Fidelity to Common Elements of Coordinated Specialty Care: Outcomes of Clients With First-Episode Psychosis.

Objective: The present study examined whether clients enrolled in coordinated specialty care (CSC) programs for first-episode psychosis (FEP) across 22 states and territories showed improved clinical and functional outcomes and assessed whether program- or client-level predictors were associated with client outcomes. The study included CSC programs that subscribe to a variety of models, including Early Assessment and Support Alliance, OnTrack, and NAVIGATE.

Methods: Deidentified demographic and outcome data were collected from clients (N=770) receiving CSC services in 36 programs at the time of program entry and every 6 months for up to 18 months.

State Mental Health Authority Level of Involvement in Coordinated Specialty Care Clinics and Client Outcomes.

Objective: State mental health authorities (SMHAs) in all U.S. states and territories administer the Mental Health Block Grant (MHBG) set-aside funding for first-episode psychosis.

Growth of Coordinated Specialty Care in the United States With Changes in Federal Funding Policies: 2014-2018.

Objective: In 2014, the number of coordinated specialty care (CSC) programs in the United States greatly expanded. The proliferation of CSC programs was likely due in part to the availability of Mental Health Block Grant (MHBG) set-aside funds for treatment of first-episode psychosis. This study aimed to explore the characteristics of CSC programs across 44 states, the District of Columbia, and three U.

Client Racial Composition in First-Episode Psychosis Programs Compared With Compositions in Program Service Areas.

Objective: The authors examined the extent to which clients served by first-episode psychosis programs reflected the racial composition of the surrounding service area and, to the extent that they did not, explored possible explanatory factors.

Methods: As part of a national study of coordinated specialty care (CSC) sites in the United States, 35 programs documented race for 772 clients. Programs identified a geographic service area for their clients.

Paths Toward Sustainable State and County Systems of Care.

The Substance Abuse and Mental Health Services Administration's Children's Mental Health Initiative (CMHI) Cooperative Agreements support the development of children's systems of care (SOCs). The National Evaluation of CMHI interviewed representatives from Mental Health Authorities (MHA) and Medicaid agencies in 25 state, county, and municipal jurisdictions in the FY13 and FY14 grant cohorts in grant years 2 and 4. This paper analyzes funding for five services (wraparound planning; intensive care coordination; family peer support; youth peer support; and flexible funding) that are a core part of SOCs, and grantee descriptions of sustainability strategies and challenges.

Opportunities for psychologists to enact community change through adverse childhood experiences, trauma, and resilience networks.

A growing body of evidence on the inequitable distribution of adverse childhood experiences (ACEs; e.g., Merrick et al.

First-Person Accounts of Change Among Young Adults Enrolled in Coordinated Specialty Care for First-Episode Psychosis.

Objective: This study investigated how clients of a coordinated specialty care (CSC) program for first-episode psychosis perceived how they changed while attending the program, what the most important changes were, and what mechanisms they believed helped bring about these changes.

Methods: Study participants were 121 individuals (71 men and 50 women) from 35 CSC programs across 22 U.S.

Family Organizations in Children's Mental Health Systems of Care: the Challenge of Maintaining Financial Sustainability.

Family-run organizations are an important source of support for families of children with serious emotional disturbance, yet little work has explored how these organizations sustain their work. The National Evaluation Team (NET) for the Substance Abuse and Mental Health Services Administration's Children's Mental Health Initiative grant program interviewed 20 family organizations in Grant Year 2 and 22 organizations in Year 4 to assess their main funding sources, the adequacy of this funding to support the organization, and changes in their funding and financial sustainability over time. Family organizations were supported mainly by mental health authority and other state agency funding and were in early stages of accessing Medicaid funding for peer services.

Coordinated Specialty Care Discharge, Transition, and Step-Down Policies, Practices, and Concerns: Staff and Client Perspectives.

Objective: In recent years, optimizing the process of transition and discharge from coordinated specialty care (CSC), a program that provides early intervention in psychosis, has emerged as an important focus area for program administrators, clinicians, and policy makers. To explore existing CSC policies and practices and to understand frontline provider and client views on discharge, the authors conducted a comprehensive analysis of staff and client interview data from the Mental Health Block Grant 10% Set-Aside Study.

Methods: Data from 66 interviews with groups of CSC providers and administrators representing 36 sites and 22 states were analyzed, as well as data from interviews with 82 CSC clients at 34 sites.

Parenting a child with autism in India: narratives before and after a parent-child intervention program.

In many low and middle income countries where autism-related resources are scarce, interventions must rely on family and parents. A 3-month Parent-Child Training Program (PCTP) at Action For Autism, New Delhi, India is aimed at empowering and educating parents, encouraging acceptance of their child, and decreasing parent stress. Forty couples were asked to describe their child with autism using the Five Minute Speech Sample (FMSS), an open-ended narrative method, before and after the program.

Adults with autism in India: a mixed-method approach to make meaning of daily routines.

Although individuals with Autism Spectrum Disorder (ASD) have been diagnosed in India for over fifty years, virtually nothing is known about the social circumstances of adults, their daily lives, and their families. Where are adults with autism? How do they spend their time? Who are they with, and what are they doing all day? A mixed-method approach was used to obtain information on daily routines of 54 adults with ASD living in New Delhi, India, and about parent levels of stress associated with these routines during a study collected from January through June, 2013. Whether or not they attended a structured setting during the day (59% did so), adults engaged in some 20 activities both inside and outside their home.

Ethical considerations in conducting research on autism spectrum disorders in low and middle income countries.

Autism spectrum disorder (ASD) is being identified in an ever-increasing number of countries, including many that are low or middle income (LMIC). Research conducted in these countries requires awareness of unique ethical issues. Drawing on the experience of two organizations that have been involved in conducting and collaborating in ASD research in India, we describe specific considerations in conducting epidemiological, genetic and treatment studies as well as general principles from the field of multinational clinical research as they apply to the conduct of ASD research.

Constructing and testing a disability index in a US sample of preschoolers with disabilities.

Purpose: To develop and test an index of disability severity in a heterogeneous population of preschoolers with disabilities.

Method: Using a nationally representative sample of 3,104 children receiving special education services in the US, questions from a parent interview were used to develop an index of disability severity consisting of domains of functioning defined by gradients of severity. Regressions were used to examine the association between 15 functional domains and 8 cognitive, social/behavioural, and functional outcomes.

A national sample of preschoolers with autism spectrum disorders: special education services and parent satisfaction.

The Pre-Elementary Education Longitudinal Study (PEELS) examines the preschool and early elementary school experiences of a nationally representative sample of 3,104 children ages 3-5 with disabilities from 2004 through 2009. This paper describes the special education and related services received by a subsample of 186 preschoolers with autism spectrum disorders (ASD) in 2003-2004 and parental satisfaction with those services. Past research and patterns of litigation suggest that parents of children with ASD are not wholly satisfied with the special education and related services their children receive.

Perceptions and congruence of symptoms and communication among second-generation Cambodian youth and parents: a matched-control design.

This study examined the relationship between perception of communication and report of symptoms among second-generation Cambodian children and their parents using a matched-control design of clinic and community children. Children reported significantly higher symptoms than parents in both samples. Clinic parents reported more symptoms than community parents, but no differences were observed between children, and the mean level of child-reported symptoms was similar to past studies examining clinic populations.

Beliefs about treatment of mental health problems among Cambodian American children and parents.

Beliefs about treatment of mental health problems are a critical area for examination among immigrant and refugee populations. Data on treatment of child problems have been conspicuously absent from the literature. This study examines explanatory models of treatment among 40 second-generation Cambodian children aged 8-18 and their parents in the US.

Relations among joint attention, amount of intervention and language gain in autism.

The purpose of the present study was to investigate the unconditional and conditional relations between amount of intervention and language development in children with autism. Joint attention skills were proposed as child characteristics that might moderate this relation. The results replicated previous findings that better joint attention skills were associated with greater language development.

From symptom recognition to diagnosis: children with autism in urban India.

The period of time between initial recognition of a symptom and initial diagnosis warrants examination because it can serve as a window into broader cultural factors and allow for more immediate treatment. Research on this process among parents of autistic children to date has been useful, but has been limited to families in Western countries, whereas autism occurs all over the world. The current study provides data on the process of initial symptom recognition, help-seeking, and initial diagnosis of a pervasive developmental disorder among 95 families of autistic children in India.

IQ on the rise: the Flynn effect in rural Kenyan children.

Multiple studies have documented significant IQ gains over time, a phenomenon labeled the Flynn effect. Data from 20 industrialized nations show massive IQ gains over time, most notably in culturally reduced tests like the Raven's Progressive Matrices. To our knowledge, however, this is the first study to document the Flynn effect in a rural area of a developing country.

"I speak a different dialect": teen explanatory models of difference and disability.

What do teens with disabilities believe about their conditions, and what do they understand to be the causes, correlates, and consequences of disability? We elicited a cultural explanatory model (EM) of disability from a longitudinal sample of 23 European American adolescents with varied cognitive disabilities and delay. We asked teens how they were similar to or different from others; the name of this difference; its causes, severity, course, effects, associated problems and benefits; and need for treatment. IQ and type of disability strongly affected quality of responses only from the lowest functioning teens.

Diagnostic conceptualization of autism among Indian psychiatrists, psychologists, and pediatricians.

Diagnostic criteria for autism and background characteristics used by 937 Indian psychiatrists, psychologists and pediatricians were examined. Participants were asked to rate 18 behaviors as necessary for a diagnosis of autism, helpful but not necessary, or not helpful in a diagnosis of autism, and were asked to provide other information about their experiences with autism. Professionals' experience with diagnosing cases did not vary by profession and, in general, the three professions agreed about the characteristics most necessary for a diagnosis.