Toward Innovative, Cost-Effective, and Systemic Solutions to Improve Outcomes and Well-Being of Military Families Affected by Autism Spectrum Disorder

The burdens faced by military families who have a child with autism are unique. The usual challenges of securing diagnostic, treatment, and educational services are compounded by life circumstances that include the anxieties of war, frequent relocation and separation, and a demand structure that emphasizes mission readiness and service. Recently established military autism-specific health care benefits set the stage for community-viable and cost-effective solutions that can achieve better outcomes for children and greater well-being for families. Here we argue for implementation of evidence-based solutions focused on reducing age of diagnosis and improving access to early intervention, as well as establishment of a tiered menu of services, individualized to the child and family, that fit with the military ethos and system of health care. Absence of this new model of care could compromise the utility and sustainability of the autism-specific benefit

Early Indicators of Autism Spectrum Disorders in the Second Year of Life

Three groups of 18 children were selected for this study, one group with autism spectrum disorders (ASD), one group with developmental delays in which ASD was ruled out (DD), and one group with typical development (TD), from a pool of 3026 children who were screened with the Communication and Symbolic Behavior Scales Developmental Profile (CSBS DP, Wetherby & Prizant, 2002) Infant-Toddler Checklist under 24 months of age. The CSBS DP Behavior Sample was videotaped on selected children as a second-level evaluation during the second year of life. The Infant-Toddler Checklist had a sensitivity and specificity of 88.9% for this sample of children. Significant group differences were found on the Infant-Toddler Checklist and the Behavior Sample, however, these differences did not distinguish children with ASD and DD with high accuracy. The videotapes of the Behavior Sample were reanalyzed to identify red flags of ASD. Nine red flags differentiated children in the ASD group from both the DD and TD groups and four red flags differentiated children in the ASD Group from the TD group but not the DD group. These 13 red flags were found to discriminate the three groups with a correct classification rate of 94.4%.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44624/1/10803_2004_Article_492544.pd

Autism and online recruiting methods: A comparison of Mechanical Turk and discussion forums

In a study by a team at the intersection of information and communication sciences and disorders, researchers worked to design an interactive, online professional development system for academic librarians to better serve students with autism spectrum disorder (ASD). In creating this program, it was imperative to have stakeholder input and support; recruiting members of this population, students with ASD, was critical. Amazon’s Mechanical Turk and online discussion forums, including Reddit, were used for recruitment for an online survey. While there was some overlap in results, there were also marked differences in responses based on online sampling frame. This paper details the online methods used for recruiting members of this community, and compares and contrasts success rates, challenges, and numbers associated with each method

Effects of Hemorrhage on Hematopoietic Cell Depletion after a Combined Injury with Radiation: Role of White Blood Cells and Red Blood Cells as Biomarkers

Combined radiation with hemorrhage (combined injury, CI) exacerbates hematopoietic acute radiation syndrome and mortality compared to radiation alone (RI). We evaluated the effects of RI or CI on blood cell depletion as a biomarker to differentiate the two. Male CD2F1 mice were exposed to 8.75 Gy γ-radiation (60Co). Within 2 h of RI, animals were bled under anesthesia 0% (RI) or 20% (CI) of total blood volume. Blood samples were collected at 4–5 h and days 1, 2, 3, 7, and 15 after RI. CI decreased WBC at 4–5 h and continued to decrease it until day 3; counts then stayed at the nadir up to day 15. CI decreased neutrophils, lymphocytes, monocytes, eosinophils, and basophils more than RI on day 1 or day 2. CI decreased RBCs, hemoglobin, and hematocrit on days 7 and 15 more than RI, whereas hemorrhage alone returned to the baseline on days 7 and 15. RBCs depleted after CI faster than post-RI. Hemorrhage alone increased platelet counts on days 2, 3, and 7, which returned to the baseline on day 15. Our data suggest that WBC depletion may be a potential biomarker within 2 days post-RI and post-CI and RBC depletion after 3 days post-RI and post-CI. For hemorrhage alone, neutrophil counts at 4–5 h and platelets for day 2 through day 7 can be used as a tool for confirmation

Providers’ Reported and Actual Use of Coaching Strategies in Natural Environments

This case study examined the agreement between reported and actual use of coaching strategies based on home visit data collected on a diverse sample of providers and families. Paired videotape and contact note data of and from providers of what transpired during those home visits were collected over a six month period and analyzed using structured protocols. Results of both descriptive and correlation analyses indicated providers used a range of coaching strategies, tended to underreport (under-represent) their efforts on contact notes, and demonstrated practices that were primarily collaborative and family-centered. Agreement between actual and reported use of coaching strategies was variable and did not support our anticipated finding. Implications for future research and practice are discussed

Bringing DEC Recommended Practices to Life: Seeking Input from the Field

DEC seeks your input and involvement with the disseminiation and product development plan to ensure that the 2014 recommended practices are understood and implemented across the broad field of early childhood. Share your perspective, brainstorm with colleagues, and strengthen dissemination efforts

Caregiver-Implemented Intervention for Communication and Motor Outcomes for Infants and Toddlers

The purpose of this study was to examine the effects of coaching caregivers to embed both communication and motor outcomes concurrently within daily routines of their infants or toddlers with significant disabilities using Enhanced Milieu Teaching (EMT) strategies. The coaching and embedding practices were part of a multicomponent intervention known as Embedded Practices and Intervention with Caregivers (EPIC). Three children, aged 15 to 23 months with significant disabilities, their caregivers, and an early intervention provider participated in this single case multiple probe design study. Primary dependent variables were caregivers’ number of naturalistic teaching strategies used and rates of correctly embedded instruction for each learning target in each routine. Child motor and communication outcomes were also examined. Results provide initial support for the positive effects of the EPIC approach using EMT strategies to embed intervention on two developmental domains concurrently in caregiver’s daily routines

Changing developmental trajectories of toddlers with autism spectrum disorder: Strategies for bridging research to community practice

Purpose: The need for community-viable, evidence-based social communication, developmental level, and adaptive intervention strategies for toddlers with autism spectrum behavior. A new measure of active engagement in the disorder (ASD) is a national priority. The purpose of this natural environment was found to be sensitive to change research forum article is to identify gaps in intervention in 3 months for young toddlers with ASD and to predict research and needs in community practice for toddlers with outcomes on the standardized measures of child outcomes. ASD, incorporate published findings from a randomized Strategies for utilizing the Autism Navigator collection of controlled trial (RCT) of the Early Social Interaction (ESI) model web-based courses and tools using extensive video footage (Wetherby et al., 2014) to illustrate community-based for families and professional development are offered for intervention, report new findings on child active engagement scaling up in community settings to change developmental from the ESI RCT, and offer solutions to bridge the research-to-community trajectories of toddlers with ASD. practice gap. Conclusions: Current health care and education systems Method: Research findings were reviewed to identify gaps in are challenged to provide intervention of adequate intensity the evidence base for toddlers with ASD. Published and new for toddlers with ASD. The use of innovative technology can findings from the multisite ESI RCT compared the effects of increase acceleration of access to evidence-based early two different ESI conditions for 82 toddlers with ASD to teach intervention for toddlers with ASD that addresses health parents how to support active engagement in natural environments. disparities, enables immediate response as soon as ASD is Results: The RCT of the ESI model was the only parent-implemented suspected, and rapidly bridges the research-to-practice gap. intervention that reported differential treatment Presentation Video: https://doi.org/10.23641/asha. effects on standardized measures of child outcomes, including 729781