Telehealth Family Navigation for Early Autism Services Access: The Autism ALERT Project

Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown. Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program. Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with \u3e30% Medicaid, located in 5 Oregon counties, were invited to enroll children in the study. 7 clinics (49 primary care providers [PCPs]) participated; 4 were randomized to the family navigation intervention and 3 to usual care. PCPs in both arms received training on autism screening and referral to medical/educational services. PCPs then referred any child age 1-55 months with a positive screen and/or provider autism concern to the study. For children in intervention arm clinics, the navigator called parents, providing information about autism and the autism diagnostic process, assistance with paperwork, social support, and appointment reminders. Control arm clinics/children received no calls. Study enrollment continued until 50 children (30 intervention, 20 control) enrolled. Child Early Intervention/Early Childhood Special Education (EI/ECSE) data were collected from Oregon’s state database 6 months after enrollment. Primary study outcomes compared intervention and control arms on: % of children receiving EI/ECSE referrals within 6 months, % receiving an evaluation in EI/ECSE within 6 months, time from enrollment to EI/ECSE evaluation, and % of evaluated children receiving an autism educational label within 6 months. Results: All clinics enrolled children; children were 40.8% (n=20) white, 26.5% (n=13) Latino, and 32.7% (n=9) multiracial and/or other race/ethnicity. 16% were female (n=8); median age was 2. Intervention families received a median of 12 navigator telehealth contacts. Overall, 70% (n=21) of intervention arm and 42% (n =8) of control arm families were successfully referred to EI/ECSE (p = 0.05). Of those referred, 86% (n=18) of intervention arm and 100% (n=8) of control arm children were evaluated in EI/ECSE (n.s.). Median time to EI/ECSE evaluation was 103 days in the intervention and 162 days in the control arm (p = 0.68; Figure 1). Overall, 40% of intervention arm (n = 12) and 21% (n = 4) of control arm children had an autism placement, with a trend toward autism as the primary placement type in the intervention arm (p = 0.12). Conclusion: Telehealth family navigation shows promise for improving access to autism services in EI/ECSE, especially for securing an early EI/ECSE evaluation, and increasing autism educational labels. A full-scale trial can investigate more distal outcomes including receipt of medical diagnosis and therapeutic services use

Opposing Effects of Impulsivity and Mindset on Sources of Science Self- 5 Efficacy and STEM Interest in Adolescents

Impulsivity has been linked to academic performance in the context of Attention Deficit Hyperactivity Disorder, though its influence on a wider spectrum of students remains largely unexplored, particularly in the context of STEM learning (i.e. science, technology, engineering, and math). STEM learning was hypothesized to be more challenging for impulsive students, since it requires the practice and repetition of tasks as well as concerted attention to task performance. Impulsivity was assessed in a cross-sectional sample of 2,476 students in grades 6-12. Results show impulsivity affects a larger population of students, not limited to students with learning disabilities. Impulsivity was associated with lower sources of science self-efficacy (SSSE) scores, interest in all STEM domains (particularly math), and self-reported STEM skills. The large negative effect observed for impulsivity was opposed by “growth” mindset, which describes a student’s belief in the importance of effort when learning is difficult. Mindset had a large positive effect, which was associated with greater SSSE, STEM interest, and STEM skills. When modeled together, results suggest that mindset interventions may benefit impulsive students who struggle with STEM. Together, these data suggest important interconnected roles for impulsivity and mindset that can influence secondary students’ STEM trajectories

Associations with Early Intervention Evaluation, Eligibility, and Services Engagement in a multi-site sample

TITLE: Associations with Early Intervention Evaluation, Eligibility, and Services Engagement in a multi-site sample Background: Parental concerns are usually highly predictive of child developmental delays; however, the relationship of parent concerns with Part C Early Intervention (EI) service use is unclear. Objective: The goals of this project were to test the associations of parent concern presence, age of child at time of parent concerns, number of concerns, type of parental concern, and recency of parental concerns, with EI evaluation, eligibility, and services engagement after referral. Design/Methods: We collected survey data on parent concerns, EI service use data, and family demographics from a sample of 483 children referred to EI in 2016-2018 from six Oregon primary care clinics serving lower income families as part of a developmental and autism screening intervention. Survey results were linked with Oregon EI database information, including if the child was evaluated, deemed eligible for services, and (if deemed eligible) whether they were engaged in services 6 months after referral. Bivariate testing and multivariable logistic regression were used to test the association of presence of parental concern, child age at time of concern, type of concern, number of concerns, and recency of concern, with EI evaluation, eligibility determination and engagement of services six months later. Results: 483 children were referred to EI, 268 (55.5%) were evaluated, 85 (63.4% of evaluated) were found eligible, and 71 (85.5% of eligible) were engaged in services six months later. Among family demographic characteristics, boys were more likely to be evaluated than girls based on bivariate analysis but not on multivariable analysis (69.9% vs. 57.5%; p = 0.011). Presence of parent concern was strongly associated with evaluation on bivariate and multivariable analysis (67.3% versus 44.2%; aOR 5.32 [2.10-13.47]). Presence of parental concern was also associated with eligibility (63.4% versus 33.3%, p = 0.001), and service engagement (85.5% vs. 64.3%, p Conclusion(s): Gender, presence of concern and recency of concern are associated with EI services use. Study results suggest that providers should assess presence of parent concern and provide additional support to parents who are not concerned at all or are concerned prior to the visit

Statistical Methods for Examining Cortical Activity in Parkinson’s Patients

Introduction: Measuring cortical activity during walking tasks has gained growing interest, specifically when measured with a functional near-infrared spectroscopy (fNIRS) device. fNIRS provides a novel way to closely measure tissue oxygenation in the prefrontal cortex without invasive procedures. The objective is to determine whether Parkinson’s Disease (PD) participants will take longer to return to automaticity in comparison to controls during a walking task. Methods: This pilot study utilizes the fNIRS device to measure oxygenated hemoglobin in 3 controls and 4 PD participants during a 2-minute walking test. The first 20 seconds of the test is measured while standing to establish a baseline oxygenated hemoglobin level. The return to automaticity is characterized by when the oxygenated hemoglobin level becomes stationary, and if it returns to the established baseline. Raw data were examined with a computationally efficient and exact changepoint detection method, Pruned Exact Linear Time (PELT), to quantify the return to automaticity. The detected changepoint location and corresponding oxygenated hemoglobin level was extracted for each participant and plotted on the same graph. Results/Discussion: This preliminary analysis is promising, but more participants are required for visual and statistical comparison. These statistical methods will be applied to 60 additional participants to produce a 95% confidence box around the controls’ points, which represents their return to automaticity. Additional data will further assess if the changepoint detection approach is an effective tool for analyzing cortical activity in PD participants

W86 - A Care Cascade Analysis of Opioid Use Disorder Services Provided in Jail

An Analysis of Opioid Use Disorder Services Provided in Oregon Jail

Opposing effects of impulsivity and mindset on sources of science self-efficacy and STEM interest in adolescents.

Impulsivity has been linked to academic performance in the context of Attention Deficit Hyperactivity Disorder, though its influence on a wider spectrum of students remains largely unexplored, particularly in the context of STEM learning (i.e. science, technology, engineering, and math). STEM learning was hypothesized to be more challenging for impulsive students, since it requires the practice and repetition of tasks as well as concerted attention to task performance. Impulsivity was assessed in a cross-sectional sample of 2,476 students in grades 6-12. Results show impulsivity affects a larger population of students, not limited to students with learning disabilities. Impulsivity was associated with lower sources of self-efficacy for science (SSSE), interest in most STEM domains (particularly math), and self-reported STEM skills. The large negative effect size observed for impulsivity was opposed by higher mindset, which describes a student's belief in the importance of effort when learning is difficult. Mindset had a large positive effect size associated with greater SSSE, STEM interest, and STEM skills. When modeled together, results offer that mindset interventions may benefit impulsive students who struggle with STEM. Together, these data suggest important interconnected roles for impulsivity and mindset that can influence secondary students' STEM trajectories

Proteomic changes induced by longevity-promoting interventions in mice.

Using mouse models and high-throughput proteomics, we conducted an in-depth analysis of the proteome changes induced in response to seven interventions known to increase mouse lifespan. This included two genetic mutations, a growth hormone receptor knockout (GHRKO mice) and a mutation in the Pit-1 locus (Snell dwarf mice), four drug treatments (rapamycin, acarbose, canagliflozin, and 17α-estradiol), and caloric restriction. Each of the interventions studied induced variable changes in the concentrations of proteins across liver, kidney, and gastrocnemius muscle tissue samples, with the strongest responses in the liver and limited concordance in protein responses across tissues. To the extent that these interventions promote longevity through common biological mechanisms, we anticipated that proteins associated with longevity could be identified by characterizing shared responses across all or multiple interventions. Many of the proteome alterations induced by each intervention were distinct, potentially implicating a variety of biological pathways as being related to lifespan extension. While we found no protein that was affected similarly by every intervention, we identified a set of proteins that responded to multiple interventions. These proteins were functionally diverse but tended to be involved in peroxisomal oxidation and metabolism of fatty acids. These results provide candidate proteins and biological mechanisms related to enhancing longevity that can inform research on therapeutic approaches to promote healthy aging