Promoting the Health of Parents & Children: Addressing Perinatal Mental Health by Building Medical Provider Capacity Through Perinatal Psychiatry Access Programs

Mental health conditions are the most common obstetric complications of the perinatal period, impacting 1 in 5 individuals during pregnancy and the year following pregnancy. Perinatal mental health (PMH) conditions have deleterious effects on the health of perinatal individuals and their children, and are a leading and preventable cause of maternal mortality. Nevertheless, PMH conditions are underrecognized, underdiagnosed, and undertreated. To address these gaps, Massachusetts created the Massachusetts Child Psychiatry Access Program (MCPAP) for Moms to build the capacity of frontline medical providers to address PMH conditions by providing education, consultation, and resources and referrals. MCPAP for Moms has emerged as a successful and scalable model with at least 25 states or organizations implementing or developing similar Perinatal Psychiatry Access Programs. This report summarizes the Perinatal Psychiatry Access Program model and its individual and national impact

Behavioral and neural evidence of increased attention to the bottom half of the face in deaf signers

PURPOSE: This study examined the effects of deafness and sign language use on the distribution of attention across the top and bottom halves of faces. METHODS: In a composite face task, congenitally deaf signers and typically hearing controls made same/different judgments of the top or bottom halves of faces presented with the halves aligned or spatially misaligned, while event-related potentials (ERPs) were recorded. RESULTS: Both groups were more accurate when judging misaligned than aligned faces, which indicates holistic face processing. Misalignment affected all ERP components examined, with effects on the N170 resembling those of face inversion. Hearing adults were similarly accurate when judging the top and bottom halves of the faces, but deaf signers were more accurate when attending to the bottom than the top. Attending to the top elicited faster P1 and N170 latencies for both groups; within the deaf group, this effect was greatest for individuals who produced the highest accuracies when attending to the top. CONCLUSIONS: These findings dovetail with previous research by providing behavioral and neural evidence of increased attention to the bottom half of the face in deaf signers, and by documenting that these effects generalize to a speeded task, in the absence of gaze shifts, with neutral facial expressions

Emergency preparedness of families of children with developmental disabilities: what public health and safety emergency planners need to know

OBJECTIVE: To assess the emergency preparedness knowledge, behaviors, and training needs of families of children with developmental disabilities (DD). DESIGN: An online survey. PARTICIPANTS: A sample of 314 self-selecting US parents/guardians of children with DD, aged birth-21 years. MAIN OUTCOME MEASURES: 1) Preparedness self-assessment; 2) self-report regarding the extent to which families followed 11 specific preparedness action steps derived from publicly available preparedness guides; and 3) parent training and support needs. RESULTS: Although most participants assessed themselves to be somewhat to moderately well prepared, even those who reported being very well prepared had taken fewer than half of 11 recommended action steps. Most participants expressed a need for preparedness support; virtually all the respondents felt that training was either important or very important. CONCLUSIONS: Children with disabilities are known to be particularly vulnerable to negative disaster impacts. Overall, parents in this study appeared under-prepared to meet family disaster needs, although they recognized its importance. The results suggest opportunities and methods for public health and safety planning, education and outreach to parents of children with DD who would benefit from targeted training such as information and skill building to develop effective family preparedness plans and connections to local emergency management and responders

Physical Activity Levels, Frequency, and Type Among Adolescents with and Without Autism Spectrum Disorder

We compared time spent in moderate and vigorous physical activity (MVPA), type, and frequency of participation in physical activities between adolescents with ASD (n = 35) and typically developing (TD) adolescents (n = 60). Accelerometers measured MVPA and participants were interviewed about engagement in physical activities. Adolescents with ASD spent less time in MVPA compared to TD adolescents (29 min/day vs. 50 min/day, p \u3c 0.001) and fewer met the Physical Activity Guidelines for Americans (14 vs. 29%, p \u3e 0.05). Among adolescents \u3c 16 years old, those with ASD participated in fewer activities than TD adolescents (5.3 vs. 7.1 activities, p \u3c 0.03). Walking/hiking and active video gaming were among the top activities for both groups. Findings support the need for interventions that meet the needs of youth with ASD

Physical Activity Enjoyment, Perceived Barriers, and Beliefs Among Adolescents With and Without Intellectual Disabilities

BACKGROUND: Youth with intellectual disabilities (ID) exhibit low levels of physical activity, but the underlying contributors to behavior are unclear. We compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy among adolescents with ID and typically developing (TD) adolescents. METHODS: A questionnaire was administered to 38 adolescents with ID (mean age 16.8 years) and 60 TD adolescents (mean age 15.3 years). Of the original 33 questionnaire items, 23 met the test-retest reliability criteria and were included in the group comparisons. RESULTS: Fewer adolescents with ID reported that they have someone to do physical activity with (64% vs. 93%, p \u3c 0.001), and a greater proportion of adolescents with ID perceived that physical activities were too hard to learn (41% vs. 0%, p \u3c 0.001). Fewer adolescents with ID believed that physical activity is good for their health (92% vs. 100%, p=0.05). More adolescents with ID reported a dislike of individual physical activities (p=0.02). A large proportion of adolescents with ID (84%) responded that they were good at doing physical activities, but the difference between groups was only of borderline significance. (95% of TD adolescents, p=0.06). CONCLUSIONS: Adolescents shared many of the same perceptions about physical activity, but some important differences between groups were identified

Does physical activity differ between youth with and without intellectual disabilities

BACKGROUND: Children and youth with intellectual disabilities (ID) are known to face obstacles to physical activity participation, yet the activity patterns of this population are not well characterized. OBJECTIVE/HYPOTHESIS: In this study, time spent in moderate to vigorous physical activity (MVPA), type, and frequency of participation in physical activities were assessed in youth with ID and in a comparison group of typically developing (TD) youth. METHODS: Weekly participation in MVPA in 38 youth with ID and 60 TD youth was assessed via accelerometry. Participants were also administered an interview about the frequency and type of physical activities they engaged in over the past year. RESULTS: After adjusting for age and sex, youth with ID spent significantly less time in MVPA (33.5 vs. 46.5min/day, p=0.03) and were less likely to meet the US Physical Activity Guidelines than TD youth (6% vs. 29%, p=0.01). Although time in MVPA was lower in youth with ID, females with ID participated in physical activities more frequently than TD females (47.1 vs. 28.2 times/month, p=0.008) and also reported engaging in a greater variety of physical activities (7.8 vs. 5.2 activities/year, p=0.01). No differences between males in the frequency of physical activity participation or the number of activities performed were observed. Both groups reported walking/hiking and active video as top activities. CONCLUSIONS: Findings emphasize the need for targeted efforts to increase MVPA in youth with ID

Enjoyment, Barriers, and Beliefs About Physical Activity in Adolescents With and Without Autism Spectrum Disorder

The authors compared physical activity enjoyment, perceived barriers, beliefs, and self-efficacy between adolescents with autism spectrum disorder (ASD) and typically developing (TD) adolescents. A questionnaire was verbally administered to 35 adolescents with ASD and 60 TD adolescents. Compared with TD adolescents, fewer adolescents with ASD enjoyed team sports (65% vs. 95%, p \u3c .001) and physical education (84% vs. 98%, p = .02). A greater proportion of adolescents with ASD perceived that physical activities were too hard to learn (16% vs. 0%, p \u3c .01), and fewer believed that physical activity was a way to make friends (68% vs. 97%, p \u3c .001). Fewer adolescents with ASD preferred to do physical activity in their free time (25% vs. 58%, p \u3c .01). Most adolescents with ASD felt that physical activity is fun (84%), but the proportion was lower than in TD adolescents (98%, p = .03). Some perceptions about physical activity were similar between the 2 groups, but differences identified may inform program development

Changes in Food Selectivity in Children with Autism Spectrum Disorder

Food selectivity is a common problem in children with autism spectrum disorder (ASD) and has an adverse impact on nutrient adequacy and family mealtimes. Despite recent research in this area, few studies have addressed whether food selectivity present in children with ASD persists into adolescence. In this study, we assessed food selectivity in 18 children with ASD at two time points (mean age = 6.8 and 13.2 years), and examined changes in food selectivity. While food refusal improved overall, we did not observe an increase in food repertoire (number of unique foods eaten). These findings support the need for interventions early in childhood to increase variety and promote healthy eating among children with ASD

Food selectivity in a diverse sample of young children with and without intellectual disabilities

Children with developmental concerns are more likely to be referred to feeding clinics for food selectivity than typically developing (TD) children. However, there is limited research on food selectivity in children with intellectual disabilities (ID). Fifty-nine TD children and 56 children with ID ages 3-8 years participated in the Children\u27s Mealtime Study to compare food selectivity, conceptualized as food refusal and narrow food repertoire, among TD children and children with ID. Parents completed a 119-item food frequency questionnaire. Food refusal rate was calculated as the number of foods the child refused of those offered. Food repertoire, comprising the number of unique foods eaten, was determined from a 3-day food record. Compared to TD children, among children with ID the food refusal rate was significantly higher (28.5% vs. 15.7%) and mean food repertoire significantly narrower (20.7 vs. 24.2 unique foods) (p \u3c 0.01). Approximately 10% of children with ID and approximately 4% of TD children reported eating no fruit on any of the three days of food intake recording, and approximately 10% of children with ID compared to approximately 2% of TD children reported no vegetable intake on any of the three days. In further analyses, we examined the two measures of food selectivity among children with both ID and probable autism spectrum disorder (ASD) (by the Autism Spectrum Rating Scale) compared to children with ID only and to TD children. Food selectivity appeared to be primarily attributable to those children who also had a probable diagnosis of ASD. These findings support the need for screening for food selectivity of children with ID, particularly those who also have ASD. Children who exhibit food selectivity should be referred for further evaluation and intervention

Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children

Time spent in sedentary behavior is largely due to time spent engaged with electronic screen media. Little is known about the extent to which sedentary behaviors for children with autism spectrum disorder differ from typically developing children. We used parental report to assess and compare time spent in sedentary behaviors for 53 children with autism spectrum disorder and 58 typically developing children aged 3-11 years. We also determined how sedentary behavior was related to child weight status (body mass index z-score). Overall, children with autism spectrum disorder spent an hour more in sedentary behaviors on weekdays compared to typically developing children (5.2 vs 4.2 h, p = 0.03), and most of this difference was due to screen time. The age- and sex-adjusted estimate of weekday total daily screen time was 1.6 h (typically developing) compared to 2.5 h (autism spectrum disorder, p = 0.004 for difference). A significant relationship between BMI z-score and total sedentary behavior time on weekend days was observed among young children with ASD, but not among TD children. The modest association between weekend sedentary behaviour time and BMI z-score among children with ASD suggests that sedentary behaiour is linked to relative weight status in these children. Further research is needed to confirm these findings and identify causal pathways