis center of the Outcomes of Sleep Disorders in Older Men (MrOS) sleep study and had serum cystatin-C and creatinine measured coincident with overnight polysomnography. CKD was defined as estimated glomerular filtration rate (eGFR)<60 ml/min/1.73 m2 using Cockcroft-Gault (CG), modification of diet in renal disease (MDRD) and Mayo Clinic formulae. SDB was defined by a respiratory disturbance index (RDI)>or=15 events/h. RESULTS: Mean cystatin-C was 1.21+/-0.30 mg/L, and mean creatinine was 1.09+/-0.23 mg/dL. Median RDI was 7.0 events/h (range 0-73). Higher quartiles of cystatin-C were associated with higher mean RDI (p for trend=0.007). This association persisted after adjustment for age and race (p for trend=0.03), but not after adjustment for body mass index (BMI, p for trend=0.34). After adjusting for age, race, BMI, diabetes, hypertension, and CVD, CKD defined by the Mayo Clinic formula, but not CG or MDRD, was associated with a higher odds of SDB [odds ratio (OR) 1.95, 95% confidence interval (CI) 1.04-3.65, p=0.04]. CONCLUSIONS: Older men with reduced renal function as defined by higher cystatin-C concentration have higher average RDI. This effect is explained by higher BMI in men with higher cystatin-C. CKD defined by the Mayo Clinic formula is independently associated with twofold higher odds for SDB. Therefore, reduced renal function may be associated with SDB in older men.     

Predicting poor school performance in children suspected for sleep-disordered breathing

ObjectiveHabitually snoring children are at a greater risk of poor school performance (PSP). We investigated the ability of conventional sleep-disordered breathing (SDB) measures for predicting PSP in habitually snoring children.MethodsThe dataset of Hannover Study on Sleep Apnea in Childhood (HASSAC), a large community-based study in primary school children, was retrospectively analyzed. All habitual snorers were included. Based on their grades, children were grouped into good and poor school performers. SDB measures obtained by a parental questionnaire, a home pulse oximetry, and a home polysomnography were evaluated for their accuracy in predicting poor school performance by calculating receiver operating characteristic curves and area under this curve (AUC). The most predictive single factors were identified and entered into a prediction model.ResultsOf 114 habitual snorers (mean age 9.6 years, 51 boys), 59 had PSP. All investigated SDB measures showed low accuracy (ie, AUC <0.8). The highest AUC observed was 0.686 for a questionnaire score, 0.565 for an oximetry factor, and 0.624 for a polysomnography factor. Of 20 single significant predictors for PSP, five were selected for inclusion into a prediction model. The model reached an unadjusted AUC of 0.826 and an adjusted AUC of 0.851.ConclusionsConventional SDB measures obtained with questionnaire, oximetry, or polysomnography may not be sufficiently predictive of PSP in children suspected for SDB. However, combining factors in a clinical prediction model may improve prediction. Results of such a model may be used to assess the risk of developing neurocognitive impairment and to decide whether a child suspected for SDB might benefit from treatment.     

Parental poverty and occupation as risk factors for pediatric sleep-disordered breathing

Objectives/BackgroundPrevious studies have found associations between pediatric sleep-disordered breathing (SDB) and socioeconomic status (SES), as well as a neighborhood-related disadvantage. This study analyzes the association among familial SES, parental occupation, and SDB in Swedish offspring.MethodsA nationwide dataset was constructed by linking Swedish census data to hospital discharge register data on all first hospitalizations of children and adolescents aged 0–18 years during the study period 1997–2007. The outcome was SDB, defined as diagnostic codes for obstructive sleep apnea (OSA), adenotonsillar hypertrophy, or tonsillar hypertrophy. Familial SES was defined as family income and maternal education. The odds ratio (OR) was calculated with a 95% confidence interval (CI).Results34,933 of three million children had a first hospital diagnosis of SDB. The OR was significantly increased in offspring in families with a low income (1.79) and maternal education (1.21). Significantly increased ORs were found in 14 of 38 maternal (37%) and 13 of 48 paternal (27%) occupations, and six of them involved both parents: drivers, welders, and workers in mechanics and iron metalware, chemical processing, and manufacture of food and glass. A significantly decreased OR was found in 12 (25%) of the paternal occupations, e.g., scientists, physicians, teachers, artists, administrators, and farmers, as well as in maternal occupations, such as artists and farmers, with offspring aged 0–6 years.ConclusionThis study indicates that low familial SES and parental occupations associated with a low educational level increased, whereas academic parental occupations and farmers decreased the risk of SDB in offspring.     

Parent report of children's sleep disordered breathing symptoms and limited academic progress in reading,writing, and math

ObjectivesTo estimate via questionnaire within a population sample of New Zealand (NZ) children aged 6-to-10 years, the prevalence of sleep disordered breathing (SDB) and those struggling academically, and to identify individual and shared risk factors (health and demographic) for parent-reported SDB symptoms and academic difficulties.MethodsIn this cross-sectional study, parents/caregivers of children were recruited through schools and social media to complete an online questionnaire covering health and demographic factors, their children's SDB symptoms (Pediatric Sleep Questionnaire; PSQ) and parental ratings of academic performance based on teacher feedback relative to expected progress in the national curriculum (well below/below/at/above) in reading, writing, and math.ResultsA total of 1205 children (53% male) aged (mean) eight years two months were included, comprising 79.4% NZ European/other and 15.0% Māori. The survey-weighted prevalence of SDB (based on the PSQ) was 17.5%. This was higher amongst those with academic difficulties rated ‘below/well below’ expected progress for reading, writing and math (estimated at 24.0%, 31.0% and 27.5% respectively), with increased odds (adjusted odds ratios) for poor progress of 1.9 (95% CI: 1.2, 3.0), 1.8 (95% CI: 1.2, 2.7) and 2.4 (95% CI: 1.6, 3.7) respectively. There were no shared risk factors common to both SDB and academic difficulties identified from multivariate analyses.ConclusionsThe findings suggest that children with parent-reported SDB symptoms may be at high risk for poor progress in reading, writing, and math. Future research could examine whether treatment of SDB reduces barriers to learning and offsets educational risk.     

Sleep-disordered breathing in cystic fibrosis

IntroductionCystic fibrosis (CF) is a life-shortening, genetic disease that affects approximately 30,000 Americans. Although patients frequently report snoring, mouth breathing, and insomnia, the extent to which sleep-disordered breathing (SDB) may underlie these complaints remains unknown.MethodsSingle-center retrospective review of polysomnography results from referred patients with and without CF individually-matched (1:2) for age, gender, race, and body mass index (BMI).ResultsMean ages were 8.0 ± 5.2 (sd) and 35.9 ± 12.9 years, among 29 children and 23 adults with CF respectively. The CF and non-CF groups were well-matched in age and BMI. Subjects with vs. without CF had three times greater odds of moderate-severe SDB (apnea-hypopnea index (AHI) ≥ 5 in children, ≥ 15 in adults) (p = 0.01). Nocturnal oxygen saturation nadir (Minimum SpO₂) was lower among CF vs. non-CF groups (p = 0.002). For every 1-unit increase in AHI, the decline in Minimum SpO₂ was larger for subjects with vs. without CF (p = 0.05). In subjects with CF, forced expiratory volume in 1 s percent predicted (FEV1 PPD) was associated with Minimum SpO₂ (Pearson r = 0.68, p < 0.0001) but not AHI (r = −0.19, p = 0.27). For every 1-unit increase in AHI, magnitude of decline in Minimum SpO₂ was larger for those with low vs. normal FEV1 PPD (p = 0.01).ConclusionSeverity of SDB may be worse among referred patients with vs. without CF. The SDB may modify the relationship between CF lung disease and nocturnal hypoxemia. Markers of lung disease severity including lung function do not predict SDB severity, suggesting the need for routine polysomnography to screen for this sleep disorder.     

Psychopathology and Academic Performance,Social Well-Being,and Social Preference at School: The TRAILS Study

Psychopathology during adolescence has been associated with poor academic performance, low social well-being, and low social preference by peers at school. However, previous research has not accounted for comorbid psychopathology, informant-specific associations between psychopathology and functioning, and gender and age differences. This study addresses these limitations by examining adolescents’ psychopathology and functioning at school, reported by child, parent, teacher, and peers during primary and secondary school in a large Dutch longitudinal cohort study (N = 2230). Teacher reports of psychopathology, especially regarding attention problems and withdrawn/depressed problems, followed by parent reports regarding hyperactivity, were most strongly associated with academic performance. The same held for social preference which was associated with teacher and parent ratings of withdrawn/depressed problems and hyperactivity. In contrast, social well-being was best predicted by child reports (at primary school) of affective problems. In girls, the association between ADHD problems and poor academic performance was stronger than in boys and conduct problems were more often associated with poor school functioning in general. These findings can help identify adolescents at risk for poor functioning and design interventions that effectively reduce or prevent poor school functioning.     

Correlations among socioeconomic and family factors and academic, behavioral, and emotional difficulties in Filipino adolescents in Hawai'i

BACKGROUND: Because of socioeconomic and acculturative challenges faced by immigrant families, Filipino adolescents in Hawai'i may be at risk for academic, behavioral and emotional difficulties. AIM: To determine, among Filipino adolescents in Hawai'i, whether measures of economic hardship and lower socioeconomic status (SES) correlate positively with poor school performance, aggressive behavior, substance use, anxiety, and depression; and whether family support and cultural identification correlate negatively with these difficulties. METHODS: 216 Filipino adolescents from four public high schools in Hawai'i (1993-1994) were given surveys that assessed basic demographic information, measures of family support and other social variables, and measures of school performance, depression, anxiety, aggression and substance use. RESULTS: In the total sample, low SES seemed to correlate with poor school performance and behavioral and emotional difficulties. In both the total sample and the sub-sample of adolescents with lower SES, family support was a universally strong protective factor. Learning genealogy was positively correlated with school performance, and speaking a language other than English was inversely correlated with substance use (in the whole sample) and depression (in the lower SES sub-sample). CONCLUSIONS: For Filipino adolescents (in both the whole and lower-SES samples), family support was an important protective factor against academic, behavioral and emotional difficulties. The role of cultural identification as a risk or protective factor among Filipino adolescents deserves further investigation.     

Cultural influences on the bedtime behaviors of young children

BACKGROUND AND PURPOSE: This study was designed to assess potential relationships of race and socioeconomic status (SES) to bedtime behavior from a community sample of 2- to 7-year-old children. PATIENTS AND METHODS: A previously validated sleep questionnaire was administered to parents of children enrolled in the Jefferson County, Kentucky school system. The sleep behavior of African-American (n=973) and Caucasian (n=2398) children was analyzed. Median annual income of residential zip codes was used as a proxy for SES. RESULTS: Mean age was 4.8+/-1.1 years. Two composite 'sleep behavior scores' were generated related to excessive daytime sleepiness and sleep-related behavior. Children in the lower SES group had significantly more impaired 'sleep behavior scores' than those in the higher SES group, regardless of race or age. African-American children had later bedtimes than Caucasian children with similar rise times, resulting in significantly shorter sleep duration and more excessive daytime sleepiness, independent of SES and age. CONCLUSIONS: Cultural variables impact sleep-related behavior in children. Race and SES have independent relationships with sleep behavior. Independent of SES, African-American children sleep less due to later bedtimes. SES does play a role, however, in parentally reported sleep-related behavior problems. Thus, cultural variables such as race and SES are important modifiers of sleep behaviors in children and should be addressed in sleep education programs.     

Socioeconomic status,child enrichment factors,and cognitive performance among preschool-age children: Results from the Follow-Up of Growth and Development Experiences study

Lower cognitive performance is associated with poorer health and functioning throughout the lifespan and disproportionately affects children from lower socioeconomic status (SES) populations. Previous studies reporting positive associations between child home enrichment and cognitive performance generally had a limited distribution of SES. We evaluated the associations of SES and child enrichment with cognitive performance in a population with a wide range of SES, particularly whether enrichment attenuates associations with SES. Children were sampled from a case–control study of small-for-gestational-age (SGA) conducted in a public hospital serving a low SES population (final n = 198) and a private hospital serving a middle-to-high SES population (final n = 253). SES (maternal education and income) and perinatal factors (SGA, maternal smoking and drinking) were obtained from maternal birth interview. Five child home enrichment factors (e.g. books in home) and preschool attendance were obtained from follow-up interview at age 4.5 years. Cognitive performance was assessed with the Differential Ability Scales (DAS), a standardized psychometric test administered at follow-up. SES and enrichment scores were created by combining individual factors. Analyses were adjusted for perinatal factors. Children from the public birth hospital had a significantly lower mean DAS general cognitive ability (GCA) score than children born at the private birth hospital (adjusted mean difference −21.4, 95% CI: −24.0, −18.7); this was substantially attenuated by adjustment for individual SES, child enrichment factors, and preschool attendance (adjusted mean difference −5.1, 95% CI: −9.5, −0.7). Individual-level SES score was associated with DAS score, beyond the general SES effect associated with hospital of birth. Adjustment for preschool attendance and home enrichment score attenuated the association between individual SES score and adjusted mean DAS-GCA among children born at both of the hospitals. The effect of being in the lower compared to the middle tertile of SES score was reduced by approximately a quarter; the effect of being in the upper compared to the middle tertile of SES score was reduced by nearly half, but this comparison was possible only for children born at the private hospital. A child's individual SES was associated with cognitive performance within advantaged and disadvantaged populations. Child enrichment was associated with better cognitive performance and attenuated the SES influence. Health care providers should reinforce guidelines for home enrichment and refer children with delays to early intervention and education, particularly children from disadvantaged populations.     

Cognitive changes and sleep disordered breathing in elderly: differences in race

OBJECTIVES: Sleep disordered breathing (SDB) is a highly prevalent sleep disorder in older persons. It is known to be associated with reductions in cognitive function. As part of a larger study examining SDB in African-Americans and Caucasians, it became possible to examine whether racial background may differentially affect the relationship between SDB and cognitive performance. METHODS: Community-dwelling African-American and Caucasian elderly (ages 65+) at high risk for SDB were tested at two time points. During each visit, subjects were interviewed in their homes about their sleep and medical condition. The Mini-Mental Status Examination (MMSE) was used to assess cognitive function. Objective sleep studies were recorded in the subjects' homes and scored for sleep, apneic events, and oxygen saturation levels. RESULTS: Increases in respiratory disturbance index (RDI) were associated with decreases in cognitive performance over time, after controlling for gender and education level. There were no differential effects of race on this relationship. There was no relationship between declining cognitive function and hypoxemia. CONCLUSIONS: Analyses of the data confirm that declining cognitive function in older persons with mild to moderate SDB is related to the amount of respiratory disturbances occurring at night, and suggest that the effect of SDB on cognitive decline is unrelated to race and measured hypoxemia. The large number of community-dwelling elderly with mild to moderate SDB may accrue considerable benefits (both cognitively and medically) from the treatment of SDB, even if they are not markedly hypoxemic.     

Predictors of adherence to positive airway pressure therapy in children: a systematic review and meta-analysis

BackgroundWhile positive airway pressure (PAP) is effective for treating sleep-disordered breathing (SDB) in children, adherence is poor. Studies evaluating predictors of PAP adherence have inconsistent findings, and no rigorous reviews have been conducted. This systematic review aims to summarize the literature on predictors of PAP therapy adherence in children.MethodsStudies evaluating baseline predictors of PAP therapy adherence in children (≤20 years) with SDB were included. We searched MEDLINE, Embase, CENTRAL, CINAHL, Clinicaltrials.gov, and the last four years of conference abstracts. Results were described narratively, with random-effects meta-analyses performed where feasible. Risk of bias and confidence in the evidence were assessed.ResultsWe identified 50 factors evaluated across 28 studies (21 full text articles, seven abstracts). The highest rates of PAP therapy adherence were most consistently found with female sex, younger age, Caucasian race, higher maternal education, greater baseline apnea-hypopnea index (AHI), and presence of developmental delay. Pooled estimates included odds ratios of 1.48 (95%CI: 0.75–2.93) favoring female sex, 1.26 (95%CI: 0.68–2.36) favoring Caucasian race, and a mean difference in AHI of 4.32 (95%CI: −0.61-9.26) events/hour between adherent and non-adherent groups. There was low quality evidence to suggest that psychosocial factors like health cognitions and family environment may predict adherence.ConclusionIn this novel systematic review, we identified several factors associated with increased odds of PAP therapy adherence in children. These findings may help guide clinicians to identify and support children less likely to adhere to PAP therapy and should be considered when developing interventions to improve adherence.     

Universal Social Competence Promotion Programme in School: Does it Work for Children with Low Socio-Economic Background?

The purpose of this study on which this paper reports was to examine the effects of a universal social competence promotion programme on children from families characterised by low socioeconomic status (SES). The study employed an age cohort design. The sample consisted of 1,153 students in fifth to seventh grade from 11 schools in Norway. Data were collected by questionnaires at baseline (2004) and after one year of programme implementation (2005). The programme resulted in significantly greater gains for low SES students on some but not all of the outcomes measured. Low SES students showed greater improvement in social competence, school performance and satisfaction with life than their medium to high SES peers. The finding that a universal programme has beneficial effects for children who report low socio-economic status is promising, since those children show a cluster of psychosocial disadvantages.     

Body mass index and depressive symptoms in older adults: the moderating roles of race, sex, and socioeconomic status.

OBJECTIVE: Although the long-term health risks associated with obesity in older adults have been well documented, less is known about the psychological consequences. The current study examined the relationship between body mass index (BMI) and subsequent depressive symptoms. The authors anticipated that BMI would predict depressive symptoms, and that this relationship would be greater among women, individuals of higher socioeconomic status (SES), and white subjects. METHODS: A three-year longitudinal epidemiological design was employed. Participants were obtained from a biracial sample of community-dwelling older adults (N = 2,406) and were interviewed in their home by trained interviewers. A comprehensive survey assessed age, gender, race, SES (education and income), and health functioning variables. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. BMI was derived from self-reported weight and height. RESULTS: BMI was found to predict depressive symptoms. Contrary to predictions, the influence of BMI on depressive symptoms was greater for African Americans than whites and, in particular, African Americans with less education. There were no sex differences. CONCLUSION: Among older adults, BMI was associated with depressive symptoms although the effect size was small. Factors contributing to this relationship may differ from those observed in younger populations, for example, health functioning may play a larger role. Obesity appears to have the most adverse impact on those who are most likely to be overweight, lower SES African Americans.     

Objectively assessed sleep-disordered breathing during pregnancy and infant birthweight

BackgroundSleep-disordered breathing (SDB) in pregnancy is associated with adverse maternal outcomes. The relationship between SDB and infant birthweight is unclear. This study's primary aim is to determine if objectively measured SDB in pregnancy is associated with infant birthweight.MethodsWe measured SDB objectively in early (6–15 weeks' gestation) and mid (22–31 weeks’ gestation) pregnancy in a large cohort of nulliparous women. SDB was defined as an Apnea-Hypopnea Index ≥5 and in secondary analyses we also examined measures of nocturnal hypoxemia. We used a modified Poisson regression approach to estimate relative risks (RR) of large-for-gestational-age (LGA: >90th percentile for gestational age) and small-for-gestational-age (SGA: <10th percentile for gestational age) birthweights.ResultsThe prevalence of early-pregnancy SDB was nearly 4%. The incidence of mid-pregnancy SDB was nearly 6.0%. The prevalence of LGA and SGA was 7.4% and 11.9%, respectively. Early-pregnancy SDB was associated with a higher risk of LGA in unadjusted models (RR 2.2, 95% CI 1.3–3.5) but not BMI-adjusted models (aRR 1.0, 95% CI 0.6–1.8). Mid-pregnancy SDB was not associated with SGA or LGA. Mid-pregnancy nocturnal hypoxemia (% of sleep time <90% oxygen saturation) and increasing nocturnal hypoxemia from early to mid-pregnancy were associated with a higher risk of LGA in BMI-adjusted models. SDB and nocturnal hypoxemia were not associated with SGA.ConclusionsSDB in pregnancy was not associated with an increased risk of LGA or SGA birthweight, independent of BMI. Some measures nocturnal hypoxemia were associated with an increase in LGA risk, independent of BMI.ClinicalTrials.gov Registration number NCT02231398.     

Social networks,caregiver strain,and utilization of mental health services among elementary school students at high risk for ADHD

OBJECTIVE: This study explores whether parental support networks vary by sociodemographic factors among children at high risk for attention-deficit/hyperactivity disorder (ADHD) and whether network characteristics influence the receipt of mental health treatment for the child. METHOD: A school district-wide, two-phase screening study design was used to identify 266 children at high risk for ADHD. Parents completed standardized instruments assessing network structure and function, DSM-IV diagnoses of disruptive disorders, caregiver strain, and treatment receipt, and children self-reported internalizing symptoms. Relationships were examined with analysis of variance and multivariate prediction, adjusting for sociodemographic characteristics, psychopathology, and parental strain. RESULTS: Network characteristics varied by race and socioeconomic status (SES), but not by child gender. African-American and disadvantaged parents reported smaller network sizes, but more frequent contact and higher levels of support than their white and high-SES counterparts. High levels of instrumental support lowered the odds of ADHD treatment during the 12 months before (OR =.7, p <.001) and after (OR =.7, p <.001) the network assessment interview. In contrast, parental strain increased the likelihood of ADHD treatment during both periods. CONCLUSIONS: Clinicians should anticipate high levels of caregiver strain and low levels of instrumental support among their patients' parents and address the potential high need for respite care in treatment plans.     

Socioeconomic status is a risk factor for epilepsy in Icelandic adults but not in children

PURPOSE: Two earlier population-based studies provide conflicting information on the association between low socioeconomic status (SES) and risk for epilepsy. Seizure etiologies (e.g., head injury, stroke) associated with low SES were not addressed in prior analyses. We assess the relation between SES indices and incident epilepsy separately for children and adults and in subgroups defined by seizure etiology. METHODS: In this population-based case-control study, a surveillance system identified incident unprovoked seizure or first diagnosis of epilepsy throughout Iceland (n = 418). Controls were selected from the population registry as the next two same-sex births alive, residing in Iceland at the time of the index seizure, and without a history of unprovoked seizure on the date of the case's incident seizure (n = 835). The odds ratio measured the association between SES and epilepsy. RESULTS: An association was found between epilepsy and SES among adults, but not among children. Among adults, low education was associated with an increased risk for epilepsy [odds ratio (OR), 2.29; 95% confidence interval (CI), 1.21-4.34), and home ownership was protective (OR, 0.63; 95% CI, 0.43-0.92). When analyses were repeated by seizure etiology, this association remained only in the group with epilepsy of unknown cause, even after adjusting for alcohol consumption. CONCLUSIONS: Low SES, indexed by low education or lack of home ownership, is a risk factor for epilepsy in adults, but not in children, suggesting a cumulative effect of SES on risk for epilepsy. This association is not explained by established risk factors for epilepsy (e.g., head injury, stroke). We find no evidence of a downward social drift among cases whose parents had epilepsy.     

The relationship between socioeconomic status and white matter microstructure in pre‐reading children: A longitudinal investigation

Reading is a learned skill crucial for educational attainment. Children from families of lower socioeconomic status (SES) tend to have poorer reading performance and this gap widens across years of schooling. Reading relies on the orchestration of multiple neural systems integrated via specific white‐matter pathways, but there is limited understanding about whether these pathways relate differentially to reading performance depending on SES background. Kindergarten white‐matter FA and second‐grade reading outcomes were investigated in an SES‐diverse sample of 125 children. The three left‐hemisphere white‐matter tracts most associated with reading, and their right‐hemisphere homologs, were examined: arcuate fasciculus (AF), superior longitudinal fasciculus (SLF), and inferior longitudinal fasciculus (ILF). There was a significant and positive association between SES and fractional anisotropy (FA) in the bilateral ILF in kindergarten. SES moderated the association between kindergarten ILF and second grade reading performance, such that it was positive in lower‐SES children, but not significant in higher‐SES children. These results have implications for understanding the role of the environment in the development of the neural pathways that support reading.     

Impact of IQ,age, SES,gender, and race on autistic symptoms

The purpose of our study was to determine differences in autism severity and symptoms as a function of IQ, age, SES, gender, and race while simultaneously controlling these variables in 777 children with autism using a comprehensive measure evaluating 30 core and associated symptoms of autism. The children were 1–17 years of age with IQs from 9 to 146. Results showed that autism severity (total score on the Checklist for Autism Spectrum Disorder) and the 30 CASD item scores were not related to gender or race. However, the two CASD items reflecting mood and behavior problems were significantly more common in the lower than higher SES group. Our findings revealed significant, though modest, IQ and age effects. Autism severity increased with decreasing IQ and age, as did the frequency of 14 of the 30 CASD symptoms. The direction of IQ and age effects was the opposite for five symptoms and was nonsignificant for 11. Though IQ was associated with autistic symptoms, the majority of children with both high functioning and low functioning autism had most CASD symptoms and their symptom profiles were overwhelmingly similar. This supports the DSM-V Work Group's position that autism is a single spectrum disorder.     

Disentangling the effects of race and SES on arthritis-related symptoms, coping, and well-being in African American and White women

This study examined both unique and interactive effects of race and socioeconomic status (SES) on arthritis-related symptoms, coping, and well-being in African American and White women. Participants included 77 African American and 98 White women, aged 45 to 90, who completed structured, face-to-face interviews. A series of 2 x 2 MANCOVAs examined race (African American, White) and SES (high/low education or high/low occupational status) differences in arthritis-related symptoms, coping, and well-being. African Americans used more religious coping, wishful-thinking, seeking social support, and emotional expression than Whites. Individuals with low SES reported worse arthritis-related symptoms, poorer well-being, and greater use of coping strategies that tend to be maladaptive. Race x SES interactions revealed higher depressive symptoms in African Americans with low versus high education and coping differences in African Americans with low versus high occupational status; however differences in depressive symptoms and coping based on SES were not evident for Whites. Results demonstrate unique and interactive race and SES differences for arthritis-related symptoms, coping, and well-being showing the complexity of race and SES in the realm of physical and mental health.     

An examination of fast mapping skills in preschool children from families with low socioeconomic status

Researchers consistently report that children from low socioeconomic status (SES) families have, on average, smaller vocabularies as assessed by measures of existing vocabulary knowledge than children from higher SES families. Yet, few studies have examined the word-learning process of children from low SES families. The present study was an examination of fast mapping by preschoolers from low SES families. The study also examined the relation between measures of existing vocabulary and performance on the fast mapping task. Forty-six preschoolers (mean age: 4;6, range: 3;11-5;3) from low SES families completed a part-term fast mapping task and two measures of existing vocabulary knowledge. On the fast mapping task, children demonstrated the use of three sources of information (familiar whole objects, possessive syntax and whole-part juxtaposition). Measures of existing vocabulary did not correlate with performance on the fast mapping task. Findings suggest that children from low SES families use multiple sources of information in linguistic input to learn words.