Factors associated with stress in families of children with autism spectrum disorder.

PURPOSE: The purpose of this study was to identify key factors associated with severe stress in families raising a child with autism spectrum disorder (ASD). METHODS: Questionnaires were mailed to families with one or more children with a diagnosis of ASD. Data from 543 surveys were analyzed using univariate and multivariate logistic regression. RESULTS: Forty-four percent (n = 241) of the caregivers reported severe family stress related to raising a child with ASD. Severe family stress was associated with (1) reduced ability to socialize; (2) not having accessed individual therapy; (3) negative co-parent relationships; and (4) high out of pockets costs due to the child's ASD. The specific ASD diagnosis, comorbid conditions, socio-demographic variables, and social support were not associated with severe family stress. CONCLUSION: The findings of the current study highlight the importance of a systemic approach to family stress, whereby individual, family, and ecological factors are investigated.

The pragmatic language, communication skills, parent-child relationships, and symptoms of children with ADHD and their playmates 18-months after a parent-delivered play-based intervention.

OBJECTIVE: This study examined the communication skills, pragmatic language, parent-child relationships, and attention deficit hyperactivity disorder (ADHD) symptoms of children with ADHD and their playmates 18-months after a pilot parent-delivered intervention for improving social play skills and pragmatic language. METHODS: Participants were five children with ADHD, their parents, and five typically-developing playmates. Outcomes were measured immediately post and 18-months following the intervention. Parent-rated norm-based assessments and an observational measure were used. Differences within and between the ADHD and playmate groups were examined. RESULTS: Children maintained all skills gained 18-months following the intervention. Compared to a normative sample, children with ADHD remained below the average range on aspects of communication skills, parent-child relationships, and ADHD symptom levels 18-months following intervention. CONCLUSIONS: After intervention, children with ADHD still experienced pragmatic language skills below those of their peers on norm-based assessments that measure their skills across contexts. School-based interventions are needed to facilitate ongoing skill development and generalization.

The appropriateness and feasibility of an online e-Portfolio for assessment of undergraduate allied health students.

BACKGROUND/AIM: Online technologies are widely used in tertiary institutions for both learning and assessment. There is a paucity of research into the use of e-Portfolios for assessment in the field of occupational therapy and other allied health disciplines. This study aimed to determine if a new assessment platform, using a flexible online learning platform, PebblePad(™) , is appropriate and feasible for use with allied health university staff and students in their first and second year of study. METHODS: A mixed methods approach was employed in two phases, before the development of a new assessment (Phase 1) and after completion of the new assessment (Phase 2), aimed to generate a comprehensive analysis of the appropriateness and feasibility of the new assessment platform. Inductive thematic analysis was used to investigate participants' focus group responses in both phases. To assess learning outcomes survey responses were analysed using t-tests, and descriptive ratings of the assessment and current use of online platforms were extracted. RESULTS: Triangulated results indicate that the assessment did not meet all five domains of appropriateness. Negative experiences and a lack of social and ecological validity were attributed to the PebblePad(™) . The PebblePad(™) was not feasible, requiring extensive support in implementation. CONCLUSIONS: While PebblePad(™) did not meet all domains of appropriateness and was not feasible, students reported learning gains after completing the assessment, suggesting that content may be more important than the assessment platform. More rigorous research is needed to determine the best online platform for assessment in the allied health disciplines.

Validity of the fine motor area of the 12-month ages and stages questionnaire in infants following major surgery.

The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.