Technologies for Supporting Individuals and Caregivers Living With Fetal Alcohol Spectrum Disorder: Scoping Review.

Background: Fetal alcohol spectrum disorder (FASD) is a common developmental disability that requires lifelong and ongoing support but is often difficult to find due to the lack of trained professionals, funding, and support available. Technology could provide cost-effective, accessible, and effective support to those living with FASD and their caregivers. Objective: In this review, we aimed to explore the use of technology available for supporting people living with FASD and their caregivers. Methods: We conducted a scoping review to identify studies that included technology for people with FASD or their caregivers; focused on FASD; used an empirical study design; were published since 2005; and used technology for assessment, diagnosis, monitoring, or support for people with FASD. We searched MEDLINE, Web of Science, Scopus, Embase, APA PsycINFO, ACM Digital Library, JMIR Publications journals, the Cochrane Library, EBSCOhost, IEEE, study references, and gray literature to find studies. Searches were conducted in November 2022 and updated in January 2024. Two reviewers (CZC and HW) independently completed study selection and data extraction. Results: In total, 17 studies exploring technology available for people with FASD showed that technology could be effective at teaching skills, supporting caregivers, and helping people with FASD develop skills. Conclusions: Technology could provide support for people affected by FASD; however, currently there is limited technology available, and the potential benefits are largely unexplored.

Impacts of COVID-19 on Food Choices and Eating Behavior among New Zealand University Students.

Extensive research suggests that COVID-19 infection can lead to persistent changes in taste and smell perception. These sensory changes have the potential to exert lasting impacts on dietary choices, nutrition, and body weight. This study aims to explore COVID-related shifts in dietary intake among New Zealand university students. We conducted a survey involving 340 university students who had experienced COVID-19 infection between 2022 and 2023. Participants reported any changes in eating behavior since before the pandemic and were asked to complete a 24-h food record. Participants' total daily energy intake, macronutrient intake, and composition were then compared with data collected from a similar cohort before the COVID-19 pandemic, spanning from 2017 to 2019. Dietary outcomes were compared using MANCOVA while controlling for individual age, gender, ethnicity, and BMI. Approximately 25% of participants reported experiencing sensory alterations with COVID-19, with those participants more likely to report changes in their experience of sweet tastes but not salty or fatty foods. Analyses of the pre- and post-COVID cohorts revealed that participants in the post-COVID group exhibited significantly higher consumption of protein and sodium. Understanding the long-term impact of COVID-19 infection may offer crucial insights into the role of chemosensory perception in dietary behavior.

Does vaping affect the taste and smell perception? An exploratory study with New Zealand young adults.

OBJECTIVE: The study aimed to assess potential effects of vaping on individual taste and smell perception in a sample of young adult New Zealanders. DESIGN: This cross-sectional study measured taste and smell perception using intensity and hedonic ratings to two olfactory (i.e., vanillin, methional) and two gustatory stimuli (i.e., sucrose, monosodium glutamate), representing sweet and savoury flavours. Detection sensitivities to sucrose and vanillin were also assessed using a forced choice detection paradigm aligned with the signal detection framework. MANCOVAs were employed to compare sensory perception between groups based on vaping use frequency. Additional regression analyses were conducted to identify potential predictors of intensity and hedonic sensory ratings. SETTING: Participants were recruited from the University of Otago student population and surrounding neighbourhoods of Dunedin, New Zealand in 2023. PARTICIPANTS: The study included 213 university students (98 vapers and 115 non-vapers) RESULTS: We found a significant difference in hedonic ratings for vanillin, indicating a stronger preference among non-vapers. However, no other differences between the two groups were significant. Notably, the use of tobacco and mint flavours were emerged as significant predictors for hedonic responses to the savoury smell and sweet taste stimulus, respectively. No significant differences were observed between groups in the ability to detect weak stimuli. CONCLUSIONS: Our findings suggest that vape use, particularly with specific flavours, may be associated with alterations in hedonic responses to smells. This finding may have potential implications for how vaping affects on food preferences and dietary choices.

Gustatory and olfactory shifts during pregnancy and the postpartum period: A systematic review and meta-analysis.

Pregnancy is a transformative phase marked by significant behavioral and physiological changes. Substantial changes in pregnancy-related hormones are thought to induce changes in chemosensory perception, as often observed in non-human animals. However, empirical behavioral research on pregnancy-related olfactory or gustatory changes has not yet reached a consensus. This PROSPERO pre-registered systematic review and meta-analysis evaluated published data of olfactory and gustatory changes in pregnant individuals, across the three pregnancy trimesters and postpartum period. Our comprehensive search strategy identified 20 relevant studies, for inclusion in the meta-analysis. The meta-analysis revealed that pregnant individuals, regardless of trimester, performed significantly poorer in terms of odour identification, however, no difference was detected between non-pregnant controls and women postpartum. Additionally, pregnant women in the second and third trimester rated olfactory stimuli to be more intense. A slight decline in odour pleasantness ratings was observed amongst those in the second trimester. No major difference was observed between pregnant and non-pregnant subjects in terms of gustatory functions, except the first trimester appeared to be associated with increased pleasantness for the sweet taste. Post-hoc meta-regression analyses revealed that pregnancy stage was a significant predictor for observed effect size for odour intensity ratings, but not for odour identification scores. These findings provide valuable insights into the interplay between pregnancy and chemosensory perception, highlighting systematic physiological changes due to pregnancy. Healthcare providers can also utilize the knowledge of sensory shifts to better support pregnant women in making appropriate dietary choices, managing sense-related discomfort, and leading to potential sensory interventions. Overall, this research enhances our comprehension of sensory shifts during pregnancy, benefiting maternal health and pregnancy-related care.

Lived experience of fetal alcohol spectrum disorder: A qualitative scoping review.

AIM: To explore the lived experiences of individuals with fetal alcohol spectrum disorder (FASD), their caregivers, and professionals working with individuals with FASD. METHOD: We conducted a scoping review using qualitative methods to explore what it is like to live with FASD from the perspective of those living with FASD, their caregivers, and stakeholders experienced in working with individuals with FASD. We searched electronic databases and grey literature for research published between 2005 and 2022. RESULTS: The 47 studies included in this scoping review show that FASD affects people's lives on a daily basis. Individuals with FASD are aware of their disability and its effects. Caregivers face daily challenges raising children with FASD and are often left unsupported by professionals. Professionals are unprepared and frustrated when supporting someone with FASD. INTERPRETATION: FASD affects individuals, caregivers, and families on a daily basis; and they require improved support and funding.

Knowledge, attitudes, and practices towards fetal alcohol spectrum disorder in the New Zealand social and community sector: An online survey.

Background: Fetal Alcohol Spectrum Disorder (FASD) is a common neurodevelopmental disorder but may be underrecognized and misunderstood by people who provide health and social support services. The aim of the research is to understand the FASD knowledge, attitudes, and practices among people employed by the social and community sector in New Zealand. Methods: We conducted an online survey of people working in the New Zealand social and community sector (i.e., social workers, support workers). The survey focused on the following areas: awareness of FASD; knowledge and beliefs about FASD; the impact of FASD on professional practice; and training needs. Results: Most participants reported a basic understanding of FASD, however only 5% felt very well prepared to support someone with FASD. A large majority of participants believed that FASD diagnosis may be stigmatising for individuals or families. Conclusion: There is a need to improve training, professional development, and workplace support for social and community workers in New Zealand to support people with FASD.

Longitudinal study of energy, neurosensory and eating responses durinG pregnancY (ENERGY cohort): A study protocol.

BACKGROUND AND AIMS: Physiological changes that occur during pregnancy can have long-term impacts on metabolism and neurosensory responses to food, which can impact nutrition and health outcomes. The ENERGY cohort is a longitudinal study that aims to capitalizes on pregnancy as a natural model of metabolic reprogramming in order to understand the neurosensory mechanisms underpinning links between metabolism and dietary behaviour. The study objectives are to test for multi-sensory shifts during pregnancy, and the effect of sensory changes on dietary choices and bodyweights, and to identify neurosensory mechanisms that determine macronutrient selection before and after pregnancy. METHODS: A longitudinal cohort study involving 130 pregravid women planning to conceive with the next 12-months and 65 pregravid women with no short-term plans to conceive. Participants will be recruited from Dunedin and Auckland, New Zealand. The study will test for changes in diet, neurosensory outcomes, and metabolism across the reproductive cycle, from pre-pregnancy to 1-year post-pregnancy. Data will be collected at six timepoint throughout the pregnancy which will occur approximately every 3 months. The primary response variables will be changes in supra-threshold sensitivity across modalities, dietary intake, and metabolism between pre-pregnancy and post-pregnancy. Longitudinal data analysis will use linear mixed models to assess changes in the response outcomes over time adjusted for age, ethnicity, and socioeconomic status. DISCUSSION: Understanding the relationship between metabolism, sensory processing, and macronutrient preferences will provide crucial insights into diet-related health issues, including obesity. This study will lead to the formation of a prospective research cohort that is unique to Aotearoa New Zealand, and will develop multidisciplinary skills that are increasingly necessary to addressing the obesity epidemic.

Knowledge, Attitudes, and Practices Towards Fetal Alcohol Spectrum Disorder in New Zealand Educators: An Online Survey.

Background:Fetal alcohol spectrum disorder (FASD) is a common form of developmental disability but may be poorly understood by professionals working with people with FASD. The aim of the research is to understand the FASD knowledge, attitudes, awareness, and practices among people employed by the education sector in Aotearoa New Zealand and identify gaps in knowledge. Methods: We conducted an online survey of New Zealand Education professionals. The survey focused on the following areas: Awareness of FASD; Knowledge and beliefs about FASD; Impact of FASD on professional practice; and Training needs. Results: Of the 419 participants, most had some knowledge of FASD and its effects on learning; however, there are still gaps that need to be addressed so educators can provide support to individuals living with FASD. Conclusion: There is a need to improve workforce capacity and develop guidelines that address the needs of front-of-line staff working with children with FASD in education settings.

Knowledge, attitudes, and practices of fetal alcohol spectrum disorder in health, justice, and education professionals: A systematic review.

BACKGROUND AND AIMS: Fetal alcohol spectrum disorder (FASD) is one of the most common forms of developmental disability, and yet, anecdotally, is poorly understood by both the public and professionals across health, justice, education, and social services. This review aims to understand the knowledge, attitudes, and practices of professionals who work across a range of sectors - specifically health, education and justice - where they may encounter people with FASD, their families and caregivers. METHOD: We conducted a systematic search for research using surveys or questionnaires to address knowledge, and attitudes of professionals in health, education, and justice with regards to FASD between 1990 and 2021. Our search consisted of electronic databases (APA PsychInfo, CINAHL, EMBASE, Medline, PubMed, and PAIS Index) and grey literature sources. RESULTS: Our search yielded 971 results, of which 58 were relevant. The studies surveyed professionals from health (n = 35), education (n = 10), justice (n = 8), social services (n = 1), and multiple settings (n = 4). Most studies were conducted in North America. The areas surveyed included knowledge of FASD, attitudes towards people with FASD, experience with FASD, practices towards people with FASD, and education and training needs. CONCLUSIONS: Knowledge, attitudes, and practices towards FASD have been surveyed extensively in healthcare professionals over the last 30 years, but less so with those working in justice and education sectors. Findings from surveys suggest that although most professionals had some knowledge of the effects of FASD, their knowledge of the specific criteria of Fetal Alcohol Syndrome (FAS) and FASD is poor across most professional groups, including most health professionals. Our review highlights the need to provide training and information across sectors ongoing surveillance to determine where gaps in knowledge are and what resources are needed. WHAT THIS PAPER ADDS: This study is the first to systematically synthesize knowledge, attitudes, and practices toward FASD across different sectors. Poor knowledge and insufficient training were common. Knowledge, attitudes, and practices about FASD have been surveyed extensively in the healthcare setting, but surveys are more limited outside of this setting. Continuous surveillance is needed to identify and respond to knowledge gaps and changes in practice.

A callosal biomarker of behavioral intervention outcomes for autism spectrum disorder? A case-control feasibility study with diffusion tensor imaging.

Tentative results from feasibility analyses are critical for planning future randomized control trials (RCTs) in the emerging field of neural biomarkers of behavioral interventions. The current feasibility study used MRI-derived diffusion imaging data to investigate whether it would be possible to identify neural biomarkers of a behavioral intervention among people diagnosed with autism spectrum disorder (ASD). The corpus callosum has been linked to cognitive processing and callosal abnormalities have been previously found in people diagnosed with ASD. We used a case-control design to evaluate the association between the type of intervention people diagnosed with ASD had previously received and their current white matter integrity in the corpus callosum. Twenty-six children and adolescents with ASD, with and without a history of parent-managed behavioral intervention, underwent an MRI scan with a diffusion data acquisition sequence. We conducted tract-based spatial statistics and a region of interest analysis. The fractional anisotropy values (believed to indicate white matter integrity) in the posterior corpus callosum was significantly different across cases (exposed to parent-managed behavioral intervention) and controls (not exposed to parent-managed behavioral intervention). The effect was modulated by the intensity of the behavioral intervention according to a dose-response relationship. The current feasibility case-control study provides the basis for estimating the statistical power required for future RCTs in this field. In addition, the study demonstrated the effectiveness of purposely-developed motion control protocols and helped to identify regions of interest candidates. Potential clinical applications of diffusion tensor imaging in the evaluation of treatment outcomes in ASD are discussed.

Quantifying the effects of the differential outcomes procedure in humans: A systematic review and a meta-analysis.

We present a systematic review and a meta-analysis comparing the differential outcomes procedure to a nondifferential outcomes procedure among clinical and nonclinical populations. Sixty distinct experiments were included in the systematic review, 43 of which were included in the meta-analysis. We calculated pooled effect sizes for accuracy (overall accuracy, test accuracy, transfer accuracy) and acquisition outcomes (latency, errors, and trials to mastery). The meta-analysis revealed significant medium-to-large effect sizes for all three accuracy measures (pooled effect size range, 0.57 to 1.30). We found relatively greater effect sizes among clinical populations (effect size = 1.04). The single-subject experimental literature included in the systematic review was consistent with the findings from the group studies, demonstrating improvements in accuracy and speed of learning for the majority of participants. Moderator and subgroup analyses suggest that discrimination difficulty may induce relatively larger differential outcomes effects. The results indicate that the differential outcomes procedure can be a valuable addition to reinforcement-based interventions.