Effectiveness of Multilevel Implementation Strategies for Autism Interventions: Outcomes of Two Linked Implementation Trials.

Objective: This study tests the effectiveness of leader- and provider-level implementation strategies to implement evidence-based interventions (EBIs) in 2 of the service systems caring for autistic children. The TEAMS Leadership Institute (TLI) targets implementation leadership and climate, and TEAMS Individualized Provider Strategy (TIPS) targets provider motivation and engagement.

Method: A cluster randomized hybrid type 3 implementation-effectiveness trial tested the effects of the implementations strategies when paired with AIM HI (An Individualized Mental Health Intervention for Autism) in mental health programs (study 1) and CPRT (Classroom Pivotal Response Teaching) in classrooms (study 2).

Therapist-Reported Adaptations to an Autism Intervention: Family-Level Predictors and Associations with Fidelity.

The purpose of this study was to: (1) confirm the factor structure of a therapist-report measure of adaptations to an autism evidence-based intervention (EBI), (2) identify predictors of adaptation types, and (3) examine associations of adaptation types with observed therapist fidelity. Participants included a subset of therapists (N = 70; 31.4% Hispanic), autistic children (N = 79; ages 5-13 years; 57.

Spherocytosis in Newborn Secondary to Novel Heterozygous Mutation in Gene: Case Report.

This case report describes a novel mutation of the gene as a potential pathogenic cause of spherocytosis. A 3-week-old male presented with clinical and laboratory signs consistent with hemolytic spherocytosis, including jaundice, hyperbilirubinemia, anemia, reticulocytosis, negative Coombs test, no ABO or Rh incompatibility, and a peripheral blood smear notable for numerous spherocytes. His laboratory work demonstrated persistent anemia despite daily folate prompting next-generation sequencing which revealed a novel mutation in the gene resulting in a nonfunctioning protein product.

Training Community Therapists in AIM HI: Individual Family and Neighborhood Factors and Child/Caregiver Outcomes.

Objective: Publicly funded mental health services play an important role in caring for children with mental health needs, including children with autism spectrum disorder (ASD). This study assessed the associations between individual family- and neighborhood-level sociodemographic factors and baseline family functioning and long-term outcomes when community therapists were trained to deliver (AIM HI).

Method: Participants included 144 children with ASD (ages 5 to 13 years; 58.

Setting Families Up for Success: A Pilot Study of a Toolkit to Enhance the Autism Spectrum Disorder Diagnostic Evaluation Process.

Families of children with autism spectrum disorder (ASD) face challenges engaging in services following diagnosis. This study: (1) developed and implemented a toolkit to tailor ASD evaluation feedback to families' needs, and (2) evaluated caregiver and provider perceptions of the toolkit. Focus groups with providers (N = 11) informed toolkit development.

Psychotropic Medication Use by Children with Autism Served in Publicly Funded Mental Health Settings.

Objective: The aim of this study was to characterize patterns of and factors associated with psychotropic medication use in children with autism spectrum disorder (ASD) receiving publicly funded mental health services.

Method: Data were extracted from 202 children with ASD participating in a cluster randomized trial of An Individualized Mental Health Intervention for ASD conducted in 29 publicly funded mental health programs. Children with ASD were aged 5 to 13 years (M = 9.

Gene x responsive parenting interactions in social development: Characterizing heterogeneity in autism spectrum disorder.

Emerging research suggests that caregiving environments and genetic variants independently contribute to social functioning in children with typical development or autism spectrum disorder (ASD). However, biologically plausible interactive models and complimentary assessment of mechanisms are needed to: (a) explain considerable social heterogeneity, (b) resolve inconsistencies in the literature, and (c) develop and select optimal treatments based on individual differences. This study examined the role of child genotypes and responsive parenting in the social development of 104 children with ASD (ages 4-7 years).

The nature and nurture of social development: The role of 5-HTTLPR and gene-parenting interactions.

Social skills are traditionally viewed as acquired through social environments including parenting. However, biopsychosocial models highlight the importance of genetic influences and gene-environment interactions (G×Es) in child development. Extant G×E investigations often fail to account for developmental changes in the phenotype or rigorously assess the social environment using observational measures.

Responsive Parenting and Prospective Social Skills Development in Early School-Aged Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) vary greatly in social functioning, and in turn, long-term relational and academic outcomes. Responsive parenting which follows a child's lead and focus of attention is predictive of language and social gains for children with or without developmental risk. The present study prospectively assessed 176 families of children with ASD (ages 4 to 7 years) to examine predictors of observed responsive parenting and associations of responsive parenting with concurrent and prospective growth in social functioning by multi-method assessment.

Adolescent and young adult couples' views of intravaginal practices: a qualitative analysis of a pilot study.

Purpose: In this study, we evaluated the risk behaviors that are drivers of the HIV epidemic among adolescent girls and young women in Zambia using a focus group research technique.

Subjects And Methods: Eighteen adolescent couples (n=18 females and 18 males) aged 16-24 participated in six focus groups discussions (3 per gender) convened at three health facilities in Lusaka, Zambia. Focus group moderators utilized a set of open-ended questions to guide the 60-minute sessions.

Patterns of Sensitivity to Parenting and Peer Environments: Early Temperament and Adolescent Externalizing Behavior.

Although parenting behavior and friendship quality predict adolescent externalizing behaviors (EBs), individual differences in temperament may differentially affect susceptibility to these factors over time. In a multi-method and multi-informant study of 141 children followed prospectively from toddlerhood to adolescence, we tested the independent and interactive associations of age 3 reactive temperament (e.g.

COMT and DAT1 polymorphisms moderate the indirect effect of parenting behavior on youth ADHD symptoms through neurocognitive functioning.

Although gene × environment interactions contribute to youth attention-deficit/hyperactivity disorder (ADHD) symptoms, the pathways mediating these influences are unknown. We tested genetic moderation of indirect effects from parenting behavior to youth ADHD symptoms through multiple neurocognitive factors. Two hundred and twenty-nine youth with and without ADHD were assessed at baseline (Wave 1; ages 5-10) and at a 2-year follow-up (Wave 2; ages 7-13).

Student-Teacher Relationships for Young Children with Autism Spectrum Disorder: Risk and Protective Factors.

The quality of early student-teacher relationships (STRs) has been shown to predict children's school adjustment, and children with autism spectrum disorder (ASD) are at risk for poor quality STRs. The present study examined 162 children with ASD (ages 4-7) and their teachers to evaluate student, teacher, and classroom characteristics that predicted concurrent and prospective STR quality across one school year. Child oppositional behavior, autism severity and teacher degree predicted changes in student-teacher conflict over a 1-year period, while child social skills and IQ positively predicted change in student-teacher closeness.

Maternal control and early child dysregulation: Moderating roles of ethnicity and child delay status.

Background: Maternal controlling behaviour has been found to influence child development, particularly in behavioural and emotional regulation. Given the higher rates of interfering parent control found in mothers of children with developmental delays (DD) and Latina mothers, their children could be at increased risk for behavioural and emotional dysregulation. While studies generally support this increased risk for children with DD, findings for Latino children are mixed and often attributed to cultural models of child rearing.

The impact of premorbid adjustment, neurocognition, and depression on social and role functioning in patients in an early psychosis treatment program.

Objective: Functional impairments are debilitating concomitants of psychotic disorders and are present early in the illness course and, commonly, prior to psychosis onset. The factors affecting social and role functioning in early psychosis (EP) following treatment are unclear. We evaluated whether six months of participation in the PREP(R), Boston, EP treatment program, part of a public-academic community mental health center, was related to improvements in social and role functioning and whether premorbid adjustment in adolescence, baseline neurocognition, and depression symptoms predicted functional improvement.

Developmental level and psychopathology: comparing children with developmental delays to chronological and mental age matched controls.

Children with developmental delays (DD) are at heightened risk for developing clinically significant behavioral and emotional difficulties as compared to children with typical development (TD). However, nearly all studies comparing psychopathology in youth with DD employ TD control groups of the same chronological age (CA). It is unclear, then, whether the heightened symptomology found in age-matched children with DD is beyond what would be expected given their developmental level.

Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

Objective: This study describes the results of a multidisciplinary conference (the Baltimore Conference) that met to develop consensus guidelines for competency specification and measurement in postdoctoral training in rehabilitation psychology.

Methods: Forty-six conference participants were chosen to include representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, persons involved in medical education practice and research, and consumers of training programs (students).

Results: Consensus education and training guidelines were developed that specify the key competencies in rehabilitation psychology postdoctoral training, and structured observation checklists were developed for their measurement.

Basophils are rapidly mobilized following initial aeroallergen encounter in naïve mice and provide a priming source of IL-4 in adaptive immune responses.

Chronic aeroallergen inhalation elicits the expansion of IL-4-producing Th2 cells and the production of IgE antibodies. In sensitized subjects, who have established IgE and Th2 responses, re-exposure to allergen leads to rapid recruitment of basophils, which are thought to be important effectors of late phase allergic reactions. Several investigations of responses to parasites and injected antigens have identified an additional role for basophils as innate immune effectors during initial antigen encounter in immunologically naïve hosts.

Maternal supportive and interfering control as predictors of adaptive and social development in children with and without developmental delays.

Background: Parents of children with developmental delays (DD) have been found to use more controlling behaviour with their children than parents of children with typical development (TD). While controlling behaviour is related to poorer developmental outcomes in TD children, there is little research on how it predicts outcomes in DD children. Furthermore, existing research tends to use inconsistent or non-specific definitions of controlling behaviour, often combining parent control which follows the child's goal (e.

Prevention and recovery in early psychosis (PREP(®)): building a public-academic partnership program in Massachusetts, United States.

Recently, there has been increasing emphasis on early intervention (EI) for psychotic disorders. EI programs in public mental health settings have been established in countries such as Australia, the United Kingdom, and Canada. However, there are relatively few EI programs in the United States (U.

Polyclonal IgE induces mast cell survival and cytokine production.

Background: Ag-dependent activation of IgE-bearing mast cells is a critical first step in immediate hypersensitivity and other allergic responses. Recent studies have revealed Ag-independent effects of monoclonal mouse IgE molecules on mast cell survival and activation. However, no studies have been performed on the effects of polyclonal IgE molecules.

IgE influences the number and function of mature mast cells, but not progenitor recruitment in allergic pulmonary inflammation.

Studies performed using cultured cells indicate that IgE functions not only to trigger degranulation of mast cells following allergen exposure, but also to enhance their survival. Such an influence of IgE on mast cell homeostasis during allergic responses in vivo has not been established. In this study, we show that inhalation of Aspergillus fumigatus extract in mice induced a dramatic rise in IgE accompanied by an increase in airway mast cells.

Test accommodations for the geriatric patient.

Obtaining accurate information about the neuropsychological functioning of elderly individuals with physical or sensorimotor limitations may be fostered by judicious use of nonstandard testing strategies. We review professional documents that support this position and discuss selected "flexible" testing techniques that can serve this goal. These approaches may permit assessment of skills that might otherwise go unmeasured (e.