Childhood health motivation and adult cardiometabolic health in the Childhood Determinants of Adult Health (CDAH) study.

OBJECTIVE: This research examined if childhood health motivation was associated with adult health behaviors and objectively measured health outcomes. METHOD: Data were from the Childhood Determinants of Adult Health study. Children aged 9 to 15 years in 1985 completed a questionnaire with health motivation items. In 2004-2006, when aged 26 to 36, participants completed assessments of health behaviors (smoking, diet, alcohol consumption, and physical activity) and cardiometabolic outcomes (body mass index, carotid intima-media thickness from ultrasound, and HOMA insulin resistance from fasting blood samples). Structural path regression analyses examined pathways from health motivation in childhood to adult cardiometabolic outcomes, mediated via adult health behaviors measured concurrently, controlling for age, sex and socioeconomic position. RESULTS: There were 6,230 (49% female) children with data on health motivation. There were two latent constructs: health motivation (4 items: visiting a dentist, visiting a doctor, knowing about your body, and eating a good diet) and risk motivation (3 items: not being a smoker, not being fat, and not drinking alcohol). Greater health motivation was directly associated with nonsmoking, lower carotid intima-media thickness, and lower body mass index in adulthood. Greater risk motivation was directly associated with smoking, higher alcohol consumption, and poorer diets in adulthood. It was also indirectly associated with higher carotid intima-media thickness and higher HOMA insulin resistance via poorer health behaviors. CONCLUSIONS: Health motivation during childhood appears important to maintain health across the life course. It could be a target for interventions to improve cardiovascular health in children and adults. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Comparison of a direct and an indirect approach for the functional assessment of insistence on sameness in a child with autism spectrum disorder and a typically developing child.

OBJECTIVE: To compare indirect and direct functional assessment of insistence on sameness associated with autism spectrum disorder (ASD) and typical development. METHODS: Parents rated the function of insistence on sameness for a 6-year-old boy with ASD (Peter) and a typically developing 4-year-old boy (Nathan) using the Motivation Assessment Scale (MAS). Ratings were compared to the results of a direct assessment. RESULTS: The results of the assessment procedures were mainly consistent for Peter and suggested that his tendency to insist on sameness was maintained by sensory consequences. The finding of an attention function for Nathan in the play-based assessment was consistent with previous functional assessment studies surrounding typically developing children, but in contrast to the MAS. CONCLUSION: While the play-based assessment may be more suitable for assessing the high rate insistence on sameness observed in individuals with ASD, the MAS may be more suitable for low rate insistence on sameness.

Functional analysis of insistence on sameness in an 11-year old boy with Asperger syndrome.

OBJECTIVE: To identify the functional properties of insistence on sameness associated with autism spectrum disorders. METHOD: An 11-year-old boy with Asperger syndrome was observed during play where scenarios (mistakes, misplaced items, interrupted activity) were created to correspond with parent-reported scenarios where the child would insist on sameness. The extent of problem behaviour was observed under four functional assessment conditions (restore environment, tangible, attention, escape), according to a multi-element design. RESULTS: The results showed an interaction between the scenario type and type of functional assessment condition. Problem behaviour appeared to have a restorative function related to correcting a mistake, an attention function related to attempting to recruit help in finding a missing item and a tangible function suggesting an attempt to regain access to the materials and activity. CONCLUSION: Problem behaviours related to insistence on sameness may be motivated by different consequences depending on the scenario created.

Children with low literacy and poor stereoacuity: an evaluation of complex interventions in a community-based randomized trial.

PURPOSE: To assess, among children with low literacy and poor stereoacuity, the efficacy of two intervention programs on child vision and education compared to a control program. METHODS: Eighty-eight children aged 8 to 13 years who had reading problems, and demonstrated poor stereoacuity as measured by the Titmus stereocircle test (> 100 seconds arc) or computerized assessment were randomized to one of two intervention programs: Lawson vision or Phono-Graphix, or a control group: Parental Literacy Support. Vision (Lang test, visual acuity, convergence insufficiency symptom survey) and education assessments (Woodcock Reading Mastery Tests-Revised) were conducted at baseline, intervention end (10 weeks), and 36 weeks. Analysis used intention to treat multi-level models. RESULTS: Compared to the parental literacy support group, convergence insufficiency symptoms were reduced 36 weeks post-randomization amongst those receiving the Lawson orthoptic intervention (mean difference -5.55; 95% confidence interval (CI): -11.1 to -0.05, P < 0.05). Stereoacuity, measured by the Lang test, improved for both the Lawson and Phono-Graphix interventions compared to the parental literacy support group (-1.01; 95% CI: -1.6 to -0.4, P = 0.001, and -0.77; 95% CI: -1.4 to -0.2, P = 0.01). At the 36 week follow-up assessment, word identification had also improved for the Lawson and Phono-Graphix groups but other educational outcomes did not improve. CONCLUSION: A formal randomized control trial was feasible in this setting. Intervention among children with poor stereoacuity and low literacy produced small improvements in stereopsis and convergence insufficiency symptom scores. Further randomized control trials should be conducted to clarify the role of orthoptic intervention on literacy in selected child populations.