CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions

BackgroundHeterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.MethodsUsing a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.ResultsClustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.LimitationsNotable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.ConclusionsConcomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis

A Behavioral Perspective of Adolescent Problem Sexual Behaviors in Residential Treatment Centers

In a setting that we hope will turn children and adolescents into functional adults, it is important to understand sexual behaviors so that healthy sexuality and sexual behaviors can be developed. This paper proposes that understanding sexual behaviors through a behavioral perspective will allow for clearer treatment and healthier, generalizable development for adolescents in residential treatment centers (RTCs). The goal of RTCs is to provide appropriate containment, support, structure, involvement, and validation for the residents, such that residents are safe and working toward stable mental health. The ultimate goal has long been to promote and facilitate \u27positive\u27 changes in specified directions (Gunderson, 1978, p. 332). One ofthe primary functions of an RTC, from conception, was to provide an environment in which children and adolescents can practice navigating social circumstances that are similar to their world outside the treatment facilities and manage their anxieties, depressions, or aggressions (Leichtman, 2006)

Quantifying Caregiver Change Across Early Autism Interventions Using the Measure of NDBI Strategy Implementation: Caregiver Change (MONSI-CC).

This study aimed to provide initial validity and reliability of the Measure of NDBI Strategy Implementation-Caregiver Change (MONSI-CC), a novel measure that captures changes in caregivers implementation of NDBI strategies during early intervention. The MONSI-CC was applied to 119 observations of 43 caregiver-child dyads of preschoolers with autism spectrum disorders (ASD). The MONSI-CC showed high inter-rater and test-retest reliability and captured significant improvements in caregivers implementation of NDBI strategies. Significant associations between improvements in caregiver NDBI implementation and improvements in the childs ASD symptoms also emerged. Our work shows promising evidence for the utility of the MONSI-CC to evaluate implementation of NDBI strategies by caregivers as a mediating and moderating factor for treatment effects on children with ASD

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions

BackgroundHeterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.MethodsUsing a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.ResultsClustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.LimitationsNotable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.ConclusionsConcomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.

BackgroundHeterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services.MethodsUsing a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups.ResultsClustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup.LimitationsNotable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic.ConclusionsConcomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis

CRISIS AFAR: an international collaborative study of the impact of the COVID-19 pandemic on mental health and service access in youth with autism and neurodevelopmental conditions.

BACKGROUND: Heterogeneous mental health outcomes during the COVID-19 pandemic are documented in the general population. Such heterogeneity has not been systematically assessed in youth with autism spectrum disorder (ASD) and related neurodevelopmental disorders (NDD). To identify distinct patterns of the pandemic impact and their predictors in ASD/NDD youth, we focused on pandemic-related changes in symptoms and access to services. METHODS: Using a naturalistic observational design, we assessed parent responses on the Coronavirus Health and Impact Survey Initiative (CRISIS) Adapted For Autism and Related neurodevelopmental conditions (AFAR). Cross-sectional AFAR data were aggregated across 14 European and North American sites yielding a clinically well-characterized sample of N = 1275 individuals with ASD/NDD (age = 11.0 ± 3.6 years; n females = 277). To identify subgroups with differential outcomes, we applied hierarchical clustering across eleven variables measuring changes in symptoms and access to services. Then, random forest classification assessed the importance of socio-demographics, pre-pandemic service rates, clinical severity of ASD-associated symptoms, and COVID-19 pandemic experiences/environments in predicting the outcome subgroups. RESULTS: Clustering revealed four subgroups. One subgroup-broad symptom worsening only (20%)-included youth with worsening across a range of symptoms but with service disruptions similar to the average of the aggregate sample. The other three subgroups were, relatively, clinically stable but differed in service access: primarily modified services (23%), primarily lost services (6%), and average services/symptom changes (53%). Distinct combinations of a set of pre-pandemic services, pandemic environment (e.g., COVID-19 new cases, restrictions), experiences (e.g., COVID-19 Worries), and age predicted each outcome subgroup. LIMITATIONS: Notable limitations of the study are its cross-sectional nature and focus on the first six months of the pandemic. CONCLUSIONS: Concomitantly assessing variation in changes of symptoms and service access during the first phase of the pandemic revealed differential outcome profiles in ASD/NDD youth. Subgroups were characterized by distinct prediction patterns across a set of pre- and pandemic-related experiences/contexts. Results may inform recovery efforts and preparedness in future crises; they also underscore the critical value of international data-sharing and collaborations to address the needs of those most vulnerable in times of crisis

Atlas of Jordan

L’ambition de cet atlas est d’offrir au lecteur des clés d’analyse spatiale des dynamiques sociales, économiques et politiques qui animent la Jordanie, pays exemplaire de la complexité du Moyen-Orient. Produit de sept années de coopération scientifique entre l’Ifpo, le Centre Royal Jordanien de Géographie et l’Université de Jordanie, l’atlas réunit les contributions de 48 chercheurs européens, jordaniens et internationaux. La formation des territoires jordaniens sur le temps long est éclairée par une longue partie historique, suivie de chapitres sur la démographie, l’économie, les disparités sociales, les défis urbains et les grands projets d’aménagement du territoire. La Jordanie fait figure d’exception au Moyen-Orient par la stabilité politique dont elle témoigne depuis la proclamation de son indépendance en 1946, cela malgré le défi qu’a constitué l’intégration de plusieurs vagues de réfugiés palestiniens, irakiens et tout récemment syriens. Elle a fait de cette stabilité et de la paix signée avec Israël en 1994 une rente économique qui lui permet d’être l’un des premiers pays au monde en terme d’aide au développement par habitant.This atlas aims to provide the reader with key pointers for a spatial analysis of the social, economic and political dynamics at work in Jordan, an exemplary country of the Middle East complexities. Being a product of seven years of scientific cooperation between Ifpo, the Royal Jordanian Geographic Center and the University of Jordan, it includes the contributions of 48 European, Jordanian and International researchers. A long historical part followed by sections on demography, economy, social disparities, urban challenges and major town and country planning, sheds light on the formation of Jordanian territories over time. Jordan has always been looked on as an exception in the Middle East due to the political stability that has prevailed since the country’s Independence in 1946, despite the challenge of integrating several waves of Palestinian, Iraqi and - more recently - Syrian refugees. Thanks to this stability and the peace accord signed with Israel in 1994, Jordan is one of the first countries in the world for development aid per capita.يطمح هذا الأطلس إلى تقديم مفاتيح أساسية في التحليل المكاني للآليات الاجتماعية والاقتصادية والسياسية التي تحرّك الأردن، هذا البلد الذي تشكّل بنيته نموذجًا مصغّرًا عن تركيبة الشرق الأوسط المعقّدة. و هذا العمل نتاج سبع سنين من التعاون العلمي بين" المعهد الفرنسي للشرق الأدنى" و "المركز الجغرافي الملكي الأردني". وهو يجمع مساهمات ثمانية وأربعين باحثًا من الأردن وأوروبا ودول أخرى. وقد خُصَّص قسم طويل تاريخي من العمل لتسليط الضوء على تشكّل الأراضي الأردنيّة عبر الأزمنة، تليه فصول عن التوزّع السكّاني والأقتصاد وتفاوت الطبقات الاجتماعية والتحدّيات العمرانية ومشاريع التخطيط الإقليمي. ويشكّل الأردن استثناءً في الشرق الأوسط لناحية الاستقرار الذي عرفه منذ إعلان استقلاله في ١٩٤٦، ذلك على الرغم من التحديّات التي واجهها في استقبال ودمج عدّة موجات من اللاجئين، من فلسطين ثمّ العراق، ومؤخّرًا من سوريا. وقد جاء استثمار هذا الاستقرار، إضافةً إلى اتفاقية السلام الموقّعة مع إسرائيل في ١٩٩٤، بمردود اقتصادي رفع حصّة الفرد من الإنفاق على التنمية ليصبح الأردن في طليعة الدول في هذا المجال في العالم