Short-term impact of a randomized multifaceted intervention for wheezing infants in low-income families.

OBJECTIVE: To present an interim analysis of the effect of a home-based intervention with low-income caregivers of wheezing infants at risk for childhood asthma on mediating variables. METHOD: Infants aged 9 to 24 months with 3 or more physician-documented wheezing episodes were randomly assigned to environmental support intervention (ES) (n = 90) or control (n = 91) groups. Nurse home visitors intervened for 1 year to decrease allergen and environmental tobacco smoke exposure and improve symptom perception and management. Assessments at baseline and 12 months included allergens in house dust, infant urinary cotinine levels, caregivers' symptom reports, quality of life, illness management, and quality of caregiving. Medical records were coded for hospitalizations, emergency department visits, and corticosteroid bursts. RESULTS: Within the ES group, cockroach allergen levels were significantly reduced and there was a trend toward reduction in dog dander levels. Among infants with detectable urinary cotinine, levels were significantly reduced in the ES group. Caregiver psychological resources modified the impact, and low-resource ES caregivers were the most strongly affected. Asthma knowledge and provider collaboration improved significantly in the ES group. Neither reports of infant symptoms nor emergency department visits or hospitalizations showed positive intervention effects. Number of corticosteroid bursts for infants was significantly higher for the ES group. CONCLUSIONS: The Childhood Asthma Prevention Study intervention was effective in reducing several environmental exposures and improving illness management. However, even with an intensive home-based intervention, we failed to reduce respiratory symptoms or medical use in the ES group relative to the control group, illustrating the difficulty of changing the course of early asthma development among low-income infants.

Etiology of the comorbidity between RD and ADHD: exploration of the non-random mating hypothesis.

The present research sought to test the validity of the non-random mating hypothesis in a community sample in order to determine whether it contributes significantly to the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and reading disability (RD) and to test whether the two disorders segregate independently. Data were gathered from 394 twin participants of the Colorado Learning Disabilities Research Center (CLDRC) and their biological parents. Parents were asked to complete retrospective questionnaires regarding their own ADHD and RD symptomatology as children, as well as rate their children on DSM-IV ADHD symptomatology before age 12. Twin RD was assessed by a composite score consisting of several reading measures. Chi-square and correlational analyses assessed the presence of non-random mating, as well as whether the two disorders were transmitted independently. Non-random mating between those with ADHD and those with RD did not significantly contribute to the comorbidity of the two disorders. Furthermore, there was some evidence that these two disorders did not segregate independently in this sample. These results are consistent with recent evidence that ADHD and RD are often comorbid because of significant genetic overlap. There was little evidence to support that non-random mating also contributes to this comorbidity in the present sample.