Working Together: Communication Between Stakeholders During the Transition from Early Intervention to School for Children Who Are Deaf or Hard of Hearing

The transition to school can be a complicated process for families of children with exceptionalities (Janus, Lefort, Cameron, & Kopechanski, 2007). Little is known about the transition to school specifically for children who are deaf or hard of hearing (D/HH). The aim of this study was to examine the communication that occurred among early intervention (EI) providers, parents, and teachers before and during the child’s first year of kindergarten. Thematic analysis was used to analyze six sets of parent interviews, pre- and post-transition, three interviews with EI providers, and three interviews with teachers of the deaf. Participants from each group described factors that facilitated or hindered the transition to school for D/HH children. Findings were interpreted through the framework of ecological systems theory, which indicate that high-intensity transition support and fluid communication facilitated the transition and fostered positive relationships among those involved in the child’s transition to school

Exposure to family stressful life events in autistic children: Longitudinal associations with mental health and the moderating role of cognitive flexibility

Mental health problems are prevalent in autistic youth, but the underpinning mechanisms are not well explored. In neurotypical youth, stressful life events are an established risk factor for mental health problems. This study tested longitudinal bidirectional associations between family-level stressful life events and mental health problems and whether these were moderated by cognitive flexibility, in a cohort of autistic children (N = 247). Family-stressful life events, assessed using the parent-reported Family Inventory of Life Events and Changes, and mental health problems, assessed using the teacher-reported Child Behavior Checklist Internalizing and Externalizing Symptoms subscales, were measured at multiple points between 7 and 11 years. Analyses showed no significant pathways from internalizing or externalizing symptoms to family-stressful life events or from family-stressful life events to internalizing or externalizing symptoms. There was some evidence of moderation by cognitive flexibility; the family-stressful life events to internalizing symptoms pathway was non-significant in the group with typical shifting ability but significant in the group with clinically significant shifting problems. Information about family-level stressful life event exposure and cognitive flexibility may be helpful in identifying autistic youth who may be at higher risk of developing mental health problems. Established risk factors for mental health problems in neurotypical populations are relevant for understanding mental health in autistic youth

Investigating longitudinal associations between parent reported sleep in early childhood and teacher reported executive functioning in school-aged children with autism

Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF difficulties in ASD are exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. A subsample (n = 217) from the Pathways in ASD longitudinal study was analyzed. The Children’s Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (mean = 3.5 years). Metacognition (MI) and Behavioral Regulation (BRI) indices, on the Teacher Behavior Rating Inventory of Executive Functioning, were used to measure cognitive and affective components of EF respectively at four time-points (7.8–11.8 years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (mean = 6.7 years). Sleep traits had different age-related impacts on behavioral regulation, but not metacognition. Longer sleep onset at 3.5 years was associated with a worsening BRI difficulties slope (b = 2.07, p < 0.04), but conversely associated with lower BRI difficulties at 7.7 years (b = −4.14, p = 0.04). A longer sleep onset at 6.7 years was related to higher BRI difficulties at 7.7 years (b = 7.78, p < 0.01). Longer sleep duration at 6.7 years was associated with higher BRI difficulties at age 7.7 (b = 3.15, p = 0.01), but subscale analyses revealed shorter sleep duration at age 6.7 was linked to a worsening inhibition slope (b = −0.60, p = 0.01). Sleep onset is a robust early correlate of behavior regulation in children with ASD, whereas sleep duration is a later childhood correlate

Predictors of language regression and its association with subsequent communication development in children with autism

Background: Language regression, broadly defined as the loss of acquired language skills in early childhood, is a distinctive feature of autism. Little is known about the factors underlying regression or the prognosis of children who exhibit regression. We examine potential predictors of language regression and test its association with language development in a prospective longitudinal sample of children with autism spectrum disorder (ASD) from diagnosis to age 10 years. Methods: We analysed data from Pathways in ASD, a prospective longitudinal study of 421 children enrolled around the time of an autism diagnosis between 2 and 5 years. Autism Diagnostic Interview-Revised data were available for 408 children, of whom 90 (22%) were classified as having language regression. Results: Demographic and other health factors including caregiver education, family income, child sex, reported seizures, and age of enrolment did not differ between children with and without language regression. Children with language regression walked earlier and attained first words sooner than those without regression. However, both groups attained phrase speech at comparable ages. Those with regression exhibited greater delays in expressive and receptive communication over the follow-up period, although this effect was attenuated when accounting for baseline differences in motor and cognitive ability. Overall, those with language regression continued to exhibit expressive but not receptive communication delay compared to those without regression. Communication trajectories were heterogeneous to age 10 years, irrespective of regression status. Conclusions: Although language regression can be alarming, our findings confirm that its occurrence does not necessarily foreshadow worse developmental outcomes relative to those without regression. Although a discrepancy in age-equivalent communication skills may persist, this can be expected to be of less practical importance with rising average levels of skills. Future studies need to account for the significant variability in language trajectories by considering factors beyond developmental regression

Parenting children with cochlear implants : challenges, stress, coping, and processes

The central goal of the current dissertation was to expand the research on the experiences of parents of children with cochlear implants (CIs). To accomplish this goal, three studies were conducted: The first study explored everyday problems associated with parenting children who undergo cochlear implantation; to investigate parents' interpersonal relationships as a resource for collaborative problem solving; and to examine links between parents' everyday problems, stress, and life satisfaction. Thirty-one parents of children with CIs responded to open-ended questions regarding the types of everyday problems they encountered in parenting their child, and also rated their stress and life satisfaction. Problems were categorized into nine domains: implant drawbacks, communication difficulties, child's behavior, child's social competence, rehabilitation demands and parenting role, financial difficulties, services, educating others/advocacy, and academic concerns. Professionals, spouses, and other parents of deaf children were frequently nominated partners for collaborative problem solving and coping. Significant correlations emerged among parents' everyday problems, stress, and life satisfaction. The second study described and categorized the attributes that parents of young children with CIs consider as facilitating their parental coping experience. Fifteen hearing mothers and thirteen hearing fathers whose children had CIs were interviewed, using the critical incident technique. A total of 430 critical incidents were documented and sorted into 20 categories. Results indicated various sources of influence on parents' coping experience, associated with social contextual aspects, with the parent himself or herself, and with the child. The third study examined the complexity of parenting children who have received CIs as well as parents' involvement in the CI rehabilitation process. Action theory and its related qualitative action-project method were used in this study. Two cases were used to describe the individual and joint actions and projects, as related to the promotion of children's outcomes post-cochlear implantation that mothers engage in with their young children. Potentially illuminative implications were drawn for the 'current thinking' in relationship to parenting children with cochlear implants. Finally, four overarching themes emerging from the findings of the three studies were identified and described. These themes were discussed in terms of implications for practice and future research.Education, Faculty ofEducational and Counselling Psychology, and Special Education (ECPS), Department ofGraduat

Examining clinical characteristics of autism and links with parent perceptions of sibling relationship quality.

Peer reviewed: TrueFunder: Sinneave Family Foundation; FundRef: https://doi.org/10.13039/100012204Funder: alberta innovates - health solutions; FundRef: https://doi.org/10.13039/501100000145Funder: Kids Brain Health Network; FundRef: https://doi.org/10.13039/501100015741Funder: Government of British ColumbiaFunder: Autism Speaks; FundRef: https://doi.org/10.13039/100000073Sibling relationship quality is important for the well-being of children on the autism spectrum and their siblings. Little is known, however, about how varied behavior and abilities of children on the autism spectrum may be associated with parent perceptions of domains of sibling relationship quality. We drew data from a subsample of 119 children on the autism spectrum (ages 10-11 years), participating in an ongoing longitudinal study. We looked at how three clinical characteristics (autism symptoms, behavioral difficulties, and communication ability) related to four areas of parent-reported sibling relationship quality (warmth/closeness, conflict, relative status/power, and rivalry). We also examined whether the strength of the association between behavioral difficulties and parent-reported sibling relationship quality was influenced by communication ability. We found that more severe autism symptoms were associated with less conflict and rivalry, and higher communication ability was associated with more relative status/power. We also found that children on the autism spectrum with more behavioral difficulties and weaker communication ability had less warmth/closeness in their sibling relationships. Our findings highlight that it is important to consider autism symptoms, behavioral difficulties, and communication ability, as well as multiple domains of relationship quality, to better understand how parents view the relationships between autistic children and their siblings. Clinically, methods for improving sibling relationships may include teaching conflict resolution strategies to children on the autism spectrum with stronger communication abilities and their siblings, and fostering sibling connection for those with lower communication abilities

The Interplay Between Sleep and Executive Functioning in Children with Autism

Study Objectives: Up to 80% of children with autism spectrum disorder (ASD) experience sleep disturbance. Poor sleep impairs executive functioning (EF), a lifelong difficulty in ASD. Evidence suggests EF impairments in ASD is exacerbated by poor sleep. We examine whether early childhood sleep disturbances are associated with worsening EF trajectories in school-aged children with ASD. Methods: A subsample (n = 217) from the Pathways in ASD longitudinal study was analyzed. The Children’s Sleep Habits Questionnaire captured sleep duration, onset, and night awakenings before age 5 (Mean = 3.5 years). Metacognition (MI) and Behavioral Regulation (BRI) indices on the Teacher Behavior Rating Inventory of Executive Functioning measured EF difficulties at four time-points (7-11 years). We applied latent growth curve models to examine associations between sleep and EF, accounting for relevant covariates, including school-age sleep (Mean = 6.7 years). Results: Longer sleep onset at 3.5 years predicted a worsening BRI difficulties slope (b = 2.07, p &lt; 0.04), but conversely predicted lower BRI difficulties at age 7.7 (b = -4.14, p = 0.04). A longer sleep onset at age 6.7 predicted higher BRI difficulties at age 7.7 (b = 7.78, p &lt; 0.01). Longer sleep duration at age 6.7 predicted higher BRI difficulties at age 7.7 (b = 3.15, p = 0.01), but subscale analyses revealed shorter sleep duration at age 6.7 predicted a worsening inhibition slope (b = -0.597, p = 0.01). Conclusions: Different sleep phenotypes have different age-related impacts on selective behavioral regulation components, but not metacognition. Delayed sleep onset is a robust early predictor, whereas shorter sleep duration is a later predictor of worsening behavior regulation in school-aged children with ASD