Parental report of vaccine receipt in children with autism spectrum disorder: Do rates differ by pattern of ASD onset?

A contentious theory espoused by some parents is that regressive-onset of autism spectrum disorder (ASD) is triggered by vaccines. If this were true, then vaccine receipt should be higher in children with regressive-onset ASD compared with other patterns of onset. Parental report of rate of receipt for six vaccines (DPT/DTaP, HepB, Hib, polio, MMR, varicella) was examined in children with ASD (N = 2755) who were categorized by pattern of ASD onset (early onset, plateau, delay-plus-regression, regression). All pairwise comparisons were significantly equivalent within a 10% margin for all vaccines except varicella, for which the delay-plus-regression group had lower rates of receipt (81%) than the early-onset (87%) and regression (87%) groups. Findings do not support a connection between regressive-onset ASD and vaccines in this cohort.     

Pediatricians’ use of the 5 A’s and nicotine replacement therapy with adolescent smokers

The purpose of this study was to examine pediatricians’ use of nicotine replacement therapy (NRT) and the 5 A’s counseling method with adolescent smokers. Using a mail survey, 203 randomly selected pediatricians (52% response rate) responded to a valid and reliable 37-item questionnaire regarding: perceptions of prescribing NRT, confidence in using NRT, perceived barriers to prescribing NRT, sources of information regarding NRT, and use of the 5 A’s counseling method. Forty-four percent of pediatricians did not feel competent in helping adolescents quit smoking cigarettes. Less than a fifth (17%) were currently prescribing NRT. A plurality (48%) perceived NRT to be safe for adolescent use but a majority (53%) rated themselves as not confident in their ability to use NRT. Those who prescribed NRT used transdermal patches (81%), nicotine gum (53%), or bupropion (44%). Pediatricians based their decisions on using NRT on whether: the adolescent showed an openness to quitting (78%), the adolescent requested NRT (72%), and if the adolescent had a health problem exacerbated by smoking (56%). The low level of perceived competence in helping adolescents quit smoking may be due to how few pediatricians identified medical school as a major source of information on helping adolescents stop smoking. Even though ample evidence suggests that NRT is safe to use with adolescents, less than half of the responding pediatricians perceived it to be safe, possibly indicating a desire for a more definitive conclusion on its safety before adopting the products or a lack of awareness of existing studies on this topic. This study was funded by the Ohio Tobacco Use Prevention and Control Foundation (Grant #04-5-015) and placed no restrictions on the published findings.     

Correlates of obesity in adolescents with and without autism spectrum disorder: The 2017–2018 National Survey of Children's Health

BackgroundThe prevalence of autism spectrum disorder (ASD) and childhood obesity are increasing, and youth with ASD are at an increased risk of obesity compared to typically developing youth. Specific obesity risk factors in adolescents with ASD remain poorly understood.ObjectiveThis study examined correlates of obesity among adolescents with and without ASD using extant 2017–2018 National Survey of Children's Health (NSCH) data.MethodsThis cross-sectional study examined the co-occurrence of obesity among US adolescents with ASD aged 10–17 years compared to those without ASD, adjusting for sociodemographic characteristics, co-occurring conditions, and relevant covariates, using 2017–2018 NSCH data. Multiple logistic regression was used to compare the odds of obesity among children with mild ASD, moderate/severe ASD, and without ASD.ResultsOdds of obesity were higher in adolescents with ASD compared to adolescents without ASD (cOR 1.9, CI 1.3–2.7). In the adjusted model, the odds of obesity were not significantly higher in those with mild or moderate/severe ASD compared to those without ASD. Odds of obesity were higher for all adolescents who were Hispanic or Black, as well as those with lower household income or with one or more co-occurring conditions.ConclusionsThe association between obesity and ASD in this study highlights the need for greater attention to nutrition, physical activity, and co-occurring conditions among adolescents with ASD. Effective interventions to curtail the risks among racial/ethnic minority adolescents and adolescents with lower household income are needed. Further research is needed to examine additional factors associated with obesity in adolescents with ASD, including family, community, organizational, and policy factors.     

‘You are labelled by your children’s disability’ – A community-based,participatory study of stigma among Somali parents of children with autism living in the United Kingdom

Objectives: Social stigma is commonly experienced by parents of children with autism. Our aim was to understand the nature of stigma experienced by Somali parents of children with autism in the United Kingdom (UK), and to consider how they coped with or resisted such stigma.

Design: We used a community-based participatory research approach, collaborating with a community organisation of Somali parents. In-depth interviews with simultaneous translation were conducted with 15 Somali parents of children with autism living in Bristol, UK, in 2015. Parents were sampled purposively to capture diversity in children’s age, severity of autism and time since diagnosis. Directed thematic analysis used Link and Phelan’s model of stigma.

Results: Of the 15 participants, 12 were mothers (mean age 36). The 17 children with autism they cared for were 4–13 years’ old, and five were girls. Two main themes with sub-themes were identified: the nature of stigma (labelling and stereotyping; separation; emotional reactions, discrimination and power), and coping and resistance (the power of language; faith as a resource; learning, peer support and community relationships). Children with autism were labelled and stereotyped (e.g. as ‘sick’, ‘naughty’, ‘different’) and parents blamed for not controlling them, leading to social rejection and isolation. Stigma was associated with a poor understanding of autism, a lack of vocabulary related to autism in the Somali community, and prejudice against mental illness and disability. There was evidence of enacted and felt stigma and examples of discrimination. Finding their own language to describe their child’s condition and drawing on faith, learning and peer support were important resources in resisting stigma.

Conclusions: Findings inform support for this community, highlighting the need to raise awareness of autism, enable parents to speak openly, and ensure appropriate professional services and interventions are available.     

A comparison of preschool children’s communication and emotional skills on the basis of their cognitive tempos

The purpose of the present study was to investigate whether the communication and emotional skills of preschoolers differ on the basis of their reflection and impulsivity. The sample of the study comprised 227 (5–6 years old) students attending nursery classes and nursery schools in central districts of Konya. Kansas Reflection–Impulsivity Scale for Preschoolers (KRISP)-Form A developed by Wright, J. C. [(1971). KRISP Kansas reflection–impulsivity scale for preschoolers. Lawrence: University of Kansas] was used to determine the reflective–impulsive cognitive tempos of children. Communication skills of the children were measured using the Communication Skills Scale developed by Görgülü, F. [(2009) [Drama destekli kuba??k ö?renme etkinliklerinin okul öncesi 5–6 ya? çocuklar?n?n ileti?im becerilerine etkisi. Yay?nlanmam?? yüksek lisans tezi. Adnan Menderes Üniversitesi, Sosyal Bilimler Enstitüsü, Ayd?n], and emotional skills were analysed with the Assessment of Children’s Emotions Scale developed by Schultz, D., & Izard, C. E. (1998) [Assessment of children’s emotions scales (ACES). University of Delaware, Newark: Assessment Tool] and adapted to Turkish by Durmu?o?lu Saltal?, N., Deniz, M. E., Çeliköz, N., & Ar?, R. (2009) [Alt? ya? çocuklar? için duygusal becerilerin de?erlendirilmesi testi’nin (ACES) TTürkçe’ye uyarlanmas?: Geçerlik ve güvenirlik çal??mas?. Ankara Üniversitesi E?itim Bilimleri Fakültesi Dergisi, 42(1), 403–420]. The results indicated that preschool children’s scores of communication and emotional skills show a difference favouring those who have a reflective–cognitive tempo.     

Can a combination of mental health services and ADL therapies improve quality of life in families of children with autism spectrum disorder?

Quality of Life Research - Due to the nature and complexity of autism spectrum disorder (ASD), which typically requires coordination among various treatments targeting different areas of need, the...     

Quality of life of adolescents with autism spectrum disorders: concordance among adolescents’ self-reports, parents’ reports, and parents’ proxy reports

Purpose  

To compare adolescent self-reports with two types of parent reports regarding the quality of life (QoL) of adolescents with Autism Spectrum Disorders (ASDs): (1) standard parent reports, in which parents give their own perspective on their adolescent child’s QoL and (2) parent proxy reports, in which parents indicate how they believe their adolescent child would answer.     

Are ‘leaky gut’ and behavior associated with gluten and dairy containing diet in children with autism spectrum disorders?

Abstract

Objectives

Studies have suggested a link between diet and behavior in children with autism spectrum disorders (ASDs). Parental reports of behavioral changes upon exposure to gluten and/or casein are common in clinical practice. An association between diet type, intestinal permeability (IP) (‘leaky gut’), and behavior has been long proposed but not substantiated. We explored this possible association in this trial.

Methods

This randomized double-blind, placebo-controlled study explored the effects of gluten and milk on IP and behavior in children with ASDs over a period of 4 weeks. IP assessed by lactulose:mannitol (L/M) sugar permeability test and behavior assessed by the Aberrant Behavior Checklist and Conners Parent Rating were measured. Gastrointestinal symptoms in both groups were also monitored.

Results

Neither the L/M ratio nor behavioral scores were different between groups exposed to gluten/dairy or placebo. The changes observed were noted to be small and not clinically significant.

Discussion

Our study although underpowered to show small differences does not support an association between dietary gluten/milk, IP, and behavioral changes in subjects with ASD.     

The impact of violence on mothers’ and children’s needs during and after parental separation

Men’s violence against mothers and children as a context of separation significantly increases the immediate and longer‐term parenting needs of affected children, according to a South Australian study of single mothers’ transition and adaptation to living in a single parent household. Qualitative research interviews with 18 separated mothers who cited violence as the main reason for ending their relationship included mothers’ views on how the violence had impacted on their children. Mothers who had fled violence named continuing concerns with their children’s behaviour including withdrawal, anxiety and aggression, as well as the children’s continuing exposure to violence during contact with their father. These mothers reported that access to professionals to seek help with their concerns about their children’s needs was often inadequate.     

Concordance of adolescent human papillomavirus vaccination parental report with provider report in the National Immunization Survey-Teen (2008–2013)

ObjectivesTo examine the accuracy of parental report of HPV vaccination through examination of concordance, with healthcare provider vaccination report as the comparison.MethodsThe 2008–2013 National Immunization Survey (NIS)-Teen was used to examine accuracy of parent reports of HPV vaccination for their female daughters aged 13–17 years, as compared with provider report of initiation and number of doses. Multivariable logistic regression models were used to examine associations related to concordance of parent and provider report.ResultsOf 51,746 adolescents, 84% concordance for HPV vaccine initiation and 70% concordance for number of doses was observed. Accuracy varied by race/ethnicity, region, time, and income. The parent report of number of doses was more likely to be accurate among parents of 13 and 14 year old females than 17 year olds. Accuracy of initiation and number of doses were lower among Hispanic and black adolescents compared to white parents. The odds of over-report was higher among minorities compared to whites, but the odds of underreport was also markedly higher in these groups compared to parents of white teens. Accuracy of parental vaccine report decreased across time.ConclusionsThese findings are important for healthcare providers who need to ascertain the vaccination status of young adults. Strengthening existing immunization registries to improve data sharing capabilities and record completeness could improve vaccination rates, while avoiding costs associated with over-vaccination.     

Young children’s screen habits are associated with consumption of sweetened beverages independently of parental norms

Objectives

This study investigated the associations between children’s screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child’s screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms.

Methods

In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children’s (n = 1,733) lifestyle and diets.

Results

Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1–1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1–3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2–1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3–2.1). TV viewing time and commercial exposure contributed to the associations independently of each other.

Conclusions

The results strengthen the assumption that it is possible to influence children’s dietary habits through their TV habits.     

Early exposure to the combined measles–mumps–rubella vaccine and thimerosal-containing vaccines and risk of autism spectrum disorder

ObjectiveThis case–control study investigated the relationship between the risk of Autism Spectrum Disorder (ASD) onset, and early exposure to the combined Measles–Mumps–Rubella (MMR) vaccine and thimerosal consumption measured from vaccinations in the highly genetically homogenous Japanese population.MethodsVaccination histories at 1, 3, 6, 12, 18, 24, and 36 months from birth were investigated in ASD cases (189 samples), and controls (224 samples) matching age and sex in each case. Crude odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated to determine relationship between MMR vaccination and ASD. The differences in mean values of the thimerosal dosage between cases and controls were analyzed using an unpaired t-test. MMR vaccination and thimerosal dosage were also investigated using a conditional multiple-regression model.ResultsThere were no significant differences in MMR vaccination and thimerosal dosage between cases and controls at any age. Furthermore, the ORs (95% CIs) of MMR vaccination and thimerosal dosage associated with ASD in the conditional multiple regression model were, respectively, 0.875 (0.345–2.222) and 1.205 (0.862–1.683) at age 18 months, 0.724 (0.421–1.243) and 1.343 (0.997–1.808) at 24 months, and 1.040 (0.648–1.668) and 0.844 (0.632–1.128) at 36 months. Thus, there were no significant differences.ConclusionsNo convincing evidence was found in this study that MMR vaccination and increasing thimerosal dose were associated with an increased risk of ASD onset.     

A psychometric evaluation of the PedsQL™ Family Impact Module in parents of children with sickle cell disease

Background  

Caring for a child with a chronic condition, such as sickle cell disease, can have a significant impact on parents and families. In order to provide comprehensive care and support to these families, psychometrically sound instruments are needed as an initial step in measuring the impact of chronic diseases on parents and families. We sought to evaluate the psychometric properties of the PedsQL™ Family Impact Module in populations of children with and without sickle cell disease. In addition, we sought to determine the correlation between parent's well being and their proxy report of their child's health-related quality of life (HRQL).     

Trajectories of parental involvement in home learning activities across the early years: associations with socio-demographic characteristics and children’s learning outcomes

This study examined the socio-demographic factors associated with trajectories of parental involvement in shared book reading and other home activities for children aged 2–6 years. The study uses data from 3836 families participating in Growing up in Australia: The Longitudinal Study of Australian Children. Latent growth curve models were estimated to describe associations between trajectories of parental involvement, socio-demographic factors, and children’s learning outcomes. Higher levels of parental involvement at 2 years were associated with better learning outcomes at 6 years. On average, the frequency of parental involvement in home learning activities decreased over time. Family socio-economic disadvantage and being a male child were associated with lower levels of parental involvement at age 2 years, and more rapid decreases in parental involvement in home activities over time. Continued attention is needed to identify effective strategies that can address inequalities in children’s home learning opportunities before children begin school.     

Analysis of burden in caregivers of people with Alzheimer’s disease using self-report and supervision hours

Objectives

This study aimed to describe the baseline characteristics of informal carers of community-living Alzheimer’s disease (AD) patients by AD severity group and to identify factors associated with two measures of caregiver burden.

Design and setting

GERAS is a prospective observational study in France, Germany, and the UK, designed to assess costs and resource use associated with AD, for patients and their caregivers, stratified by disease severity.

Participants

1497 community-dwelling AD patients and their primary caregivers.

Measurements

Subjective caregiver burden assessed using the Zarit Burden Interview [ZBI] and time spent supervising patients (an objective measure of burden recorded using the Resource Utilization in Dementia instrument) during the month before the baseline visit were recorded. Separate multiple linear regression analyses using ZBI total score and caregiver supervision time as dependent variables were performed to identify patient and caregiver factors independently associated with caregiver burden.

Results

Increasing AD severity was associated with both subjective caregiver burden (ZBI total score) and overall caregiver time, which includes supervision time (both p<0.001, ANOVA). Better patient functioning (on instrumental activities of daily living) was independently associated with both a lower ZBI total score and less supervision time, whereas higher levels of caregiver distress due to patient behavior were associated with greater caregiver burden. Other factors independently associated with an increased ZBI total score included younger caregiver age, caregiver self-reported depression, caring for a male patient, and longer time since AD diagnosis. Caregivers living with the patient, being a male caregiver, patient living in a rural location, higher patient behavioral problem subdomain scores for apathy and psychosis, more patient emergency room visits, not receiving food delivery and receiving financial support for caregiving were all associated with greater caregiver supervision time.

Conclusion

Our results show that subjective caregiver burden and caregiver time are influenced by different factors, reinforcing the need to consider both aspects of caregiving when trying to minimize the burden of AD. However, interventions that minimize caregiver distress and improve patient functioning may impact on both subjective and objective burden.     

Maternal emotion framing and children’s social behavior: the role of children’s feelings and beliefs about peers

Children’s feelings and beliefs about peer relationships were examined as a possible mediator between mothers’ positive and negative emotional framing and children’s (n = 46) behavior with peers. Mothers’ emotion framing was assessed as they and their young children read a picture book depicting emotionally‐laden content, but no printed text. Feelings and beliefs about self and peers were assessed during a puppet interview focusing on beliefs about self and peers. Teachers rated children’s aggressive, competent and withdrawn behavior. Mothers’ emotion framing was significantly associated with children’s cognitive representations of self and peers (r = 0.35 and ?0.44, both p < 0.01, for positive and negative emotional framing, respectively) and with withdrawn social behavior (r = ?0.39 and 0.41, p < 0.01 for positive and negative framing, respectively). Findings suggest that children’s beliefs about self and peers may mediate the association between mothers’ emotion framing and children’s withdrawn behavior.