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1.
Child Adolesc Psychiatr Clin N Am ; 31(2): 193-209, 2022 04.
Article in English | MEDLINE | ID: mdl-35361359

ABSTRACT

Data from the US Department of Education clearly documents the chronic and persistent disproportionality of negative educational outcomes for students of color. To move closer to an antiracist system that provides all youth with the resources, protections, and opportunities to which they are entitled through public education, we recommend that mental health clinicians understand the social determinants of education; become familiar with the historical legacy of inequity in schools; identify current trends of racial disparities in education; engage in opportunities for antiracist school transformation; and reflect on their personal practices in providing access, diagnosis, and treatment to underresourced and minoritized youth.


Subject(s)
Schools , Social Justice , Adolescent , Humans , Racial Groups , Students/psychology
2.
J Autism Dev Disord ; 45(4): 919-31, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25261247

ABSTRACT

Clinical applications of advanced technology may hold promise for addressing impairments associated with autism spectrum disorders (ASD). This project evaluated the application of a novel physiologically responsive virtual reality based technological system for conversation skills in a group of adolescents with ASD. The system altered components of conversation based on (1) performance alone or (2) the composite effect of performance and physiological metrics of predicted engagement (e.g., gaze pattern, pupil dilation, blink rate). Participants showed improved performance and looking pattern within the physiologically sensitive system as compared to the performance based system. This suggests that physiologically informed technologies may have the potential of being an effective tool in the hands of interventionists.


Subject(s)
Adaptation, Physiological/physiology , Autistic Disorder/physiopathology , Autistic Disorder/therapy , Communication , Social Behavior , Virtual Reality Exposure Therapy/methods , Adolescent , Autistic Disorder/psychology , Computer Simulation , Female , Humans , Male , Pilot Projects
3.
Autism ; 18(5): 555-61, 2014 Jul.
Article in English | MEDLINE | ID: mdl-23847130

ABSTRACT

The increased prevalence of autism spectrum disorder and documented benefits of early intensive intervention have created a need for flexible systems for determining eligibility for autism-specific services. This study evaluated the effectiveness of a training program designed to enhance autism spectrum disorder identification and assessment within community pediatric settings across the state. Twenty-seven pediatric providers participated in regional trainings across a 3.5-year period. Trainings provided clinicians with strategies for conducting relatively brief within-practice interactive assessments following positive autism spectrum disorder screenings. Program evaluation was measured approximately 1.5 years following training through (a) clinician self-reports of practice change and (b) blind diagnostic verification of a subset of children assessed. Pediatric providers participating in the training reported significant changes in screening and consultation practices following training, with a reported 85% increase in diagnostic identification of children with autism spectrum disorder within their own practice setting. In addition, substantial agreement (86%-93%) was found between pediatrician diagnostic judgments and independent, comprehensive blinded diagnostic evaluations. Collaborative training methods that allow autism spectrum disorder identification within broader community pediatric settings may help translate enhanced screening initiatives into more effective and efficient diagnosis and treatment.


Subject(s)
Autistic Disorder/diagnosis , Pediatrics/education , Practice Patterns, Physicians'/statistics & numerical data , Child Development Disorders, Pervasive/diagnosis , Child, Preschool , Community Health Services , Humans , Mass Screening
4.
IEEE Trans Neural Syst Rehabil Eng ; 21(1): 55-64, 2013 Jan.
Article in English | MEDLINE | ID: mdl-23033333

ABSTRACT

Children with autism spectrum disorder (ASD) demonstrate potent impairments in social communication skills including atypical viewing patterns during social interactions. Recently, several assistive technologies, particularly virtual reality (VR), have been investigated to address specific social deficits in this population. Some studies have coupled eye-gaze monitoring mechanisms to design intervention strategies. However, presently available systems are designed to primarily chain learning via aspects of one's performance only which affords restricted range of individualization. The presented work seeks to bridge this gap by developing a novel VR-based interactive system with Gaze-sensitive adaptive response technology that can seamlessly integrate VR-based tasks with eye-tracking techniques to intelligently facilitate engagement in tasks relevant to advancing social communication skills. Specifically, such a system is capable of objectively identifying and quantifying one's engagement level by measuring real-time viewing patterns, subtle changes in eye physiological responses, as well as performance metrics in order to adaptively respond in an individualized manner to foster improved social communication skills among the participants. The developed system was tested through a usability study with eight adolescents with ASD. The results indicate the potential of the system to promote improved social task performance along with socially-appropriate mechanisms during VR-based social conversation tasks.


Subject(s)
Autistic Disorder/physiopathology , Autistic Disorder/rehabilitation , Biofeedback, Psychology/methods , Imaging, Three-Dimensional/methods , Interpersonal Relations , Therapy, Computer-Assisted/methods , User-Computer Interface , Adolescent , Biofeedback, Psychology/instrumentation , Equipment Design , Eye Movements , Female , Fixation, Ocular , Humans , Imaging, Three-Dimensional/instrumentation , Male , Therapy, Computer-Assisted/instrumentation , Treatment Outcome
5.
Autism ; 17(6): 693-700, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23045221

ABSTRACT

There is limited evidence surrounding the ability of families of children with autism spectrum disorders to access and implement recommended interventions following diagnosis. The distress a family may encounter with regard to inability to access recommended services is also poorly understood. In this study, we present preliminary data regarding implementation of clinical recommendations following autism spectrum disorder diagnosis as well as associations of implementation with maternal functioning. In total, 75 mothers of young children diagnosed with autism spectrum disorder through a university-based preschool autism clinic returned surveys regarding access to recommended services as well as maternal mental health and distress. Results indicate that while families were able to implement numerous recommendations, specific categories of intervention were less likely to be received. Challenges implementing recommended services were not related to increased maternal distress. These results suggest that despite potential barriers toward accessing some specific recommended services following diagnosis of autism spectrum disorder, many families may be quite successful in implementing many other core recommended services and that failure to access such services may not necessarily negatively impact maternal mental health and distress.


Subject(s)
Child Development Disorders, Pervasive/therapy , Child Health Services/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Mothers/psychology , Child, Preschool , Female , Humans , Language Therapy , Male , Needs Assessment , Occupational Therapy , Referral and Consultation , Speech Therapy , Stress, Psychological
6.
Autism Res ; 5(1): 31-8, 2012 Feb.
Article in English | MEDLINE | ID: mdl-21972233

ABSTRACT

Autism spectrum disorder (ASD) is considered among the most heritable of all neurodevelopmental and psychiatric disorders, but identification of etiologically significant genetic markers and risk variants has been hampered by a lack of sufficiently large samples. Rapid phenotyping procedures, where self-report measures are used instead of extensive clinical assessment, have been proposed as methods for amassing large genetic databases due to their hypothesized time-efficiency and affordability. We assessed the diagnostic accuracy of potential rapid phenotyping procedures using the Social Communication Questionnaire and the Social Responsiveness Scale in a sample of 333 children who also received extensive phenotypic assessments. While the rapid phenotyping measures were able to accurately identify a large number of children with ASD, they also frequently failed to differentiate children with ASD from children with other complex neurobehavioral profiles. These data support the continued need of expert clinical validation in combination with rapid phenotyping procedures in order to accurately amass large-scale genetic collections of children with ASD.


Subject(s)
Autistic Disorder/diagnosis , Parents , Phenotype , Social Behavior , Surveys and Questionnaires/standards , Adolescent , Child , Child Behavior , Child, Preschool , Female , Humans , Male , Reproducibility of Results
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