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Parent training (i.e. group-based supports and psychoeducation aimed at parent as primary agent of change) in Autism Spectrum Disorders (autism) is well-documented as an Evidence-Based Intervention designed to increase advocacy, knowledge, and empowerment. While research on Parent Training acknowledges the cultural limitations, the field lacks culturally grounded models. Furthermore, barriers in diagnosis, service acquisition, and inclusion of under-represented populations including Black families have been established; however, research programs have traditionally failed to include these families. This study aims to provide a first toward addressing the lack of inclusion. We describe the practice-based implementation of a culturally concordant Parent Training program (Spectrum of Care) developed by a community organization (the Color of Autism) as well as feedback from parents after the implementation process. The findings indicate that culturally grounded strategies could promote engagement and empowerment of Black families. There, however, is still a need for research that attends to parental mistrust and examines culturally grounded strategies more closely. Lay abstract Parent training programs have been well-studied in Autism Spectrum Disorders and shown to increase a parent’s feeling of empowerment, advocacy skills, and treatment enrollment for their child. The majority of parent training interventions have been developed without considering the unique needs of under-represented communities, such as the Black community. Black children with autism are not only misdiagnosed or not diagnosed at all, but are not accessing services equally compared to their White peers. There is an urgent need for culturally adapted interventions in order to decrease the disparity gap. The Color of Autism Foundation developed and ran a parent training program for Black parents of children with autism. The program was grounded in two key features: (1) creating a circle of support for parents to connect and heal from ongoing and historical racial trauma and (2) using parents of Black children with autism as the main facilitators. We believe this increased parent’s ability to engage in the educational aspects of the training. Overall, parents reported high levels of satisfaction with the training were highly engaged (attended an average of five of six sessions) and reported high levels of empowerment. Parents also reported continued mistrust in the medical and research community and a need for more Black providers. Further work should examine the relationship of the parent and provider in autism treatment and study the impact of circles of healing for Black families.

This study was performed to determine (a) the age at which ASD is first diagnosed in Ugandan children receiving mental health services; (b) whether age at diagnosis varies by sex and clinical presentation and (c) the average age of ASD diagnosis in children manifesting comorbid conditions. A retrospective chart review was performed and demographic as well as clinical data were collected from children with ASD diagnoses who attended two mental health clinics in Uganda between 2014 and 2019. Descriptive statistics such as percentages, means and standard deviations were used to summarize the data. Independent t-test was also performed to determine differences in the mean age of diagnosis between males and females. Two hundred and thirty-seven (156 males, 81 females) children with ASD were identified. The average age of ASD diagnosis was (6.9±4.0 years). A statistically significant difference in age of ASD diagnosis was found between males and females [t= −2.106, p=0.036], such that on average females received a diagnosis at least one year later than males. Of the 237 participants, 53.6% were identified with ASD only, 16.0% had ASD and ADHD, 10.5% were diagnosed with ASD and epilepsy and 7.2% had a diagnosis of complex ASD. The results confirm delays in access to ASD diagnosis and suggest that females are more likely to receive a diagnosis of ASD later than males within the Ugandan context. ASD awareness should be intensified to improve public or professional knowledge about ASD in Uganda. Finally, effective strategies should be developed to improve early identification.

Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge.Prospective cohort study.Eight hospitals comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 18 additional sites across the United States.Eligible patients had laboratory confirmation of pertussis infection, were less than 1 year old, and were admitted to the PICU for at least 24 hours.The Mullen Scales of Early Learning was administered at a 1-year follow-up visit. Functional status was determined by examination and parental interview.Of 196 eligible patients, 111 (57%) completed the Mullen Scales of Early Learning. The mean scores for visual reception, receptive language, and expressive language domains were significantly lower than the norms (p0.001), but not fine and gross motor domains. Forty-one patients (37%) had abnormal scores in at least one domain and 10 (9%) had an Early Learning Composite score 2 or more SDs below the population norms. Older age (p0.003) and Hispanic ethnicity (p0.008) were associated with lower mean Early Learning Composite score, but presenting symptoms and PICU course were not.Infants who survive critical pertussis often have neurodevelopmental deficits. These infants may benefit from routine neurodevelopmental screening.

There are no epidemiological data on autism for Mexico. This study was conducted to generate a first estimate of ASD prevalence in Mexico. We surveyed children age eight in Leon (Guanajuato). The sample was stratified in two strata: (1) children having special education and medical records (SEMR; N = 432) and (2) children attending regular schools (GSS; N = 11,684). GSS children were screened with the SRS and those with the highest scores were invited to a diagnostic evaluation. The final sample comprised 36 children (80.6 % male) who had confirmed ASD. A third had intellectual disability, 25 % were non-verbal, 69 % had co-occurring behavioral problems. The prevalence overall was 0.87 % (95 % CI 0.62, 1.1 %). This survey provides an estimate for ASD prevalence in Mexico that is consistent with recent studies.