Implementing COVID-19 Mitigation in the Community Mental Health Setting: March 2020 and Lessons Learned.

In March 2020, at the beginning of the COVID-19 pandemic, state-funded community mental health service programs (CMHSP) in Michigan, organized into 10 regions known as a "Prepaid Inpatient Health Plan" (PIHP), grappled with the task of developing a modified plan of operations, while complying with mitigation and social distancing guidelines. With the premise that psychiatric care is essential healthcare, a panel of physician and non-physician leaders representing Region 5, met and developed recommendations, and feedback iteratively, using an adaptive modified Delphi methodology. This facilitated the development of a service and patient prioritization document to triage and to deliver behavioral health services in 21 counties which comprised Region 5 PIHP. Our procedures were organized around the principles of mitigation and contingency management, like physical health service delivery paradigms. The purpose of this manuscript is to share region 5 PIHP's response; a process which has allowed continuity of care during these unprecedented times.

Promoting Adapted Physical Activity Regardless of Language Ability in Young Children With Autism Spectrum Disorder.

Purpose: There is a relationship between motor and language skills in children with Autism Spectrum Disorder (ASD), but little work addresses the ramifications of this relationship for professionals who teach motor skills to this population. Within a motor skills intervention, this study probed the importance of language skills for motor intervention. We examined the relationship between motor and language skills at baseline, and then the relationship between baseline language skills and motor improvements resulting from the intervention. Method: Twenty children aged 4-6 years with ASD participated. Eleven children received 20 hr per week of motor intervention for 8 weeks. Nine children did not receive motor intervention. Language skills (Mullen Scales of Early Learning) and motor skills (Test of Gross Motor Development - 2) were assessed at baseline and post-intervention. Spearman correlations tested the associations between baseline language and baseline motor skills. This analysis was repeated in the intervention sample to test the association between baseline language level and response to intervention (motor skill changes from baseline to post-intervention). Results: Prior to intervention, locomotor skills are positively correlated (p < .001) with both receptive (rs = 0.827) and expressive (rs = 0.722) language skills. Similarly, object-control skills are positively correlated (rs < .001) with receptive (rs = 0.779) and expressive (rs = 0.729) language skills. However, those baseline language skills do not relate to motor change in the experimental group. Conclusion: These results suggest that motor programs may improve motor skills in children with ASD when language is supported, regardless of pre-program language ability.

Infant blood lipids: a systematic review of predictive value and influential factors.

INTRODUCTION: Blood lipid screening recommendations begin at ages 9-11 years, despite poor adherence and evidence of fatty streaks in coronary arteries by 3 years of age. For cardiovascular disease (CVD) prevention, there may be value in earlier measurement of blood lipids. AREAS COVERED: The present systematic review examines evidence concerning total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides during the infant period. Included are studies examining the extent to which infant blood lipids predict later values in childhood and factors that influence their magnitude. A total of 38 articles (published from 1965 to 2013) met inclusion criteria and were examined in this review. EXPERT OPINION: Longitudinal data suggest correlative relationships in all lipid values around 6 months of age, except for TRG. Influential factors related to blood lipids in infancy include sex, race, family history, feeding, gestational length, birth weight, and maternal factors. Clinical measurement of infant lipids could perhaps provide an early marker of CVD and a target of early CVD prevention strategies. The identification of personal characteristics that associate with high or low values in each lipid could become important in the early identification of vulnerable populations and the promotion of personalized CVD prevention.

How Much Instructional Time Is Necessary? Mid-intervention Results of Fundamental Movement Skills Training Within ABA Early Intervention Centers.

Background: The purpose of this study was to explore the question of the minimal amount of instructional time needed to still be effective by assessing the efficacy at mid-intervention of an early fundamental movement skill (FMS) intervention for preschoolers with Autism Spectrum Disorder (ASD). Method: Fourteen preschoolers participated in this randomized controlled trial daily over 10 weeks (10 h total at mid-intervention). A two-factor mixed MANOVA tested the significance of group*time interactions for two dependent variables: object control and locomotor raw scores on the Test of Gross Motor Development-III. Results: Group*time interactions approached significance with large effect sizes on the vector of both dependent variables and in a univariate fashion on object control scores, but not locomotor scores. Conclusions: These findings hold relevance for physical educators working with young children with ASD, indicating that 10 h of FMS instruction, at least in this form, is not adequate to improve FMS.

Wakeful Prone "Tummy Time" During Infancy: How Can We Help Parents?

AIMS: This study's purpose is to present facilitators and barriers for wakeful prone positioning or "tummy time" during infancy by exploring the personal perspectives of infant caregivers attempting to provide daily tummy time. METHODS: The study was qualitative in design, using thematic analysis to identify major and minor themes from semi-structured interviews. The Capability, Opportunity, Motivation - Behavior Model provided a conceptual framework for the interview guide and categorization of major themes. RESULTS: Within capability, opportunity, and motivation, the major themes of self-efficacy, scheduling, variations, siblings, committed adult help, social responses of acquaintances, and caregiver enjoyment could be barriers or facilitators, depending on the context. Optimized physical circumstances, caregiver interest, perceived benefits to the infant, pride and accomplishment, and obligation were identified as facilitators only. Barriers included negative infant affect. CONCLUSIONS: These results offer preliminary guidance in a knowledge gap: tummy time support that addresses the self-identified concerns of infant caregivers.