Inclusion in an Interdisciplinary Leadership Training Program: Perspectives From Self-Advocates.

Leadership Education in Neurodevelopmental and Related Disabilities (LEND) programs are interdisciplinary, graduate-level training programs that seek to promote improved outcomes for individuals with disabilities and their families. Many of these programs include individuals with disabilities as members of the self-advocacy discipline. In this study, 10 self-advocate trainees were interviewed to provide insight into the value of including self-advocates in training and the kinds of accommodations and supports that facilitated their success and inclusion. Interviewees endorsed the importance of including self-advocates in LEND programs. Although several accommodations were discussed as helpful, interpersonal supports from faculty and peers were equally important in ensuring their success and inclusion in LEND. The findings from this study provide support for the expansion of self-advocacy as a formal discipline in LEND programs.

The adhesion GPCRs CELSR1-3 and LPHN3 engage G proteins via distinct activation mechanisms.

Adhesion G protein-coupled receptors (aGPCRs) are a large GPCR class that direct diverse fundamental biological processes. One prominent mechanism for aGPCR agonism involves autoproteolytic cleavage, which generates an activating, membrane-proximal tethered agonist (TA). How universal this mechanism is for all aGPCRs is unclear. Here, we investigate G protein induction principles of aGPCRs using mammalian latrophilin 3 (LPHN3) and cadherin EGF LAG-repeat 7-transmembrane receptors 1-3 (CELSR1-3), members of two aGPCR families conserved from invertebrates to vertebrates. LPHNs and CELSRs mediate fundamental aspects of brain development, yet CELSR signaling mechanisms are unknown. We find that CELSR1 and CELSR3 are cleavage deficient, while CELSR2 is efficiently cleaved. Despite differential autoproteolysis, CELSR1-3 all engage GαS, and CELSR1 or CELSR3 TA point mutants retain GαS coupling activity. CELSR2 autoproteolysis enhances GαS coupling, yet acute TA exposure alone is insufficient. These studies support that aGPCRs signal via multiple paradigms and provide insights into CELSR biological function.

The adhesion GPCRs CELSR1-3 and LPHN3 engage G proteins via distinct activation mechanisms.

Adhesion GPCRs (aGPCRs) are a large GPCR class that direct diverse fundamental biological processes. One prominent mechanism for aGPCR agonism involves autoproteolytic cleavage, which generates an activating, membrane-proximal tethered agonist (TA). How universal this mechanism is for all aGPCRs is unclear. Here, we investigate G protein induction principles of aGPCRs using mammalian LPHN3 and CELSR1-3, members of two aGPCR families conserved from invertebrates to vertebrates. LPHNs and CELSRs mediate fundamental aspects of brain development, yet CELSR signaling mechanisms are unknown. We found that CELSR1 and CELSR3 are cleavage-deficient, while CELSR2 is efficiently cleaved. Despite differential autoproteolysis, CELSR1-3 all engage GαS, and CELSR1 or CELSR3 TA point mutants retain GαS coupling activity. CELSR2 autoproteolysis enhances GαS coupling, yet acute TA exposure alone is insufficient. These studies support that aGPCRs signal via multiple paradigms and provide insights into CELSR biological function.

To Connect and Educate: Why Families Engage in Family-Professional Partnership Training Experiences.

Successful family-professional partnerships (FPP) have been shown to positively impact both satisfaction with care and health outcomes for children with disabilities and their families. Many healthcare training programs have recognized the benefit of FPP training and often include learning experiences that feature families as teachers or mentors. However, most research on FPP training has focused on professionals' experiences, and not on families' experience in the roles of mentors and experts. The Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program is a graduate-level interdisciplinary training program with sites across the country. LEND programs train future healthcare and service professionals in the disability field and often utilize a Family Mentor Experience (FME) as one aspect of their training. This study used qualitative interviews to examine the experiences of eight family mentors who worked with trainees in one LEND program. Overall, the family mentors expressed positive views regarding the FME, describing how it allowed them to connect with trainees, other families, and community resources, as well as educating trainees. Family mentors also identified several facilitators and barriers to participation. Study findings provide information on the FFP's impact on family mentors and guidance on how programs can support sustainable, effective FPP experiences.

Evaluating the Availability and Quality of HIV/AIDS Services and Supports for Individuals with Intellectual and Developmental Disabilities.

We used a community-based participatory research (CBPR) framework to conduct a needs assessment of the availability and quality of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) services for persons with intellectual and developmental disabilities (PWIDD) in the Atlanta metropolitan area. We present the findings of a three-phase research project. Findings from the research informs organizations and policymakers on how to provide persons with disabilities better access to HIV/AIDS care.

Comparing Traditional Versus Retrospective Pre-/Post-assessment in an Interdisciplinary Leadership Training Program.

Objectives As the U.S. healthcare system shifts toward collaboration, demand for leaders with interdisciplinary skills increases. Leadership competencies guide interdisciplinary training programs; however, identifying cost-effective methods for evaluating leadership competencies is challenging, particularly when interdisciplinary trainees have different areas of expertise and professional goals. Traditional pre-/post-testing, a common method for evaluating leadership competencies, is subject to response-shift bias, which can occur when participants' understanding of a construct changes between pre- and post-test. As a result, participants may rate their knowledge of the construct lower at post-test. Retrospective pre-tests are one method thought to reduce response-shift bias in pre-/post-tests. The current study explores the use of a retrospective pre-test to control for response-shift bias in an interdisciplinary training program. Methods Over three cohort years, thirty-four trainees from an interdisciplinary leadership program completed a self-assessment aligned with MCH leadership competencies. The traditional pre-test self-assessment was completed at the beginning of the training program. The retrospective pre-/post-test self-assessment was completed at the end of the training program. Results Retrospective pre/post-test scores indicate significant self-reported increases in all 24 leadership areas (p ≤ .001). Furthermore, participants' self-ratings were significantly higher on the traditional pre-test for all 24 areas than on the retrospective pre-test (p ≤ .001). Conclusions for Practice Retrospective pre-tests appeared to control for response-shift bias and may be a cost-effective way to evaluate trainee change within an interdisciplinary leadership program. These findings suggest the methodology's usefulness in interdisciplinary training and its potential use in the broader world of community-based MCH training initiatives.

Better together: Developmental screening and monitoring best identify children who need early intervention.

BACKGROUND: Widely recommended developmental surveillance methods include developmental monitoring (DM) and development screening (DS). Much research has been done on DS, but very little research has compared the effectiveness of DM and DS together. OBJECTIVES: To investigate the relationship between DM and DS in Part C early intervention (EI) service receipt. METHODS: Authors used data from the 2007/2008 and 2011/2012 National Survey of Children's Health (NSCH). Authors report the prevalence of children aged 10 months to 3 years who received (a) DM only, (b) DS only, (c) both DM and DS, and (c) no DM or DS across survey years. Authors compare the odds of EI receipt across these groups. RESULTS: During both periods, estimated EI receipt prevalence was higher for children receiving both DM and DS (8.38% in 2007/2008; 6.47% in 2011/2012) compared to children receiving no DM or DS (1.31% in 2007/2008; 1.92% in 2011/2012), DM alone (2.74% in 2007/2008; 2.70% in 2011/2012), or DS alone (3.59% in 2007/2008; 3.09% in 2011/2012) (for both time frames, p < .05). From 2007/2008 to 2011/2012, the proportion of children receiving DS only and both DM and DS increased, while children receiving DM only and no DM or DS decreased. CONCLUSIONS: Children receiving DM and DS together were more likely to receive EI compared to children receiving DM alone, DS alone, or neither DM nor DS. These findings support the AAP recommendations indicating that DM and DS are complementary strategies for improving early identification and linkage to EI for young children.

Socioemotional developmental surveillance in young children: monitoring and screening best identify young children that require mental health treatment.

BACKGROUND: Widely recommended socioemotional developmental surveillance methods include monitoring and development screening techniques. Currently, very little research has compared the effectiveness of monitoring and screening together, and existing research primarily focuses on the relationship between surveillance techniques and referrals or receipt of early intervention (EI). This study investigates the relationship between monitoring and screening and mental health treatment receipt in 3-5 year olds. METHODS: The authors conducted logistic regression analyses on data from the National Surveys of Children's Health (NSCH; 2007) and NSCH (2011/2012) on the odds of mental health treatment receipt in children aged 3-5 years of age who either received (a) screening only, (b) monitoring only, (c) both monitoring and screening, or (d) no monitoring or screening. Sociodemographic control variables were also considered. RESULTS: In both 2007 and 2011/2012 datasets, monitoring and screening together was the best predictor of mental health treatment receipt. Neither screening alone nor monitoring alone was associated with mental health treatment receipt. CONCLUSIONS: Children who received monitoring and screening together had the greatest odds of treatment receipt compared with children receiving screening only, monitoring only, or no monitoring or screening.

Commentary: Response to Foreman's commentary on detecting unmet mental health needs in preschool children (2018).

In this response, we build on insights from Dr. David Foreman's commentary on our recent article "Socio-emotional Surveillance in Preschoolers: Monitoring and Screening Best Identify Children Who Need Mental Health Treatment." In particular, we build on Foreman's insights that underidentification is likely related to clinician error, measurement error, and population properties by also including the role of community systems within which children are identified. We also provide frameworks for considering screening tools and developmental monitoring processes to help direct future research on this important topic.

Caretaker Awareness of Health Care Provided Developmental Screening: Increases from 2007 to 2012.

Objectives Developmental screening is considered critical to identifying children with developmental delays and disabilities so that they may receive early intervention. To date, only a handful of studies report data on the percentage of health care professionals (HCP) who provide developmental screening. These reports are limited by low participation rates and reporters being pediatricians who may be biased towards reporting higher rates of developmental screening. The purpose of this study is to verify reported increases by reporting on changes in caretakers' awareness of HCP provided developmental screening from 2007/2008 to 2011/2012. Methods Authors report data on caretaker reported receipt of HCP provided developmental screening from the National Survey of Children's Health (NSCH, 2007/2008) and NSCH (2011/2012), as well as changes from the 2007/2008 to 2011/2012. Changes for the 50 states plus Washington D.C. are visualized using 'micromapST' and states are organized in ascending order according to changes in caretaker awareness of developmental screening. Results Nationally, the proportion of caretakers aware that their HCP provided developmental screening increased from 23.0% in 2007/2008 (range 12.6-46%) to 33.3% in 2011/2012 (range 19.4-61.6%) and states level changes ranged from -2 to +35%, with a median change of +10%. Conclusions for Practice Data reported here indicate that a greater number of caretakers are aware that their HCP is providing developmental screening. This reinforces the existing reports indicating increases in HCP reported developmental screening. Despite growth, there is still a need to increase developmental screening efforts in many states.